Term
| Do males with SCI appear to have any problems with the production of sperm of sufficient quality and quantity for fertilization? |
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Definition
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Term
| Do males with SCI appear to have any problems with the ability to deliver sperm? |
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Definition
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Term
| Because of the complexity of ejaculation, an injury to any level of the SC (whether high or low, complete or incomplete) usually prevents ejaculation from occurring how? |
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Definition
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Term
| In males with SCI is ejeculation related to whether or not the individual has erections or can have intercourse? |
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Definition
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Term
| Is it possible to have ejaculation without erection? |
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Definition
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Term
| In males with SCI it is more common to see erection without what? |
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Definition
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Term
| Even with erection sufficient for sexual activity, as many as 90% of men with SCI are not able to __ during intercourse. |
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Definition
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Term
| In males with SCI, an erection is not controlled; name 2 ways in which it might occur. |
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Definition
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Term
| In order for males to be fertile, they must be able to do what 2 things? |
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Definition
1. Produce and store large numbers of active sperm
2. Deliver the sperm to a receptive egg (ejaculation) |
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Term
| A very complicated process that is best considered as two separate actions, emission and ejaculation proper because of the way it is controlled by the nervous system |
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Definition
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Term
| Namethe 2 separate actions of ejaculation |
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Definition
Emission
Ejaculation Proper |
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Term
| The contraction of the epididymis, vas deferens, seminal vesicles, and prostate gland to expel their contents into the urethra at the level of the prostate. Together all of these substances compose what is known as semen. |
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Definition
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Term
| During this time, the bladder neck closes to prevent the semen from going backwards (retrograde) into the bladder and the urinary sphincter closes to trap the semen between the bladder neck and the sphincter while pressure builds up. This phase is controlled by the sympathetic nervous system located in the SC at T10-L2 |
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Definition
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Term
| The rhythmic contraction of the urethra and pelvic muscles to propel the semen thru the penis to the outside. As the pressure builds in the urethra, the urinary sphincter opens to permit escape of the semen. The force of the expulsion is dependent on how much pressure develops before the sphincter relaxes. This phase is controlled by the sacral reflex center at S2-4 |
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Definition
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Term
| This can occur if the bladder neck is not tight enough as the pressue builds in the urethra, the semen may escape backwards into the bladder. |
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Definition
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Term
| When ejaculation doesn't occur spontaneously, several techniques for stimulation have been tried with varying degrees of success, dependent on the level of completeness of SCI, the time since injury, the method of urinary management, the # of acute UTIs or epididymitis. If sperm is obtained with any of these stimulation methods it can then be placed into the vagina at the appropriate time for ovulation. This is known as |
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Definition
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Term
| Can some individuals achieve ejaculation via masturbation? |
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Definition
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Term
| If __ is applied to the penis, it can sometimes trigger ejaculation. When this is successful, it could be done at home. However, potential complications should be well understood. |
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Definition
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Term
| This is essentially the same procesdure that is used in cattle to obtain sperm for breeding. It is the most effective technique, but is considerably more dangerous than using a vibrator and should not be used except in a medical setting under general anesthesia. The stimulation is usually applied over the prostate thru the rectum and the sperm is medically harvested. |
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Definition
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Term
| Can ejaculation cause AD? |
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Definition
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Term
| For individuals who can ejaculate with masturbation or vibration but not with intercourse, its fairly easy to have a sperm count done (to confirm # and quality of sperm) and learn how to do __ __ at home. |
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Definition
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Term
| When electrical stimulation is done, the sperm is collected by a DR and preserved until the insemination can be done. What is this insemination process called? |
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Definition
| Intrauterine insemination |
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Term
| This process involves collecting sperm by either masturbation, vibration, or e-stim, collecting an egg from the female, combining the two in a test tube until fertilization occurs and then re-implanting the egg in the uterus. This is probably the most successful and reliable method, but is also the most difficult and expensive. |
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Definition
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Term
| Does a SCI have a significant effect on male hormone levels (testosterone) or on the ability to produce and store sperm? |
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Definition
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Term
| Since ejaculation rarely occurs, what is the major problem for men with SCI? |
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Definition
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Term
| Does the effect of SCI have more of an impact on males or females? |
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Definition
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Term
