"Our results suggest that fresh sperm from NEs serves as an alternative source of sperm for patients with idiopathic anejaculation. The purpose of sperm collection should be considered before performing procedures such as PVS and EEJ. These procedures cause several side effects, such as skin abrasion, penis edema, and autonomic dysreflexia in men with a history of SCI. This study is the first to evaluate the quality of semen obtained by NEs in men with idiopathic anejaculation. The semen collected by NEs had higher motility and more normal morphology than that collected by PVS and EEJ. The semen collected by EEJ had higher motility and more normal morphology than that collected by PVS. The present results provide new insights into the quality of semen from this subgroup of patients with idiopathic anejaculation."