Cardiovascular Responses to Vibrostimulation for Sperm Retrieval in Men With Spinal Cord Injury

Claydon, Victoria E.; Elliott, Stacy; Sheel, A. William; Krassioukov, Andrei V.

doi:10.1080/10790268.2006.11753876

Cited by 74 publications

(55 citation statements)

References 43 publications

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“…reported in SCI men, 15 with tachycardia in numerous autonomic dysreflexia cases also being found. 4 Recent times have shown considerable advances in rehabilitation medicine 16 as well as in assisted reproductive techniques for individuals with sexual dysfunction.…”

Section: R Brown Et Almentioning

confidence: 84%

Cutaneous vasoconstriction as a measure of incipient autonomic dysreflexia during penile vibratory stimulation in spinal cord injury

et al. 2008

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Study design: Measurement of haemodynamic responses, cutaneous blood flow and sweat release during penile vibratory stimulation (PVS) in spinal cord-injured men. Objective: To assess the validity of using markers of sympathetic activity (cutaneous blood flow and sweat release) as a measure of incipient autonomic dysreflexia during PVS in spinal cord-injured men. Setting: Prince of Wales Medical Research Institute, Australia. Subjects: Ten spinal cord-injured men with injuries ranging from C3 to T6. Methods: Continuous arterial pressure, intermittent auscultation, heart rate (HR), respiration, cutaneous blood flow and sweat release from both finger and toe were recorded during PVS. Results: Vibration of the penis caused immediate cutaneous vasoconstriction, but negligible sweat release, in the hands and feet of the quadriplegics and the feet of the paraplegics. Systolic blood pressure (BP) increased by up to 90 mm Hg, and a compensatory vagal bradycardia was observed in five of the six quadriplegics and two of the four paraplegic subjects. Conclusion: Given that there wasFin generalFan inverse relationship between BP and skin blood flow, we conclude that continuous measurements of skin blood flow above and below the lesion can provide important information on the state of the sympathetic nervous system and early identification of reflexly evoked increases in sympathetic vasoconstrictor drive, below a spinal lesion. Coupled with a decrease in HR, this cutaneous vasoconstriction infers an increased BP.

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Section: R Brown Et Almentioning

confidence: 84%

Cutaneous vasoconstriction as a measure of incipient autonomic dysreflexia during penile vibratory stimulation in spinal cord injury

et al. 2008

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“…When reporting BP outcomes, some studies compared baseline BP and maximal BP, whereas others compared the BP changes. It is recommended to use BP changes as the primary outcome measure of AD owing to the fact that normal resting arterial BP in individuals with cervical and high thoracic SCI is approximately 15-20 mm Hg lower than in able-bodied individuals, 62 and thus elevated BP due to episodes of AD may not always be obvious.…”

Section: Discussionmentioning

confidence: 99%

Iatrogenic urological triggers of autonomic dysreflexia: a systematic review

et al. 2015

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Study design: This is a systematic review. Objective: The objective of this study was to review the literature on iatrogenic urological triggers of autonomic dysreflexia (AD). Setting: This study was conducted in an international setting. Methods: A systematic review was conducted from PubMed search using AD/ autonomic hyperreflexia and spinal cord injury (SCI). Studies selected for review involved iatrogenic urological triggers of AD in individuals with SCI, including original articles, previous practice guidelines, case reports and literature reviews. Studies that did not report AD or blood pressure (BP) assessments during urological procedures were excluded. Results: Forty studies were included for analysis and categorized into four groups: (1) urodynamics and cystometry; (2) cystoscopy and transurethral litholapaxy; (3) extracorporeal shock-wave lithotripsy (ESWL); and (4) other procedures. During urodynamics, the incidence of AD ranged from 36.7% to 77.8%. The symptomatic rate ranged from 50% to 65%, with AD symptoms seen predominantly in cervical SCI patients. The studies imply no consensus regarding the relationship between AD, neurogenic detrusor overactivity and detrusor sphincter dyssynergia. Without anesthesia, the majority of individuals develop AD during cystoscopy, transurethral litholapaxy and ESWL. The effectiveness of different anesthesia methods relies on blocking the nociceptive signals from the lower urinary tract (LUT) below the level of the neurological lesion. Other iatrogenic urological triggers were commonly associated with bladder filling. Conclusion: The LUT triggers of episodes of AD are often associated with iatrogenic urological procedures. AD was more prevalent in cervical SCI than in thoracic SCI. To detect this potential life-threatening complication following cervical and high thoracic SCI, routine BP monitoring during urological procedures is highly recommended.

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“…9,[34][35][36][37][38] These studies expand our understanding of the neurophysiologic changes in sexual responses following SCI and provide an excellent model for a holistic and reintegrated approach to sexual rehabilitation. Furthermore, as evident from literature, individuals with SCI rate the recovery of sexual functions among their highest priorities for improving of quality of life.…”

Section: Sexual Changes Following Scimentioning

confidence: 99%

Neural Control and Physiology of Sexual Function: Effect of Spinal Cord Injury

Krassioukov

Elliott

2017

Topics in Spinal Cord Injury Rehabilitation

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Objective: To present the current understanding of normal anatomy, physiology, sexual physiology, pathophysiology and the consequential sexual changes and dysfunctions following a spinal cord injury (SCI). Methods: Narrative review of the latest literature. Results: Peripheral innervations of the pelvis involve 3 sets of efferent neurons coordinated though the pelvic plexus (somatic, thoracolumbar sympathetic, and sacral parasympathetic), and these are under cerebral descending excitatory and inhibitory control. SCI, depending on the level of lesion and completeness, can alter this cerebral control, affecting the psychological and reflexogenic potential for genital arousal and also ejaculation and orgasm. During arousal, nitric oxide is the main neurotransmitter for smooth muscle relaxation in both male and female erectile tissue. In men, erection, ejaculation, and orgasm are under separate neurological control and can be individually affected by SCI. Conclusions: Since sexual function is rated amongst the highest priorities by individuals living with SCI, methods employed to affect the neurological changes to maximize sexual neurophysiology prior to initiating medical therapies including paying attention to sexual sensate areas and visceral signals with mindfulness techniques, practicing body mapping, and sexual stimulation of sensate areas to encourage neuroplasticity. Attention should be paid to the biopsychosocial sexual contexts within which persons with SCI live to maximize their sexual and fertility rehabilitation.

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Cardiovascular Responses to Vibrostimulation for Sperm Retrieval in Men With Spinal Cord Injury

Cited by 74 publications

References 43 publications

Cutaneous vasoconstriction as a measure of incipient autonomic dysreflexia during penile vibratory stimulation in spinal cord injury

Cutaneous vasoconstriction as a measure of incipient autonomic dysreflexia during penile vibratory stimulation in spinal cord injury

Iatrogenic urological triggers of autonomic dysreflexia: a systematic review

Neural Control and Physiology of Sexual Function: Effect of Spinal Cord Injury

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