Semen quality in ejaculates produced by masturbation in men with spinal cord injury

Kathiresan, A.S.Q.; Ibrahim, Emad; Modh, Rishi; Aballa, Teodoro C.; Lynne, Charles M.; Brackett, Nancy L.

doi:10.1038/sc.2012.71

Cited by 21 publications

(12 citation statements)

References 14 publications

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“…Patients can use commercial vibrators, such as more powerful massagers, 62,63 or the FertiCare personal device with optimal stimulation parameters 64 (high amplitude and speed) that are specifically designed for use in men with SCI. The FertiCare improves the ejaculation success rate from 49% 57,58 to 55% 62,65 and even 83%. 64 Studies with the FertiCare further suggest that 2 stimulators can be used together (sandwich technique) to improve ejaculation success.…”

Section: More Advanced Techniques To Attain Orgasm and Ejaculationmentioning

confidence: 99%

Improving Sexual Satisfaction in Persons with Spinal Cord Injuries: Collective Wisdom

Alexander

Courtois

Elliott

et al. 2017

Topics in Spinal Cord Injury Rehabilitation

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Sexuality is an important part of life, and it is necessary for clinicians to have a specific format in which to address sexual issues with their patients. A systematic approach to working with patients with spinal cord injury (SCI) to improve their sexual functioning and response is presented. Nonjudgmental communication about sexual concerns is followed by a detailed pre-and postinjury medical, psychosocial, and sexual history. If preexisting sexual issues are present, it is recommended that the patient be referred for assessment and treatment of these separate from the patient's SCI-related concerns. Physical examination, with special attention to issues that could impact the patient's sexuality, is followed by a detailed neurologic assessment with specific attention to the T11-L2 and S3-5 spinal segments. Education of the patient with regard to his or her sexual potential and the need to be flexible in his or her sexual repertoire is followed by self-exploration and practice. Routine follow-up is suggested after patient's initial sexual exploration. Treatment of confounding and iatrogenic factors related to SCI is followed by more sexual experience. Afterwards the clinician is encouraged to use simple techniques to treat sexual issues and follow-up with the patient to assess the outcome. A structured program utilizing vibratory stimulation with or without midodrine is described as a way to achieve ejaculation and potentially orgasm, and techniques for treating severe autonomic dysreflexia are discussed. If these interventions do not alleviate the patient's sexual concerns, the clinician should refer the patient for more specialized consultation.

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Section: More Advanced Techniques To Attain Orgasm and Ejaculationmentioning

confidence: 99%

Improving Sexual Satisfaction in Persons with Spinal Cord Injuries: Collective Wisdom

Alexander

Courtois

Elliott

et al. 2017

Topics in Spinal Cord Injury Rehabilitation

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“…Via nvestigating the method of assisted ejaculation in patients with SCI much has been reported about their semen quality. In addition to earlier data about lower sperm motility from semen collected by EEJ compared to semen obtained by PVS [39], it was established that sperm motility may be significantly higher when obtained by masturbation (36,9%) than by PVS (25,9%) or EEJ (15%) [40]. Since the semen quality remains stable without clinically significant changes during the chronic phase of SCI after the injury, this information may be useful for family planning [41].…”

Section: Semen Abnormalitiesmentioning

confidence: 95%

Fertility in men with spinal cord injury

Čehić

Kasum

Šimunić³

et al. 2016

Gynecological Endocrinology

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“…The most common methods of semen retrieval for men with SCI are penile vibratory stimulation (PVS), electroejaculation (EEJ), surgical sperm retrieval, and prostate massage. Only about 9% of men with SCI can achieve antegrade ejaculation via masturbation (Kathiresan et al ., ). Penile vibratory stimulation is successful in obtaining antegrade ejaculation in 86% of men whose level of injury is T10 or rostral, and up to 17% of men whose level of injury is caudal to T10.…”

Section: Ejaculatory Dysfunction In Men With Scimentioning

confidence: 97%

“…Further, in men with SCI, sperm concentration was significantly lower in antegrade ejaculates obtained by EEJ than in antegrade ejaculates obtained by PVS or masturbation. Of final note, the study showed that antegrade semen volume was lower in SCI subjects compared to control subjects (Kathiresan et al ., ).…”

Section: Semen Quality In Men With Scimentioning

confidence: 97%

Male fertility following spinal cord injury: an update

2015

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SUMMARYSpinal cord injury (SCI) occurs most often in young men at the peak of their reproductive health. The majority of men with SCI cannot father children naturally. Three major complications contribute to infertility in men with SCI: erectile dysfunction, ejaculatory dysfunction, and abnormal semen quality. Erectile dysfunction can be managed by regimens available to the general population, including oral administration of phosphodiesterase-5 (PDE-5) inhibitors, intracavernosal injections, vacuum devices, and penile prostheses. Semen may be obtained from anejaculatory men with SCI via the medically assisted ejaculation methods of penile vibratory stimulation (PVS) or electroejaculation (EEJ). Sperm retrieval is also possible via prostate massage or surgical sperm retrieval. Most men with SCI have abnormal semen quality characterized by normal sperm concentrations but abnormally low sperm motility and viability. Accessory gland dysfunction has been proposed as the cause of these abnormalities. Leukocytospermia is evident in most SCI patients. Additionally, elevated concentrations of pro-inflammatory cytokines and elevated concentrations of inflammasome components are found in their semen. Neutralization of these constituents has resulted in improved sperm motility. There is a recent and alarming trend in the management of infertility in couples with SCI male partners. Although many men with SCI have sufficient motile sperm in their ejaculates for attempting intrauterine insemination (IUI) or even intravaginal insemination, surgical sperm retrieval is often introduced as the first and only sperm retrieval method for these couples. Surgical sperm retrieval commits the couple to the most advanced, expensive, and invasive method of assisted conception: in vitro fertilization with intracytoplasmic sperm injection (IVF/ICSI). Couples should be informed of all options, including semen retrieval by PVS or EEJ. Intravaginal insemination or IUI should be considered when indicated.

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Semen quality in ejaculates produced by masturbation in men with spinal cord injury

Cited by 21 publications

References 14 publications

Improving Sexual Satisfaction in Persons with Spinal Cord Injuries: Collective Wisdom

Improving Sexual Satisfaction in Persons with Spinal Cord Injuries: Collective Wisdom

Fertility in men with spinal cord injury

Male fertility following spinal cord injury: an update

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