Sexual Dysfunction and Infertility in the Male Spina Bifida Patient

Nanfu Deng; Nannan Thirumavalavan; Jonathan A. Beilan; Alexander J. Tatem; Mark S. Hockenberry; Alexander W. Pastuszak; Larry I. Lipshultz


Transl Androl Urol. 2018;7(6):941-949. 

In This Article

Summary and Conclusions

Spina bifida is a congenital defect in neural tube closure with potential to affect various aspects of life, including sexual function and fertility. Infertility in this population can be caused by problems of sperm transport or defects in spermatogenesis. Reproductive potential is favored by lower lesions with intact sacral reflexes and absence of hydrocephalus as a comorbidity. Treatment strategies vary depending on the cause of infertility. Sildenafil citrate is an effective pharmacotherapy for maintaining erections while assisted reproductive technologies, such as sperm retrieval followed by ICSI, represent promising treatment options for infertility in those with ejaculatory dysfunction or decreased spermatogenesis. Genetics of infertility as it relates to spina bifida is still an area of growing research and represent an avenue for future studies. Finally, a large majority of adolescents and young adults suffering from spina bifida lack the essential knowledge regarding how spina bifida may affect their sexual health and reproductive potential. Failure of healthcare professionals to address this important matter poses significant challenges to men with spina bifida who wish to achieve fatherhood.