脊髓损伤男性的精囊抽吸：对精子质量差的深入了解。

Seminal vesicle aspiration in spinal cord injured men: insight into poor sperm quality.

作者信息

Ohl D A, Menge A C, Jarow J P

机构信息

Department of Surgery, University of Michigan, Ann Arbor, USA.

出版信息

J Urol. 1999 Dec;162(6):2048-51. doi: 10.1016/S0022-5347(05)68097-4.

DOI:10.1016/S0022-5347(05)68097-4

PMID:10569566

Abstract

PURPOSE

In men with spinal cord injury poor quality semen is seen when performing electroejaculation and penile vibratory stimulation. We determined whether sperm stasis within the seminal vesicles is a potential cause of this problem.

MATERIALS AND METHODS

Seminal vesicle aspiration was performed immediately before electroejaculation or penile vibratory stimulation in men with aspermia secondary to spinal cord injury. Sperm count and quality of seminal vesicle aspiration and subsequent ejaculation were compared with historical ejaculated counts, ultrasound findings and patient characteristics.

RESULTS

Mean total number of right plus left seminal vesicle sperm plus or minus standard deviation was 511 +/- 960 x 10(6). Mean total number of sperm obtained by seminal vesicle plus electroejaculation or penile vibratory stimulation was 918 +/- 1,261 x 10(6). Average motility and viability of the seminal vesicle aspirated sperm were 1.3 and 3.2%, respectively. Average motility of the ejaculated sperm was 26.4% after seminal vesicle aspiration versus 16.3% in previous ejaculation induction procedures performed in the same patients. Seminal vesicle aspirated sperm represented 66% of the total number of sperm obtained during the session and was equal to 49% of the sperm obtained at previous electroejaculation or penile vibratory stimulation sessions. The period of abstinence correlated only with ejaculate count (simple regression p = 0.009). No other clinical characteristics had any effect on sperm count or quality.

CONCLUSIONS

Large numbers of poor quality sperm are present within the seminal vesicles of spinal cord injured men and these sperm comprise a large portion of the specimens collected by electroejaculation or penile vibratory stimulation. This phenomenon is independent of the period of abstinence, implicating disordered storage of sperm due to spinal cord injury rather than infrequent ejaculation. The large number of senescent sperm within the seminal vesicles appears to be a primary cause of poor sperm quality in spinal cord injured men.

摘要

目的

在脊髓损伤男性中，进行电射精和阴茎振动刺激时会出现精液质量差的情况。我们确定精囊内精子淤滞是否是该问题的潜在原因。

材料与方法

对因脊髓损伤导致无精子症的男性，在电射精或阴茎振动刺激前立即进行精囊抽吸。将精囊抽吸液和随后射精的精子计数及质量与既往射精计数、超声检查结果和患者特征进行比较。

结果

左右精囊精子总数的平均值±标准差为511±960×10⁶。通过精囊抽吸加电射精或阴茎振动刺激获得的精子总数平均值为918±1261×10⁶。精囊抽吸精子的平均活力和存活率分别为1.3%和3.2%。精囊抽吸后射精精子的平均活力为26.4%，而在同一患者先前的射精诱导程序中为16.3%。精囊抽吸精子占该时段获得精子总数的66%，相当于先前电射精或阴茎振动刺激时段获得精子的49%。禁欲时间仅与射精量相关（简单回归p = 0.009）。没有其他临床特征对精子计数或质量有任何影响。