Evaluation of Sexual Function and Associated Clinical Factors in Women with Spinal Cord Injury: A Cross-Sectional Controlled Study

Study Design: Prospective, cross-sectional, comparative study. Objectives: To evaluate sexual function in women with spinal cord injury (SCI) using Female Sexual Function Index (FSFI) and to compare results with healthy controls. Secondary objectives were to determine prevalence of sexual dysfunction and to examine associations between sexual function and neurological level, functional independence, bladder and bowel function, and clinical complications. Setting: Ankara Bilkent City Hospital, Türkiye. Methods: 26 women with SCI and 23 age-matched healthy women were included. Sexual function was assessed using FSFI. Functional independence was evaluated with Spinal Cord Independence Measure III (SCIM III) and bowel dysfunction with Neurogenic Bowel Dysfunction (NBD) score. Group comparisons were performed using non-parametric tests and correlations were analyzed using Spearman correlation analysis. Results: Women with SCI had significantly lower FSFI total and domain scores than healthy controls ( p<0.001). Sexual dysfunction (FSFI <26.55) was highly prevalent in SCI group. FSFI total scores were not significantly associated with neurological level or ASIA classification. FSFI scores showed a strong positive correlation with SCIM III (r=0.77, p<0.001) and a moderate negative correlation with NBD scores (r=−0.44, p=0.024). Urinary incontinence was associated with significantly lower FSFI scores (p=0.008). FSFI scores differed significantly according to bladder management method with highest scores in spontaneous voiding and lowest in indwelling catheter users (p<0.001). Conclusions: Sexual function is markedly impaired in women with SCI and is strongly related to functional independence, bladder and bowel function and urinary management than to neurological injury level, highlighting need for a multidisciplinary approach in SCI rehabilitation.