Abstract
Male infertility is a well recognised problem following spinal cord injury. The techniques of vibration induced ejaculation and transrectal electroejaculation have significantly increased the likelihood of sperm retrieval in spinal cord injured males; however, the reproductive capacity remains markedly reduced due to poor semen quality. The Spinal Injuries Unit at Royal North Shore Hospital has developed a programme to achieve seminal emission and enhance fertility. This study analysed the results of the first sample obtained at stimulation in 70 spinal cord injured males with respect to procedure performed, neurological level, completeness of lesion, bladder management, infection, age and duration since injury. Our study demonstrated that bladder management and neurological level were significant factors affecting the presence of motile sperm. Individuals managing their neuropathic bladder by catheter (intermittent self-catheterisation, indwelling urethral or suprapubic catheter) had significantly enhanced semen quality compared to those voiding by reflex or straining. Differences were also noted within the catheter group itself with intermittent self-catheterisation achieving a higher percentage of motile sperm present.
Similar content being viewed by others
Article PDF
References
Home M W, Paull D P, Munro D . Fertility studies in the human male with traumatic injuries of the spinal cord and cauda equina. New Engl J Med 1948; 237: 959–961.
Talbot H S . The sexual function in paraplegia. J Urol 1955; 73: 91–100.
Bors E, Comarr E . Neurological disturbances of sexual function with special reference to 529 patients with spinal cord injury. Urol Surv 1960; 10: 191–222.
Linsenmeyer T A, Perkash I . Infertility in men with spinal cord injury. Arch Phys Med Rehabil 1991; 72: 747–754.
Wolff H et al. Leukocytospermia associated with poor semen quality. Fertil Steril 1990; 53: 528–536.
Ohl D A et al. Predictors of success in electroejaculation of spinal cord injured men. J Urol 142: 1483–1486.
Brindley G S (1984) The fertility of men with spinal injuries. Paraplegia 1984; 22: 337–348.
Hosmer D W, Lemeshow S . Applied logistic regression. John Wiley & Sons: New York, 1989.
Norusis M J . SPSS for Windows Advanced Statistics Release 6.0. SPSS Inc: Chicago, 1993.
Brindley G S . Physiology of erection and management of paraplegic infertility. In: TB Hargreave (ed). Male Infertility. Springer Verlag: Berlin, 1983, pp 261–279
Crich J P, Jequier A M . Infertility in men with retrograde ejaculation: The action of urine on sperm motility, and a simple method for achieving antegrade ejaculation. Fertil Steril 1978; 30: 572–576.
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Rutkowski, S., Middleton, J., Truman, G. et al. The influence of bladder management on fertility in spinal cord injured males. Spinal Cord 33, 263–266 (1995). https://doi.org/10.1038/sc.1995.59
Issue Date:
DOI: https://doi.org/10.1038/sc.1995.59