Midodrine improves ejaculation in spinal cord injured men.
OBJECTIVE
We evaluated the effect of the alpha1-adrenergic agonist midodrine given orally for anejaculation in spinal cord injured men.


METHODS
A total of 185 spinal cord injured patients who reported absent ejaculation during sexual intercourse and who failed to respond to penile vibratory stimulation were treated with midodrine 30 to 120 minutes before a new stimulation. The procedure was repeated weekly, increasing doses by 7.5 mg to a maximum of 30 mg. Cardiovascular effects were monitored throughout the procedure.


RESULTS
Antegrade or retrograde ejaculation was achieved in 102 spinal cord injured men (64.6%). A positive response was more frequent in patients with complete lesions (American Spinal Injury Association A) and upper motor neuron lesions above T10. Midodrine induced a significant but moderate increase (maximum 10 mm Hg) in mean arterial pressure in all patients. The highest systolic blood pressure (more than 200 mm Hg) was seen in patients with quadriplegia. No other significant side effect was recorded. The average dose of midodrine required for ejaculation was 18.7 mg.


CONCLUSIONS
Midodrine is a safe and efficient adjunct to penile vibratory stimulation for anejaculation in spinal cord injured patients.
Soler
J M
JM
Laboratoire d'urodynamique et de sexologie, Centre Bouffard Vercelli, Cap Peyrefite, Cerbère, France.
Previnaire
J G
JG
Plante
P
P
Denys
P
P
Chartier-Kastler
E
E
D000284:Administration, Oral; D000316:Adrenergic alpha-Agonists / Q000008:administration & dosage / Q000627:therapeutic use*; D000328:Adult; D003075:Coitus / Q000502:physiology; D004305:Dose-Response Relationship, Drug; D004542:Ejaculation / Q000187:drug effects*; D007172:Erectile Dysfunction / Q000188:drug therapy* / Q000209:etiology / Q000503:physiopathology; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008879:Midodrine / Q000008:administration & dosage / Q000627:therapeutic use*; D012189:Retrospective Studies; D013119:Spinal Cord Injuries / Q000150:complications* / Q000503:physiopathology; D013904:Thoracic Vertebrae; D016896:Treatment Outcome
D000316:Adrenergic alpha-Agonists; D008879:Midodrine