Wei Qun, Hong Xia, He Yu, Wang Zilian
Nursing Department, College of Medicine, Sir Run Run Shaw Hospital, Zhejiang University, Qingchun East Road No.3, Hangzhou, Zhejiang Province, 310016, People's Republic of China.
Basic Clin Androl. 2025 Sep 2;35(1):34. doi: 10.1186/s12610-025-00281-2.
High paraplegia, primarily affecting young men during their reproductive years, often results in ejaculatory dysfunction and infertility. Testicular sperm aspiration (TESA) combined with intracytoplasmic sperm injection (ICSI) offers a viable path to biological parenthood for this population. However, evidence on nursing strategies supporting such procedures is limited. This study aimed to evaluate the clinical and psychosocial outcomes of patients with high paraplegia due to spinal cord injury who underwent TESA-ICSI and explore the effectiveness of specialized nursing interventions.
A retrospective case series was conducted on nine male patients with high paraplegia treated at Sir Run Run Shaw Hospital (Zhejiang, China) between January 2021 and October 2023. The mean age of the patients was 31.89 ± 4.83 years, with injury durations ranging from 1 to 13 years. Psychological evaluations using the SAS, SDS, SSRS, and WHOQOL-BREF scales revealed that three patients had anxiety, four had depression, and most had moderate to high social support. The WHOQOL-BREF scores indicated generally good perceived quality of life (score range, 82-91). TESA was performed under local anesthesia, with perioperative nursing measures including bladder management, wound care, and infection prevention. Viable sperm were successfully retrieved in all cases without complications. Eight couples proceeded to ICSI, with viable embryos obtained in all. Six couples achieved pregnancy (66.7%)and live births. One case ended in miscarriage due to trauma, and one couple had no embryos suitable for transfer.
Comprehensive nursing interventions, including psychological support, ethical evaluation and procedural adaptations, may facilitate the successful application of TESA-ICSI in men with high paraplegia, highlighting the need for standardized interdisciplinary nursing protocols to optimize fertility outcomes in this underserved population.
高位截瘫主要影响处于生育年龄的年轻男性，常导致射精功能障碍和不育。睾丸精子抽吸术（TESA）联合卵胞浆内单精子注射（ICSI）为这一人群实现生物学意义上的为人父母提供了一条可行途径。然而，支持此类手术的护理策略的证据有限。本研究旨在评估因脊髓损伤导致高位截瘫并接受TESA-ICSI治疗的患者的临床和心理社会结局，并探讨专业护理干预措施的有效性。
对2021年1月至2023年10月期间在浙江大学医学院附属邵逸夫医院（中国浙江）接受治疗的9例高位截瘫男性患者进行了回顾性病例系列研究。患者的平均年龄为31.89±4.83岁，受伤时间为1至13年。使用SAS、SDS、SSRS和WHOQOL-BREF量表进行的心理评估显示，3例患者有焦虑情绪，4例有抑郁情绪，大多数患者有中度至高社会支持。WHOQOL-BREF评分表明总体生活质量感知良好（评分范围为82-91）。TESA在局部麻醉下进行，围手术期护理措施包括膀胱管理、伤口护理和感染预防。所有病例均成功获取了有活力的精子，无并发症发生。8对夫妇进行了ICSI，均获得了有活力的胚胎。6对夫妇成功怀孕（66.7%）并顺利分娩。1例因外伤流产，1对夫妇没有适合移植的胚胎。
综合护理干预措施，包括心理支持、伦理评估和程序调整，可能有助于TESA-ICSI在高位截瘫男性中的成功应用，这凸显了制定标准化跨学科护理方案以优化这一服务不足人群生育结局的必要性。
