Ejaculation and sperm characteristics in men with cauda equina and conus medullaris syndromes
Study design: Retrospective. Objectives: The objective of the study was to describe the type of ejaculation in patients with cauda equina (CE) and conus medullaris (CM) lesions, and to analyse sperm quality. Setting: France. Methods: One hundred sixty-six patients with CE and CM lesions were include...
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| Veröffentlicht in: | Spinal cord 2017-06, Vol.55 (6), p.612-617 |
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| creator | Hadiji, N Mieusset, R Previnaire, J G Castel-Lacanal, E Soler, J M |
| description | Study design:
Retrospective.
Objectives:
The objective of the study was to describe the type of ejaculation in patients with cauda equina (CE) and conus medullaris (CM) lesions, and to analyse sperm quality.
Setting:
France.
Methods:
One hundred sixty-six patients with CE and CM lesions were included. Diagnosis was based on clinical (no motor responses, sensation or sacral reflexes) and urodynamic assessments (no detrusor activity). Vibromassage (VM) was used to induce ejaculation according to the recommendations for patients with spinal cord injury. If ejaculation did not occur, oral midodrine was administered in progressive doses. Retrograde ejaculation was systematically sought. Sperm parameters were analysed according to World Health Organisation recommendations (2010).
Results:
Eighty-nine patients were included. Eleven ejaculated on the first VM trial (four anterograde (AE), six retrograde (RE) and one antero-retrograde (ARE)). Five patients continued trials of VM alone, two of whom ejaculated following a mean 1.9 trials (one RE, one ARE). Twenty-six patients underwent trials of VM+ midodrine, 18 of whom ejaculated following a mean 4.4 trials with a mean dose of 22.5 g of midodrine (2 AE, 13 RE and 5 ARE). Fifty-three ejaculates from 26 patients were analysed. Sperm concentration was low in 90.6% of samples; total necrospermia was found in 65% and asthenospermia in 95% of samples.
Conclusion:
Ejaculation is difficult to induce using VM in patients with CE and CM lesions, and requires high doses of midodrine. Sperm counts were generally low, and asthenospermia and necrospermia were found in the majority of specimens. Cryopreservation of sperm should be systematic in case of medically assisted procreation. |
| doi_str_mv | 10.1038/sc.2017.5 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_1911618326</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>1911618326</sourcerecordid><originalsourceid>FETCH-LOGICAL-c416t-4c8668e84569a6cdbda7351d1349283da2e513774adfd68a726e7238d03abfee3</originalsourceid><addsrcrecordid>eNqFkU1rGzEQhkVpaBI3h_6BIuilCayrr9VKx2CcDwjk0hzDMpbkZo1Xa2tWBP_7KrVTSnPIaQbmmXc-XkK-cDblTJof6KaC8WZafyAnXDW6qrVQH0sutaiUtPKYnCKuGGOWW_OJHAvDbS2EOSGP8xW4vIaxGyKF6CluQuqpe4IEbgypw7FzSLtI-xDpczc-UQfZAw3b3EX40-KGmLHUfV6voXRQ3EWfhj7gZ3K0hDWGs0OckIer-c_ZTXV3f307u7yrnOJ6rJQzWptgVK0taOcXHhpZc8-lssJIDyLUXDaNAr_02kAjdGiENJ5JWCxDkBPyfa-7ScM2BxzbvkMXyjoxDBlbbjnX3Eih30eNNuVjlquCfvsPXQ05xXJIEWSqMUZbU6jzPeXSgJjCst2kroe0azlrX-xp0bUv9rR1Yb8eFPOi_Osv-epHAS72AJZS_BXSPyPfqP0GeCmYQg</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1904788698</pqid></control><display><type>article</type><title>Ejaculation and sperm characteristics in men with cauda equina and conus medullaris syndromes</title><source>MEDLINE</source><source>SpringerLink Journals</source><source>Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals</source><creator>Hadiji, N ; Mieusset, R ; Previnaire, J G ; Castel-Lacanal, E ; Soler, J M</creator><creatorcontrib>Hadiji, N ; Mieusset, R ; Previnaire, J G ; Castel-Lacanal, E ; Soler, J M</creatorcontrib><description>Study design:
Retrospective.
Objectives:
The objective of the study was to describe the type of ejaculation in patients with cauda equina (CE) and conus medullaris (CM) lesions, and to analyse sperm quality.
Setting:
France.
Methods:
One hundred sixty-six patients with CE and CM lesions were included. Diagnosis was based on clinical (no motor responses, sensation or sacral reflexes) and urodynamic assessments (no detrusor activity). Vibromassage (VM) was used to induce ejaculation according to the recommendations for patients with spinal cord injury. If ejaculation did not occur, oral midodrine was administered in progressive doses. Retrograde ejaculation was systematically sought. Sperm parameters were analysed according to World Health Organisation recommendations (2010).
