Gonadal regulation in men with flaccid paraplegia

Previous clinical studies have shown that some men with spinal cord injury (SCI) have aspermatogenesis and germinal epithelial atrophy. Additionally, an altered response to a luteinizing hormone releasing hormone (LHRH) challenge has been observed in men having SCI with abnormal testicular biopsy. In the present study, an LHRH challenge was given to 13 SCI and able-bodied men, and serum levels of follicular stimulating hormone (FSH), luteinizing hormone (LH), prolactin, and testosterone was determined by RIA. Based on physical examinations, the 13 subjects were divided into four groups: (A) men with SCI and a lower motor neuron lesion but no evidence of lumbosacral spinal cord function, (B) men with SCI and a lower motor neuron lesion but evidence of sacral cord function, (C) men with SCI and a spastic upper motor neuron lesion, and (D) able-bodied men as the control group. The only significant differences were associated with group A which showed increased levels of FSH before and after LHRH challenge and increased LH levels 30 min after injection relative to all other groups. The data suggest that SCI which results in a persistent bladder atonia and flaccid paraplegia, also produces an alteration in gonadal regulation. Thus, assessment of serum FSH and LH levels may provide information concerning somatic, visceral, and gonadal function after SCI.