How injury may affect function
Male reproductive system
The male reproductive system includes the penis, testes, scrotum, and prostate gland. These parts all play a role in allowing a man to father a child. They also allow a man to have sexual pleasure.
- The penis allows urine to pass out of the body and allows semen and sperm to pass out of the body during sexual intercourse.
- The scrotum is a sac that houses the testes. Because the scrotum is sensitive to touch, pressure, and temperature, it protects the testes. It also has nerve endings for sexual pleasure.
- The testes are oval-shaped organs, housed in the scrotum that produce sperm. The testes are located in the scrotum because sperm need a lower temperature than the rest of the body to stay alive. They also produce testosterone to allow for sex drive.
- The prostate gland is located below the bladder and provides a thin milky fluid that sperm swim in for protection and nourishment.
In addition, male breasts are sensitive to touch and can be an area of sexual pleasure.
Male sexuality and spinal cord injury
Spinal cord injury (SCI) can affect male sexuality in a range of ways.
- Fertility: A method called electro-ejaculation allows a doctor to collect sperm to artificially inseminate a woman. It works in about 30 percent of males with SCI. Vibro-stimulation has also been shown to increase ejaculation and fertility. Sometimes a spinal cord injury may change the body temperature in the scrotum and cause damage to the sperm, decreasing the number of healthy sperm able to fertilize an egg.
- Erections: Discuss options with your doctor. Most males with SCI can have a reflexogenic erection, which results from direct stimulation. The chance of having erections decreases with lower level injuries. If a man has a complete SCI above the L2 level, he will not be able to have a psychogenic erection, though the mental desire and excitement remains the same as before.
- The Osbon ErecAid device uses vacuum pressure to draw blood into the penis, allowing the male to have an erection that lasts about 30 minutes. It is affordable and can be used often.
- Additional options include penile implant surgery and medication.
- Ejaculation: This is usually impaired in men with SCI. Sometimes the sperm go backwards into the bladder, or it may be weak or stop. This does not pose any medical danger to you.
- Orgasm: The ability to have an orgasm depends on the amount of sensation below the navel. If feeling below the navel is absent, orgasm may not occur, however, the pleasure leading up to and after orgasm is likely to remain. If you are unable to have an orgasm because of SCI, you usually will not feel the frustration as before your injury.
- Intermittent catheterization: Be sure to empty your bladder before and after having sexual intercourse. Limit amount of caffeine and alcohol before sex as it may cause urinary leakage. Good hygiene before and after sexual intercourse will help prevent a bladder infection.
- Bowel program: Wait two hours after finishing your bowel program before having sex. If the person who does your bowel program is also your sex partner, do not talk about sex during your bowel program. Talk about other topics instead.
- Sexual positions: “Anything you can do, you can do.” Act safely to prevent falls, but otherwise sexual positions are up to you.