Miami Project to Cure Paralysis and Department of Urology (CML), University of Miami Miller School of Medicine, Miami, Florida 33136, USA.
J Urol. 2010 Nov;184(5):2073-7. doi: 10.1016/j.juro.2010.06.112. Epub 2010 Sep 17.
In a longitudinal study we examined changes in semen quality with time during the chronic phase of spinal cord injury.
Included in this study were 87 men with spinal cord injury who underwent 2 or more semen retrieval procedures with a minimum of 3 years between the first and last procedures. Patients were selected from our database of 500 with spinal cord injury who were volunteers enrolled in the Male Fertility Research Program of the Miami Project to Cure Paralysis from January 1, 1991 through April 31, 2009. Semen was collected by masturbation, penile vibratory stimulation or electroejaculation. Semen analysis was done according to WHO criteria. We used a statistical generalized linear mixed model to analyze changes in sperm concentration, total sperm count, total motile sperm count and sperm motility with time.
Mean patient age was 30.1 years (range 16 to 48) and mean time after injury at the initial sperm retrieval procedure was 7.1 years (range 1 to 26). Sperm concentration decreased slightly with time but all other parameters were unchanged, including total sperm count, indicating a stable, null pattern in measures with time.
Semen quality does not show clinically significant progressive changes during years after injury in men with spinal cord injury. This information is relevant for urologists who counsel these patients on family planning. Also, routine sperm freezing for fertility preservation is not indicated in this patient population.
在一项纵向研究中,我们考察了慢性脊髓损伤期间精液质量随时间的变化。
本研究纳入了 87 名脊髓损伤男性患者,他们在第一次和最后一次精液采集之间至少间隔 3 年,进行了 2 次或更多次精液采集。这些患者均选自我们数据库中 500 名脊髓损伤志愿者,他们于 1991 年 1 月 1 日至 2009 年 4 月 31 日期间自愿加入迈阿密瘫痪治愈研究计划中的男性生育研究项目。精液通过自慰、阴茎振动刺激或电刺激采集。精液分析按照世界卫生组织(WHO)标准进行。我们使用统计广义线性混合模型分析了精子浓度、总精子数、总活力精子数和精子活力随时间的变化。
患者平均年龄为 30.1 岁(16-48 岁),首次精液采集时损伤后平均时间为 7.1 年(1-26 年)。精子浓度随时间略有下降,但其他所有参数均未改变,包括总精子数,表明各项指标随时间呈稳定的零模式变化。
脊髓损伤男性在损伤后数年,精液质量并未显示出临床上显著的渐进性变化。这一信息对于为这些患者提供生育计划咨询的泌尿科医生很重要。此外,在该患者群体中,常规精子冷冻保存用于生育力保存并不合适。