Paraplegias and anal sex

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Sexuality is an important part of life, and it is necessary for clinicians to have a specific format in which to address sexual issues with their patients. A systematic approach to working with patients with spinal cord injury SCI to improve their sexual functioning and response is presented. Nonjudgmental communication about sexual concerns is followed by a detailed pre- and postinjury medical, psychosocial, and sexual history. If preexisting sexual issues are present, it is recommended that the patient be referred for assessment and treatment of these separate from the patient's SCI-related concerns. Physical examination, with special attention to issues that could impact the patient's sexuality, is followed by a detailed neurologic assessment with specific attention to the TL2 and S spinal segments. Education of the patient with regard to his or her sexual potential and the need to be flexible in his or her sexual repertoire is followed by self-exploration and practice.
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SEX after Spinal Cord Injury: Confident, Outspoken, Candid, Kinky and Safe

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Anorectal function in patients with complete supraconal spinal cord lesions.

Anorectal manometry and sphincter electromyography were performed in 23 patients with complete supraconal traumatic spinal injuries and 30 age and sex matched control subjects. Basal pressures in the spinal group were similar to those in normal subjects but conscious control of sphincter activity was abolished in all spinal patients. Phasic rectal contraction and anal relaxation were present but exaggerated and induced at lower distending volumes than in normal subjects. The external anal sphincter response to rectal distension was noticeably attenuated, reinforcing the view that this spinal reflex is heavily modulated by supraspinal centres under normal circumstances. The external anal sphincter response to increases in abdominal pressure was also attenuated, and the anal pressures were strongly correlated with the level of the lesion and the abdominal pressure the patient could generate. No spinal patient showed a decrease in external anal sphincter activity during straining 'as if to defecate.
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Improving Sexual Satisfaction in Persons with Spinal Cord Injuries: Collective Wisdom

Almost anyone who has experienced any degree of paralysis can tell you that friends often share questions about your disability once they feel close enough to ask. And when the braver friends have exhausted their polite questions— Do you feel any pain? Do you enjoy it? But just as we said while discussing back injuries and amputation , paralysis is not the same thing as being sentenced to a sexless life.
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METHOD: The sample consisted of 60 outpatients with traumatic paraplegia from whom clinical and demographic data were obtained. Although The most frequent cause of paraplegia was firearm injury The most common complications observed in the patients were urinary
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