Ranit Mishori, MD, MHS Suzanne L. Groah, MD, MSPH Oritsetsemaye Otubu, MD, MPH Melanie Raffoul, MD Katherine Stolarz, DO Georgetown University Department of Family Medicine, Washington, DC (Dr. Mishori); MedStar National Rehabilitation Hospital, Washington, DC (Dr. Groah); Howard University Department of Community and Family Medicine, Washington, DC (Dr. Otubu); The Robert Graham Center for Policy Studies in Family Medicine and Primary Care, Washington, DC (Dr. Raffoul); MedStar Franklin Square Medical Center Department of Family Medicine, Baltimore, Md (Dr. Stolarz) mishorir@georgetown.edu
The authors reported no potential conflict of interest relevant to this article.
This manuscript was drafted to support the development of a patient-centered medical home for people with spinal cord injury and disease, a 3-year program award from the Craig H. Neilsen Foundation, which is dedicated to research and programs to improve the quality of life for people living with spinal cord injuries.
From The Journal of Family Practice | 2016;65(5):302-306,308-309.
References
Sexuality and sexual function are often adversely affected in both men and women with SCI/D. Loss of sensation in the sexual organs, combined with difficulty with positioning and mobility and bowel and bladder dysfunction, contribute not only to sexual dysfunction, but to lower self-esteem and altered body image.40
It is important to remember that fertility is often unaffected in women, so routine discussions about contraception with women who have SCI/D and who are sexually active are imperative. At the same time, male fertility is usually profoundly affected by SCI/D; patients and their partners who are interested in having children will require specialized interventions. Address sexuality and fertility during primary care visits and refer patients to counseling or specialists as necessary.41-43
SCI/D requires a whole-person approach
The care of individuals with SCI/D requires a holistic approach that takes into consideration physical, psychological, environmental, and interpersonal factors44,45 and involves ongoing support from a variety of specialists. FPs, with their whole-person orientation, can be instrumental in ensuring the successful rehabilitation of patients affected by SCI/D, and in helping individuals attain, preserve, and enhance their health and well-being.
CORRESPONDENCE Ranit Mishori, MD, MHS, FAAFP, Georgetown University School of Medicine, 3900 Reservoir Road, NW, Pre-clinical Building GB-01D, Washington, DC 20007; mishorir@georgetown.edu.
