ORIGINAL ARTICLES   Free access

Europa Medicophysica 2003 June;39(2):79-86

Copyright © 2003 EDIZIONI MINERVA MEDICA

language: English

Rectal probe electroejaculation as a method of treatment for male infertility due to spinal cord injury. A Riyadh Armed Forces Hospital experience

Jadid A., Ashraff A.

Division of Rehabilitation Medicine Department of Neurosciences Riyadh Armed Forces Hospital Riyadh, Saudi Arabia

Aim. The aim of ­this ­paper was to ­review the ­method and effec­tive­ness of ­rectal ­probe elec­tro­ejac­u­la­tion (RPE) ­used to ­obtain ­semen in indi­vid­uals ­with ane­jac­u­la­tion due to ­spinal ­cord ­injury. ­This pros­pec­tive ­study ­tekes ­into con­sid­er­a­tion ­male ­patients ­admitted for reha­bil­i­ta­tion fol­lowing ­spinal ­cord ­injury plan­ning to ­have chil­dren and/or to ­know ­about ­their fer­tility ­status. It was car­ried out in an out­pa­tient ­clinic and inpa­tient reha­bil­i­ta­tion ­unit of 26 ­beds at ­Riyadh ­Armed ­Forces Hos­pital, ­Saudi ­Arabia, a ter­tiary ­referral hos­pital.
­Methods. ­During the ­year 1998, a ­total of 15 ­patients, ­aged 19-50 ­years, ­from inpa­tient ­unit and out­pa­tient ­clinic ­having ­expressed ­their ­wish to ­have chil­dren and/or to ­know ­their fer­tility ­status, under­went elec­tro­ejac­u­la­tion. The ­semen col­lected by elec­tro­ejac­u­la­tion was ­used for sem­inal anal­ysis and fer­til­iza­tion.
­Results. Fif­teen ­patients under­went the elec­tro­ejac­u­la­tion pro­ce­dure ­using ­rectal ­probes. Suf­fi­cient ­semen sam­ples ­were ­obtained ­from 13 ­patients by ante­grade emis­sion. Two ­patients ­failed to pro­duce an ante­grade ejac­u­late. ­There ­were 3 cer­vical, 10 tho­racic and 2 ­lumbar ­lesions of ­both com­plete and incom­plete ­types ­according to the ­ASIA (Amer­ican ­Spinal Inju­ries Asso­ci­a­tion) clas­sifi­ca­tion. The ­mean ­details are as fol­lows: age was 30 ­years old, ­number of ­stimuli ­applied was 16, max­imum cur­rent was 14.33 ­volts, ­number of ejac­u­la­tions per ­patient was 1.73, ­number of ­stimuli ­required to ­obtain ejac­u­late per ­patient was 7.61, ­volume of ejac­u­late was 1.84 ml, ­sperm ­count was 78.46 mil/ml, ­motility was 18.92 % and ­normal mor­phology was 32.61%. Suc­cessful preg­nancy was ­achieved fol­lowing in ­vitro fer­til­isa­tion (IVF) in ­3 mar­ried cou­ples.
Con­clu­sion. Elec­tro­ejac­u­la­tion is a ­well-­accepted ­method of ­obtaining ­semen ­from ­spinal ­cord ­injured ­males ­with ane­jac­u­la­tion. ­This can ­result in ­assisted fer­til­iza­tion and suc­cessful con­cep­tion and preg­nancy.