A young man is in an accident that crushes his spinal cord at the neck and leaves him paralyzed from the neck down. The man asks his physician if he will be able to have erections and father any children. What should the doctor tell him? Explain your answer.

Answer:

The physician should tell the man that he may be able to have erections but likely not father any children.

Men get erections in 3 ways viz. psychogenic (thoughts), reflexogenic (in response to physical touch or stimulation of the penis), and spontaneous (due to fullness of bladder, etc.). After the crushing spinal cord injury and paralysis, psychogenic erections usually get abolished but reflexogenic and spontaneous erections do continue to occur. However, ejaculation is rarely achieved and even when it occurs there may be retrograde ejaculation (discharge of semen in one's own bladder) or there may not be any discharge at all.