電気刺激による射精障害患者からの精液採取法の研究  [in Japanese] STUDY ON SEMEN COLLECTION FROM PATIENTS WITH ANEJACULATION BY ELECTROSTIMULATION  [in Japanese]

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Abstract

射精不能者に対して,さまざまな人工的精液採取法が行われているが,Brindley法とパルス電流を用いるように改良したSeager改良法による電気射精を,脊髄損傷40例,直腸癌根治術後の射精不能例1例に対して行い,その有用性を検討した.Seager改良法では,刺激に際して患者に与える電気エネルギーを減じるため,正弦交流にかえ両極性のパルス電流を用いた.Brindley法では18例中11例から精子を回収し,Seager改良法では29例中24例から精子を回収した.直腸癌根治術後の射精不能例1例もSeager改良法により精子を回収することができた.電気射精の副作用としては,自律神経過反射と疼痛がみられた.自律神経過反射は,刺激の中止により速やかに消失し,この点でネオスチグミンのくも膜下腔注入法より安全な方法と考えられた.脊髄損傷例の精液所見では,受傷後経過期間とともに回収できた総精子数は減少する傾向がみられ,運動率は慢性期のみならず,受傷後1ヵ月以内の急性期の症例においても低下がみられた.したがって,脊髄損傷における精巣,精巣上体等の障害はかなり早期からおこる可能性が示唆された.

Several methods to provoke ejaculations artificially have been used to treat patients with anejaculation. The purpose of this study is to investigate the clinical usefulness of electroejaculation for patients with anejaculation induced by spinal cord injury or surgical operation. Forty patients with spinal cord injury and one with anejaculatin after radical operation for rectal cancer underwent electroejaculation by Brindley's technique and/or modified Seager's technique. To reduce the electric energy consumed in patients, we applied bipolar pulses for modified Seager's technique instead of sine-wave current. Seminal emissions were obtained from 11 out of 18 patients by Brindley's technique and from 24 out of 29 patients by Seager's technique. From the patient with anejaculation after radical operation for rectal cancer, semen was obtained by modified Seager's technique. Most common complications were autonomic dysreflexia and pain. Since these complications disappeared soon after the termination of electrostimulation, this method was thought to be safer than intrathecal injection of neostigmine. Regarding the semen quality, it seemed that total sperm counts got worse as the interval after injury was extended. Not only in the chronic stage but also in the first one month after spinal cord injury, sperm motility was low. It was suggested that dysfunction of the testis and epididymis appeared in the early stage of spinal cord injury.

Journal

The Japanese Journal of Urology   [List of Volumes]

The Japanese Journal of Urology 84(8), 1479-1488, 1993-08-20  [Table of Contents]

The Japanese Urological Association

Cited by:  4

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Codes

  • NII Article ID (NAID) :
    110003087442
  • NII NACSIS-CAT ID (NCID) :
    AN00196577
  • Text Lang :
    JPN
  • Article Type :
    Journal Article
  • ISSN :
    00215287
  • Databases :
    CJPref  NII-ELS  J-STAGE