Abdominal electric stimulation facilitates penile vibratory stimulation for ejaculation after spinal cord injury: a single-subject trial.
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.
Goetz
Lance L
LL
Veterans Affairs North Texas Health Care System, Spinal Cord Injury Center, Dallas, TX 75216, USA.
Stiens
Steven A
SA
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