Skip to main content

Éjaculation provoquée par le vibromassage ou l’électrostimulation endorectale chez le blessé médullaire: injection intracytoplasmique de spermatozoïdes obtenus par stimulation endorectale chez neuf couples

Ejaculation induced by penile vibratory stimulation or rectal probe electrostimulation in the treatment of anejaculatory spinal cord injured men: the use of intracytoplasmic sperm injection with electroejaculates in 9 couples

Résumé

Moins de 15% des hommes avec une lésion complète de la moelle obtiennent une éjaculation lors de rapports sexuels ou de la masturbation. Le vibromassage du pénis permet d’obtenir une éjaculation pour au moins 70% d’entre eux. L’éjaculat recueilli au domicile par le couple est utilisé pour, des auto-inséminations au moment le plus opportun du cycle. Les patients en échec du vibromassage obtiennent une éjaculation par stimulation endorectale dans la majorité des cas. Le stimulateur actuellement disponible est celui mis au point par SEAGER. Seule l’absence de spermatozoïde viable dans l’éjaculat conduit au prélèvement microchirurgical. L’échec des auto-inséminations, l’altération importante de la qualité du sperme chez ces blessés amènent fréquemment à la médicalisation de la procréation. Les neuf couples, à qui nous avons proposé une I.C.S.I. avec des spermatozoïdes obtenus par électrostimulation endorectale, ont mené à terme quatre grossesses.

Abstract

800 to 1,000 cases of traumatic spinal cord injury (S.C.I.) are observed in France each year. At present time, there are more than 35,000 survivors of S.C.I. in France. Studies show that 80% of injuries occur in men and 82% occur in individuals between the ages of 16 and 45 years. It is well known that more than 80% of men with S.C.I. suffer from ejaculation dysfunction. Since most of these couples are young, many desire a family and seek help to remedy their infertility. Two methods are mainly used to retrieve sperm from S.C.I. men: penile vibratory stimulation and rectal electrostimulation.

Penile vibratory stimulation to induce ejaculation is recommended as first-line treatment, and S.C.I. men should only be referred for electroejaculation after failure of this technique.

More than 70% of patients respond to penile vibratory stimulation with anterograde ejaculation. Patients who fail to ejaculate by penile vibratory stimulation are treated by electroejaculation.

Their ejaculates often have normal sperm counts, but with a higher proportion of immotile sperm than in men without S.C.I. The authors report the pregnancy outcome of a series of 9 couples undergoing combined electroejaculation and in vitro fertilization with intracytoplasmic sperm injection: 25% pregnancies per cycle and 33% pregnancies per couple.

Références

  1. 1.

    BENNETT C.J. et al.: Electroejaculation and assisted reproductive techniques for anejaculatory infertility. Obstet. Gynecol., 1996, 87: 22–26

    Article  Google Scholar 

  2. 2.

    BIERING-SORENSEN F, SONKSEN J.: Sexual function in spinal cord lesioned men. Spinal Cord, 2001, 39: 455–470

    PubMed  Article  CAS  Google Scholar 

  3. 3.

    BRINDLEY G.S.: The fertility of men with spinal injuries. Paraplégia, 1984, 22: 337–348

    PubMed  CAS  Google Scholar 

  4. 4.

    BRINDLEY G.S.: Electroejaculation: its techniques neurological implications and use. J. Neurol. Neurosurg. Psychiatry, 1981, 44: 9–18

    PubMed  Article  CAS  Google Scholar 

  5. 5.

    CHUNG PH et al.: Assisted fertility using electroejaculation in men with spinal cord injury — a review of literature. Fertil. Steril., 1995; 64: 1–9

    PubMed  CAS  Google Scholar 

  6. 6.

    COMARR A.E.: Sexual function among patients with spinal cord injury. Urol. Int., 1970, 25: 134

    PubMed  CAS  Article  Google Scholar 

  7. 7.

    DAHLBERG A., RUUTU M, HOVATTA O.: Pregnancy results from a vibrator application, electroejaculation, and vas aspiration program in spinal cord injured men. Hum. Reprod., 1995, 10; 2305–2307

    PubMed  CAS  Google Scholar 

  8. 8.

