Sexual dysfunction and infertility in the male spina bifida patient.
Sexual dysfunction and infertility in the male spina bifida patient.
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DOI：
10.21037/tau.2018.10.08
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发表时间：
2018-12
影响因子：
2
通讯作者：
Lipshultz LI
中科院分区：
文献类型：
--
作者：
Deng N;Thirumavalavan N;Beilan JA;Tatem AJ;Hockenberry MS;Pastuszak AW;Lipshultz LI
脊柱裂是一种先天性神经管缺陷，具有许多神经系统的影响，以及性功能下降和不育。很少有研究直接调查男性脊柱裂患者的不育情况。这一特殊患者人群的不育主要是由于精子发生缺陷和/或由于勃起或射精功能障碍导致的精子运输失败。性和生殖功能障碍的严重程度似乎与脊髓损伤程度较高和脑积水的存在相关。磷酸二酯酶5抑制剂（PDE 5is）已被证明对某些脊柱裂男性的勃起功能障碍有效。从泌尿生殖道手术取精和直肠探针电射精可以作为从射精功能障碍或逆行射精患者中收集精子的方法。辅助生殖技术，如卵胞浆内单精子注射，可以使不育男性的精子实现受精。由于大多数脊柱裂患者由于医疗和手术的进步而存活到青春期和成年期，因此医疗保健专业人员解决与其性和生殖功能相关的问题至关重要。
Spina bifida is a congenital neural tube defect with many neurological implications, as well as decreased sexual function and infertility. Few studies have directly investigated infertility in men with spina bifida. Infertility in this special patient population is primarily the result of spermatogenic defects and/or failure of sperm transport due to erectile or ejaculatory dysfunction. The severity of sexual and reproductive dysfunction seems to correlate with higher level of spina cord lesion and presence of hydrocephalus. Phosphodiesterase 5 inhibitors (PDE5is) have been shown to be effective for erectile dysfunction in some men with spina bifida. Surgical sperm retrieval from the genitourinary tract and rectal probe electroejaculation can serve as methods for collecting sperm from those with ejaculatory dysfunction or retrograde ejaculation. Assisted reproductive technology such as intracytoplasmic sperm injection allows isolated sperm from men with infertility to achieve fertilization. Since most spina bifida patients are surviving into adolescence and adulthood due to improved medical and surgical advancements, it is paramount for healthcare professionals to address issues related their sexual and reproductive function.
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