Rutkowski S B, Middleton J W, Truman G, Hagen D L, Ryan J P
Spinal Injuries Unit, Royal North Shore Hospital, St Leonards, New South Wales, Australia.
Paraplegia. 1995 May;33(5):263-6. doi: 10.1038/sc.1995.59.
Male infertility is a well recognised problem following spinal cord injury. The techniques of vibration induced ejaculation and transrectal electroejaculation have significantly increased the likelihood of sperm retrieval in spinal cord injured males; however, the reproductive capacity remains markedly reduced due to poor semen quality. The Spinal Injuries Unit at Royal North Shore Hospital has developed a programme to achieve seminal emission and enhance fertility. This study analysed the results of the first sample obtained at stimulation in 70 spinal cord injured males with respect to procedure performed, neurological level, completeness of lesion, bladder management, infection, age and duration since injury. Our study demonstrated that bladder management and neurological level were significant factors affecting the presence of motile sperm. Individuals managing their neuropathic bladder by catheter (intermittent self-catheterisation, indwelling urethral or suprapubic catheter) had significantly enhanced semen quality compared to those voiding by reflex or straining. Differences were also noted within the catheter group itself with intermittent self-catheterisation achieving a higher percentage of motile sperm present.
男性不育是脊髓损伤后一个广为人知的问题。振动诱导射精和经直肠电射精技术显著提高了脊髓损伤男性获取精子的可能性；然而，由于精液质量差，其生殖能力仍明显降低。皇家北岸医院的脊髓损伤科制定了一项计划，以实现射精并提高生育能力。本研究分析了70名脊髓损伤男性在刺激时获取的首个样本的结果，涉及所进行的操作、神经平面、损伤的完整性、膀胱管理、感染、年龄以及受伤后的时长。我们的研究表明，膀胱管理和神经平面是影响活动精子存在的重要因素。与通过反射或用力排尿的人相比，通过导尿管（间歇性自我导尿、留置尿道或耻骨上导尿管）管理神经源性膀胱的个体精液质量显著提高。在导尿管组内部也观察到差异，间歇性自我导尿时活动精子的比例更高。
