Seminal vesicle aspiration in spinal cord injured men: Insight into poor sperm quality

Purpose: In men with spinal cord injury poor quality semen is seen when per forming electroejaculation and penile vibratory stimulation. We determined whether sperm stasis within the seminal vesicles is a potential cause of th is problem. Materials and Methods: Seminal vesicle aspiration was performed immediately before electro ejaculation or penile vibratory stimulation in men with asp ermia secondary to spinal cord injury. Sperm count and quality of seminal v esicle aspiration and subsequent ejaculation were compared with historical ejaculated counts, ultrasound findings and patient characteristics. Results: Mean total number of right plus left;seminal vesicle sperm plus or minus standard deviation was 511 +/- 960 x 16(6). Mean total number of spe rm obtained by seminal vesicle plus electroejaculation or penile vibratory stimulation was 918 +/- 1,261 x 10(6). Average motility and viability of th e seminal vesicle aspirated sperm were 1.3 and 3.2%, respectively. Average motility of the ejaculated sperm was 26.4% after seminal vesicle aspiration versus 16.3% in previous ejaculation induction procedures performed in the same patients. Seminal vesicle aspirated sperm represented 66% of the tota l number of sperm obtained during the session and was equal to 49% of the s perm obtained at previous electroejaculation or penile vibratory stimulatio n sessions. The period of abstinence correlated only with ejaculate count ( simple regression p = 0.009). No other clinical characteristics had any eff ect on sperm count or quality. Conclusions: Large numbers of poor quality sperm are present within the sem inal vesicles of spinal cord injured men and these sperm comprise a large p ortion of the specimens collected by electroejaculation or penile vibratory stimulation. This phenomenon is independent of the period of abstinence, i mplicating disordered storage of sperm due to spinal cord injury rather tha n infrequent ejaculation. The large number of senescent sperm within the se minal vesicles appears to be a primary cause of poor sperm quality in spina l cord injured men.