SIDE-EFFECTS OF CHRONIC INTRATHECAL BACLOFEN ON ERECTION AND EJACULATION IN PATIENTS WITH SPINAL-CORD LESIONS

Objective: Assess modifications of sexual function in men treated with intrathecal baclofen for spinal spasticity. Design: Prospective befor e-after trial. Setting: A rehabilitation department of a university ho spital; follow-up was on an outpatient basis. Patients: A convenience sample of nine consecutively recruited men with spinal cord injury or multiple sclerosis who were receiving intrathecal baclofen by an impla ntable pump; average follow-up was 44.4 months. Main Outcome Measures: A questionnaire focusing on: libido; ability to sustain reflexive and psychogenic erections; rigidity, evaluated by a visual analog scale; maximum duration of erection; possibility of ejaculation. Results: Lib ido and the ability to obtain psychogenic or reflexogenic erections we re not modified. However, eight patients reported a decrease of erecti on rigidity and/or duration. Ejaculation was possible in three cases b efore implantation. It disappeared in two patients, and was more diffi cult to obtain in the last one. It reappeared after treatment withdraw al. No differences were found between multiple sclerosis and spinal co rd injured patients. Conclusion: Intrathecal baclofen may compromise e rection and ejaculation. This effect is reversible. Patients should be informed of this effect. (C) 1998 by the American Congress of Rehabil itation Medicine and the American Academy of Physical Medicine and Reh abilitation.