Penile Vibratory Stimulation for Semen Retrieval in Men with Spinal Cord Injury: Patient Perspectives

Research and Reports in Urology, 2022 · DOI: https://doi.org/10.2147/RRU.S278797 · Published: April 21, 2022

Spinal Cord Injury Urology Women's Health

Simple Explanation

Spinal cord injury often leads to ejaculatory dysfunction, hindering the ability to father children and negatively impacting self-esteem and social rehabilitation. Penile vibratory stimulation (PVS) is a safe and effective method for sperm retrieval in men with SCI, particularly those with injuries at or above the T10 level. PVS offers a less invasive and more patient-preferred alternative to electroejaculation (EEJ), with a high success rate in obtaining motile sperm suitable for assisted reproductive techniques.

Study Duration

30 years

Participants

500 men with SCI

Evidence Level

Not specified

Key Findings

1
PVS is highly effective (86% success rate) for sperm retrieval in SCI patients with injury levels at or rostral to T10.
2
PVS yields a higher percentage of motile sperm compared to EEJ in men with SCI.
3
Specific somatic reflexes, like piloerection, withdrawal responses, extremity spasms, and thigh abduction, are more frequently observed during successful PVS trials.

Research Summary

This review outlines the evolution of penile vibratory stimulation (PVS) as a primary method for sperm retrieval in men with spinal cord injury (SCI), highlighting its safety, efficacy, and cost-effectiveness. The Male Fertility Program's 30-year experience demonstrates that PVS can produce an ejaculate in a significant percentage of SCI patients, offering them a reasonable chance at biologic fatherhood through assisted reproductive techniques. An algorithm incorporating neurological considerations, injury level, and reflex assessment is presented to optimize sperm retrieval outcomes and minimize morbidity in men with SCI desiring biologic parenthood.

Practical Implications

Clinical Practice

PVS should be considered as the first-line method for sperm retrieval in men with SCI, especially those with injuries at or above T10.

Patient Counseling

Patients should be educated about the benefits and risks of PVS, as well as the importance of managing autonomic dysreflexia.

Research

Further research is needed to optimize PVS techniques and improve sperm quality in men with SCI.

Study Limitations

1
The success of PVS is dependent on the level of spinal cord injury.
2
Autonomic dysreflexia is a potential complication of PVS in patients with injuries at or above T6.
3
Semen quality may be impaired in men with SCI, even when sperm is obtained through PVS.

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