title: Abdominal electric stimulation facilitates penile vibratory stimulation for ejaculation after spinal cord injury: a single-subject trial.
abstract: OBJECTIVE
  To compare the success rate of penile vibratory stimulation (PVS) alone with PVS and abdominal electric stimulation (AES).
  
  
  METHODS
  Single-subject trials.
  
  
  METHODS
  Outpatient.
  
  
  METHODS
  Man with chronic T3 complete (American Spinal Injury Association Impairment Scale grade A) spinal cord injury. Spasticity, Babinski response, anal wink, and bulbocavernosus reflexes were all present.
  
  
  METHODS
  Stimulation was presented to the frenulum using a Ferti Care Personal vibrator set at maximal settings (frequency, 110 Hz; amplitude, 3.55 mm). AES was applied to the abdomen using a commercially available muscle stimulator at maximal stimulus intensity and duration settings. Trials were randomized to PVS only or PVS plus AES.
  
  
  METHODS
  Presence or absence of ejaculation, and time to ejaculation.
  
  
  RESULTS
  Only 4 of 30 trials were positive with PVS alone, while 31 of 34 trials were positive with PVS plus AES. Additionally, 17 of 26 PVS trials, which were initially negative with PVS alone, were then positive with the addition of AES. This represents a clinically relevant improvement with use of AES. Time to ejaculation for positive trials with either technique was not statistically significant.
  
  
  CONCLUSIONS
  AES significantly lowered the threshold for ejaculation elicited with vibratory stimulation and increased the success rate over that when PVS alone was used.
authors.affiliation: Veterans Affairs North Texas Health Care System, Spinal Cord Injury Center, Dallas, TX 75216, USA.
authors.forename: Lance L
authors.initials: LL
authors.lastname: Goetz
authors.forename: Steven A
authors.initials: SA
authors.lastname: Stiens
mesh_terms: D000328:Adult; D004542:Ejaculation / Q000502:physiology*; D004558:Electric Stimulation / Q000379:methods*; D007172:Erectile Dysfunction / Q000209:etiology / Q000534:rehabilitation*; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D010264:Paraplegia / Q000150:complications / Q000175:diagnosis; D010413:Penis / Q000294:innervation*; D011336:Probability; D013119:Spinal Cord Injuries / Q000150:complications* / Q000175:diagnosis; D013904:Thoracic Vertebrae; D016896:Treatment Outcome; D014732:Vibration / Q000627:therapeutic use