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Male Fertility After A Spinal Cord Injury

Following a spinal cord injury, it is common for men to experience changes in their sexual function and fertility. These changes may include:

  • Changes in erection and ejaculation function including erectile dysfunction;
  • Decreased or absent sensation and movement below the level of injury;
  • Heightened sensitivity in areas above the level of injury; and/or
  • Semen abnormalities.

These changes may result in complete infertility or impaired fertility. However, the symptoms and degree of infertility can vary depending on the type and severity of the spinal cord injury.

The physicians and staff at the Center for Men’s Health at TUCC work closely with Craig Hospital and Dr. William Schoolcraft at the Colorado Center for Reproductive Medicine to develop fertility treatment programs for men with spinal cord injuries and their partners. We have a proven track record of successful microsurgical procedures for these men, with 20-30 microsurgical sperm retrievals performed an annual basis.

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Diagnosing Infertility

To diagnose infertility following a spinal cord injury, we will discuss any symptoms the patient is experiencing as well as the actual injury. Tests on semen levels and reproductive function will be run in order to determine the most effective treatment option available.

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Treatments

The Center for Men’s Health at TUCC offers a number of treatment options to help counter impaired fertility following a spinal cord injury. There are three main issues treated in men with spinal cord injuries: erectile dysfunction, sperm retrieval and sperm abnormalities.

Though an erection is not necessary for fertility, treating erectile dysfunction allows couples to try for natural conception, which can occur in up to 10 percent of cases in which the male partner has a spinal cord injury. Treatments for erectile dysfunction include prescription medication such as Viagra, Levitra and Cialis, self-injected medication, urethral suppositories or vacuum erection devices. In more severe cases, surgical treatments may also be an option. Surgical procedures used to treat erectile dysfunction include penile implants, which involve the insertion of malleable or inflatable rods into the penis, and vascular reconstructive surgery, a procedure that improves blood flow to the penis.

Many men with spinal cord injuries are unable to ejaculate and therefore require medical assistance to procure sperm for fertility purposes. Some methods assist ejaculation to obtain semen, while others bypass ejaculation and retrieve sperm surgically. For more difficult cases, surgical sperm retrieval (MESA and TESE) is the best option. Penile Vibratory Stimulation (PVS) is usually the first option for sperm retrieval. It is considered safe, reliable and cost-effective.

 

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