Vibratory stimulation for treatment of anejaculation in quadriplegic men

Pryor, Jon L.; LeRoy, Suzanne C.; Nagel, Theodore C.; Hensleigh, Hugh C.

doi:10.1016/s0003-9993(95)80044-1

Cited by 22 publications

(14 citation statements)

References 18 publications

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“…These rates were substantially higher than for the group using electroejaculation and IVI (10% per couple and 5% per cycle). Possible factors contributing to greater success at home include di erences in sperm motility between di erent retrieval techniques 29,55 and neurological levels, 22 improved sperm motility with increased vibrator use at home 9,56 and increased number of inseminations per cycle.…”

Section: Discussionmentioning

confidence: 99%

A comprehensive approach to the management of male infertility following spinal cord injury

et al. 1999

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Objectives: To review the outcomes of management of male infertility following spinal cord injury in a specialised fertility clinic. Study Design: Retrospective review of medical records. Setting: The Fertility Clinic of a 45-bed spinal cord injury service in New South Wales, Australia. Methods: The medical and fertility clinic records of 113 males who attended the clinic between 1987 and 1997 were reviewed. Results: The rates of semen retrieval using vibroejaculation and electroejaculation were 67% and 97% respectively. Thirty-one individuals (37%) and their partners sought assistance with the primary aim of achieving a pregnancy. Intravaginal insemination (IVI) undertaken at home following vibroejaculation resulted in a pregnancy rate per cycle of 22%. Electroejaculation and IVI proved less successful with a pregnancy rate per cycle of only 5%, although with intrauterine insemination (IUI) this rate improved to 30%. Micromanipulation in vitro fertilisation (IVF) procedures, primarily intracytoplasmic sperm injection, were used in 18 couples resulting in a pregnancy rate per cycle of 19%. In the 31 couples there have been a total of 17 pregnancies in 97 cycle attempts for an overall pregnancy rate per cycle of 18% and a cumulative pregnancy rate per couple of 55%. Twelve of the pregnancies have resulted in 14 live births (including two sets of twins), there were three pregnancies ongoing at the date of review and there have been two spontaneous abortions. Conclusion: The bene®ts of a specialised fertility clinic o ering a comprehensive, clientfocused approach with education, fertility assessment and a range of semen retrieval and assisted reproduction options, are highlighted.

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Section: Discussionmentioning

confidence: 99%

A comprehensive approach to the management of male infertility following spinal cord injury

et al. 1999

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“…Reflex contraction of this muscle after stimulation of the DNP has been documented with electrophysiological studies [ 12]. Vibratory stimuli applied to the glans penis induced ejaculation in men with spinal cord injury [ 13, 14], supporting the concept that the DNP is the principal source of afferent excitatory drive to the BCM and ejaculation.…”

Section: Discussionmentioning

confidence: 91%

“…Reflex contraction of this muscle after stimulation of the DNP has been documented with electrophysiological studies Discussion [12]. Vibratory stimuli applied to the glans penis induced ejaculation in men with spinal cord injury [13,14], Erection and ejaculation in man require the participation of the autonomic and somatic nervous systems [7]. The supporting the concept that the DNP is the principal source of aCerent excitatory drive to the BCM and emphasis in most human anatomical studies has focused on the contribution of the autonomic nervous system ejaculation.…”

Section: Resultsmentioning

confidence: 99%

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Neuroanatomy of the penile portion of the human dorsal nerve of the penis

Yang

Bradley

1998

British Journal of Urology

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Objective To determine the distribution of the dorsal nerve of the penis (DNP), the principal somatosensory nerve innervating the phallus, along the penile shaft and within the glans penis. Materials and methods The DNP was dissected in human autopsy specimens, using low magnification, following the course of the nerve from the symphysis pubis into the glans penis. Results The shaft and glans were innervated by separate populations of axons. The lateral and ventral portions of the penile shaft were innervated by branches arcading from the dorsal midline radiating toward the ventral surface. These branches were very variable and some were seen to penetrate the corpus spongiosum. The axons innervating the glans were constant in a dorsal, midline location along most of the penile shaft, and once within the glans, there was abundant branching. Undulations in the nerves were noted along the penile shaft. Conclusions The lateral arcading branches of the DNP provide a sensory pathway on the ventral and lateral penile shaft, and the termination of the fibres at the corpus spongiosum is consistent with pudendal innervation of the penile urethra. The distinct pattern of innervation of the glans emphasizes the role of the glans as a sensory structure. These findings may aid in planning penile surgical procedures.

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“…The preservation of the frenular web is also associated with prolonged ejaculation latency time [17]. In patients with spinal cord injury, vibratory stimulation applied to the frenulum of the penis produced ejaculates sufficient for intrauterine insemination [18]. By sparing this important structure in our technique, these unique qualities that the frenulum possesses are protected.…”

Section: Discussionmentioning

confidence: 99%