Sexual dysfunction and infertility in the male spina bifida patient
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.