Di Bello Francesco, Creta Massimiliano, Napolitano Luigi, Califano Gianluigi, Passaro Francesco, Morra Simone, Giovanni Angelo di, Fusco Giovanni Maria, Cirillo Luigi, Abate Marco, Morgera Vincenzo, Cacace Gianluigi, De Luca Luigi, Spena Gianluca, Collà Ruvolo Claudia, Calace Francesco Paolo, Manfredi Celeste, La Rocca Roberto, Celentano Giuseppe, Turco Carmine, Capece Marco, D'Alterio Carlo, Giordano Alessandro, Mauro Ernesto di, Trama Francesco, Amicuzi Ugo, Arcaniolo Davide, Fusco Ferdinando, Longo Nicola
Department of Neurosciences, Reproductive Sciences and Odontostomatology, Urology Unit, University of Naples "Federico II", 80138 Napoli, Italy.
Urology Unit, Department of Woman, Child and General and Specialized Surgery, University of Campania "Luigi Vanvitelli", 80138 Naples, Italy.
J Pers Med. 2022 May 26;12(6):873. doi: 10.3390/jpm12060873.
Spinal cord injury (SCI) is a relevant medical and social problem. According to the World Health Organization, the commonly estimated worldwide annual incidence of SCI is 40 to 80 cases per million population. After the SCI experience, most men present with sexual dysfunction (erectile dysfunction (ED) and ejaculatory dysfunction), fertility problems (such as impaired spermatogenesis, abnormalities in sperm viability, motility, and morphology), and systemic disorders such as genitourinary infection and endocrine imbalances. The best options available for managing the ejaculatory disorders in patients suffering from SCI are penile vibratory stimulation (PVS) and electroejaculation (EEJ). Furthermore, the treatment of ED in SCI patients consists of medical therapies including phosphodiesterase 5 inhibitors (PDE5i), intracavernosal injections (ICI), vacuum erection devices (VEDs), and surgical as penile prosthesis (PP). This review provides a snapshot of the current evidence for the mechanisms of sexual dysfunction and infertility in SCI patients, discusses the best management strategies for these conditions, and offers our perspective on the direction of future research.
脊髓损伤（SCI）是一个重要的医学和社会问题。根据世界卫生组织的数据，全球范围内脊髓损伤的年发病率通常估计为每百万人口40至80例。经历脊髓损伤后，大多数男性会出现性功能障碍（勃起功能障碍（ED）和射精功能障碍）、生育问题（如精子发生受损、精子活力、运动能力和形态异常）以及泌尿生殖系统感染和内分泌失调等全身性疾病。治疗脊髓损伤患者射精障碍的最佳选择是阴茎振动刺激（PVS）和电射精（EEJ）。此外，脊髓损伤患者勃起功能障碍的治疗包括药物治疗，如磷酸二酯酶5抑制剂（PDE5i）、海绵体内注射（ICI）、真空勃起装置（VEDs）以及手术治疗，如阴茎假体（PP）。本综述概述了目前关于脊髓损伤患者性功能障碍和不育机制的证据，讨论了这些病症的最佳管理策略，并对未来研究方向提出了我们的观点。