Results:
Eighty-nine patients were included. Eleven ejaculated on the first VM trial (four anterograde (AE), six retrograde (RE) and one antero-retrograde (ARE)). Five patients continued trials of VM alone, two of whom ejaculated following a mean 1.9 trials (one RE, one ARE). Twenty-six patients underwent trials of VM+ midodrine, 18 of whom ejaculated following a mean 4.4 trials with a mean dose of 22.5 g of midodrine (2 AE, 13 RE and 5 ARE). Fifty-three ejaculates from 26 patients were analysed. Sperm concentration was low in 90.6% of samples; total necrospermia was found in 65% and asthenospermia in 95% of samples.
Conclusion:
Ejaculation is difficult to induce using VM in patients with CE and CM lesions, and requires high doses of midodrine. Sperm counts were generally low, and asthenospermia and necrospermia were found in the majority of specimens. Cryopreservation of sperm should be systematic in case of medically assisted procreation.</description><identifier>ISSN: 1362-4393</identifier><identifier>EISSN: 1476-5624</identifier><identifier>DOI: 10.1038/sc.2017.5</identifier><identifier>PMID: 28195228</identifier><identifier>CODEN: SPCOFM</identifier><language>eng</language><publisher>London: Nature Publishing Group UK</publisher><subject>692/308 ; 692/700/565/1783 ; Administration, Oral ; Adolescent ; Adult ; Aged ; Anatomy ; Biomedical and Life Sciences ; Biomedicine ; Ejaculation - drug effects ; Ejaculation - physiology ; Human Physiology ; Humans ; Male ; Middle Aged ; Midodrine - administration & dosage ; Neurochemistry ; Neuropsychology ; Neurosciences ; original-article ; Polyradiculopathy - pathology ; Polyradiculopathy - physiopathology ; Retrospective Studies ; Sperm Count ; Sperm Motility ; Spermatozoa - pathology ; Spermatozoa - physiology ; Spinal Cord Compression - pathology ; Spinal Cord Compression - physiopathology ; Sympathomimetics - administration & dosage ; Vibration ; Young Adult</subject><ispartof>Spinal cord, 2017-06, Vol.55 (6), p.612-617</ispartof><rights>International Spinal Cord Society 2017</rights><rights>Copyright Nature Publishing Group Jun 2017</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c416t-4c8668e84569a6cdbda7351d1349283da2e513774adfd68a726e7238d03abfee3</citedby><cites>FETCH-LOGICAL-c416t-4c8668e84569a6cdbda7351d1349283da2e513774adfd68a726e7238d03abfee3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1038/sc.2017.5$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1038/sc.2017.5$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,776,780,27903,27904,41467,42536,51297</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/28195228$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Hadiji, N</creatorcontrib><creatorcontrib>Mieusset, R</creatorcontrib><creatorcontrib>Previnaire, J G</creatorcontrib><creatorcontrib>Castel-Lacanal, E</creatorcontrib><creatorcontrib>Soler, J M</creatorcontrib><title>Ejaculation and sperm characteristics in men with cauda equina and conus medullaris syndromes</title><title>Spinal cord</title><addtitle>Spinal Cord</addtitle><addtitle>Spinal Cord</addtitle><description>Study design:
Retrospective.
Objectives:
The objective of the study was to describe the type of ejaculation in patients with cauda equina (CE) and conus medullaris (CM) lesions, and to analyse sperm quality.
Setting:
France.
Methods:
One hundred sixty-six patients with CE and CM lesions were included. Diagnosis was based on clinical (no motor responses, sensation or sacral reflexes) and urodynamic assessments (no detrusor activity). Vibromassage (VM) was used to induce ejaculation according to the recommendations for patients with spinal cord injury. If ejaculation did not occur, oral midodrine was administered in progressive doses. Retrograde ejaculation was systematically sought. Sperm parameters were analysed according to World Health Organisation recommendations (2010).
Results:
Eighty-nine patients were included. Eleven ejaculated on the first VM trial (four anterograde (AE), six retrograde (RE) and one antero-retrograde (ARE)). Five patients continued trials of VM alone, two of whom ejaculated following a mean 1.9 trials (one RE, one ARE). Twenty-six patients underwent trials of VM+ midodrine, 18 of whom ejaculated following a mean 4.4 trials with a mean dose of 22.5 g of midodrine (2 AE, 13 RE and 5 ARE). Fifty-three ejaculates from 26 patients were analysed. Sperm concentration was low in 90.6% of samples; total necrospermia was found in 65% and asthenospermia in 95% of samples.
