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.

Miami Project to Cure Paralysis and Department of Urology (CML), University of Miami Miller School of Medicine, Miami, Florida

Study received institutional review board approval.

Supported by The Miami Project to cure Paralysis and the State of Florida Department of Health.

For another article on a related topic seepage 2451.

^*Correspondence: Miami Project to Cure Paralysis, University of Miami Leonard M. Miller School of Medicine, Miami, Florida 33136; e-mail: [email protected].

Submitted for publication October 8, 2009

Journal of Urology 183(6):p 2304-2308, June 2010.

Purpose

In what is to our knowledge the largest study of its kind to date we retrospectively reviewed the records of 3,152 semen retrieval procedures in a total of 500 men with spinal cord injury to make recommendations to the medical field on ejaculatory dysfunction treatment in this specialized patient population.

Materials and Methods

We retrospectively studied data from 1991 to 2009 in the Miami Project to Cure Paralysis male fertility research program at our institution. We assessed the semen retrieval success rate and semen quality.

Results

Of the 500 men 9% could ejaculate by masturbation. Penile vibratory stimulation was successful in 86% of patients with a T10 or rostral injury level. Electroejaculation was successful in most cases of failed penile vibratory stimulation. Sperm were obtained without surgical sperm retrieval, in 97% of patients completing the treatment algorithm. Total motile sperm counts exceeded 5 million in 63% of cases.

Conclusions

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.