Penile vibratory stimulation in patients with spinal cord injury [Penilní vibrostimulace u pacientů s míšním poraněním]
Abstract
Objectives: Following spinal cord injury (SCI), ejaculatory dysfunctions are frequent. In men who wish to father children, assisted sperm retrieval is often necessary.
Penile vibratory stimulation (PVS) is a non-invasive method for sperm retrieval in patients with a lesion above T10. The aim of our research was to evaluate the effectiveness and safety of PVS, semen quality and further utilization of the ejaculate.
Methods: Between 2010 and 2014, we performed PVS in 20 patients. An injury of the cervical (C) and thoracic (T) spinal cord was present in 13 and seven patients, respectively.
The mean age of patients was 30.8 years. The mean time from the injury to PVS was 64 months.
Seven patients had the first PVS more than 3.5 years after the injury and 13 patients less than 3.5 years. FERTi CARE Multicept was used for PVS.
Results: Ejaculation was achieved in 11 patients (55%) - in nine with C and in two with T SCI. Success rate of PVS in patients less than 3.5 years after the injury was 77%, compared to 14% in patients more than 3.5 years after the injury, p = 0.027.
Total sperm count (p = 0.03), sperm concentration (p = 0.025) and the number of sperm with progressive motility (p = 0.027) increased in the semen from the second PVS. Obtained ejaculate is mostly (72%) cryopreserved only for further use.
The ejaculate was used for fertilisation in two patients. One patient had azoospermia.
Autonomic dysreflexia during PVS occurred in seven patients, symptoms resolved within 3 mins. Conclusion: PVS is a safe method for sperm retrieval.
Semen quality improved with repeated PVS. The ejaculate was successfully used for fertilisation in two patients.