Sexuality and Reproductive Health Following Spinal Cord Injury: Evidence Report/Technology Assessment, Number 109

This report focuses on two questions: (1) issues related to fertility pregnancy rates and live births in persons with SCI and (2) issues related to male impotence post-SCI. Reproductive health: What is the current fertility rate for men and women after SCI? Are fertility rates changed by freezing a new patient’s sperm? Are there better fertility rates using electroejaculation or vibration? Does order of method influence outcome? To improve fertility rates when should invasive techniques such as testicular biopsy or aspiration or ICSI be pursued? Are there pregnancy complications and prospective obstetric management issues for SCI females? Male sexuality: How has the availability of Viagra® and other remediation affected sexual function frequency of activity and adjustment after SCI? Is Viagra® really more benign than intracavernous injections? How does the morbidity of prostaglandin injections compare to the older (less expensive) papaverine? What is the morbidity of vacuum tumescence devices? What indications if any remain for implantable penile prosthetic devices? (excerpt)