The effect of penile vibratory stimulation on male fertility potential, spasticity and neurogenic detrusor overactivity in spinal cord lesioned individuals.
OBJECTIVE
Present the possibility for treatment of male infertility, spasticity, and neurogenic detrusor overactivity in spinal cord lesioned (SCL) individuals with penile vibratory stimulation (PVS).


METHODS
Obtaining reflex-ejaculation by PVS, by using a vibrator developed for this purpose. The stimulation was performed with a vibrating disc of hard plastic placed against the frenulum of the penis (amplitude > or = 2.5 mm). The vibration continued until antegrade ejaculation or for a maximum of 3 minutes followed by a pause of 1 minute before the cycle was repeated, maximally 4 times.


RESULTS
>80% SCL men are able to obtain ejaculation with PVS. Pregnancy rates obtained with home PVS and intra-vaginal insemination was 22-62% (4 studies), and with PVS or electroejaculation and intrauterine insemination/in-vitro fertilization/intracytoplasmatic sperm injection 39-64% (9 studies). PVS was demonstrated to decrease spasticity significantly when measured by the modified Ashworth scale. In addition, a decrease of the number of spontaneous EMG events which probably indicate spasms was observed. Increase in bladder capacity at leakpoint following 4 weeks of frequent ejaculation with PVS treatment was likewise demonstrated.


CONCLUSIONS
PVS has proved its importance for SCL male fertility, in the years to come its place in treatment of spasticity and neurogenic detrusor overactivity has to be established.
Clinic for Spinal Cord Injuries, NeuroScience Centre, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark. finbs@rh.dk
F
F
Biering-Sørensen
L
L
Laeessøe
J
J
Sønksen
P
P
Bagi
J B
JB
Nielsen
J K
JK
Kristensen
D006801:Humans; D007248:Infertility, Male / Q000209:etiology / Q000534:rehabilitation*; D008297:Male; D009122:Muscle Hypertonia / Q000209:etiology* / Q000534:rehabilitation*; D010413:Penis / Q000294:innervation / Q000503:physiopathology*; D010812:Physical Stimulation / Q000379:methods*; D020127:Recovery of Function; D013119:Spinal Cord Injuries / Q000150:complications / Q000534:rehabilitation*; D016896:Treatment Outcome; D014732:Vibration / Q000627:therapeutic use*