title: Retrospective review on effectiveness of high-amplitude penile vibratory stimulation for conservative sperm retrieval in anejaculatory men with spinal cord injury: an Asian case series.
abstract: High-amplitude penile vibratory stimulation (PVS) is recommended as the first line method for conservative sperm retrieval in anejaculatory Caucasian men with spinal cord injury (SCI). Evidence of its effectiveness in Asian population is lacking. We described the effectiveness of high amplitude PVS for conservative sperm retrieval in the anejaculatory local men with SCI. Records of all SCI patients referred for conservative sperm retrieval trial from August 2014 to August 2015 were screened. Those who failed in artificial stimulation methods for sperm retrieval including masturbation, prostatic massage and low amplitude PVS were subjected to high amplitude PVS using Viberect X3. Data pertaining to detailed neurological findings, time to ejaculate, seminal fluid volume and its gross appearance, somatic responses at ejaculation and any adverse events were retrieved. Successful outcome is defined as occurrence of antegrade ejaculation. Thirteen out of 16 patients fulfilled all study criteria. 46% of the patients had neurological level above T6 followed by 34% with neurological level between T7-T12. Preserved reflexogenic and spontaneous erection were reported by 84.6% and successful coitus was reported by 45.4% of the patients. The overall ejaculatory success using high amplitude, high-frequency vibratory stimulation in our study was 46.15%. Among the patients with lesion at T6 and above, the ejaculatory success rate was 66.7% while for the study subjects with lesions below T6 was 33.3%. In conclusion, PVS outcome for sperm retrieval in asian population is comparable to that of Caucasian population. Its use is highly applicable in local population.
authors.affiliation: Rehabilitation Medicine Department, Hospital Sungai Buloh , Selangor, Malaysia.
authors.forename: Akmal Hafizah
authors.initials: AH
authors.lastname: Zamli
authors.affiliation: Rehabilitation Medicine Department, Hospital Sungai Buloh , Selangor, Malaysia.
authors.forename: Nor Azira
authors.initials: NA
authors.lastname: Ismail
authors.affiliation: Rehabilitation Medicine Department, Hospital Raja Perempuan Zainab 2 , Kelantan, Malaysia.
authors.forename: Kuo Ghee
authors.initials: KG
authors.lastname: Ong
keywords: Rehabilitation; Reproductive techniques