Sources, sb and sex

Sources read so far:

[TOMAX]
Restoring penis sensation in patients with low spinal cord lesions: the role of the remaining function of the dorsal nerve in a unilateral or bilateral TOMAX procedure.
https://www.ncbi.nlm.nih.gov/pubmed/24481885

Increased sexual health after restored genital sensation in male patients with spina bifida or a spinal cord injury: the TOMAX procedure.
https://www.ncbi.nlm.nih.gov/pubmed/23079372

Overgoor.pdf freely available from:
https://dspace.library.uu.nl/bitstream/handle/1874/303506/overgoor.pdf?sequence=1


[SB, Sexuality and QOL]
Sexual Function and Quality of Life in Young Men With Spina Bifida: Could It Be Neglected Aspects in Clinical Practice?
https://www.sciencedirect.com/science/article/pii/S0090429517301644

[Sexuality and seeking medical help for erectile dysfunction in young adults with spina bifida]
https://onlinelibrary.wiley.com/doi/full/10.1111/j.1442-2042.2006.01559.x
> It was reported that many patients with sacral spinal cord injury retain psychogenic erectile ability even though the reflexogenic erection is abolished, and these cerebrally induced erections are noticed more frequently in patients with lower motor neuron lesions below T12.10 In patients with psychogenic erection, elongation and engorgement of the penis are observed but rigidity is insufficient.11 In patients with sacral spinal cord lesion, the cerebral impulses can still travel by means of the sympathetic pathway to inhibit noradrenaline release, and nitrous oxide (NO) and acetylcholine can still be released through synapses with the postganglionic parasympathetic and somatic neurons. Because the number of synapses between the thoracolumbar outflow and the postganglionic parasympathetic and somatic neurons is less than the sacral outflow, the resulting erection will not be very strong.12

[Sexual dysfunction and infertility in the male spina bifida patient]
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6256049/
> Game et al. observed that erectile dysfunction was more common in those with impaired sacral reflexes, as seen on electromyography, associated with sacral nerve root lesions (27). Similarly, Diamond et al. noted that in cases where the lesion occurred above the sympathetic outflow (T10), those with anocutaneous (sacral) reflexes were more likely to have erections compared to those without this reflex (29). In a study of 12 spina bifida males, Cass et al. found that all males with intact sacral reflexes and urinary continence had potency (8). In those without sacral reflexes, 64% of men with lesions below T10 were potent while rates of potency decreased to only 14% for those with higher lesions above T10 (8). These studies convincingly show that spina bifida men with lower lesions and intact sacral reflexes have the best chance at preserved sexual function and fertility potential. This data is summarized in Table 2.