Clinical Experience with Electroejaculation in Anejaculatory Spinal Cord Injured Men Who Failed in Chemoejaculation Using Physostigmine

Choi, Ho Cheol; Park, Won Hee; Shim, Hong Bang

Abstract

About 85-97% of patients get to lose an ejaculatory function with a little difference according to the level of spinal cord injury. Fifty eight trials of electroejaculation stimulation were performed in total 17 patients that failed in chemoejaculation with physostigmine. Mean age was 36.9 years. Of the 17 spinal cord injured patients, 1 had cervical, 13 thoracic 3 lumbar paraplegia; 7 had complete and 10 had incomplete lesions. Semens could be obtained in 14 patients ( 82.4%) among total 17 patients and in 51 of total 58 trials( 87.9%). Average total sperm counts and motile sperm numbers were 35.98 x 106 and 6.09 x 106 respectively in the obtained semen. However, motility was very poor. We performed more than 4 trials in 6 patients, but there results were not predictable. Two pregnancies were achieved in their spouse after an artificial insemination. Side effects were trivial. and there were lower abdominal discomforts or pains in 7 patients among incomplete paraplegics. In conclusion we could expect high successful rates of ejaculation in anejaculatory spinal cord injured patients by electroejaculation stimulation in case of the failure in chemoejaculation. However, we suggest that in vitro fertilization with advanced recent technology should be tried with adequate preparation after an experimental electroejaculation, because a quality of sperm motility was very poor and sperm motility was not improved after several trials.