Can-SCIP Coach App
  1. Can-SCIP
  2. Recommendations
  3. Guidelines
  4. Section 2 - MANAGEMENT OF SCI COMPLICATIONS

J - AUTONOMIC DYSREFLEXIA (AD)




Be aware of and educate individuals with SCI at or above T6 that sexual activity may provoke autonomic dysreflexia. (PVA-AD 2020, p.642; Level C)
Be aware that for men and women with SCI at or above T6 who use intense sexual stimulation (including vibratory stimulation), the likelihood of autonomic dysreflexia is increased. (PVA-AD 2020, p.642; Level C)
Encourage individuals with SCI at T6 and above to periodically monitor their blood pressure during sexual activities. (PVA-AD 2020, p.642; Level C)
Individuals prone to autonomic dysreflexia during sexual activity should be encouraged to use a home blood pressure monitor. (PVA-AD 2020, p.642; Level C)
If sexual activity causes symptomatic autonomic dysreflexia, individuals should be encouraged to immediately cease sexual stimulation and follow autonomic dysreflexia protocol. (PVA-AD 2020, p.642; Level C)

Consider instructing and prescribing pharmacological prophylaxis prior to sexual activity in selected individuals who:

  1. Have no history of symptomatic orthostatic hypotension (OH)
  2. Are not taking medication that may potentiate hypotension
  3. Developed autonomic dysreflexia with systolic blood pressure at or above 150 mmHg (i.e., during vibratory stimulation, ejaculation, orgasm, sperm retrieval, or urological procedures)
  4. Have symptomatic autonomic dysreflexia and/or systolic blood pressure greater than 150 mmHg prior to sexual activity or during sperm retrieval
(PVA-AD 2020, p.643; Level C)
If pharmacological treatment for autonomic dysreflexia is used in a home setting, instruct individuals on how to recognize, monitor, and treat pharmacologically induced hypotension. (PVA-AD 2020, p.643; Level C)
Instruct individuals at risk of autonomic dysreflexia to recheck blood pressure within 5 minutes of cessation of sexual activity, regardless of symptoms. If the individual’s high blood pressure does not resolve after 5 minutes, refer to steps for treatment of autonomic dysreflexia. (PVA-AD 2020, p.643; Level C)
Instruct individuals that if all conservative home measures to treat autonomic dysreflexia or pharmacologically induced hypotension following sexual activity are unsuccessful, an urgent visit to the emergency department is warranted. (PVA-AD 2020, p.643; Level C)