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A. Neuro-urological disease affects patients’ sexual lives physically, psychologically, and sensorily. A negative effect may be caused by direct impairment of the nerves that signal the pelvic and genital area. The psychosocial and emotional impact of neuro-urological disease can also be negative and must be addressed along with other causes.
A. Erectile dysfunction (ED): If you have difficulty getting and maintaining an erection sufficient for sex, you may have erectile dysfunction, or ED. Your doctor will usually start treatment after doing the usual diagnostic tests for ED.
Male fertility: Male neurological patients often have a combination of erectile dysfunction, ejaculation disorder, and impaired sperm quality. This combination causes decreased fertility. If you want to father a child and it is not possible naturally, sperm can be collected for later use in assisted reproduction.
In men with spinal cord injury, especially of the thoracic spine (T-6 disc or above), sudden high blood pressure (autonomic dysreflexia) might occur during sexual activity and ejaculation.
If you have a spinal cord injury, you should keep this in mind and tell the staff at your fertility clinic.
Some men have retrograde ejaculation, which causes sperm to go inside the bladder during ejaculation instead of out of the penis.
It can be reversed using specific drugs or a balloon that prevents sperm going to the bladder.
Different techniques can be used to collect sperm from men with spinal cord injury.
Techniques like prostatic massage or stimulation with a vibrator may be used for sperm collection. Transrectal electro-ejaculation uses a light electrical current to cause ejaculation while the patient is asleep under anaesthesia, but it yields less viable sperm.
If these techniques do not work, sperm can be collected through microsurgery of the tube that carries sperm from the testicles (epididymis) or surgical removal of testicular pulp.
Intracytoplasmic sperm injection is an assisted reproductive technology. Since its introduction, spinal cord injury patients have a good chance of becoming biological fathers regardless of the technique used to collect sperm.
A. Most of the information available is from women with spinal cord injury and multiple sclerosis. Several areas of sexual life are frequently impaired in neuro-urological female patients, such as sexual desire, lubrication, and orgasm. Most women continue to be sexually active but show decreased satisfaction levels.
Female fertility: Women with spinal cord injury may have a short period without menstruation (about 6 months) immediately after the injury. However, many are able to become pregnant once menstruation returns.
Special care must be taken during labour and delivery because complications can occur such as bladder problems, spasticity, pressure sores, anaemia, and sudden high blood pressure (autonomic dysreflexia).