SUMMARY :
Introduction : Sexological management by a working method based on the system
of functional analysis described by A.A. Lazarus, Basic Idea, facilitates a
global approach to the sexuality of the subject, integrating all the dimensions
of his personality.
Materials and methods : a 22 year-old patient with paraplegia due to medullary
compression at T8, was unable to ejaculate during sexual intercourse. He achieved
ejaculation with the aid of a vibrator. During his medical follow-up, he was
unable to provide the second and third semen samples (required for the conservation
of the patient’s sperm for use in medically-assisted procreation) due to
a failure to maintain erection. Sexological management was initiated. The patient
was interviewed twice and the questions and comments used at the two interviews
were formulated based on the items of Basic Idea.
Results : at the first interview, we evaluated each item and the direction of
our work was determined from this evaluation. Initial treatment was the practice
of masturbation and exploration of the five senses. At the second interview,
an improvement was noted. The patient was more assertive and managed to ejaculated
during sexual intercourse.
Discussion : patients with medullary injuries must mourn their loss, then discover
all the healthy parts of their bodies and exercise the five senses and their
imaginary capacities to invent a new sexuality rather than searching in vain
to retrieve the sexuality they had before becoming paraplegic.
Conclusion : sexological therapy for medullary injuries could be given earlier
and could be based on Basic Idea.