Objective

The goal is to characterize the ejaculation rate and the type of ejaculation experienced by men living with a lumbosacral spinal cord injury. The secondary objective is to seek a relation between ejaculatory rate and the type of neurogenic bladder hyperactive or areflexive.

Material/patients and methods

Monocentric retrospective analysis of 22 men with a lumbosacral spinal cord injuries of neurological level varying from L1 to S5. Six men (27.3%) had complete lesions and 16 men (72.7%) had incomplete lesions. Data were collected from retrospective medical files. Every patient answered questions on sexual function. A clinical examination was also realized, including an evaluation of perineal, cremasteric, patellar and Achilles reflexes and anal testing. Urodynamics were analyzed to identify the type of neurogenic bladder, either hyperactive or areflexive.

Results

Fifteen out of 22 men (68.2%) maintained ejaculation with masturbation or during sexual intercourse. In this 15 men, compared to pre-injury, 4 men (26.7%) described their ejaculation as normal, 3 (20%) described it as dribbling, 2 (13.3%) described it as premature and dribbling, 2 (13.3%) described it as spontaneous triggered with psychogenic stimulation, 1 (6,6%) describe it as premature, 1 (6.6%) described it as spontaneous and dribbling, 1 man (6.6%) found that his ejaculation was delayed and 1 man (6,6%) mentioned having retrograde ejaculations. Ejaculation was preserved in 11 of the 13 subject (84.6%) with areflexive bladder whereas ejaculation was preserved in 4 of the 7 subject (57.1%) with overactive bladder.

Discussion–conclusion

Our results show that ejaculation is often preserved in the lumbosacral lesions compared to the general population of men with spinal cord injury. The results also show the presence of premature and dribbling ejaculations appearing after the spinal lesion, and which are in contrast with the usual lack of ejaculation reported in men with spinal cord injury. However, there are different characteristics of ejaculation ranging from the anejaculation to premature ejaculation and clinical or urodynamic examination do not predict the type of ejaculation.