Treatment for Ejaculatory Dysfunction in Men With Spinal Cord Injury: An 18-Year Single Center Experience

Brackett, Nancy L.; Ibrahim, Emad; Iremashvili, Viacheslav; Aballa, Teodoro C.; Lynne, Charles M.

doi:10.1016/j.juro.2010.02.018

Cited by 120 publications

(97 citation statements)

References 24 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…7 Our algorithm of sperm retrieval in patients with SCI has been previously described. 3 In brief, patients who were unable to ejaculate with masturbation were administered a trial of PVS with one vibrator. Failures with one vibrator were administered a trial with two vibrators (that is, the 'sandwich' technique) unless: (1) their level of injury was T11 or caudal or (2) they had complete absence of somatic responses, that is, absence of muscle contractions below the level of injury.…”

Section: Methodsmentioning

confidence: 99%

See 1 more Smart Citation

The choice of assisted ejaculation method is relevant for the diagnosis of azoospermia in men with spinal cord injuries

et al. 2010

View full text Add to dashboard Cite

Study design: Retrospective analysis of research data collected over 418 years at our center. Objectives: Examine results of repeated semen retrievals in men with spinal cord injury (SCI) who were initially found to be azoospermic. Setting: Major university medical center. Methods: Three different groups were analyzed in this study. Group 1 (n ¼ 15) consisted of patients who were found to be azoospermic after the first ejaculation obtained by penile vibratory stimulation (PVS) and who had subsequent ejaculates obtained by PVS. Group 2 (n ¼ 8) consisted of patients who were found to be azoospermic after the first ejaculation obtained by PVS and who had subsequent ejaculates obtained by electroejaculation (EEJ). Group 3 (n ¼ 18) consisted of patients who were found to be azoospermic after the first ejaculation obtained by EEJ and who had subsequent ejaculates obtained by EEJ. Results: In group 1 (PVS-PVS), the second ejaculate contained sperm in none of the 15 patients. In group 2 (PVS-EEJ), the second ejaculate contained sperm in three of eight patients. In group 3 (EEJ-EEJ), the second EEJ resulted in semen with sperm in 6 of 18 patients. In the 388 study subjects, the overall prevalence of azoospermia was 7.0%. Conclusion: In a study of a large group of subjects with SCI, the vast majority had normal sperm concentrations. In the minority who were azoospermic on their first ejaculate, and who were past the acute phase of injury, obtaining a second ejaculate by EEJ versus PVS may be a reasonable step before proceeding to surgical sperm retrieval.

show abstract

Section: Methodsmentioning

confidence: 99%

“…2 According to our experience, application of this algorithm results in ejaculation in 97% of SCI patients. 3 The quality of semen obtained from men with SCI is usually poor. Low sperm motility and low sperm viability are the most common abnormalities.…”

Section: Introductionmentioning

confidence: 99%

The choice of assisted ejaculation method is relevant for the diagnosis of azoospermia in men with spinal cord injuries

et al. 2010

View full text Add to dashboard Cite

show abstract

“…У многих пациентов с АЭ сперматозоиды, при-годные для ВРТ, могут быть обнаружены в эяку-ляте, полученном при использовании пенильной вибростимуляции и электроэякуляции [14,15]. Вибростимуляцию целесообразно применять у па-циентов с сохраненной дугой рефлекса, состоящей из чувствительных афферентных волокон полово-го члена и эфферентных симпатических нервов, а также участков спинного мозга на уровне их входа (S2-S4) и выхода (Т10-Т12).…”

Section: оригинальные статьи 13unclassified

The infertility overcoming in men with retrograde ejaculation and anejaculation

et al. 2017

View full text Add to dashboard Cite

In this descriptive retrospective, single-center study, we analyzed the local database of 82 men treated for infertility due to retrograde ejaculation and anejaculation in the International Centre for Reproductive Medicine. Spermatozoa for IVF/ICSI cycles were retrieved from post-ejaculatory urine and by aspiration biopsies (PESA/TESA). An algorithm for diagnosis and treatment of infertile men with retrograde ejaculation and anejaculation has been suggested. (For citation: Korneyev IA, Zasseev RD. The infertility overcoming in men with retrograde ejaculation and anejaculation. Urologicheskie vedomosti. 2017;7(2):10-15. doi: 10.17816/uroved7210-15).