Conclusion:
Ejaculation is difficult to induce using VM in patients with CE and CM lesions, and requires high doses of midodrine. Sperm counts were generally low, and asthenospermia and necrospermia were found in the majority of specimens. Cryopreservation of sperm should be systematic in case of medically assisted procreation.</description><subject>692/308</subject><subject>692/700/565/1783</subject><subject>Administration, Oral</subject><subject>Adolescent</subject><subject>Adult</subject><subject>Aged</subject><subject>Anatomy</subject><subject>Biomedical and Life Sciences</subject><subject>Biomedicine</subject><subject>Ejaculation - drug effects</subject><subject>Ejaculation - physiology</subject><subject>Human Physiology</subject><subject>Humans</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Midodrine - administration & dosage</subject><subject>Neurochemistry</subject><subject>Neuropsychology</subject><subject>Neurosciences</subject><subject>original-article</subject><subject>Polyradiculopathy - pathology</subject><subject>Polyradiculopathy - physiopathology</subject><subject>Retrospective Studies</subject><subject>Sperm Count</subject><subject>Sperm Motility</subject><subject>Spermatozoa - pathology</subject><subject>Spermatozoa - physiology</subject><subject>Spinal Cord Compression - pathology</subject><subject>Spinal Cord Compression - physiopathology</subject><subject>Sympathomimetics - administration & dosage</subject><subject>Vibration</subject><subject>Young Adult</subject><issn>1362-4393</issn><issn>1476-5624</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2017</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>GNUQQ</sourceid><recordid>eNqFkU1rGzEQhkVpaBI3h_6BIuilCayrr9VKx2CcDwjk0hzDMpbkZo1Xa2tWBP_7KrVTSnPIaQbmmXc-XkK-cDblTJof6KaC8WZafyAnXDW6qrVQH0sutaiUtPKYnCKuGGOWW_OJHAvDbS2EOSGP8xW4vIaxGyKF6CluQuqpe4IEbgypw7FzSLtI-xDpczc-UQfZAw3b3EX40-KGmLHUfV6voXRQ3EWfhj7gZ3K0hDWGs0OckIer-c_ZTXV3f307u7yrnOJ6rJQzWptgVK0taOcXHhpZc8-lssJIDyLUXDaNAr_02kAjdGiENJ5JWCxDkBPyfa-7ScM2BxzbvkMXyjoxDBlbbjnX3Eih30eNNuVjlquCfvsPXQ05xXJIEWSqMUZbU6jzPeXSgJjCst2kroe0azlrX-xp0bUv9rR1Yb8eFPOi_Osv-epHAS72AJZS_BXSPyPfqP0GeCmYQg</recordid><startdate>20170601</startdate><enddate>20170601</enddate><creator>Hadiji, N</creator><creator>Mieusset, R</creator><creator>Previnaire, J G</creator><creator>Castel-Lacanal, E</creator><creator>Soler, J M</creator><general>Nature Publishing Group UK</general><general>Nature Publishing Group</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7QL</scope><scope>7RV</scope><scope>7T7</scope><scope>7TK</scope><scope>7U9</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FD</scope><scope>8FE</scope><scope>8FH</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BBNVY</scope><scope>BENPR</scope><scope>BHPHI</scope><scope>C1K</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FR3</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>H94</scope><scope>HCIFZ</scope><scope>K9.</scope><scope>KB0</scope><scope>LK8</scope><scope>M0S</scope><scope>M1P</scope><scope>M7N</scope><scope>M7P</scope><scope>NAPCQ</scope><scope>P64</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope></search><sort><creationdate>20170601</creationdate><title>Ejaculation and sperm characteristics in men with cauda equina and conus medullaris syndromes</title><author>Hadiji, N ; Mieusset, R ; Previnaire, J G ; Castel-Lacanal, E ; Soler, J M</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c416t-4c8668e84569a6cdbda7351d1349283da2e513774adfd68a726e7238d03abfee3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2017</creationdate><topic>692/308</topic><topic>692/700/565/1783</topic><topic>Administration, Oral</topic><topic>Adolescent</topic><topic>Adult</topic><topic>Aged</topic><topic>Anatomy</topic><topic>Biomedical and Life Sciences</topic><topic>Biomedicine</topic><topic>Ejaculation - drug effects</topic><topic>Ejaculation - physiology</topic><topic>Human Physiology</topic><topic>Humans</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Midodrine - administration & dosage</topic><topic>Neurochemistry</topic><topic>Neuropsychology</topic><topic>Neurosciences</topic><topic>original-article</topic><topic>Polyradiculopathy - pathology</topic><topic>Polyradiculopathy - physiopathology</topic><topic>Retrospective Studies</topic><topic>Sperm Count</topic><topic>Sperm Motility</topic><topic>Spermatozoa - pathology</topic><topic>Spermatozoa - physiology</topic><topic>Spinal Cord Compression - pathology</topic><topic>Spinal Cord Compression - physiopathology</topic><topic>Sympathomimetics - administration & dosage</topic><topic>Vibration</topic><topic>Young Adult</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Hadiji, N</creatorcontrib><creatorcontrib>Mieusset, R</creatorcontrib><creatorcontrib>Previnaire, J