Male sexual dysfunction and infertility associated with neurological disorders

Authors

Mikkel Fode, University of Copenhagen
Sheila Krogh-Jespersen, Department of Psychology, Florida International University
Nancy L. Beckett, University of Miami
Dana A. Ohl, University of Michigan
Charles M. Lynn, University of Miami
Jens Sønksen, University of Copenhagen

Date of this Version

1-2012

Document Type

Article

Abstract

Normal sexual and reproductive functions depend largely on neurological mechanisms. Neurological defects in men can cause infertility through erectile dysfunction, ejaculatory dysfunction and semen abnormalities. Among the major conditions contributing to these symptoms are pelvic and retroperitoneal surgery, diabetes, congenital spinal abnormalities, multiple sclerosis and spinal cord injury. Erectile dysfunction can be managed by an increasingly invasive range of treatments including medications, injection therapy and the surgical insertion of a penile implant. Retrograde ejaculation is managed by medications to reverse the condition in mild cases and in bladder harvest of semen after ejaculation in more severe cases. Anejaculation might also be managed by medication in mild cases while assisted ejaculatory techniques including penile vibratory stimulation and electroejaculation are used in more severe cases. If these measures fail, surgical sperm retrieval can be attempted. Ejaculation with penile vibratory stimulation can be done by some spinal cord injured men and their partners at home, followed by in-home insemination if circumstances and sperm quality are adequate. The other options always require assisted reproductive techniques including intrauterine insemination or in vitro fertilization with or without intracytoplasmic sperm injection. The method of choice depends largely on the number of motile sperm in the ejaculate.

DOI

10.1038/aja.2011.70

Identifier

FIDC002634

Creative Commons License

This work is licensed under a Creative Commons Attribution-Noncommercial-Share Alike 3.0 License.

Comments

Originally published in the Asian Journal of Andrology .

Recommended Citation

Asian Journal of Andrology (2012) 14, 61–68; doi:10.1038/aja.2011.70;