Brackett N L, Ferrell S M, Aballa T C, Amador M J, Padron O F, Sonksen J, Lynne C M
Miami Project to Cure Paralysis and Department of Urology, University of Miami School of Medicine, Florida 33136, USA.
J Urol. 1998 Jun;159(6):1931-4. doi: 10.1016/S0022-5347(01)63200-2.
We evaluated ejaculatory response and semen quality in 653 trials of penile vibratory stimulation in 211 men with spinal cord injury, and compared results with low versus high amplitude vibratory stimulation.
Low and/or high amplitude penile vibratory stimulation was performed 1 to 27 times in each patient, and antegrade and retrograde specimens of those who ejaculated were analyzed.
Significantly more patients ejaculated using high (54.5%) versus low (39.9%) amplitude stimulation. Using either amplitude the ejaculatory success rate was highest in men with injuries at C3 to C7, followed by T1 to T5, T6 to T10 and T11 to L3. While high amplitude stimulation increased the ejaculatory success rate in each group, the highest rate occurred in men with injuries at C3 to C7 (65.6%). Ejaculation was reliable, since most men who ejaculated did so during 100% of the trials and within 2 minutes of stimulation onset. Symptoms of autonomic dysreflexia were safely managed with nifedipine. All patients who ejaculated produced antegrade specimens. With the exception of ejaculate volume, which was significantly higher with high versus low amplitude stimulation, semen parameters were similar using both vibrator amplitudes.
Ejaculatory success is better while semen quality is similar using high versus low amplitude penile vibratory stimulation in men with spinal cord injury. This method may be considered first line treatment for anejaculation in men with spinal cord injury due to its safety, relative effectiveness, and relatively low investment of time and money.
我们评估了211例脊髓损伤男性患者653次阴茎振动刺激试验中的射精反应和精液质量，并比较了低振幅与高振幅振动刺激的结果。
对每位患者进行1至27次低振幅和/或高振幅阴茎振动刺激，并对射精患者的顺行和逆行标本进行分析。
与低振幅刺激（39.9%）相比，高振幅刺激（54.5%）使更多患者射精。无论使用哪种振幅，C3至C7损伤的男性射精成功率最高，其次是T1至T5、T6至T10和T11至L3。虽然高振幅刺激提高了每组的射精成功率，但最高成功率出现在C3至C7损伤的男性中（65.6%）。射精是可靠的，因为大多数射精的男性在100%的试验中且在刺激开始后2分钟内射精。硝苯地平可安全处理自主神经反射异常症状。所有射精患者均产生顺行标本。除高振幅刺激组的射精量显著高于低振幅刺激组外，两种振动器振幅下的精液参数相似。
脊髓损伤男性患者使用高振幅与低振幅阴茎振动刺激时，射精成功率更高，而精液质量相似。由于其安全性、相对有效性以及相对较低的时间和金钱投入，该方法可被视为脊髓损伤男性患者不射精的一线治疗方法。
