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The penis is placed in a cylinder and the air is pumped out, causing blood to be drawn into the erectile tissues. Some men experience retrograde ejaculation in which semen travels in reverse, back into the bladder. Professional counseling can help in working through feelings of fear or anxiety over establishing or continuing a healthy relationship after paralysis. A reflex erection is involuntary and can occur without sexual or stimulating thoughts. Penile vibratory stimulation PVS is an inexpensive and fairly reliable way to produce an ejaculation at home. Emotional changes occur, of course, and these too can affect a person's sexuality.

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After recovery, stroke survivors may feel depressed.

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Paralyzed men with ED should have a thorough physical exam by a urologist familiar with their condition before using any medications or assistive devices. During genital stimulation, spasticity is more likely to be increased and autonomic dysreflexia may occur, thus requiring temporary cessation of sexual activity. Fertility Fertility is the third biggest issue: A reflex erection is involuntary and can occur without sexual or stimulating thoughts. Couples may also want to explore the very rewarding options available to adopt children. An injection erection is a more difficult option for those with limited hand function. Men with complete injuries are less likely to experience psychogenic erections.

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