Tags

Type your tag names separated by a space and hit enter

Advances in the management of infertility in men with spinal cord injury.
Asian J Androl. 2016 May-Jun; 18(3):382-90.AJ

Abstract

Couples with a spinal cord injured male partner require assisted ejaculation techniques to collect semen that can then be further used in various assisted reproductive technology methods to achieve a pregnancy. The majority of men sustaining a spinal cord injury regardless of the cause or the level of injury cannot ejaculate during sexual intercourse. Only a small minority can ejaculate by masturbation. Penile vibratory stimulation and electroejaculation are the two most common methods used to retrieve sperm. Other techniques such as prostatic massage and the adjunct application of other medications can be used, but the results are inconsistent. Surgical sperm retrieval should be considered as a last resort if all other methods fail. Special attention must be paid to patients with T6 and rostral levels of injury due to the risk of autonomic dysreflexia resulting from stimulation below the level of injury. Bladder preparation should be performed before stimulation if retrograde ejaculation is anticipated. Erectile dysfunction is ubiquitous in the spinal cord injured population but is usually easily managed and does not pose a barrier to semen retrieval in these men. Semen analysis parameters of men with spinal cord injury are unique for this population regardless of the method of retrieval, generally presenting as normal sperm concentration but abnormally low sperm motility and viability. When sperm retrieval is desired in this population, emphasis should be placed on initially trying the simple methods of penile vibratory stimulation or electroejaculation before resorting to more advanced and invasive surgical procedures.

Authors+Show Affiliations

No affiliation info availableThe Miami Project to Cure Paralysis, University of Miami Miller School of Medicine, Miami, FL; Department of Urology, University of Miami Miller School of Medicine, Miami, FL, USA.No affiliation info available

Pub Type(s)

Journal Article
Review

Language

eng

PubMed ID

27048781

Citation

Ibrahim, Emad, et al. "Advances in the Management of Infertility in Men With Spinal Cord Injury." Asian Journal of Andrology, vol. 18, no. 3, 2016, pp. 382-90.
Ibrahim E, Brackett NL, Lynne CM. Advances in the management of infertility in men with spinal cord injury. Asian J Androl. 2016;18(3):382-90.
Ibrahim, E., Brackett, N. L., & Lynne, C. M. (2016). Advances in the management of infertility in men with spinal cord injury. Asian Journal of Andrology, 18(3), 382-90. https://doi.org/10.4103/1008-682X.178851
Ibrahim E, Brackett NL, Lynne CM. Advances in the Management of Infertility in Men With Spinal Cord Injury. Asian J Androl. 2016 May-Jun;18(3):382-90. PubMed PMID: 27048781.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Advances in the management of infertility in men with spinal cord injury. AU - Ibrahim,Emad, AU - Brackett,Nancy L, AU - Lynne,Charles M, PY - 2016/4/7/entrez PY - 2016/4/7/pubmed PY - 2017/1/11/medline SP - 382 EP - 90 JF - Asian journal of andrology JO - Asian J Androl VL - 18 IS - 3 N2 - Couples with a spinal cord injured male partner require assisted ejaculation techniques to collect semen that can then be further used in various assisted reproductive technology methods to achieve a pregnancy. The majority of men sustaining a spinal cord injury regardless of the cause or the level of injury cannot ejaculate during sexual intercourse. Only a small minority can ejaculate by masturbation. Penile vibratory stimulation and electroejaculation are the two most common methods used to retrieve sperm. Other techniques such as prostatic massage and the adjunct application of other medications can be used, but the results are inconsistent. Surgical sperm retrieval should be considered as a last resort if all other methods fail. Special attention must be paid to patients with T6 and rostral levels of injury due to the risk of autonomic dysreflexia resulting from stimulation below the level of injury. Bladder preparation should be performed before stimulation if retrograde ejaculation is anticipated. Erectile dysfunction is ubiquitous in the spinal cord injured population but is usually easily managed and does not pose a barrier to semen retrieval in these men. Semen analysis parameters of men with spinal cord injury are unique for this population regardless of the method of retrieval, generally presenting as normal sperm concentration but abnormally low sperm motility and viability. When sperm retrieval is desired in this population, emphasis should be placed on initially trying the simple methods of penile vibratory stimulation or electroejaculation before resorting to more advanced and invasive surgical procedures. SN - 1745-7262 UR - https://www.unboundmedicine.com/medline/citation/27048781/Advances_in_the_management_of_infertility_in_men_with_spinal_cord_injury_ L2 - http://www.ajandrology.com/article.asp?issn=1008-682X;year=2016;volume=18;issue=3;spage=382;epage=390;aulast=Ibrahim DB - PRIME DP - Unbound Medicine ER -