Zamli Akmal Hafizah, Ismail Nor Azira, Ong Kuo Ghee
Rehabilitation Medicine Department, Hospital Sungai Buloh , Selangor, Malaysia.
Rehabilitation Medicine Department, Hospital Raja Perempuan Zainab 2 , Kelantan, Malaysia.
Spinal Cord Ser Cases. 2016 Apr 7;2:15038. doi: 10.1038/scsandc.2015.38. eCollection 2016.
High-amplitude penile vibratory stimulation (PVS) is recommended as the first line method for conservative sperm retrieval in anejaculatory Caucasian men with spinal cord injury (SCI). Evidence of its effectiveness in Asian population is lacking. We described the effectiveness of high amplitude PVS for conservative sperm retrieval in the anejaculatory local men with SCI. Records of all SCI patients referred for conservative sperm retrieval trial from August 2014 to August 2015 were screened. Those who failed in artificial stimulation methods for sperm retrieval including masturbation, prostatic massage and low amplitude PVS were subjected to high amplitude PVS using Viberect X3. Data pertaining to detailed neurological findings, time to ejaculate, seminal fluid volume and its gross appearance, somatic responses at ejaculation and any adverse events were retrieved. Successful outcome is defined as occurrence of antegrade ejaculation. Thirteen out of 16 patients fulfilled all study criteria. 46% of the patients had neurological level above T6 followed by 34% with neurological level between T7-T12. Preserved reflexogenic and spontaneous erection were reported by 84.6% and successful coitus was reported by 45.4% of the patients. The overall ejaculatory success using high amplitude, high-frequency vibratory stimulation in our study was 46.15%. Among the patients with lesion at T6 and above, the ejaculatory success rate was 66.7% while for the study subjects with lesions below T6 was 33.3%. In conclusion, PVS outcome for sperm retrieval in asian population is comparable to that of Caucasian population. Its use is highly applicable in local population.
高振幅阴茎振动刺激（PVS）被推荐为患有脊髓损伤（SCI）的射精障碍白种男性保守取精的一线方法。目前尚缺乏其在亚洲人群中有效性的证据。我们描述了高振幅PVS在患有SCI的射精障碍本地男性中进行保守取精的有效性。筛选了2014年8月至2015年8月期间因保守取精试验而转诊的所有SCI患者的记录。那些在包括手淫、前列腺按摩和低振幅PVS等人工刺激取精方法中失败的患者，使用Viberect X3进行高振幅PVS。收集了有关详细神经学检查结果、射精时间、精液量及其外观、射精时的躯体反应以及任何不良事件的数据。成功的结果定义为顺行射精的发生。16名患者中有13名符合所有研究标准。46%的患者神经损伤平面高于T6，其次是34%的患者神经损伤平面在T7 - T12之间。84.6%的患者报告有保留的反射性和自发性勃起，45.4%的患者报告有成功性交。在我们的研究中，使用高振幅、高频振动刺激的总体射精成功率为46.15%。在T6及以上水平有损伤的患者中，射精成功率为66.7%，而在T6以下水平有损伤的研究对象中，射精成功率为33.3%。总之，亚洲人群中PVS取精的结果与白种人群相当。它在本地人群中具有高度适用性。