show abstract

“…Anterior lumbar approaches, particularly at the L5-S1 level, carry a greater potential for damage to the superior hypogastric sympathetic plexus, which innervates the internal vesicle sphincter muscle. Other etiologies of RE including diabetes, benign prostate hypertrophy and its treatment, multiple sclerosis, pelvic trauma, and pelvic or rectal surgery [1][2][3][4][5][6]. RE following anterior lumbar spine surgery is also purported to be related to the surgical approach [7][8][9].…”

Section: Point-counterpointmentioning

confidence: 99%

Point-counter-point debate: the association between recombinant human bone morphogenetic protein utilization and complications in spine surgery

Siemionow

Sundberg

Tyrakowski³

et al. 2014

Curr Rev Musculoskelet Med

View full text Add to dashboard Cite

Bone morphogenetic proteins (BMPs) have been utilized in spine surgery for over 10 years as a bone graft substitute. Potential BMP-related adverse effects including retrograde ejaculation and heterotopic neuroforaminal bone formation have been described. Additionally, some studies have suggested an association between BMP and cancer. Inconsistencies exist in the published spine literature with regards to the incidence and association of complications with BMP utilization. In a point-counterpoint format, this article discusses the current evidence concerning the relationship between the utilization of BMP in spinal fusion and the risk of cancer, retrograde ejaculation (RE), neuroforaminal bone formation, and its role in anterior cervical spine surgery and adolescents.Keywords Bone morphogenetic protein . Retrograde ejaculation . Anterior cervical fusion . Neuroforaminal bone growth . Cancer Point-counterpointRetrograde Ejaculation (RE) RE occurs secondary to impaired function of the internal vesicle sphincter muscle. Anterior lumbar approaches, particularly at the L5-S1 level, carry a greater potential for damage to the superior hypogastric sympathetic plexus, which innervates the internal vesicle sphincter muscle. Other etiologies of RE including diabetes, benign prostate hypertrophy and its treatment, multiple sclerosis, pelvic trauma, and pelvic or rectal surgery [1][2][3][4][5][6]. RE following anterior lumbar spine surgery is also purported to be related to the surgical approach [7][8][9].Burkus et al first published a prospective, randomized, nonblinded FDA-approved study concerning the use of rhBMP-2 in ALIF [8]. Six males (4.1 %; 6/146) reported RE following surgery, of which 4 underwent a transperitoneal approach (TPA) (13.3 %; 4 of all 30 males that underwent TPA) and 2 underwent a retroperitoneal approach (RPA) (1.8 %; 2 of 116 males that underwent RPA). Since the difference in RE between the TPA and RPA groups was statistically significant the authors concluded that a TPA was associated with a higher risk of RE. No comparison in RE between the investigational and control group was performed. The reported differences between the 2 approaches persisted at the 2-year follow-up period [10]. However, in 2010 Smoljanovic et al reviewed the data by Burkus et al [11] and reported that all 6 patients with RE had received rhBMP-2. Thus, the prevalence of RE in the investigational group (rhBMP-2) would have been 7.7 % (6/78 males), which was significantly greater than the control group (ICBG). The reason for ignoring the relationship between RE and rhBMP-2 was questioned, which sparked an intense debate over the potential association between the utilization of rhBMP-2 and RE.Correlation between rhBMP-2 utilization and RE Curr Rev Musculoskelet Med (2014) 7:200-207 DOI 10.1007/s12178-014-9219-x patients (7.2 %) in the rhBMP-2 group developed RE while only 1 of 174 patients (0.6 %; 1/69) reported RE in the control group. Significant differences in RE were also evident among patients that underwent a singl...

show abstract

Treatment for Ejaculatory Dysfunction in Men With Spinal Cord Injury: An 18-Year Single Center Experience

Abstract: Sperm can be easily obtained nonsurgically from most men with spinal cord injury. Sufficient sperm are available for simple insemination procedures. A treatment algorithm based on our experience is presented.

Cited by 120 publications

References 24 publications

The choice of assisted ejaculation method is relevant for the diagnosis of azoospermia in men with spinal cord injuries

The choice of assisted ejaculation method is relevant for the diagnosis of azoospermia in men with spinal cord injuries

The infertility overcoming in men with retrograde ejaculation and anejaculation

Point-counter-point debate: the association between recombinant human bone morphogenetic protein utilization and complications in spine surgery

Contact Info

Product

Resources

About