Erectile Function and Fertility in Patients With Spinal Cord Injury

Abstract

Spinal cord injury (SCI) is predominantly seen in young men with the average patient age of 32 years. Ejaculation and erection disorders are common consequences of SCI, and result in decreased sexual satisfaction. Treatment modalities for erectile dysfunction in patients with SCI are similar to treatments for those without SCI. Some of the most common treatment modalities for the management of erectile dysfunction include penile implants, oral phosphodiesterase type 5 inhibitors, vacuum devices, intraurethral prostaglandins and intracavernous injections. Reproductive dysfunction in men with SCI is the result of combination of erectile dysfunction, ejaculatory failure, and abnormal semen parameters. The first line of therapy for infertility in men with SCI is collection of semen. Penile vibratory stimulation and electroejaculation are both effective in the treatment of ejaculatory dysfunction. In selected patients, intravaginal and intrauterine insemination and in patients with extremely low total motile sperm count, In vitro fertilization and intracytoplasmic sperm injection are feasible option for the treatment of infertility.