Incidence of autonomic dysreflexia and silent autonomic dysreflexia in men with spinal cord injury undergoing sperm retrieval: implications for clinical practice. 2008

Marci B Ekland, and Andrei V Krassioukov, and Kate E McBride, and Stacy L Elliott
International Collaboration On Repair Discoveries, GF Strong Rehab Centre, Sexual Health Rehabilitation Service, Vancouver, British Columbia, Canada. Marci.ekland@vch.ca

OBJECTIVE To determine the incidence of symptomatic autonomic dysreflexia (AD) and asymptomatic autonomic dysreflexia (silent AD) in men with spinal cord injury (SCI) undergoing sperm retrieval procedures. METHODS Descriptive study. METHODS Thirteen men underwent cardiovascular monitoring during vibrostimulation (or self-stimulation) to the point of ejaculation. Cardiovascular results were compared with objective and subjective signs of AD to determine the incidence of symptomatic and silent AD. Past history and knowledge of AD were correlated to participants' experience of AD in the clinical setting. METHODS Change in diastolic and systolic blood pressure is the primary outcome data that will be compared to AD history and data from each participant's questionnaire. RESULTS Twelve of the 13 men experienced a rise in blood pressure consistent with AD (defined as an increase in blood pressure > 20 mmHg). Men with incomplete tetraplegia were able to identify symptoms associated with AD, and those with complete tetraplegia did not experience symptoms. Eleven of the 13 men knew that sexual activity could cause AD; however, only 2 of the 13 men acknowledged a history of AD with sexual activity and/or ejaculation. CONCLUSIONS Symptomatic and silent AD occur frequently during sperm retrieval in men with SCI above T6. Knowledge and past history of AD are not accurate indicators of who will experience AD with sexual activity and/or ejaculation.

UI MeSH Term Description Entries
D008297 Male Males
D008875 Middle Aged An adult aged 45 - 64 years. Middle Age
D010812 Physical Stimulation Act of eliciting a response from a person or organism through physical contact. Stimulation, Physical,Physical Stimulations,Stimulations, Physical
D001794 Blood Pressure PRESSURE of the BLOOD on the ARTERIES and other BLOOD VESSELS. Systolic Pressure,Diastolic Pressure,Pulse Pressure,Pressure, Blood,Pressure, Diastolic,Pressure, Pulse,Pressure, Systolic,Pressures, Systolic
D004542 Ejaculation The emission of SEMEN to the exterior, resulting from the contraction of muscles surrounding the male internal urogenital ducts. Ejaculations
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000328 Adult A person having attained full growth or maturity. Adults are of 19 through 44 years of age. For a person between 19 and 24 years of age, YOUNG ADULT is available. Adults
D013094 Spermatozoa Mature male germ cells derived from SPERMATIDS. As spermatids move toward the lumen of the SEMINIFEROUS TUBULES, they undergo extensive structural changes including the loss of cytoplasm, condensation of CHROMATIN into the SPERM HEAD, formation of the ACROSOME cap, the SPERM MIDPIECE and the SPERM TAIL that provides motility. Sperm,Spermatozoon,X-Bearing Sperm,X-Chromosome-Bearing Sperm,Y-Bearing Sperm,Y-Chromosome-Bearing Sperm,Sperm, X-Bearing,Sperm, X-Chromosome-Bearing,Sperm, Y-Bearing,Sperm, Y-Chromosome-Bearing,Sperms, X-Bearing,Sperms, X-Chromosome-Bearing,Sperms, Y-Bearing,Sperms, Y-Chromosome-Bearing,X Bearing Sperm,X Chromosome Bearing Sperm,X-Bearing Sperms,X-Chromosome-Bearing Sperms,Y Bearing Sperm,Y Chromosome Bearing Sperm,Y-Bearing Sperms,Y-Chromosome-Bearing Sperms
D013119 Spinal Cord Injuries Penetrating and non-penetrating injuries to the spinal cord resulting from traumatic external forces (e.g., WOUNDS, GUNSHOT; WHIPLASH INJURIES; etc.). Myelopathy, Traumatic,Injuries, Spinal Cord,Post-Traumatic Myelopathy,Spinal Cord Contusion,Spinal Cord Laceration,Spinal Cord Transection,Spinal Cord Trauma,Contusion, Spinal Cord,Contusions, Spinal Cord,Cord Contusion, Spinal,Cord Contusions, Spinal,Cord Injuries, Spinal,Cord Injury, Spinal,Cord Laceration, Spinal,Cord Lacerations, Spinal,Cord Transection, Spinal,Cord Transections, Spinal,Cord Trauma, Spinal,Cord Traumas, Spinal,Injury, Spinal Cord,Laceration, Spinal Cord,Lacerations, Spinal Cord,Myelopathies, Post-Traumatic,Myelopathies, Traumatic,Myelopathy, Post-Traumatic,Post Traumatic Myelopathy,Post-Traumatic Myelopathies,Spinal Cord Contusions,Spinal Cord Injury,Spinal Cord Lacerations,Spinal Cord Transections,Spinal Cord Traumas,Transection, Spinal Cord,Transections, Spinal Cord,Trauma, Spinal Cord,Traumas, Spinal Cord,Traumatic Myelopathies,Traumatic Myelopathy
D020211 Autonomic Dysreflexia A syndrome associated with damage to the spinal cord above the mid thoracic level (see SPINAL CORD INJURIES) characterized by a marked increase in the sympathetic response to minor stimuli such as bladder or rectal distention. Manifestations include HYPERTENSION; TACHYCARDIA (or reflex bradycardia); FEVER; FLUSHING; and HYPERHIDROSIS. Extreme hypertension may be associated with a STROKE. (From Adams et al., Principles of Neurology, 6th ed, pp538 and 1232; J Spinal Cord Med 1997;20(3):355-60) Autonomic Hyperreflexia,Dysreflexia, Autonomic,Hyperreflexia, Autonomic,Spinal Autonomic Dysreflexia,Autonomic Dysreflexia, Spinal,Autonomic Dysreflexias,Autonomic Dysreflexias, Spinal,Autonomic Hyperreflexias,Dysreflexia, Spinal Autonomic,Dysreflexias, Autonomic,Dysreflexias, Spinal Autonomic,Hyperreflexias, Autonomic,Spinal Autonomic Dysreflexias

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