Effects of spinal cord injury on semen parameters.
OBJECTIVE
Neurogenic reproductive dysfunction in men with spinal cord injury (SCI) is common and the result of a combination of impotence, ejaculatory failure, and abnormal semen characteristics. It is well established that the semen quality of men with SCI is poor and that changes are seen as early as 2 weeks after injury. The distinguishing characters of poor quality are abnormal sperm motility and viability. In the majority of the men with SCI, the sperm count is not abnormal. We elaborate on the effects of the SCI on semen parameters that may contribute to poor motility and poor viability.


METHODS
Review.


METHODS
PubMed and MEDLINE databases were searched using the following key words: spinal cord injuries, fertility, sexual dysfunction, and spermatogenesis. All literature was reviewed by the team of authors according to the various stages of sperm development and transport in the male reproductive cycle.


RESULTS
The cause of asthenozoospermia appears to be multifactorial.


CONCLUSIONS
Current literature does not support the preeminence of a single factor relating to neurogenic reproductive dysfunction in men with SCI. After SCI, there is ample evidence of disturbance of sperm production, maturation and storage, and transport due to an abnormal neuroendocrine milieu. Semen quality seems to be primarily affected by changes to the seminal plasma constituents, type of bladder management, and the neurogenic impairment to the ejaculatory function. Further focused and structured studies are required.
Neurourology Department, London Spinal Cord Injury Centre, Royal National Orthopaedic Hospital, Middlesex, UK. prasadpatki@hotmail.com
Prasad
P
Patki
Joe
J
Woodhouse
Rizwan
R
Hamid
Michael
M
Craggs
Julian
J
Shah
D000818:Animals; D053627:Asthenozoospermia / Q000209:etiology; D006801:Humans; D008297:Male; D039781:PubMed / Q000706:statistics & numerical data; D012661:Semen / Q000502:physiology*; D012735:Sexual Dysfunction, Physiological / Q000209:etiology*; D013119:Spinal Cord Injuries / Q000150:complications*