二分脊椎症における性機能の検討

Abstract

当科において平成5年7月より1年間の泌尿器科評価を行った18歳以上の二分脊椎症患者においてアンケートで性機能の評価を行った. 1)異性に対する興味, 性に対する興味, 性欲は男性で, 95%, 95%, 100%であり, 女性で83%, 75%, 75%であった. 2)男性において, 勃起は視聴覚刺激によるものが95%, 触覚刺激によるものは86%であり, 勃起高度に満足しているものは73%, 射精は77%可能であった.オーガスムを感じるものは67%であった. 3)女性において全体では月経の周期は96%が定期的にあり, 分泌は88%に認めたが, 陰部の快感は19%にしかなかった.これら項目についてSharrad分類, 排尿筋-括約筋の活動性, 年齢で比較したが有意な傾向はなかった

In the present study, sexual function in 46 patients (22 males and 24 females) with myelomeningocele was assessed by a questionnaire study. The mean age of the patients was 24.0 +/- 9.6 years (with an age range of 18 to 50) for male patients and 25.2 +/- 6.2 years (with an age range of 18 to 42) for female patients. Having interest in the opposite sex and sexual desire were evident in 95% and 100% of male patients, and 83% and 75% of female patients, respectively. In male patients, erection was achieved in 95% by visual stimulation and in 86% by tactile stimulation. However, only 27% of the patients with erectility were satisfied with penile rigidity. Ejaculation and orgasm was noted in 67%. Orgasm was frequently seen in patients whose external sphincter activity was maintained. The age and the degree of lower extremity paralysis according to Sharrard classification were not significantly correlated with sexual function. In female patients, menstruation was regular in 95%, vaginal secrete was adequate in 88%, but only 19% of the patients felt ecstacy around perineal lesion at coital movements. In female patients, sexual function was not correlated with the age, the degree of lower extremity paralysis and detrusor activity-sphincter activity. Although most patients had sexual desire, only 18% of the males, and 33% of the females, had sexual intercourse activities. It appears, therefore, that these patients need to be given appropriate advice.