G</creatorcontrib><creatorcontrib>Castel-Lacanal, E</creatorcontrib><creatorcontrib>Soler, J M</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Bacteriology Abstracts (Microbiology B)</collection><collection>Nursing & Allied Health Database</collection><collection>Industrial and Applied Microbiology Abstracts (Microbiology A)</collection><collection>Neurosciences Abstracts</collection><collection>Virology and AIDS Abstracts</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Technology Research Database</collection><collection>ProQuest SciTech Collection</collection><collection>ProQuest Natural Science Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>Biological Science Collection</collection><collection>ProQuest Central</collection><collection>Natural Science Collection</collection><collection>Environmental Sciences and Pollution Management</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Engineering Research Database</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>SciTech Premium Collection</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>ProQuest Biological Science Collection</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Algology Mycology and Protozoology Abstracts (Microbiology C)</collection><collection>Biological Science Database</collection><collection>Nursing & Allied Health Premium</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><jtitle>Spinal cord</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Hadiji, N</au><au>Mieusset, R</au><au>Previnaire, J G</au><au>Castel-Lacanal, E</au><au>Soler, J M</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Ejaculation and sperm characteristics in men with cauda equina and conus medullaris syndromes</atitle><jtitle>Spinal cord</jtitle><stitle>Spinal Cord</stitle><addtitle>Spinal Cord</addtitle><date>2017-06-01</date><risdate>2017</risdate><volume>55</volume><issue>6</issue><spage>612</spage><epage>617</epage><pages>612-617</pages><issn>1362-4393</issn><eissn>1476-5624</eissn><coden>SPCOFM</coden><abstract>Study design:
Retrospective.
Objectives:
The objective of the study was to describe the type of ejaculation in patients with cauda equina (CE) and conus medullaris (CM) lesions, and to analyse sperm quality.
Setting:
France.
Methods:
One hundred sixty-six patients with CE and CM lesions were included. Diagnosis was based on clinical (no motor responses, sensation or sacral reflexes) and urodynamic assessments (no detrusor activity). Vibromassage (VM) was used to induce ejaculation according to the recommendations for patients with spinal cord injury. If ejaculation did not occur, oral midodrine was administered in progressive doses. Retrograde ejaculation was systematically sought. Sperm parameters were analysed according to World Health Organisation recommendations (2010).
Results:
Eighty-nine patients were included. Eleven ejaculated on the first VM trial (four anterograde (AE), six retrograde (RE) and one antero-retrograde (ARE)). Five patients continued trials of VM alone, two of whom ejaculated following a mean 1.9 trials (one RE, one ARE). Twenty-six patients underwent trials of VM+ midodrine, 18 of whom ejaculated following a mean 4.4 trials with a mean dose of 22.5 g of midodrine (2 AE, 13 RE and 5 ARE). Fifty-three ejaculates from 26 patients were analysed. Sperm concentration was low in 90.6% of samples; total necrospermia was found in 65% and asthenospermia in 95% of samples.
Conclusion:
Ejaculation is difficult to induce using VM in patients with CE and CM lesions, and requires high doses of midodrine. Sperm counts were generally low, and asthenospermia and necrospermia were found in the majority of specimens. Cryopreservation of sperm should be systematic in case of medically assisted procreation.</abstract><cop>London</cop><pub>Nature Publishing Group UK</pub><pmid>28195228</pmid><doi>10.1038/sc.2017.5</doi><tpages>6</tpages><oa>free_for_read</oa></addata></record> |
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| source | MEDLINE; SpringerLink Journals; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals |
| subjects | 692/308 692/700/565/1783 Administration, Oral Adolescent Adult Aged Anatomy Biomedical and Life Sciences Biomedicine Ejaculation - drug effects Ejaculation - physiology Human Physiology Humans Male Middle Aged Midodrine - administration & dosage Neurochemistry Neuropsychology Neurosciences original-article Polyradiculopathy - pathology Polyradiculopathy - physiopathology Retrospective Studies Sperm Count Sperm Motility Spermatozoa - pathology Spermatozoa - physiology Spinal Cord Compression - pathology Spinal Cord Compression - physiopathology Sympathomimetics - administration & dosage Vibration Young Adult |
| title | Ejaculation and sperm characteristics in men with cauda equina and conus medullaris syndromes |
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