International Journal of Clinical Science and Medical Research

Background: Sexual satisfaction is a critical yet understudied domain of quality of life after spinal cord injury (SCI), particularly in sub-Saharan Africa.

Objective: To evaluate patient-reported sexual satisfaction trajectories and identify predictors of good outcomes following SCI at National Orthopaedic Hospital Dala, Kano, Nigeria.

Methods: Retrospective cohort of 618 SCI patients (January 2019-June 2025). Sexual satisfaction was assessed at 3, 6, and 12 months using a structured patient-reported questionnaire. Outcomes were classified as good (satisfied) or poor (dissatisfied). Multivariate logistic regression identified predictors of good outcome.

Results: Of 618 patients, 513 (83.0%) completed 12-month follow-up. Sexual satisfaction was reported by 213/552 (38.5%) at 3 months, 242/531 (45.6%) at 6 months, and 268/513 (52.2%) at 12 months. Among complete injuries (AIS A-B, n=302), satisfaction at 12 months was 118/302 (39.1%); among incomplete injuries (AIS C-D, n=217), it was 150/217 (69.1%). Independent predictors of good outcome included incomplete injury (AOR 3.42, 95% CI 2.21-5.29), stable partnership (AOR 2.18, 95% CI 1.44-3.30), younger age (AOR 1.87, 95% CI 1.21-2.89), and absence of chronic pain (AOR 1.65, 95% CI 1.08-2.52).

Conclusion: Sexual satisfaction improves over 12 months post-SCI and is strongly predicted by injury completeness and psychosocial factors. Structured sexual rehabilitation is warranted.

spinal cord injury, sexual satisfaction, patient-reported outcomes, Nigeria, rehabilitation, predictors

1. Anderson KD. Targeting recovery: priorities of the spinal cord-injured population. J Neurotrauma. 2004;21(10):1371-83.
2. Anderson KD, Borisoff JF, Johnson RD, Stiens SA, Elliott SL. The impact of spinal cord injury on sexual function: concerns of the general population. Spinal Cord. 2007;45(5):328-37.
3. Nwuga VC. Sexual adjustment among upper class Nigerian male paraplegics and tetraplegics. Int J Rehabil Res. 1982;5(2):79-84.
4. Fisher TL, Laud PW, Byfield MG, Brown TT, Hayat MJ, Fiedler IG. Sexual health after spinal cord injury: a longitudinal study. Arch Phys Med Rehabil. 2002;83(8):1043-51.
5. Gérard M, Gagnon M, Arbour C, Bourbonnais A, Rouleau G, Côté J, et al. Looking beyond the chair: psycho-perceptual predictors of sexual distress and sexual satisfaction in individuals with spinal cord injury. J Sex Res. 2023;61(2):1-12.
6. Ferro JKO, Lemos A, Padilha SM, Oliveira DA. Predictive factors for sexual dissatisfaction in men after traumatic spinal cord injury. ABCS Health Sci. 2025;50:e025210.
7. Malomo AO, Aminu K, Adeolu AA, Adeleye AO, Balogun JA, Badejo OA, et al. Subjective evaluation of life satisfaction by community-dwelling spinal cord injury patients managed at the University College Hospital, Ibadan. J Community Med Prim Health Care. 2020;32(2):1-10.
8. Otero-Villaverde S, Ferreiro-Velasco ME, Montoto-Marqués A, Salvador de la Barrera S, Arias-Pardo AI, Rodriguez-Sotillo A. Sexual satisfaction in women with spinal cord injuries. Spinal Cord. 2015;53(7):557-60.
9. Siosteen A, Lundqvist C, Blomstrand C, Sullivan L, Sullivan M. Sexual ability, activity, attitudes and satisfaction as part of adjustment in spinal cord-injured subjects. Paraplegia. 1990;28(5):285-95.
10. Zanin E, Salizzato S, Aiello EN, Leochico CFD, Rey-Matias RR, Pauletto P, et al. The contribution of bio-psycho-social dimensions on sexual satisfaction in people with spinal cord injury and their partners: an explorative study. Spinal Cord Ser Cases. 2022;8(1):42.
11. Sipski ML, Alexander CJ. Sexual activities, response and satisfaction in women pre- and post-spinal cord injury. Arch Phys Med Rehabil. 1993;74(10):1025-9.
12. Valtonen K, Karlsson AK, Siosteen A, Dahlof LG, Viikari-Juntura E. Satisfaction with sexual life among persons with traumatic spinal cord injury and meningomyelocoele. Disabil Rehabil. 2006;28(16):965-76.
13. Kennedy P, Lude P, Taylor N. Quality of life, social participation, appraisals and coping post spinal cord injury: a review of four community samples. Spinal Cord. 2006;44(2):95-105.
14. Westgren N, Hultling C, Levi R, Seiger A, Westgren M. Sexuality in women with traumatic spinal cord injury. Acta Obstet Gynecol Scand. 1997;76(10):977-83.
15. Post MW, Van Dijk AJ, Van Asbeck FW, Schrijvers AJ. Life satisfaction of persons with spinal cord injury compared to a population group. Scand J Rehabil Med. 1998;30(1):23-30.
16. White MJ, Rintala DH, Hart KA, Fuhrer MJ. Sexual activities, concerns and interests of women with spinal cord injury living in the community. Am J Phys Med Rehabil. 1993;72(6):372-8.
17. Julia PE, Othman AS. Barriers to sexual activity: counselling spinal cord injured women in Malaysia. Spinal Cord. 2011;49(7):791-4.
18. New PW, Seddon M, Redpath C, Currie KE, Warren N. Recommendations for spinal rehabilitation professionals regarding sexual education needs and preferences of people with spinal cord dysfunction: a mixed-methods study. Spinal Cord. 2016;54(12):1203-9.