As far as the ability to get and maintain an erection is concerned, the location of the spinal cord injury is crucial. If the nerves which connect to the penis are injured in the place in the lower back where they leave the spinal cord, a man probably will not be able to get an erection because the nerves controlling erection are injured. (Occasionally, patients with such injuries report that they can get an erection from being mentally aroused, but not from physical stimulation.) If the injury is higher and actually inside the spinal cord, a man may be able to get reflex erections from local stimulation even though he doesn’t feel it. Such erections may not be well maintained, and they may disappear quickly. In some men, however, the erections work well and they are pleased they can satisfy their partner.

For Eddie, 28 years old, making his wife happy is important. An automobile accident two years ago left him permanently paralyzed from the waist down. Eddie’s nerves were damaged so severely that now he can’t feel anything below his waist, and he is completely unable to get an erection. But Eddie’s brain was unaffected by the accident, and he still has quite powerful sexual desires for his wife, Carla. At first, Eddie and Carla went to see a urologist because they wanted to have another child. They found it easier to talk about fertility than about sexuality. But after some discussion, it was clear to them and the doctor that having a satisfactory sex life was also a great concern.

It’s a terrible fact that Eddie will never recover from the devastating damage done to his nervous system. But he and his wife don’t have to live the rest of their lives without being able to enjoy intercourse. Penile shots helped Eddie and Carla have sex for the first time in two years. This made them both very happy.

Back Problems

Back problems can cause erection difficulties. If a disc between the vertebrae slips and compresses the nerves coming out of the spinal cord, the pressure on the nerves can short-circuit the process necessary for erection. (And certainly the pain from a slipped disc can make sex the farthest thing from a man’s mind.) Sometimes, surgery on the disc corrects the problem and restores potency; in other cases, the back pain disappears but the lack of erection remains. Such cases can be helped with penile shots or implants.

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