Spinal cord injury (SCI) is a relevant medical and social problem. According to the World Health Organization, the commonly estimated worldwide annual incidence of SCI is 40 to 80 cases per million population. After the SCI experience, most men present with sexual dysfunction (erectile dysfunction (ED) and ejaculatory dysfunction), fertility problems (such as impaired spermatogenesis, abnormalities in sperm viability, motility, and morphology), and systemic disorders such as genitourinary infection and endocrine imbalances. The best options available for managing the ejaculatory disorders in patients suffering from SCI are penile vibratory stimulation (PVS) and electroejaculation (EEJ). Furthermore, the treatment of ED in SCI patients consists of medical therapies including phosphodiesterase 5 inhibitors (PDE5i), intracavernosal injections (ICI), vacuum erection devices (VEDs), and surgical as penile prosthesis (PP). This review provides a snapshot of the current evidence for the mechanisms of sexual dysfunction and infertility in SCI patients, discusses the best management strategies for these conditions, and offers our perspective on the direction of future research.
Journal of personalized medicine. 2022 May 26*** epublish ***
Francesco Di Bello, Massimiliano Creta, Luigi Napolitano, Gianluigi Califano, Francesco Passaro, Simone Morra, Angelo di Giovanni, Giovanni Maria Fusco, Luigi Cirillo, Marco Abate, Vincenzo Morgera, Gianluigi Cacace, Luigi De Luca, Gianluca Spena, Claudia Collà Ruvolo, Francesco Paolo Calace, Celeste Manfredi, Roberto La Rocca, Giuseppe Celentano, Carmine Turco, Marco Capece, Carlo D'Alterio, Alessandro Giordano, Ernesto di Mauro, Francesco Trama, Ugo Amicuzi, Davide Arcaniolo, Ferdinando Fusco, Nicola Longo
Department of Neurosciences, Reproductive Sciences and Odontostomatology, Urology Unit, University of Naples "Federico II", 80138 Napoli, Italy., Urology Unit, Department of Woman, Child and General and Specialized Surgery, University of Campania "Luigi Vanvitelli", 80138 Naples, Italy., Department of Andrology and Urogynecological Clinic, University of Perugia, Santa Maria Terni Hospital, 05100 Terni, Italy.