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S22-18
(P)
WILL I HAVE NORMAL ERECTIONS? HYDROCEPHALUS, MOBILITY AND ERECTION
QUALITY IN MEN WITH SPINA BIFIDA.
Konrad SZYMANSKI, Rosalia MISSERI and Mark CAIN
Riley Hospital for Children, Pediatric Urology, Indianapolis, USA
PURPOSE
Little is known about erectile dysfunction in men with spina bifida (SB), specifically whether it is associated with
ambulatory status or ventriculoperitoneal shunting (VPS). We aimed to determine erection quality and if it varied with
these factors.
MATERIAL AND METHODS
An international sample of men with SB were surveyed online (January 2013-August 2014). We collected data on
demographics, bladder/bowel surgeries and function. Ambulation was assessed on the Hoffer 5-point scale: normal,
community, household, non-functional and none. Erections were assessed using a question from the validated EPIC
questionnaire (4-point scale: normal being “firm enough for intercourse”). Logistic regression was used for analysis.
RESULTS
Mean age of 122 participants was 33.8 years (VPS: 70.5%, community ambulators: 45.1%). Those without a VPS were
more likely to report normal erections (60.5% vs. 31.7%, p=0.004). Normal, community and household ambulators
reported normal erections more commonly (63.6%, 60.6% and 72.7%, respectively) than non-functional ambulators or
non-ambulators (25.0% and 15.4%, respectively, p<0.001). Age, race, country of residence and continence were not
associated with normal erections (p≥0.16). On multivariate analysis, VPS status and age were not correlated with
normal erections (p=0.71 and p≥0.34, respectively). Patients who ambulated at least at home were more likely to have
normal erections after correcting for age and VPS status (OR≥9.30, p≤0.0005).
CONCLUSIONS
Only two in five men with SB report erections suitable for intercourse. Ambulatory status, rather than hydrocephalus,
appears to be the primary factor associated with erectile function, with normal erections reported by 2/3 of those who
walk at least at home and only 1/6 of those who do not.