Patient: I am a 34 year old woman with a 5 yr old daughter I have spina biffida and whilst I have reasonable sensation during sex i do not climax and the more aroused I am I am the more likely I am to leak urine? although I use catheters and my bladder should be empty. I have had some gynae reconstructive work at 11 years old and wonder could this be a factor in being able to fully enjoy sex?
Doctor: Spina bifida is a broad term that may be used to describe a number of open defects of the spinal column of various degre es of severity in affecting nervous functions for example: movement of lower limbs, absence of perineal sensation are common symptoms incontinence (bladder an fecal) or sex problems. Other alterations may be found in the arrangement or configuration of the toes, along with discrepancies in lower extremity muscle size and strength, weakness, or abnormal gait. In your particular case, according to your description the difficulty to fully enjoy sex is due to the myelodysplasia (spina bifida) most likely. On the other hand you can benefit of taking medication to treat your bladder dysfunction. Treatment usually covers 3 major elements: the use of antibiotics to prevent infection, the use of anticholinergic medications to relax the bladder and (hopefully) to increase storage capacity, and the use of other specific medications to attempt to improve continence.