Penile vibratory stimulation in spinal cord injured men: optimized vibration parameters and prognostic factors.

OBJECTIVE

To study the efficacy of penile vibratory stimulation (PVS) with optimized vibration parameters in spinal cord injured (SCI) men and to examine prognostic factors for success.

DESIGN

Case series.

SETTING

University hospital outpatient clinic.

PATIENTS

Thirty-four consecutive SCI men seeking fertility treatment.

INTERVENTION

PVS with optimized vibration parameters to induce reflex ejaculation.

MAIN OUTCOME MEASURES

Ejaculatory response; semen analysis.

RESULTS

Antegrade ejaculation was seen in 65% of patients. High rates were seen in lesions above T10 (81%) and in presence of hip flexion and bulbocavernosus reflexes (77%). Of men with lesions above T10, those with a penile prosthesis had lower ejaculation rates (40% vs 90%). Average total sperm counts were 968 million, with 26% motility.

CONCLUSIONS

High rates of ejaculation are seen with optimized vibration parameters, especially in men with lesions above T10 and intact lower spinal reflexes. A penile prosthesis may impair success with PVS.