Clinical Predictors of Vibrator-Assisted Ejaculation following Spinal Cord Injury: A Prospective Observational Study.

Autor: Alisseril S; Department of Physical Medicine and Rehabilitation, TD Medical College, Alappuzha, Kerala, India., Prakash NB; Department of Neurological Rehabilitation, National Institute of Mental Health and Neurological Sciences, Bengaluru, Karnataka, India., Chandy BR; Department of Physical Medicine and Rehabilitation, Christian Medical College, Vellore, Tamil Nadu, India., Tharion G; Department of Physical Medicine and Rehabilitation, Christian Medical College, Vellore, Tamil Nadu, India.
Jazyk: angličtina
Zdroj: Journal of neurosciences in rural practice [J Neurosci Rural Pract] 2021 Sep 28; Vol. 12 (4), pp. 758-763. Date of Electronic Publication: 2021 Sep 28 (Print Publication: 2021).
DOI: 10.1055/s-0041-1735819
Abstrakt: Introduction  Infertility in men with spinal cord injury (SCI) occurs due to combination of factors like erectile dysfunction, ejaculatory failure, and semen abnormalities. Penile vibratory stimulation (PVS) is a known method of treatment for anejaculation. Predicting successful outcome of PVS depends on several clinical factors, which assess the intactness of the neural arc pertaining to the spinal ejaculation pattern generator. This study reports the clinical predictors for successful candidacy for a PVS trial in males with SCI. Methods  Twenty-three males with SCI, satisfying the inclusion criteria, were recruited in this prospective observational study. Participants underwent two trials of PVS with single high-amplitude vibrator. The clinical predictors recorded were neurological level, superficial abdominal reflex, cremasteric reflex, bulbocavernosus reflex, plantar reflex, ankle jerk, knee jerk, lower abdominal sensation, and hip flexor response. In addition, somatic responses during PVS were recorded and corelated. Participants who had successful ejaculation were "responders" and the others were termed as "nonresponders." Binary logistic regression analysis of the clinical parameters was done to compare responders against nonresponders. Results  Of the twenty-three males (mean age 33.2 ± 6.8 years) with paraplegia, all four persons with neurological level above T9 had successful ejaculation with PVS. Among all the clinical parameters in the study, presence of somatic responses showed statistical significance in predicting successful ejaculation ( p -value = 0.02). Conclusion  This study reports that in men with SCI, along with the level of injury, somatic responses and other clinical reflexes, should be considered concurrently to predict the outcome of vibrator assisted ejaculation.
Competing Interests: Conflict of Interest None declared.
(Association for Helping Neurosurgical Sick People. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. ( https://creativecommons.org/licenses/by-nc-nd/4.0/ ).)
Databáze: MEDLINE
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