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.