HOMERO BRUSCHINI
Projetos de Pesquisa
Unidades Organizacionais
Departamento de Cirurgia, Faculdade de Medicina - Docente
LIM/55 - Laboratório de Urologia, Hospital das Clínicas, Faculdade de Medicina - Líder
LIM/55 - Laboratório de Urologia, Hospital das Clínicas, Faculdade de Medicina - Líder
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conferenceObject ASSESSMENT OF THE MALE SEXUAL QUOTIENT SCALE RELIABILITY TO EVALUATE SEXUAL FUNCTION OF MEN WITH SPINAL CORD INJURY(2015) MIRANDA, Eduardo; GOMES, Cristiano; BESSA JUNIOR, Jose de; CASTRO FILHO, Jose de; BELLUCCI, Carlos; BATTISTELLA, Linamara; BARROS FILHO, Tarcisio; CARVALHO, Fabricio; ABDO, Carmita; BRUSCHINI, Homero; NAHAS, William; SROUGI, MiguelconferenceObject FEMALE SEXUAL DYSFUNCTION AFTER SPINAL CORD INJURY: AN IMPORTANT FACTOR ASSOCIATED TO LIFE DISSATISFACTION(2013) GOMES, C.; JR, J. Castro; BELLUCCI, C.; JR, J. Bessa; PINHEIRO, M.; BARROS FILHO, T.; BATTISTELLA, L.; BRUSCHINI, H.; SROUGI, M.conferenceObject IMPACT OF SPINAL CORD INJURY IN FEMALE SEXUAL FUNCTION(2012) CASTRO, Jose; GOMES, Cristiano; BESSA JR., Jose; BRUSCHINI, Homero; ABDO, Carmita; ABREU, Luiz; ARAUJO FILHO, Julio; SOUZA, Daniel; SCAZUFCA, Marcia; BATTISTELLA, Linamara; BARROS, Tarcisio; SROUGI, MiguelconferenceObject IMPACT OF SPINAL CORD INJURY IN MALE SEXUAL FUNCTION(2012) CASTRO, Jose; GOMES, Cristiano; BESSA JR., Jose; BRUSCHINI, Homero; ABDO, Carmita; ABREU, Luiz; ARAUJO FILHO, Julio; SOUZA, Daniel; SCAZUFCA, Marcia; MIRANDA, Eduardo; SROUGI, Victor; BATTISTELLA, Linamara; BARROS, Tarcisio; SROUGI, Miguel- Contemporary Trends in the Epidemiology of Traumatic Spinal Cord Injury: Changes in Age and Etiology(2015) BELLUCCI, Carlos Henrique Suzuki; CASTRO FILHO, Jose Everton de; GOMES, Cristiano Mendes; BESSA JR., Jose de; BATTISTELLA, Linamara Rizzo; SOUZA, Daniel Rubio de; SCAZUFCA, Marcia; BRUSCHINI, Homero; SROUGI, Miguel; BARROS FILHO, Tarcisio E. P.Background: Epidemiological features of spinal cord injury (SCI) have been changing over the last decades. We evaluated the contemporary trends in the epidemiology of traumatic SCI patients from a rehabilitation center. Methods: In a cross-sectional study, a consecutive series of 348 patients with traumatic SCI were evaluated. Variables were collected through an epidemiological form, which included gender, age at injury, duration and cause of SCI. We investigated SCI epidemiological trends over time including the association between gender and age at injury with SCI features such as etiology, injury severity and level. Results: The mean age at SCI has increased from 26.0 +/- 11.8 in patients with SCI before 2003 to 37.9 +/- 15.7 in those with SCI after 2009 (p < 0.001). Gunshot wounds were the main cause of injury in patients with SCI before 2003, dropping from 40.6 to 16.9% after 2009 and being surpassed by road traffic injuries (38.6%) and falls (31.4%) after 2009 (p < 0.001). Gender, SCI severity and level have not changed significantly over the time. Conclusions: There was a major increase in the average age of patients as well as changes in the etiology of SCI over the past fifteen years, including a significant decrease in gunshot wounds and an increase in the frequency of road traffic injuries and falls. These changes and accompanying risk factors must be taken into consideration when planning measures to prevent SCI. (C) 2015 S. Karger AG, Basel
- Cross-cultural adaptation and validation of the neurogenic bladder symptom score questionnaire for brazilian portuguese(2019) CINTRA, Lisley Keller Liidtke; BESSA JUNIOR, Jose de; KAWAHARA, Victor Ikky; FERREIRA, Thereza Phitoe Abe; SROUGI, Miguel; BATTISTELLA, Linamara Rizzo; SOUZA, Daniel Rubio de; BRUSCHINI, Homero; GOMES, Cristiano MendesObjective: To cross-culturally adapt and check for the reliability and validity of the neurogenic bladder symptom score questionnaire to Brazilian portuguese, in patients with spinal cord injury and multiple sclerosis. Materials and Methods: The questionnaire was culturally adapted according to international guidelines. The Brazilian version was applied in patients diagnosed with neurogenic bladder due to spinal cord injury or multiple sclerosis, twice in a range of 7 to 14 days. Psychometric properties were tested such as content validity, construct validity, internal consistency, and test-retest reliability. Results: Sixty-eight patients participated in the study. Good internal consistency of the Portuguese version was observed, with Cronbach alpha of 0.81. The test-retest reliability was also high, with an Intraclass Correlation Coefficient of 0.86 [0.76 - 0.92] (p<0.0001). In the construct validity, the Pearson Correlation revealed a moderate correlation between the Portuguese version of the NBSS and the Qualiveen-SF questionnaire (r = 0.66 [0.40-0.82]; p < 0.0001). Conclusions: The process of cross-cultural adaptation and validation of the NBSS questionnaire for the Brazilian Portuguese in patients with neurogenic lower urinary tract dysfunction was concluded.
