Article

Objectives : Review the literature on the acute or
prophylactic treatment of autonomic dysreflexia in the context of sexual
activities.Setting:InternationalMethods:Medline search using AD and spinal cord
injury and all years of publication.Results:Thirty-seven papers on the specific
treatment of AD showed that nifedipine, prazosin, captopril and clonidine are
candidates in the context of sexual activities. Prazosin, however, has an initial
hypotensive effect requiring to begin treatment 12 h before intercourse, which
makes it less ideal for spontaneous sexual activities. Captopril has an initial
hypotensive effect and was only studied in acute AD. Its usefulness in
prophylaxis remains to be demonstrated. Clonidine has successfully been used
clinically for decades, but never studied in randomized control trials.
Nifedipine remains the most widely studied and significant treatment of AD
whether in acute or prophylactic conditions. Recent concerns suggest increased
cardiovascular risks with sublingual nifedipine in non-SCI populations, but
negative long-term effects have not been reported in the SCI
population.Conclusion:Sexual function is a priority for men with SCI. As sexual
activities, in particular ejaculation, can be a source of AD, adequate treatments
and prophylaxis must be considered in the context of sexual activities. Experts
must meet and conclude on the thresholds, parameters and treatments that should
be considered in the long-term management of AD in the context of sexual function
in men with SCI.

Langue : ANGLAIS