Abstract
Ejaculation and orgasm are two entities of sexual satisfaction in men after spinal cord injury (SCI). The scientific literature focuses on potentiating erection and on the sperm retrieval procedures for fertility purposes, but little has been written about the pleasurable aspects of ejaculation and the potential for orgasm in men after SCI. Men with SCI who have lower motor neuron or incomplete injuries appear to have an increased chance of ejaculating through sexual practices, whereas men who have injuries above neurological level T10 respond best to vibrostimulation. Orgasm after SCI is a local, learned spinal reflex that is interpreted via cerebral centers. In general, intense genital stimulation may be needed to elicit the subjective experience of orgasm, but extragenital stimulation or cerebral input alone can lead to orgasmic release for some men after SCI. Sexual rehabilitation includes three principles: maximization of the innate physiological potential, adaptation to limitations, and promotion of a positive outlook for sexual potential via experimentation.
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