Predictors of Success in Electroejaculation of Spinal Cord Injured Men

Ohl, Dana A.; Bennett, Carol J.; McCabe, Marcianna; Menge, Alan C.; McGuire, Edward J.

doi:10.1016/s0022-5347(17)39132-2

Cited by 111 publications

(41 citation statements)

References 10 publications

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“…Irrespective of the technique, the sperm quality has consistently been reported as poor in all series evaluating the semen of SCI men. [12][13][14][15][16] The sperm motility, forward progression and morphology are abnormal.…”

Section: Introductionmentioning

confidence: 99%

Effects of repeated ejaculations on semen characteristics following spinal cord injury

et al. 2005

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Study design: Prospective randomised controlled study. Objective: To evaluate the effects of repeated ejaculation on semen characteristics following spinal cord injury (SCI) in a prospective randomised controlled study. Setting: Spinal Research Centre, Stanmore, UK and Institute of Urology and Nephrology, London, UK. Methods: A total of 74 patients with SCI above T10 were tested by vibro-ejaculation using a Ferticare penile vibrator (Multicept A/S Horsholm, Denmark) using a standardised technique. The ejaculate was examined according to WHO protocol. The successfully vibro-ejaculated subjects (n ¼ 32) were randomised into a study group (n ¼ 18) and a control group (n ¼ 14). The patients in the study group vibro-ejaculated weekly for 3 months with semen analysis performed at baseline and then monthly. The control group vibro-ejaculated at baseline and at the end of the 3-month period. Two experienced observers performed the semen analysis independently. All measures were compared for statistical significance across the two groups at the beginning and at the end of the 3-month period using a two-tailed student t-test. Significance was determined at the 95% confidence interval (Po0.05). Results: In total, 10 patients in the study group and nine in the control group have completed the study so far. Six patients have dropped out of the study group and three from the control group for varied reasons. Two patients are currently enrolled in the study and control groups. The morphology and forward progression of sperm shows a statistically significant increase in the study group. The motility improves but is not statistically significant in the study group. No significant adverse effects were reported. Conclusions: We have shown in this unique randomised controlled study that repeated ejaculation does improve the sperm characteristics in SCI patients. It is suggested that SCI men should undergo repeated ejaculation for at least 3 months before trying intravaginal or intrauterine insemination techniques. If this fails then in vitro fertilisation can be used. This method promotes natural conception, is intimate and cost effective.

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Section: Introductionmentioning

confidence: 99%

Effects of repeated ejaculations on semen characteristics following spinal cord injury

et al. 2005

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“…2,6,7,17 In the present study, sperm quality was determined after repeated EEJ attempts, therefore, these 32 patients represent a group of SCI patients with poor reproductive prognosis. Quite often inappropriate management and treatments such as delayed treatment of accessory gland infections or repeated traumatic self-catheterizations may lead to either testicular failure or obstruction.…”

Section: Discussionmentioning

confidence: 99%

Testicular sperm retrieval and intra cytoplasmic sperm injection provide favorable outcome in spinal cord injury patients, failing conservative reproductive treatment

et al. 2013

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Study design: Retrospective cohort analysis. Objectives: The objective of this study was to determine the in vitro fertilization (IVF) outcome after testicular sperm extraction (TESE) in a group of spinal cord injury (SCI) male patients not compatible with conservative fertility treatment. Setting: University-affiliated medical center. Methods: Thirty two SCI patients (C2 to L2) were referred to IVF after repeated trials of electroejaculation (EEJ) or penile vibratory stimulation (PVS), and full andrological evaluation. Testicular sperm aspiration (TESA) was the method of choice for sperm extraction. Open TESE was performed only after a negative TESA attempt. Clinical pregnancy and live birth rates were determined. Results: A total of 106 testicular procedures were performed. Sperm was found in 95 cycles (89.6%). The average metaphase II (MII) oocyte number was 11.0 ± 4.2, an average of 5.1 ± 2.3 oocytes became normally fertilized after Intra Cytoplasmic Sperm Injection (ICSI) (fertilization rate 57.1%). On average, 2.7 ± 1.2 embryos were replaced. The clinical pregnancy rate was 32/106 (30.2%) per cycle and 19/32 (59.3%) per couple. Live birth rate was 62.5% (20/32). Conclusions: TESA/E and IVF can provide excellent prognosis for SCI patients that cannot be treated by EEJ or PVS.

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“…Semen was obtained from 20 normal, healthy and fertile controls following masturbation and 16 SCI patients undergoing either vibratory or electrostimulation to induce ejaculation as described by Sùnksen et al 6 and Ohl et al 7 Details about the patients included are given in Table 1. Before assisted ejaculation procedures a urine culture was performed in all SCI patients.…”

Section: Methodsmentioning

confidence: 99%

Seminal plasma PSA in spinal cord injured men: a preliminary report

et al. 1998

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Objective: The aim of the study was to evaluate the impact of spinal cord injury on seminal plasma PSA concentration. Material: Semen obtained from normal controls (n=20) and patients (n=16) with spinal cord injury. Results: The concentration of prostate speci®c antigen in seminal plasma depended on the level of spinal cord injury, with signi®cantly lower concentrations in patients with spinal cord lesions below T7 compared to both normal age-matched controls (P=0.007) and patients with spinal cord injuries at or above T7 (P=0.017). Conclusions:The results add to the previously reported observations of the possible impact of neurogenic stimulation on prostate activity. More studies of neurogenic stimulation in prostate growth and development are warranted to further elucidate the possible impact of neurogenic factors in the development of prostatic diseases.

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Predictors of Success in Electroejaculation of Spinal Cord Injured Men

Cited by 111 publications

References 10 publications

Effects of repeated ejaculations on semen characteristics following spinal cord injury

Effects of repeated ejaculations on semen characteristics following spinal cord injury

Testicular sperm retrieval and intra cytoplasmic sperm injection provide favorable outcome in spinal cord injury patients, failing conservative reproductive treatment

Seminal plasma PSA in spinal cord injured men: a preliminary report

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