(095) CHRONIC EPIDURAL SPINAL CORD STIMULATION AS A POTENTIAL TREATMENT FOR SEXUAL DYSFUNCTION IN WOMEN WITH SPINAL CORD INJURY
Notice bibliographique
Résumé
Abstract Introduction Spinal cord injury (SCI) is a lifelong condition that affects approximately 294,000 individuals in the United States, with an estimated 17,900 new cases occurring each year. Despite sexual function being reported as a top priority to restore after injury, research on sexual dysfunction after SCI is scarce, especially among people with gynecological anatomy. One major challenge in treating female sexual dysfunction (FSD) after SCI is the heterogeneity of symptoms. Women can have impacted libido, genital sensitivity, lubrication, and/or ability to orgasm. This is further complicated by the comorbidities of bladder and bowel dysfunction, which are also common after SCI. Epidural spinal cord stimulation (eSCS) has emerged as a promising treatment for SCI, demonstrating positive results across various domains for motor-complete patients, including bladder, bowel, and sexual function. Objective The primary objective is to determine if chronic eSCS improves survey-reported sexual function after SCI in women. The secondary objective is to determine if chronic eSCS improves survey-reported bladder and bowel function. Methods Seven female participants who are motor and sensory complete after traumatic SCI with injury levels between cervical (C)6 and thoracic (T)10 were recruited for the study. Participants were implanted with a 16-contact paddle lead epidural spinal cord stimulation at the T11-T12 level and followed for 13 months. The Female Sexual Distress Scale (FSDS), Neurogenic Bowel Dysfunction Score (NBDS), and Neurogenic Bladder Symptom Score (NBSS) were administered monthly. Participants received continuous stimulation over 13 months. A generalized linear model was created for each outcome to examine trends in function over time with an alpha of 0.025 (Bonferroni corrected). Results In the first 6 participants analyzed, we found that sexual distress improves over time (p<0.001) in the largest series of women participants with SCI targeted for restoration of function (Figure 1). One woman reported restoration of orgasm after five years of chronic SCI. Additionally, we found a statistically significant improvement in bowel function as measured by the NBDS with stimulation (p<0.003) from the generalized linear mixed effects fit corresponding to the follow-up visit number. There were no statistically significant trends in the NBSS scores, however, one participant noted that she no longer uses an intermittent catheter to empty her bladder indicating functional improvements that are not captured by the survey. Conclusions Epidural SCS is a promising therapy to improve female sexual function after chronic SCI. Although quantitative surveys remain the most valid and reliable measures of pelvic organ function after SCI, we saw improvements in function that were not captured by the questionnaires. Still, we found significant improvements in validated surveys of bowel function and female sexual distress over time. These high-priority outcomes for women with SCI are potential targets of restoration using commercially available spinal cord stimulation. Disclosure Yes, this is sponsored by industry/sponsor: Abbott. Clarification: No industry support in study design or execution. Any of the authors act as a consultant, employee or shareholder of an industry for: Stim Sherpa.
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Comment cette classification a été obtenuedéplier
Prédiction distillée sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Apprise à partir de 10 348 étiquettes directes de Codex et de 10 348 étiquettes directes de Gemma. Le mode candidate est l'union des têtes enseignantes seuillées; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont ni des étiquettes humaines ni des étiquettes directes de modèles de pointe.
Scores Codex et Gemma par catégorie
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,001 | 0,000 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,001 | 0,000 |
| Bibliométrie | 0,001 | 0,001 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,000 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule tête enseignante, pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».