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Thread: Dr. Young-one question regarding sci injury

  1. #1

    Dr. Young-one question regarding sci injury

    Dr. Young-

    Could you explain in as much detail as you can what would need to be done to restore male sexual potency? This is assuming that the SCI is Thoracic and/or lumbrosacral and bowel and bladder function and sensation are obliterated.
    Fopr example, when i self cath, I do not feel the catheter enter my bladder. When my injury started to move up the spinal cord, I remember being cathed, but with sensation, and I almost passed out. It was extremely uncomfortable! What has to be done, and by what method, theoretically, to restore sensation and erection and emission?

    thanks Dr. Young,
    bent

  2. #2
    Senior Member
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    While you're at in Dr. Young, could you please answer the same question regarding cervical injuries? Is there a difference in regaining sexual function and regaining full sensation in the beloved regions? Which most likely would occur first? Thanks

    "I will drive the lane,
    I will drain the three,
    I will finger roll,
    but the one thing I will not do is FADE AWAY"

  3. #3
    Also Dr. Young when you get a free moment-
    I know this sounds kind of weird- when I think sensual thoughts, I can feel a sensation within going down to my injury area ( T12) and stopping dead in their tracks. My hips kind of stiffen up. I mean I think I can really feel these nerves originate in the brain, then going downtown and being halted by my ichemic lesion.

  4. #4
    The mechanisms of erection are pretty well understood. Ejaculation is less well understood. And, of course, orgasms are a mystery still to most scientists. Most of the research today have focussed on erection and fertility. I need some direction because this is a huge topic. Would you like to start with the anatomy and then the physiology of erection and ejaculation? Wise.

  5. #5
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    Dr. Young, my question didn't relate so much to restoration of sexual function, but more of restoration of feeling in the genital area. Are they one in the same, and if not, which is most liely "simpler" to restore? Thanks

    "I will drive the lane,
    I will drain the three,
    I will finger roll,
    but the one thing I will not do is FADE AWAY"

  6. #6
    sensory signals from the penis are transmitted by the dorsal penile nerve which enters the spinal cord at S2-S3. These then distribute to different parts of the spinal cord, some to sacral sympathetic nuclei that initiate copulation reflexes and others of which send signals to the brain. The exact pathways of the sensory paths going up, particularly in humans, are not known (at least not to me). However, some evidence suggest that multiple pathways carry such signals to the brain, including non-spinal paths. For example, women with transected spinal cords can achieve orgasm apparently through the vagal nerve (the tenth cranial nerve) that does not go through the spinal cord at all. While there are speculations that this pathway exists in men, there isn't enough known on the subject.

    Sensations in the genital area are represented by the sacral dermatomes. The penis and testicles are served by S2-S3, the anal region S4-S5. Surface sensations are probably carried in the standard spinal sensory pathways, i.e. the dorsal columns for touch and position senses and the spinothalamic tracts for noxious pain (pin) and heat. There may be other pathways that mediate visceral sensations (gut and bladder) but the spinal tracts that carry these signals are not well understood (at least by me).

    Restoration of orgasmic sensations would be helped by the integrity or regeneration of one or more of multiple pathways that carry sexual signals to the brain. Note that such sensations may not be necessary for orgasms. For example, people do get "wet dreams" at night from just dreaming (which presumably happens in the brain).

    Wise.

  7. #7
    Is it possible, Dr. Young, for atrophy to make ejaculation impossible even if there were to be a regenerative treatment? Or is that muscle powerful enough that regeneration would be likely to restore ejaculatory function?

  8. #8
    Donny247, the penis is not a muscle. It is a very vascular tissue and erection occurs as a result of blood engorgement of the organ. To my knowledge, there should not be "atrophy" of the penis in the same way that muscles atrophy due to denervation. Many people with spinal cord injury have erections. Wise.

  9. #9
    Senior Member DA's Avatar
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    if the penis could atrophy, i think women would like it.

  10. #10
    Sorry, Dr. Young, I I should have been more clear. I wasn't talking about erections, but ejaculation. Isn't that controlled by a muscle? And wouldn't non-use cause atrophjy in the ejaculatory process?

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