척수손상 환자에서 방광 및 요도 압력이 정액의 질에 미치는 영향

Abstract

Objective: To evaluate the influences of detrusor and urethral pressure on the sperm quality in spinal cord injured male patients. Method: 34 spinal cord injured male patients were participated in this study. We measured the maximal detrusor pressure, compliance of detrusor, involuntary detrusor reflex and urethral pressure by urodynamic study. And we induced ejaculatory stimulation by vibratory (FerticareⰒ) and electrical stimulation (SeagerⰒ) and analyzed the sperm volume, the concentration, the total sperm count, the motile sperm count and motility. Analysis of variance (ANOVA) and paired t-test were used to compare sperm quality among groups of urodynamic parameters.

Results: Semen quality such as sperm concentration, sperm volume, motile sperm count was significantly (p＜0.05) better in patients with low maximal detrusor pressure, high detrusor compliance, normtonic urethral pressure than with high maximal detrusor pressure, low detrusor compliance, hypertonic urethral pressure, regardless of involuntary detrusor reflex.

Conclusion: The proper management of neurogenic bladder for improving semen quality in spinal cord injured male patients may be needed for better pregnant outcomes.