Electroejaculation in patients with spinal cord injury: first report of a large-scale experience from Japan.
BACKGROUND
Ejaculatory dysfunction is a substantial obstacle for spinal cord-injured men who have a desire to father their own children. Electroejaculation can potentially solve this problem. Recently, Halsted et al. reported outstanding results of the rectal probe electrostimulation (RPE) using newly developed equipment (Seager Model). In this paper, we report the first large-scale clinical trial in Japan of RPE for spinal cord-injured men.


METHODS
RPE using the Seager Model was attempted on 328 occasions in 53 patients with an age range of 19-47 years; 1-38 years had elapsed since injury.


RESULTS
Antegrade ejaculation was obtained in 46 patients (86.8%). Ninety-three percent of patients with upper motor neuron lesion-type neurogenic bladder produced antegrade ejaculation by RPE, whereas the rate in patients with lower motor neuron lesion type one was 63.6% (P < 0.05). Semen analyses revealed affected sperm motility rate as low as 17.2%. Artificial insemination from these husbands (AIH) was attempted on 54 occasions in 11 wives of the patients. On April 2, 1992, we had the first recorded birth in Japan with the assistance of RPE and AIH. On July 21, 1993, we had another successful birth.


CONCLUSIONS
These promising results will encourage Japanese researchers to use electro-ejaculation, although the low success rate in patients with lower motor neuron lesion-type neurogenic bladder and the low motility of the sperm are obstacles to be overcome.
Momose
H
H
Department of Urology, Nara Medical University, Kashihara, Japan.
Hirao
Y
Y
Yamamoto
M
M
Yamada
K
K
Okajima
E
E
D000328:Adult; D004542:Ejaculation / Q000502:physiology; D004599:Electric Stimulation Therapy; D005260:Female; D006801:Humans; D007248:Infertility, Male / Q000209:etiology / Q000503:physiopathology / Q000628:therapy*; D007317:Insemination, Artificial, Homologous; D007564:Japan; D008297:Male; D008875:Middle Aged; D011247:Pregnancy; D012099:Reproductive Techniques; D012189:Retrospective Studies; D013076:Sperm Count; D013081:Sperm Motility / Q000502:physiology; D013094:Spermatozoa / Q000502:physiology; D013119:Spinal Cord Injuries / Q000150:complications* / Q000503:physiopathology