Rectal probe electrostimulation in the treatment of anejaculatory spinal cord injured men

Halstead, Lauro S.; VerVoort, S; Seager, S. W. J.

doi:10.1038/sc.1987.21

Cited by 86 publications

(50 citation statements)

References 6 publications

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“…In the present study, pushing of spermatozoa back into the bladder by the catheter was a possibility, but 'stripping' was used to clear the semen from the urethral tract before introducing the catheter (Roussel & Austin, 1968;Halstead et al, 1987) and any residual semen in the tract could not have produced the significant numbers of spermatozoa found in the bladder. In addition, no spermatozoa were found in the bladder infúsate of one collection that produced significant numbers of spermatozoa in the ejaculated sample, indicating that 'stripping' the urethra per rectum was an effective means of removing semen from the urethra.…”

Section: Resultsmentioning

confidence: 99%

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Viable spermatozoa in the bladder after electroejaculation of lion-tailed macaques (Macaca silenus)

et al. 1989

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Summary. The bladder of 6 lion-tailed macaques was emptied and flushed with sterile saline. TALP-Hepes buffer was infused and the animals were electroejaculated. After electroejaculation, the semen quality was determined in the ejaculate and the bladder infusate. Of the 15 ejaculates analysed, a mean (\m=+-\s.e.m.) sperm count of 133\m=.\8(\m=+-\30\m=.\7) \m=x\106 with 69\m=.\5( \ m=+-\ 6\m=.\0%motility was obtained in the infusate as compared to the sperm count of 72\m=.\4 (\ m=+-\38\m=.\6 \m=x\106 with significantly lower (47\m=.\7\ m=+-\5\m=.\8%motility in the ejaculate.

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Section: Resultsmentioning

confidence: 99%

“…Analysis of available data (Halstead et al, 1987) from three retroejaculatory patients reported loss of 3-50% total sperm numbers to the bladder.…”

Section: Resultsmentioning

confidence: 99%

Viable spermatozoa in the bladder after electroejaculation of lion-tailed macaques (Macaca silenus)

et al. 1989

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“…1 Semen retrieval may be accomplished by rectal probe electroejaculation (EEJ), 2,3 or by penile vibratory stimulation (PVS). 4,5 Of these two methods, PVS has been recommended as ®rst line treatment due to its safety, e cacy, and low investment of time and money.…”

Section: Introductionmentioning

confidence: 99%

Reflexes and somatic responses as predictors of ejaculation by penile vibratory stimulation in men with spinal cord injury

et al. 2001

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Study design: Retrospective chart review. Objective: To identify factors in addition to level of injury (LOI) that may predict ejaculation by penile vibratory stimulation (PVS) in spinal cord injured males. Setting: Major urban medical school and teaching hospital. Materials and methods: Presence of a bulbocavernosus response (BCR) and a hip¯exor response (HR) before PVS (n=123 patients), and somatic responses during PVS (n=204 trials performed on a subset of 44 patients) were evaluated for their frequency of occurrence on trials with and without ejaculation. Results: Overall ejaculation success rates for cervical, T1 ± T6, and T7 ± T12 LOI were 71%, 73%, and 35%, respectively. Eighty per cent of patients who were positive for both BCR and HR ejaculated with PVS, while only 8% of patients who were negative for both BCR and HR ejaculated with PVS. For cervical injuries, BCR and HR were no more predictive of ejaculation by PVS than LOI alone. T1 ± T6 patients were more likely to ejaculate when at least one re¯ex was present. T7 ± T12 patients with no BCR were unlikely to ejaculate by PVS. Except for abdominal contractions, somatic responses were not present in the majority of PVS trials. When they were present, however, they occurred in a high percentage of ejaculation trials: withdrawal response (hip¯exion, knee¯exion and thigh adduction) (90%), piloerection (84%), extremity spasms (83%), thigh abduction (80%), and thigh adduction (72%). Conclusion: We recommend that patients with cervical injuries initially undergo PVS. Patients with T1 ± T6 LOI with at least one re¯ex present, and patients with T7 ± T12 LOI with both re¯exes, or only BCR present, may undergo PVS. Certain somatic/autonomic responses, when seen, may help in deciding whether to continue with a given trial, or give a repeat trial, of PVS.

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“…In the 1980s the EEJ method was re®ned and new equipment developed by Seager. 119 EEJ is carried out with an electrical probe, which is inserted rectally and placed in contact with the rectal wall in the area of the prostate gland and the seminal vesicles. The electrical stimulation is given in a wavelike pattern with progressively increasing voltage with 1 ± 2 V increments until ejaculation occurs.…”

Section: Electroejaculation (Eej)mentioning

confidence: 99%

Sexual function in spinal cord lesioned men

2001

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Study design: Review of literature. Objective: To review the physical aspects related to penile erection, ejaculatory dysfunction, semen characteristics, and techniques for enhancement of fertility in spinal cord lesioned (SCL) men. Setting: Worldwide: individuals with traumatic as well as non-traumatic SCL. Results: Recommendations for management of erectile dysfunction in SCL men: If it is possible to obtain a satisfactory erection but of insucient duration, then try to use a venous constrictor band to ®nd out if this is sucient to maintain the erection. Otherwise we recommend Sildena®l. If Sildena®l is not satisfactory then use intracavernous injection with prostaglandin E 1 (some SCL men may prefer cutaneous or intraurethral application). We discourage the implantation of penile prosthesis for the sole purpose of erection. Recommendations for management of ejaculatory dysfunction in SCL men: Penile vibratory stimulation (PVS) to induce ejaculation is recommended as ®rst treatment choice. If PVS fails, SCL men should be referred for electroejaculation (EEJ). Semen characteristics: Impaired semen pro®les with low motility rates are seen in the majority of SCL men. Recently reported data gives evidence of a decline in spermatogenesis and motility of ejaculated spermatozoa shortly after (few weeks) an acute SCL. It is suggested that some factors in the seminal plasma and/or disordered storage of spermatozoa in the seminal vesicles are mainly responsible for the impaired semen pro®les in men with chronic SCL. Fertility: Home insemination with semen obtained by PVS and introduced intravaginally in order to achieve successful pregnancies may be an option for some SCL men and their partners. The majority of SCL men will further enhance their fertility potential when using either PVS or EEJ combined with assisted reproduction techniques such as intrauterine insemination or in vitro fertilization with or without intracytoplasmic sperm injection. Spinal Cord (2001) 39, 455 ± 470

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Rectal probe electrostimulation in the treatment of anejaculatory spinal cord injured men

Cited by 86 publications

References 6 publications

Viable spermatozoa in the bladder after electroejaculation of lion-tailed macaques (Macaca silenus)

Viable spermatozoa in the bladder after electroejaculation of lion-tailed macaques (Macaca silenus)

Reflexes and somatic responses as predictors of ejaculation by penile vibratory stimulation in men with spinal cord injury

Sexual function in spinal cord lesioned men

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