    EGON G. et al.: Ejaculation provoquée chez le paraplégique. Andrologie, 1994, 4: 160–168

    Article  Google Scholar 

  9. 9.

    FRANCOIS N., LICHTENBERGER J.M., JOUANNET P et al: L’éjaculation par le vibromassage chez le paraplégique: à propos de 50 cas avec 7 grossesses. Ann. Med. Phys., 1980: 23–24

  10. 10.

    HALSTEAD L.S., VERVOORT S, SEAGER S. W. J.: Rectal probe électrostimulation in the treatment of inejaculatory spinal cord injured men. Paraplégia, 1987, 25: 120–129

    PubMed  CAS  Google Scholar 

  11. 11.

    HERUTI R. J et al: Treatment of male infertility, due to spinal cord injury using rectal probe electroejaculation: the Israeli experience. Spinal Cord, 2001, 39: 168–175

    PubMed  Article  CAS  Google Scholar 

  12. 12.

    HORNE H. W. PAULL D. P. MUNRO D.: Fertility studies in human male with traumatic injuries of the spinal cord and cauda equina. N. Engl. J. Med, 1948. 239: 959–961

    PubMed  CAS  Article  Google Scholar 

  13. 13.

    LUCAS M.G. et al: Sperm retrieval by electroejaculation. Preliminary experience in patients with secondary anejaculation. Br. J. Urol., 1991, 67: 191–194

    PubMed  Article  CAS  Google Scholar 

  14. 14.

    LOCHNER-ERNST D. et al: Conservative and surgical semen retrieval in patients with spinal cord injury. Spinal Cord, 1997, 35: 463–468

    PubMed  Article  CAS  Google Scholar 

  15. 15.

    NEHRA A. et al.: Vibratory stimulation and rectal probe electroejaculation as therapy for patients with spinal cord injury: semen parameters and pregnancy rates. J. Urol., 1996, 155: 554–559

    PubMed  Article  CAS  Google Scholar 

  16. 16.

    OHL D.A. et al.: Predictors of success in electroejaculation of spinal cord injured man. J. Urol 1993, 149: 1350–1354

    Google Scholar 

  17. 17.

    SCHATTE E. C. et al.: Treatment of infertility due to anejaculation in the male with electroejaculation and intracytoplasmic sperm injection. J. Urol., 2000, 163: 1717–1720

    PubMed  Article  CAS  Google Scholar 

  18. 18.

    SEAGER S.W.J.: The Breeding of captive wild species by artificial methods. Zoo. Biol., 1983, 2: 235

    Article  Google Scholar 

  19. 19.

    SEAGER S.W.J., DVM LAURO S., HALSTEAD MD: Fertility options and success after spinal cord injury. Spinal Cord, 1993, 20, 543–548

    CAS  Google Scholar 

  20. 20.

    SONKSEN M. D. et al: Ejaculation induced by penile vibratory stimulation in men with spinal cord injuries. The importance of the vibratory amplitude. Paraplegia, 1994, 32: 651–660

    PubMed  CAS  Google Scholar 

  21. 21.

    SONKSEN J. et al: Pregnancies after assisted ejaculation procedures in men with spinal cord injuries. Arch. Phys. Med. Rehabil., 1997, 78: 1059–1061

    PubMed  Article  CAS  Google Scholar 

Download references

Author information

Affiliations

Authors

Corresponding author

Correspondence to G. Egon.

Additional information

Communication à la Session SALF-AFU des 6o Journées de la Fédération Française d’Étude de la Reproduction Lyon, 5–7 septembre, 2001

Rights and permissions

Reprints and Permissions

About this article

Cite this article

Egon, G., Scobai, A., Ferrapie, A.L. et al. Éjaculation provoquée par le vibromassage ou l’électrostimulation endorectale chez le blessé médullaire: injection intracytoplasmique de spermatozoïdes obtenus par stimulation endorectale chez neuf couples. Androl. 11, 253–257 (2001). https://doi.org/10.1007/BF03034640

Download citation

Mots clés

  • blessés médullaires
  • électrostimulation
  • vibromassage
  • éjaculation
  • injection intracystoplasmique de spermatozoïdes

Key-words

  • spinal cord injury
  • electrostimulation
  • vibration
  • ejaculation
  • intracystoplasmic sperm injection
\