Document Detail


Side effects of intradetrusor botulinum toxin injections on ejaculation and fertility in men with spinal cord injury: preliminary findings.
MedLine Citation:
PMID:  21981647     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To investigate the effect of botulinum neurotoxin A on ejaculation potential and fertility. Intradetrusor injection of botulinum neurotoxin A is most commonly used nowadays to treat overactive bladder in patients with spinal cord injury (SCI).
PATIENTS AND METHODS: Retrospective analyses were carried out of 11 patients with complete lesions from C5 to T6 who had received botulinum (BT) injections for their overactive bladder and who had undergone ejaculation tests before and after BT treatment.
RESULTS: BT treatment was found effective in improving bladder function in up to 85% of the cases. While no patients maintained natural ejaculation following their SCI, BT treatment was found to increase the incidence of retrograde ejaculation (vibrostimulation) in 46% of cases and to diminish semen volume in 77% of cases, from an average of 1.8 mL to 1 mL. Semen quality was slightly improved following BT treatment, sperm mobility increased in 67% of cases, sperm vitality in 50% and semen culture improved in 43%.
CONCLUSIONS: BT treatment has beneficial and detrimental effects on ejaculation function. The detrimental effects involve retrograde ejaculation and reduced semen volume, which are explained by the spread of toxin to the bladder neck, reducing its tonus, and to the smooth muscle sexual accessory organs, reducing the strength of their contraction. The beneficial effects are explained by the reduced contamination of the semen by urinary infection, which may improve spermatogenesis and subsequent semen quality. The results are discussed in terms of their clinical implications and advice to patients.
Authors:
Romain Caremel; Frédérique Courtois; Kathleen Charvier; Alain Ruffion; Nicolas Morel Journel
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Publication Detail:
Type:  Journal Article     Date:  2011-10-07
Journal Detail:
Title:  BJU international     Volume:  109     ISSN:  1464-410X     ISO Abbreviation:  BJU Int.     Publication Date:  2012 Jun 
Date Detail:
Created Date:  2012-05-08     Completed Date:  2012-08-06     Revised Date:  2013-03-21    
Medline Journal Info:
Nlm Unique ID:  100886721     Medline TA:  BJU Int     Country:  England    
Other Details:
Languages:  eng     Pagination:  1698-702     Citation Subset:  IM    
Copyright Information:
© 2011 THE AUTHORS. BJU INTERNATIONAL © 2011 BJU INTERNATIONAL.
Affiliation:
Hospices civils de Lyon, Route de Vourles, Saint-Genis Laval, France.
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MeSH Terms
Descriptor/Qualifier:
Adult
Botulinum Toxins, Type A / administration & dosage,  adverse effects*
Ejaculation / drug effects*
Fertility / drug effects*
Humans
Injections, Intramuscular
Male
Neuromuscular Agents / administration & dosage,  adverse effects*
Retrospective Studies
Semen Analysis
Spinal Cord Injuries / complications*,  physiopathology
Urinary Bladder, Overactive / drug therapy*,  etiology,  physiopathology
Urodynamics
Young Adult
Chemical
Reg. No./Substance:
0/Neuromuscular Agents; EC 3.4.24.69/Botulinum Toxins, Type A
Comments/Corrections
Comment In:
J Urol. 2013 Mar;189(3):1038-9   [PMID:  23394665 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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