Predictors of changes in sentimental and sexual life after traumatic spinal cord injury

Objective: To investigate changes and identify predictors in interpersonal functioning and sexual life after traumatic spinal cord injury (SCI). Design: Prospective, multicenter, follow-up observational study. Setting: Subjects at home, interviewed by phone during a 6-month period, 3.8 mean years after discharge from 24 centers participating in a previous epidemiologic prospective survey. Participants: Subjects (N=403) with traumatic SCI. Interventions: Not applicable. Main Outcome Measures: Dependent variables: satisfaction with sentimental life and satisfaction with sexual life compared with before the injury. Independent variables: demographic (age, sex, marital status, vocational status), SCI related (severity, level, bowel/bladder continence), car-driving ability, perceived quality of life (QoL), and impact of sentimental life, social integration, and vocational status on QoL. Results: Satisfaction with sentimental life was reportedly increased or the same as before SCI in 69% of the sample, but satisfaction with sexual life in only 31%. Lesser satisfaction with sexual life was reported by men than women (P=.002) and by married people than singles (P2=.195). Bladder continence was positively associated with a better satisfaction with sexual life (R²=.368). Bowel continence did not remain a significant predictor of satisfaction with sexual life in multivariate analysis. Conclusions: The challenge of a comprehensive rehabilitation of SCI, addressing the recovery of well-being including a satisfying sentimental and sexual life, requires identifying new issues that should be considered in up-to-date rehabilitation programs. The results indicate associations between driving ability and a better satisfaction with sentimental life. Further investigations are needed to explore whether the relationship is causative.