Rectal probe electrostimulation in the treatment of anejaculatory spinal cord injured men

This paper reviews our experience with rectal probe electroejaculation (RPE) which is part of a larger effort to determine the correlates of successful ejaculation and fertility in SCI men. RPE is performed in the outpatient clinic using specially designed rectal probes. Over the past 18 months, we have attempted RPE on 38 occasions in 12 subjects (eight paraplegics and four quadriplegics) with an age range of 23-38 years and 0.5-18 years since onset of injury. Anterograde ejaculation occurred in nine subjects with improvement in percent motility and total live sperm count on repeated stimulations in five subjects. Significant retrograde ejaculation occurred in one person and sperm acceptable for artificial insemination (AI) was obtained from four subjects. The major side effects were mild dysreflexia (three subjects) and disruption of a normal bowel program (one subject). We conclude that RPE is a safe, relatively brief outpatient procedure and, with repeated stimulations, has a good potential for producing sperm acceptable for AI in selected patients.