title: [Evaluation of the management of erectile and ejaculatory dysfunction in a series of 90 patients with spinal cord injuries].
abstract: OBJECTIVE
  To evaluate the erectile dysfunction and ejaculatory on patients injured in conus medullaris (CMI) and the efficacy of treatment.
  
  
  METHODS
  Ninety patients with injured conus medullaris underwent a retrospective and monocentric study. They have all an assessment of erectile dysfunction and ejaculatory by the International Index of Erectile Function (IIEF-15) and a clinic scenario. We evaluated the erection by a clinical scoring scale (Shrameck). Seventy-seven out of 90 (85.55%) had therapeutic tests to restore erection: prostaglandin (PGE1), phosphodiesterase type 5 inhibitors (PDE5) and Papaverine. Seventy-four out of 90 (82.22%) underwent a penile stimulation tests (VM) more or less associated with Midodrine(®) (alpha mimetic) to cause ejaculation with a systematic search of spermatozoa in urine. Data were entered and analyzed using Microsoft Office Excel.
  
  
  RESULTS
  Ninety patients with a complete lesion of the sacral metameres (S2S3S4) were included. They were responding to PGE1, PDE5, respectively 81.63% and 30.76%. The association VM/Midodrine(®) improves ejaculation in 52.63% of cases. Orgasm is absent in all our CMI.
  
  
  CONCLUSIONS
  In this series of BCM patients, we observed a good efficacy of PGE1 and PDE 5 on erection. We also observed positive results of vibromassage and alpha-agonists on ejaculation.
authors.affiliation: Centre Bouffard-vercelli-Cap Peyrefite, 66290 Cerbère, France. Electronic address: naderhadiji@yahoo.fr.
authors.forename: N
authors.initials: N
authors.lastname: Hadiji
authors.forename: R
authors.initials: R
authors.lastname: Benbouzid
authors.forename: J G
authors.initials: JG
authors.lastname: Previnaire
authors.forename: C
authors.initials: C
authors.lastname: Leblond
authors.forename: R
authors.initials: R
authors.lastname: Mieusset
authors.forename: M
authors.initials: M
authors.lastname: Enjalbert
authors.forename: J M
authors.initials: JM
authors.lastname: Soler
mesh_terms: D000293:Adolescent; D000316:Adrenergic alpha-Agonists / Q000627:therapeutic use; D000328:Adult; D000368:Aged; D000527:Alprostadil / Q000627:therapeutic use; D004542:Ejaculation; D007172:Erectile Dysfunction / Q000209:etiology / Q000628:therapy*; D006801:Humans; D008297:Male; D008405:Massage; D008875:Middle Aged; D008879:Midodrine / Q000627:therapeutic use; D010208:Papaverine / Q000627:therapeutic use; D058986:Phosphodiesterase 5 Inhibitors / Q000627:therapeutic use; D010726:Phosphodiesterase Inhibitors / Q000627:therapeutic use; D012189:Retrospective Studies; D012735:Sexual Dysfunction, Physiological / Q000209:etiology / Q000628:therapy*; D013119:Spinal Cord Injuries / Q000150:complications*; D014665:Vasodilator Agents / Q000627:therapeutic use; D014732:Vibration / Q000627:therapeutic use; D055815:Young Adult
chemical_list: D000316:Adrenergic alpha-Agonists; D058986:Phosphodiesterase 5 Inhibitors; D010726:Phosphodiesterase Inhibitors; D014665:Vasodilator Agents; D008879:Midodrine; D010208:Papaverine; D000527:Alprostadil
keywords: Blessé médullaire; Conus medullaris; Cône médullaire; Dysérection; Ejaculation; Erectile dysfunction; Midodrine(®); Penile vibratory stimulation; Spinal cord injury; Thérapeutique; Treatment; Vibromassage; Éjaculation