| Treatment of infertility in men with spinal cord injury. | |
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MedLine Citation:
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PMID: 20157304 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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Most men with spinal cord injury (SCI) are infertile. Erectile dysfunction, ejaculatory dysfunction and semen abnormalities contribute to the problem. Treatments for erectile dysfunction include phosphodiesterase type 5 inhibitors, intracavernous injections of alprostadil, penile prostheses, and vacuum constriction devices. In anejaculatory patients who wish to father children, semen retrieval is necessary. Penile vibratory stimulation is recommended as the first line of treatment. Patients who fail penile vibratory stimulation can be referred for electroejaculation. If this approach is not possible, prostate massage is an alternative. Surgical sperm retrieval should be considered as a last resort when other methods fail. Most men with SCI have a unique semen profile characterized by normal sperm count but abnormally low sperm motility. Scientific investigations indicate that accessory gland dysfunction and abnormal semen constituents contribute to the problem. Despite abnormalities, sperm from men with SCI can successfully induce pregnancy. In selected couples, the simple method of intravaginal insemination is a viable option. Another option is intrauterine insemination. The efficacy of intrauterine insemination increases as the total motile sperm count inseminated increases. In vitro fertilization and intracytoplasmic sperm injection are options in cases of extremely low total motile sperm count. Reproductive outcomes for SCI male factor infertility are similar to outcomes for general male factor infertility. |
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Authors:
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Nancy L Brackett; Charles M Lynne; Emad Ibrahim; Dana A Ohl; Jens Sønksen |
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Publication Detail:
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Type: Journal Article; Review Date: 2010-02-16 |
Journal Detail:
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Title: Nature reviews. Urology Volume: 7 ISSN: 1759-4820 ISO Abbreviation: Nat Rev Urol Publication Date: 2010 Mar |
Date Detail:
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Created Date: 2010-03-11 Completed Date: 2010-10-28 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 101500082 Medline TA: Nat Rev Urol Country: England |
Other Details:
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Languages: eng Pagination: 162-72 Citation Subset: IM |
Affiliation:
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The Miami Project to Cure Paralysis, University of Miami Miller School of Medicine, Lois Pope Life Center, 1095 Northwest 14th Terrace, Miami, FL 33136, USA. nbrackett@miami.edu |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Erectile Dysfunction
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etiology,
therapy Humans Infertility, Male / etiology*, therapy* Male Spinal Cord Injuries / complications*, therapy* Treatment Outcome |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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