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Spinal Cord (2014) 52, 905910& 2014 International Spinal Cord Society All rights reserved 1362-4393/14
http://www.nature.com/sc
Web End =www.nature.com/sc
ORIGINAL ARTICLE
Premature ejaculation associated with lumbosacral lesions
F Courtois1 and K Charvier2
Study design: Retrospective study.
Objectives: Spinal cord injuries are usually associated with anejaculation, but few premature ejaculations (PE) are described in lumbosacral lesions. The objective of the study is to analyze the retrospective les of patients with lumbosacral lesions to explore whether PE is systematic, and which type of lesions (conus teminalis, epiconal, cauda equina) is associated with these PE. Methods: Standard sexological consultations from 34 men with L5-S4 lesions were analyzed including questions on psychogenic and reexogenic erection, and ejaculation. Medical assessment included bulbocavernosus, anal, and cremasteric reexes and urodynamics. Results: Thirty one (31/33) patients maintained natural ejaculations, but 18 complained of PE and ve of spontaneous ejaculations. Fourteen patients complained of dribbling ejaculation, and 27 of non-climactic ejaculation (13 no sensation, 10 some sensation, 4 painful sensation). Medical assessments showed absent or diminished anal sensation in 28 patients, absent or diminished anal reexes in 21, absent or diminished bulbocavernosus reexes in 20, but 12/13 positive cremasteric reex. Urodynamics showed 12/20 areex and 2/20 hyperactive bladders.
Conclusions: Most men with lower lumbosacral lesions maintain natural ejaculation, but often complain of PE following injury. The PE is such that a mere sexual thought can trigger the response, or appear spontaneously as daytime (sticky paints) or nighttime (sticky sheets) emissions. PE appears to be a direct consequence of the lesion as it is reported from the very rst ejaculation post injury, in men who otherwise controlled their ejaculation prior to injury. Underlying mechanisms may involve sacral inhibition on ejaculation, or simultaneous activation of psychogenic erection and emission. Clinical implications are discussed.
Spinal Cord (2014) 52, 905910; doi:http://dx.doi.org/10.1038/sc.2014.175
Web End =10.1038/sc.2014.175; published online 4 November 2014
INTRODUCTIONSpinal cord injuries (SCI) are most often associated with a loss of ejaculation,1 at least with natural stimulation.2 Although most authors have emphasized this loss of ejaculation following injury, a few authors have described the occurrence of premature ejaculations (PE),38
arising after the injury and related to lower lesions to lumbar or lumbosacral segments of the spinal cord (that is, conus terminalis, epiconal or cauda equina).
These PEs, described by...