Stien Ragnar
Tidsskr Nor Laegeforen. 2008 Feb 14;128(4):453-6.
Spinal injuries may disturb men's sexual functions in various ways.
Review article based on extensive clinical experience, lecturing, research and selected articles.
A spinal injury may disrupt or disturb the connection between the brain's main centres for sexual function to the genitals. This often leads to extensive problems with erection, ejaculation, orgasm and fertility. Hormonal affection of sexuality is not much altered. Libido problems are of a more psychological nature, such as a poor self-esteem and lack of understanding from the surroundings. Sedative effects of medicines affect all aspects of sexuality. About 80% of men with spinal injuries have erection problems; mainly erection of short duration that can be treated with medicines administered orally (such as phosphodiesterase inhibitors) or by self injection of alpha-adrenergic inhibitors directly into the sinusoids in the penis. Only 10-15% ejaculate spontaneously. Ejaculation may be assisted in various ways, the vibro-ejaculation method being the most effective. The semen quality is reduced, possibly because of altered neurogen control of sperm maturation. Modern techniques for in vitro fertilisation combined with assisted ejaculation and careful control of the semen quality, has made it possible for most spinal-injured men to have their own children.
脊髓损伤可能以多种方式干扰男性的性功能。
基于广泛临床经验、讲座、研究及精选文章撰写的综述文章。
脊髓损伤可能破坏或干扰大脑中主要性功能中枢与生殖器之间的联系。这常常导致勃起、射精、性高潮及生育方面的广泛问题。性激素对性功能的影响改变不大。性欲问题更多具有心理性质，比如自尊低下以及缺乏周围人的理解。药物的镇静作用会影响性功能的各个方面。约80%的脊髓损伤男性存在勃起问题；主要是持续时间短的勃起，可通过口服药物（如磷酸二酯酶抑制剂）或直接向阴茎海绵体注射α-肾上腺素能抑制剂进行治疗。只有10 - 15%的人能自然射精。射精可通过多种方式辅助，其中振动射精法最为有效。精液质量下降，可能是由于对精子成熟的神经原控制改变所致。现代体外受精技术结合辅助射精及对精液质量的仔细把控，使大多数脊髓损伤男性有可能拥有自己的孩子。