conferenceObject IMPACT OF URINARY INCONTINENCE ON MALE SEXUAL FUNCTION AFTER SPINAL CORD INJURY(2013) GOMES, C.; JR, J. Castro; JR, J. Bessa; BELLUCCI, C.; PINHEIRO, M.; BATTISTELLA, L.; BARROS FILHO, T.; BRUSCHINI, H.; SROUGI, M.Hypothesis / aims of study Sexual function is tremendously affected by spinal cord injury (SCI).(1, 2) Sexuality is identified as a very important aspect of life, and restoration of sexual function may have a significant impact in the rehabilitation process and may improve quality of life. After spinal cord injury (SCI), sexuality may be affected by physiological, psychological and emotional consequences. Genitalorgans’ functions may be damaged depending on the level and completeness of the neurological injury. Furthermore, the impaired ability to maintain continence after SCI puts individuals at risk of presenting urinary leakage during typical daily activities, such as sexual intercourse, impairing the willingness to engage in sexual activity. In this study we sought to investigate sexual function and satisfaction in men with SCI, and the impact of urinary incontinence. Study design, materials and methods We prospectively evaluated 295 men with traumatic SCI (>12 months) with a mean age of 40.8 ± 14.4 years. Median time from SCI was 3.6 years [1.7-7.0]. The lesion level was cervical in 129 (43.7%), thoracic in 133 (45.1%), lumbar in 32 (10.8%) and sacral in 1 (0.3%) patient. The American Spinal Injury Association (ASIA) impairment scale was A in 192 (65.1%), B in 33 (11.2%), C in 27 (9.2%), D in 34 (11.4%) and E in 9 (1.1%). Urinary incontinence was defined as any complaint of involuntary leakage of urine during the past month. Two groups were created, comprising 138 (46.8%) continent and 157 (53.2%) incontinent patients, respectivelly. A structured questionnaire was applied to all subjects including a detailed sexual anamnesis regarding orgasmic and ejaculatory functions, as well as the subjective satisfaction with sexual life (SSL–scale varrying from 0=dissatisfied to 10=satisfied). Moreover, the International Index of Erectile Function-5 item (IIEF-5) was applied to all subjects. Results Table 1– Sexual parameters before and after SCI Before SCI (n=295) After SCI (n=295) p Sexually active 289 (97.9%) 159 (53.9%) <0.001 IIEF*-5 [0-16] IIEF*>17-63 (21.4%) Orgasm 286 (96.9%) 105 (35.6%) <0.001 Masturbation 116 (39.3%) 27 (9.1%) <0.001 Ejaculation 288 (97.6%) 61 (20.6%) <0.001 SSLº 9 [8-10] 4 [0-6] <0.001 *International Index of Erectile Function °Satisfaction with Sexual Life Table 2– Comparisons between continent and incontinent SCI men Continent (n=157) Incontinent (n=138) p Odds Ratio Sexually active 95 (60.1%) 64 (46.3%) 0.019 1.7[1.1-2.8] IIEF* 9 [0-17] 0 [0-13] 0.026 IIEF*>17 37 (23.5%) 26 (18.8%) 0.3931.3[0.7-2.3] Orgasm 61 (46.3%) 44 (38.8%) 0.2251.3[0.8-2.2] Ejaculation 43 (27.3%) 18 (13.1%) 0.002 2.5[1.3-4.6] SSSLº 5[0-6] 3[0-3] 0.036 *International Index of Erectile Function °Subjective Satisfaction with Sexual Life Interpretation of results Table 1 shows the tremendous negative impact of SCI in male sexual life, with significant reduction of sexually active men after SCI, as well as in the ability to achieve orgasm and ejaculation. Consequently, satisfaction with sexual life was markedly reduced after SCI. Table 2 compares sexual parameters between continent and incontinent men after SCI. Continent men had better results in a number of parameters including the prevalence of sexually active men, median IIEF-5 score, ability to achieve ejaculat ion and the overall satisfaction with sexual life. The ability to achieve orgasm was similarly low in the two groups. Concluding message Sexual dysfunction is highly prevalent in SCI men and has a tremendous negative impact in the satisfaction with sexua l life. Urinary incontinence is associated with worse sexual outcomes in SCI men, with inferior rates of sexually active men, decreased IIEF-5 scores, decreased ability to achieve ejaculation and overall satisfaction with sexual life.