According to statistics, there are currently about 300,000 spinal cord injury patients in China, of which the ratio of men to women: 6:1, the age of onset is mostly below 30 years old, and the number of people is increasing by about 20,000 every year, with the progress of rehabilitation level, the life expectancy of spinal cord injury patients is not much different from that of normal people, motor function, self-care ability has also been significantly improved, but the sexual and reproductive dysfunction after spinal cord injury is rarely mentioned. However, sexual and reproductive dysfunction after spinal cord injury is rarely mentioned, and the rehabilitation of sexual and reproductive function after spinal cord injury can be said to be almost blank in China. In fact, according to WHO and the relevant laws in China, the right to enjoy sexual life and the right to be a parent is the basic right of every person, even the disabled after spinal cord injury is no exception.
First, the current situation of sexual and reproductive dysfunction of spinal cord injury in China exists as follows.
Medical personnel have a serious lack of relevant knowledge and are not able to provide proper guidance to patients;
Patients are reluctant to mention and seek medical treatment, and they and their companions live a sexless life for years, and some families break up as a result;
Patients with spinal cord injury have high rates of unmarriage, divorce and childlessness (especially for traditionally conscious one-child families, where childlessness is particularly important);
There are serious misconceptions about sexual and reproductive dysfunction after spinal cord injury; many people believe that it is impossible to have a sexual life and have children of their own after the injury.
Therefore, it is very important to carry out the rehabilitation of sexual and reproductive functions after spinal cord injury.
In 1990, Kotani collected statistics from the literature and concluded that the total number of cases: 2930 cases could get an erection: 1802 cases (62%); could ejaculate: 445 cases (15%); could have intercourse: 730 people (25%); had children: 55 cases (2%). With the progress of modern medicine, it is no longer a taboo to have a relatively normal sex life after spinal cord injury, and it is not a dream to have children of your own.
Sex includes three levels, sexual desire, sexual behavior, and sexual love. Normal sexual function includes.
1, the lifting with the opposite sex ;
2.sexual desire.
3.Erection ;
4, sexual intercourse
5.Ejaculation ;
6.Pleasure ;
7, insemination; women also include: pregnancy, childbirth, etc.
Second, spinal cord injury male sexual dysfunction mainly includes
Spermatogenic disorders: low sperm, weak, malformations, etc. ;
Erectile dysfunction mental erection, reflex erectile dysfunction ;
Sexual intercourse disorder: no erection and the degree of persistence;
Ejaculation disorder: premature ejaculation, late ejaculation; retrograde ejaculation; no ejaculation; intravaginal ejaculation disorder.
1, sperm production disorder.
After spinal cord injury men are still able to make normal sperm, but the causes associated with spinal cord injury result in less sperm, weaker, more malformations, etc. ;
Causes: infection, scrotal humidity and heat, sedentary, long-term non-discharge of semen, etc
Treatment.
1, control urinary tract infection, manage urination and defecation well, and use antibiotics appropriately and reasonably;
2, scrotal temperature should be appropriate;
3.Regularly perform artificial ejaculation;
4, take drugs: vitamins, lycopene, eight flavors of Dihuangwan, tonic Chinese and Yi Qi soup, etc.;
5, avoid sedentary, strengthen exercise and training;
2, erectile dysfunction.
Erectile dysfunction is probably the most serious obstacle affecting the sexual function and reconstruction of spinal cord injury patients on their own.
In fact, many patients can develop erections after spinal cord injury, and those with injuries between T10-S1, psychogenic erections and
reactive erection are present; as long as the S2-4 center is preserved, the penis can be reflexively erected by stimulation.
Treatment.
First-line treatment.
Sildenafil (improves 64% of SCI patients without any previous erection and 78% of those with previous erection)
Vacuum negative pressure suction device: effective rate 85.6% (recommended, non-invasive, low cost, convenient, semi-permanent use,)
Second-line therapy.
Intra-urethral administration: Bifal topical cream (containing prostate E1 1mg)
Intracavernous penile injection: poppyrine + phentolamine + prostate E1 or alone: prostate E1
Third-line therapy.
Penile prosthesis implantation surgery.
3, sexual intercourse disorder: mainly for no erection, insufficient duration, postural disorders
Treatment.
Opposite-led, with appropriate position and posture;
With the help of drugs and external devices;
To deal with erectile problems;
4.Ejaculatory disorders.
Over time, there is a tendency for sperm production to deteriorate, and one of the reasons for poor semen properties is stagnation of semen without excretion, after injury due to early induction of artificial ejaculation.
Methods.
Vibrator method; can be used repeatedly, the success rate of menstruation extraction is low ;
Drug stimulation method: lumbar puncture, injection of neostigmine, 1-3 hours to induce ejaculation, high success rate of sperm retrieval, invasive, some drug side effects;
Electrical stimulation method: anal insertion of stimulation electrodes, 10-15 minutes to produce ejaculation; high success rate of menstruation;
Third, female sexual dysfunction after spinal cord injury.
Women are hormone-dependent, the main existence of sensory disorders, but also can secrete fluid to lubricate the vagina and enjoy orgasm, except for the feeling of little impact.
Fourth, male reproductive dysfunction.
Men with spinal cord injury can still produce sperm after the injury, and as long as they have the ability to have an erection and ejaculate, they have a high probability of causing pregnancy in women. The problem is how the sperm meets the egg and unites to form a fertilized egg.
The main influencing factors are: poor spermatozoa formation; urinary tract infection causing inflammation blocking the vas deferens; erectile insufficiency causing obstruction to intercourse; obstruction to semen entering the uterus; obstruction to semen meeting the egg.
Treatment: family planning, one by one, to deal with same-sex dysfunction.
V. Female reproductive dysfunction.
Although there is no menstruation for several months after spinal cord injury, ovulation and pregnancy will still be renewed, and there is little impact on female reproductive function.
Attention.
1.Consider clearly how to take care of yourself and your fetus, baby
2.Be sure to manage your urine and stool to control infection.
3.T6 or above is prone to induce autonomic hyperreflexia and can be treated with medication.
4, try to avoid percussion, knocking bladder, later it is recommended to retain the urinary catheter
5.No indiscriminate use of drugs and indiscriminate examination.
Sixth, concluding remarks.
As long as both couples have patience and cooperate with the specialist’s guidance, having a satisfactory sex life and having their own children will not be just a dream.”