One man was in a terrifying logging accident. Another dove into a shallow pond as a teenager. A third was the victim of a drive-by shooting. And yet another was in a horrific car crash. Miraculously, after surviving these unreal incidents, they shared the same problem: a spinal cord injury. And they all came to me for the same reason: they really wanted kids.
Broken Dreams
There is absolutely nothing redeeming about spinal cord injury. Often wheelchair bound with two working arms at best, men with these injuries find that nothing in everyday life is easy. And sex suffers too. Depending on exactly where the back is broken, erections are either unpredictable, or entirely silent. Ejaculation is nowhere to be found. And orgasm is a thing of the past. The one ray of hope in all the muck is that fertility is generally preserved. And that possibility gives life-sustaining meaning to a life turned upside down in every imaginable way.
Mechanics of Sex
Since ejaculation is a reflex, similar to a sneeze, the back, and more specifically, the spinal cord, is the key to its normal occurrence. Erections aren’t a reflex, but still rely on brain signals sent down the spinal cord to activate nerve centers in the pelvis. Interrupting the critical pathways within the cord wreaks havoc on both functions. But fertility potential resides mainly in the testicles which are generally unaffected by spinal cord injury. Think of spinal injuries as “functional” vasectomies in which the sperm “pump” is not blocked, but simply isn’t working well.
So, how do we get the pump working again? If the spinal injury is low, such that arms are usable and legs are paralyzed, then the ejaculation reflex is down for the count. In this case, we use a technique called rectal probe electroejaculation to manually get the pump to work and produce an ejaculate. If the spinal injury is high enough, then the ejaculation reflex is preserved. In this case, we can simply apply a high frequency vibrator to the penis to get the pump running and stimulate ejaculation. And once learned by the couple, the technique can be done at home and babies made the old-fashioned way. Amazing!
Seeing a wheelchair-bound dad with little kids running around him is the most satisfying feeling I think I’ve ever had at work. I stand in awe of the power of the human spirit, the willpower to survive, and the determination to thrive that these patients possess in spades. They are a constant source of inspiration to me and I am honored to help in any way I can.
This article first appeared on Dr. Turek’s blog.
