'Complete' spinal cord injury does not block perceptual responses to genital self-stimulation in women

Background: A priori hypothesis: vaginal and/or cervical self-stimulation will not produce perceptual responses in women with ''complete'' spinal cord injury (SCI) at or above the highest level of entry of the hypogastric nerves (T10-12) but will produce perceptual responses if SCI is below T-10. Design: Women with complete SCI were assigned to a group with ''upper'' (T-10 and/or above) (n=6) or ''lower'' (below T-10) (n=10) SCI; uninjured women (n=5) constituted a control group. Perceptual response to vaginal and/or cervical self-stimulation was quantified as magnitude of analgesia to calibrated finger compressive force. Setting: Rutgers, The State University of New Jersey, Human Physiology Laboratory, College of Nursing, Newark. Participants: Consecutive samples of first 16 of 34 women with SCI who responded to nationwide advertisements, met inclusion criteria, and volunteered; control group was the first 5 respondents. Intervention: Vaginal or cervical (cervix uteri) self-stimulation applied for 12 minutes, interspersed with non-stimulation periods, while measuring analgesia. Main Outcome Measure: Quantify analgesia magnitude to vaginal or cervical self-stimulation. Results: Significant analgesia was produced in the uninjured group and the group with lower SCI, supporting the hypothesis. Unexpectedly, significant analgesia was also produced in the group with upper SCI. Women in the group with upper SCI also experienced menstrual discomfort, awareness of vaginal and/or cervical stimulation per se, and orgasms. Conclusions: (1) Genitospinal visceral afferent pathways function in the women in the group with upper SCI, although unrecognized by the American Spinal Injury Association criteria, and/or (2) there exists a functional genital afferent pathway that bypasses the spinal cord and projects directly to the brain, which we propose to be via the vagus nerves.