Date: Tue Nov 20 19:33:02 2001
Posted By: R. James Swanson, Faculty, Biological Sciences, Obstetrics & Gynecology, Old Dominion University
Area of science: General Biology
Dan, Yes a paraplegic can have an erection and ejaculate depending on the level and severity of the injury. It is difficult (not normal intercourse but manual or mechanical means must be used) and not of much pleasure for the individual so affected. For
more sever cases like quadriplegia, the only means of erection and ejaculation are by electrical stimulation with a rectal probe. This generally requires anesthesia and the procedure can have (but not always) severe affect on blood pressure and other ph
ysiologic systems that might give one pause before undergoing this form of collection. The nerves that control erection (parasympathetic) and ejaculation (sympathetic) are derived from the spinal cord at about vertebral levels T12 to L2 and involve sacra
l nerve roots S2-3 for erection and lumbar roots (approximately) T12-L2 (into the sympathetic chain) for ejaculation so you can see that the functional control is low in the back. However, the sensory pleasure derived from this act must make it all the w
ay up to the brain to be appreciated and so higher level injuries may leave the functional potential intact without the sensory appreciation of what is happening. A newer but more expensive technique for those who want a family but canít have normal inte
rcourse is epididymal or testicular biopsy with intrauterine insemination (IUI) or in vitro fertilization (IVF) with or without intracytoplasmic sperm injection (ICSI) depending on the motility and overall quality of the sperm recovered. In either para-
or quadriplegia, the sensory function and pleasure will be minimal to nonexistent in comparison to a person with a normal CNS. This is not to say that a couple that finds themselves in this situation cannot have a satisfying physical relationship. Sex i
s more in the head than in the penis anyway, although it is hard to convince a young person of this fact. There can be gratifying pleasure and satisfaction if goals and endpoints can be adjusted to fit the circumstances.
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