- Erectile Function Predicts Sexual Satisfaction in Men With Spinal Cord Injury(2017) GOMES, Cristiano M.; MIRANDA, Eduardo P.; BESSA JR., Jose de; BELLUCCI, Carlos Henrique Suzuki; BATTISTELLA, Linamara Rizzo; ABDO, Carmita Helena Najjar; BRUSCHINI, Homero; SROUGI, Miguel; MULHALL, John P.Introduction: Spinal cord injury (SCI) is usually a sudden traumatic event and has a negative effect on sexual function. Aim: To evaluate the characteristics of sexual activity in men with SCI and identify predictors of being sexually active and having a satisfactory sex life. Methods: We assessed sexual activity profiles of men with SCI from a Brazilian tertiary rehabilitation center from February to August 2012. All patients older than 18 years with SCI for longer than 1 year were invited to participate. We analyzed age, time since SCI, patient age at SCI, employment status, partner status, completeness of lesion, functional independence, urinary continence, and Sexual Health Inventory for Men (SHIM) score. Main Outcome Measures: The SHIM was used to assess erectile function (EF). Satisfaction with sex life was analyzed as a dichotomous variable. Predictors of an active and satisfactory sex life were identified using univariable and multivariable analyses. Results: We evaluated 295 men with mean age of 40.7 +/- 14.5 years. Most patients had a complete SCI (65.1%) and 159 (53.9%) were incontinent. The median SHIM score was 5 (interquartile range = 0-16) and only 71 men (24.1%) had a SHIM score of at least 17. Of these men, 159 (53.9%) were sexually active. Only 63 men (39.6%) were satisfied with their sex life after SCI. In univariable analysis, all variables were associated with an active sex life. Those with a SHIM score of at least 17 had a greater likelihood of being sexually active (odds ratio = 116, 95% confidence interval = 14-432). EF was the only parameter associated with a satisfactory sex life (odds ratio = 1.3, 95% confidence interval = 1.2-1.4). Conclusions: Most men with SCI were sexually inactive and/or dissatisfied with their sex life. Age, duration of SCI, completeness of SCI, continence, having a partner, and good EF were identified as predictors of an active sex life. However, only EF was a predictor of a satisfactory sex life.
- Evaluation of Sexual Dysfunction in Men With Spinal Cord Injury Using the Male Sexual Quotient(2016) MIRANDA, Eduardo P.; GOMES, Cristiano Mendes; BESSA JR., Jose de; ABDO, Carmita Helena Najjar; BELLUCCI, Carlos Henrique Suzuki; CASTRO FILHO, Jose Everton de; CARVALHO, Fabricio Leite de; SOUZA, Daniel Rubio de; BATTISTELLA, Linamara Rizzo; SCAZUFCA, Marcia; BRUSCHINI, Homero; BARROS FILHO, Tarcisio; SROUGI, Miguel.Objective: To assess different aspects of sexual function in men with spinal cord injury (SCI) using the Male Sexual Quotient (MSQ), a newly developed tool to assess sexual function and satisfaction. Design: Cross-sectional study. Setting: Tertiary rehabilitation center. Participants: Patients (N=295) older than 18 years (mean age +/- SD, 40.7 +/- 14.5y) with SCI for more than 1 year (median time since SCI, 3.6y; range, 1.6-7.0y) were assessed from February to August 2012. Patients completed the MSQ questionnaire and the Sexual Health Inventory for Men (SHIM). Interventions: Not applicable. Main Outcome Measures: Performance in various domains of sexual function was evaluated using the MSQ and SHIM questionnaires. Results: Erectile function, ejaculation, and orgasm were the most severely affected domains. The median MSQ score was 40 (range, 8-66), and the median SHIM score was 5 (range, 0-16). The diagnostic properties of the 2 instruments were similar in the discrimination of sexually active subjects. The area under the receiver operating characteristic curve was .950 (95% confidence interval [CI], .923.979) for the MSQ and .942 (95% CI, .915.968) for the SHIM. There was a strong correlation between the 2 instruments (r=.826; 95% CI, .802.878). Conclusions: Different domains of sexual function are severely impaired in men with SCI, although their sexual interest remains high. The MSQ and SHIM scores strongly correlate, but the MSQ provides a more comprehensive assessment of sexual dysfunction in male patients with SCI. (C) 2016 by the American Congress of Rehabilitation Medicine