Use of sildenafil in the treatment of erectile dysfunction in patients with spinal cord injury

Erectile dysfunction (ED) is one of the major complications after spinal cord injury (SCI) that decreases the quality of life of the patients. Although many efforts have been made to decrease ED, they are frequently cumbersome, with a high failure rate. The aim of this study was to assess the effects of sildenafil citrate at several doses, an oral agent that has been shown to improve a broad spectrum of ED. Sixty male patients with SCI were divided into 2 groups and received 25 mg or 50 mg sildenafil citrate, respectively, during a 4-week treatment period I hour before sexual intercourse. Our results demonstrated that sildenafil citrate significantly improved reflexogenic erectile response in both groups (P = 0.02 and P = 0.01, respectively). Subjects receiving sildenafil citrate reported that treatment had significantly improved their erections, frequency of sexual intercourse, satisfaction, enjoyment, sexual desire, overall sex life, sexual relationship, and self-confidence in erections (P 0.05). The authors concluded that sildenafil citrate might be used effectively for the treatment of ED in patients with SCI, even in a low-dose (25 mg) regimen

The functional independence measure in spinal cord injured patients: Comparison of questioning with observational rating

Functional independence measure (FIM) is becoming widely used for all aspects of disabling diseases including spinal cord injury (SCI). It is recommended that it is rated by trained clinicians familiar with the patients. We aimed to compare the ratings of those patients who were questioned with those who were observed in a simulated environment

Traumatic spinal cord injuries in Southeast Turkey: an epidemiological study

In 1994, a retrospective study of new cases of traumatic Spinal Cord Injury (SCI) was conducted in all the hospitals in Southeast Turkey: 75 new traumatic SCI were identified. The estimated annual incidence was 16.9 per million population. The male/female ratio was 5.8/1. The mean age was 31.3, being 31.25 for male patients and 31.36 for female patients. 70.7% of all patients were under the age of 40. The major causes of SCI were falls (37.3%) and gunshot wounds (29.3%), followed by car accidents (25.3%), and stab wounds (1.3%). Thirty one patients (41.3%) were tetraplegic and 44 (58.7%) paraplegic. In tetraplegic patients the commonest level was C5, in those with paraplegia L1. The commonest associated injury was head trauma followed by fractures of the extremity(ies). Severe head trauma, being a major cause of death, may have obscured the actual incidence of SCI. Most of gunshot injured SCI patients were young soldiers fighting against the rebels. As there was no available data for the rebels with SCI, the actual incidence of SCI in Southeast (SE) Turkey should be higher than that found in this study

TRAUMATIC SPINAL-CORD INJURIES IN ISTANBUL, TURKEY - AN EPIDEMIOLOGIC-STUDY

This is a retrospective study conducted in all of the hospitals of Istanbul to survey new patients with a traumatic spinal cord injury (SCI) in 1992. In that year 152 new traumatic SCI were identified. The estimated annual incidence was 21 per million population. The male/female ratio was 3/1. The mean age was 33, being 34 for male patients and 31 for female patients. 72% of all patients were under the age of forty. The major causes of SCI were falls (43%) and car accidents (41%), followed by being struck by an object (7%), gunshot injury (5%), stab injury (2%). Fifty patients (33%) were tetraplegic and 102 (67%) paraplegic. Regarding the tetraplegic patients the commonest level was C5, in those who were paraplegic L1. There were no cases at levels C1, T1 or T2. The commonest associated injury was head trauma, followed by fractures of an extremity (or extremities). Severe head trauma, as a major cause of death, may obscure the actual incidence of SCI in this study. Accidental falls (exceeding road accidents) were mostly due to falls from buildings and accidents on work premises

A quantitative skin impedance test to diagnose spinal cord injury

The purpose of this study was to develop a quantitative skin impedance test that could be used to diagnose spinal cord injury (SCI) if any, especially in unconscious and/or non-cooperative SCI patients. To achieve this goal, initially skin impedance of the sensory key points of the dermatomes (between C3 and S1 bilaterally) was measured in 15 traumatic SCI patients (13 paraplegics and 2 tetraplegics) and 15 control subjects. In order to classify impedance values and to observe whether there would be a significant difference between patient and subject impedances, an artificial neural network (ANN) with back-propagation algorithm was employed. Validation results of the ANN showed promising performance. It could classify traumatic SCI patients with a success rate of 73%. By assessing the experimental protocols and the validation results, the proposed method seemed to be a simple, objective, quantitative, non-invasive and non-expensive way of assessing SCI in such patients