A spinal cord lesion (SCL) changes most functions below the level of lesion, including sexual function. Most women had sexual intercourse after the lesion, but describe practical problems. Many of them are capable of achieving organism, and are normally fertile. During pregnancy there is an increased risk of urinary tract infection. Delivery can take place vaginally. In the case of lack of progression or severe autonomic dysreflexia, cesarean section may be necessary. For erectile dysfunction in men with SCL, oral sildenafil may be used, alternatively intracavernous injection with prostaglandin E1. To obtain ejaculation penile vibratory stimulation (PVS) is used, and if this fails then electroejaculation. Impaired sperm quality with low motility is observed. Vaginal insemination at home with sperm obtained by PVS is possible. The fertility potential may be enhanced with assisted reproduction techniques, like intrauterine insemination and in vitro fertilisation.
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