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The free testosterone level was calculated using the Vermeulen formula.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Outcomes<\/jats:title>\n                  <jats:p>The outcomes include the relationship between sexual health and life satisfaction in men with SCI.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>A LiSat-9 score &amp;lt;4, suggestive for life dissatisfaction, was exhibited by 49% of men. When compared with the life-satisfied group, a significantly higher percentage of them had sexual dissatisfaction and erectile dysfunction (ED); they also exhibited significantly lower levels of TT and calculated free testosterone (cFT) and a more severe impairment of bowel-bladder function. The life satisfaction degree correlated with sexual satisfaction degree, IIEF-5 score, TT, cFT, and bowel-bladder function degree. At the logistic regression model, including sexual LiSat-9 subscore and bowel-bladder SCIM subscore, only the former exhibited a significant negative association with life dissatisfaction. In a further logistic regression model, including the putative key determinants of sexual satisfaction, erectile function, and cFT levels, a higher odd of life dissatisfaction was independently associated both with a lower IIEF-5 score (OR: 0.93; 95% CI: 0.88, 0.98) and lower cFT levels (OR: 0.98; 95% CI: 0.98, 0.99).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Clinical Implications<\/jats:title>\n                  <jats:p>In men with chronic SCI, assessment of erectile function and testosterone levels can help to predict life satisfaction.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Strengths &amp; Limitations<\/jats:title>\n                  <jats:p>This is the first demonstration of the independent association of androgen deficiency and ED with life satisfaction in men with SCI. Prospective studies are warranted to clarify the cause-effect relationships.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>In men with SCI, ED and low testosterone levels exhibit a significant independent association with life dissatisfaction; longitudinal intervention studies could explore possible effects of their treatment in improving sexual and life satisfaction in this population.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1016\/j.jsxm.2020.01.018","type":"journal-article","created":{"date-parts":[[2020,2,21]],"date-time":"2020-02-21T06:28:18Z","timestamp":1582266498000},"page":"911-918","update-policy":"https:\/\/doi.org\/10.1016\/elsevier_cm_policy","source":"Crossref","is-referenced-by-count":16,"title":["Independent Association of Erectile Dysfunction and Low Testosterone Levels with Life Dissatisfaction in Men with Chronic Spinal Cord Injury"],"prefix":"10.1093","volume":"17","author":[{"given":"Settimio","family":"D'Andrea","sequence":"first","affiliation":[{"name":"Andrology Unit , L'Aquila, , Italy"},{"name":"Department of Life, Health and Environment Sciences , L'Aquila, , Italy"},{"name":"University of L'Aquila , L'Aquila, , Italy"},{"name":"Spinal Unit , Sulmona, , Italy"},{"name":"San Raffaele Institute of Sulmona , Sulmona, , Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elisa","family":"Minaldi","sequence":"additional","affiliation":[{"name":"Andrology Unit , L'Aquila, , Italy"},{"name":"Department of Life, Health and Environment Sciences , L'Aquila, , Italy"},{"name":"University of L'Aquila , L'Aquila, , Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chiara","family":"Castellini","sequence":"additional","affiliation":[{"name":"Andrology Unit , L'Aquila, , Italy"},{"name":"Department of Life, Health and Environment Sciences , L'Aquila, , Italy"},{"name":"University of L'Aquila , L'Aquila, , Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesca","family":"Cavallo","sequence":"additional","affiliation":[{"name":"Spinal Unit , Sulmona, , Italy"},{"name":"San Raffaele Institute of Sulmona , Sulmona, , Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giorgio","family":"Felzani","sequence":"additional","affiliation":[{"name":"Spinal Unit , Sulmona, , Italy"},{"name":"San Raffaele Institute of Sulmona , Sulmona, , Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sandro","family":"Francavilla","sequence":"additional","affiliation":[{"name":"Andrology Unit , L'Aquila, , Italy"},{"name":"Department of Life, Health and Environment Sciences , L'Aquila, , Italy"},{"name":"University of L'Aquila , L'Aquila, , Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Felice","family":"Francavilla","sequence":"additional","affiliation":[{"name":"Andrology Unit , L'Aquila, , Italy"},{"name":"Department of Life, Health and Environment Sciences , L'Aquila, , Italy"},{"name":"University of L'Aquila , L'Aquila, , Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arcangelo","family":"Barbonetti","sequence":"additional","affiliation":[{"name":"Andrology Unit , L'Aquila, , Italy"},{"name":"Department of Life, Health and Environment Sciences , L'Aquila, , Italy"},{"name":"University of L'Aquila , L'Aquila, , Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2020,2,20]]},"reference":[{"key":"2023011111092617900_bib1","doi-asserted-by":"crossref","first-page":"e148e","DOI":"10.1016\/j.esxm.2017.06.002","article-title":"Erectile function predicts sexual satisfaction in men with spinal cord injury","volume":"5","author":"Gomes","year":"2017","journal-title":"Sex Med"},{"key":"2023011111092617900_bib2","doi-asserted-by":"crossref","first-page":"47","DOI":"10.1038\/sc.2016.80","article-title":"Associations between disability-management self-efficacy, participation and life satisfaction in people with long-standing spinal cord injury","volume":"55","author":"Cijsouw","year":"2017","journal-title":"Spinal Cord"},{"key":"2023011111092617900_bib3","doi-asserted-by":"crossref","first-page":"443","DOI":"10.1016\/j.apmr.2017.06.012","article-title":"Health conditions: effect on function, health-related quality of life, and life satisfaction after traumatic spinal cord injury. 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