Surgeons have found a way to establish or restore penile sensation in men with spina bifida and spinal cord injury.
The TOMAX procedure (“TO MAX-imize sensation, sexuality, and quality of life”) was performed on 30 patients between the ages of 13 and 55 in the Netherlands. Eighteen of the patients had spina bifida; the remaining twelve had spinal cord injury.
According to a study published online last fall in the Journal of Urology, the men had “no penile sensation but good groin sensation” before the surgery. The procedure involves removing a portion of the nerve that provides sensation to the thigh skin. That portion is then transferred to the nerve that provides skin sensation to the penis.
Twenty-four (80%) of the patients developed unilateral glans penis sensation. This feeling was originally felt in the groin, but for 11 patients, the feeling “transformed into real glans sensation.” These patients had better overall sexual function and satisfaction after the surgery, but the 13 patients who had only groin sensation said their sexual satisfaction was only slightly less than those who had glans sensation.
“In about 90% of the patients, this will lead to restored sensation, which is firstly felt in the groin, but in most patients this will be transferred to the glans penis through plasticity of the brain,” researcher Dr. Max L. E. Overgoor told Reuters Health. Dr. Overgoor is affiliated with the Department of Plastic, Reconstructive and Hand Surgery at the Isala Clinic in Zwolle, The Netherlands.
The increased sensations helped men manage urinary incontinence more effectively, which improved hygiene and independence. “Most patients felt more complete and less handicapped with their penis now part of their body image,” the authors wrote. “They also reported having more open and meaningful sexual relationships with their partners.”
The procedure was performed for the first time in the United States in Seattle. The patient was a 19-year-old man with spina bifida. At an 18-month follow up, the man reported having good sensation.
Specialists from the University of Washington plan to expand the surgery’s availability to patients with traumatic spinal cord injury. They also hope to study whether the surgery could help women with spinal cord lesions.
The Journal of Urology
Overgoor, M. L. E., et al.
“Increased Sexual Health After Restored Genital Sensation in Male Patients with Spina Bifida or a Spinal Cord Injury: the TOMAX Procedure”
(Abstract. Published online: October 17, 2012)
Reuters Health via ModernMedicine
Boggs, Will, MD
“Procedure restores genital sensation in men with spina bifida, spinal cord injury”
(October 24, 2012)
University of Washington
“Surgery establishes penile sensation in men with spina bifida”
(December 28, 2012)