| Females may not have a period for __ months after the injury, however they can still get pregnant. |
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Definition
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Term
| The physiological changes normally associated with sexual response are not essential for women to be able to have ___. From a practical standpoint the most significant response is lubrication of the vagina and this can easily be substituted. Sexual counseling needs to be directed at issues such as pregnancy, contraception, pleasure, and practical things like positioning, bowel and bladder management, etc. |
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Definition
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Term
| This is thought to be the physiological equivalen of erection in the male and is probably innervated in the same way. Some SCI women report that they do not have reflex __ and others do not. This has never need carefully documented and correlated with the level of injury. |
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Definition
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Term
| When lubrication needs to be substituted, always used __ __ lubricants such as TODAY, astroglide, KY jelly, etc. Never use vasoline (because it is oil based) |
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Definition
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Term
| Why is positioning so important to make the woman comfortable during intercourse? |
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Definition
Spasticity
Contractures
Areas of hypersensitivity to touch |
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Term
| The intense pleasure that accompanies a climax and is usually associated with other physical events such as ms spasms followed by a feeling of relaxation. |
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Definition
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Term
| Do we know if orgasm is different with women who have SCIs? |
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Definition
| No b/c women vary a lot with this anyway |
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Term
| Women are much more likely to use what type of catheter than men? |
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Definition
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Term
| Is the foley catheter located in the woman's vagina? |
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Definition
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Term
| Can you leave a catheter in during sex? |
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Definition
| Yes, must be VERY careful not to pull it out |
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Term
| The menstrual cycle is under hormonal control (not neurologic) in non-SCI women and distributed via what? |
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Definition
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Term
| Will a SCI at any level affect a woman's ability to get pregnant? |
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Definition
| No because fertilization is hormonal and distributed thru bloodstream, it is not neurological |
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Term
| About 50% of newly injured SCI women will not miss any periods and most will resume regular periods within what time frame? |
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Definition
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Term
| If a womans periods have not resumed __ months after her injury, a DR should be consulted about possible hormone therapy to stimulate ovulation. |
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Definition
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Term
| Does the type of contraception matter with SCI? |
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Definition
| Not really but BP problems are an issue more with SCI women |
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Term
| Inhibition of ovulation using hormones is safer now than ever but there is still and increased risk of thrombophlebitis (blood clots). Women who use a w/c are at further risk for phlebitis because of inactivity. Smoking greatly increases this risk. Its recommended that hormone use should not be started until 6-12 months after injury and should be avoided completely in anyone with a history of clots. |
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Definition
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Term
| This new method of implanting hormones under the skin sounds promising, but there hasn't been enough research to know what the long-term risks might be. Theres no reason to think that the risks for SCI are any diff than normal women. |
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Definition
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Term
| This form of contraception includes all methods of mechanically preventing sperm from reaching the uterus such as condom, diaphragm, sponge, etc. The risks are no diff for SCI than non-SCI except quads may need assistance inserting the diaphragm. |
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Definition
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Term
| There is a high rate of complications in all women and this method is generally discouraged in SCI b/c the serious complications that can occur will usually be recognized by symptoms of pain. With an inability to feel, these complications may go unnoticed. |
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Definition
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Term
| This method consists of avoiding intercourse during the peak fertility period (3-4 days around ovulation). The problem is that this time is not easy to predict, especially if periods are irregular. This is one of the least reliable methods of contraception |
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Definition
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Term
| What is the most diffcult thing about a SCI woman being pregnant? |
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Definition
| Finding a DR familiar with SCI |
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Term
| Women after SCI who are pregnant will be considered high risk due to the following 9 things: |
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Definition
1. Pressure of fetus can complicate bowel and bladder programs
2. Weight gain (w/c may not fit)
3. Affecting mobility skills
4. Increasing pressure sore risk
5. Increased risk for UTIs
6. Changes in spasticity patterns
7. Decreased respiratory capacity from pressure of fetus on diaphragm
8. Cardiovascular changes
9. Alterations in normal feeling of and response to contractions during labor |
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Term
| Is breast feeding any different with SCI women? |
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Definition
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Term
| What 5 things is the PT involved in with pregnant or new mothers and fathers with SCI? |
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Definition
Equipment ordering
Home evals
Mobility management
Positioning evals
Education |
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Term
| Can an SCI woman deliver vaginally? |
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Definition
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