Results of April survey 2007

Penile Vibratory Stimulation (PVS) has shown to be effective in:

1. Inducing ejaculation in anorgasmic men with spinal cord injury: Percentage of answers: 41,2%
2. Decreasing somatic spasticity in men with spinal cord injury: Percentage of answers: 0%
3. Restoring orgasm in neurologically intact men affected with idiopathic secondary anorgasmia/anejaculation: Percentage of answers: 11,80%
4. 1 + 2 + 3

Comments

Penile vibratory stimulation is currently considered the treatment of first choice for anejaculation in men with spinal cord injury, as it is effective and less invasive compared to electroejaculation and surgical sperm retrieval. Answer 1 is undoubtedly correct. Men affected with secondary anorgasmia are a very challenging subset of patients in sexual medicine. It has been shown that also in neurologically normal men, affected with secondary anorgasmia and with normal penile biothesiometry (penile vibration sensation) PVS can be effective, restoring orgasm in almost three quarters of cases [1]. Therefore answer 3 is right too.
Interestingly, a recent study reported that, used in SCI patients, PVS has also a positive antispastic effect, whit good clinical and electromyographic results [2]. The effect (measured with the Ashworth scale) tended to continue until hour 24 but did not show statistical significance after hour 6 [3]. The reason for the antispastic effect of penile vibratory stimulation is unknown: both the release of a humoral factor and the afferent nerve activity generated by the procedure might be involved.
The limitations of the latter study are that there was no control group and that the study was designed in a nonblinded fashion. Larger and more detailed studies are needed to address the extent and duration of the antispastic effect of penile vibratory stimulation, and also to elucidate if the antispastic effect is due to the stimulation itself or to the consequent ejaculation. However, in patient undergoing PVS some antispastic affect is expectable. Answer 2, then, is right as well. Very correctly, 47% of responders selected answer 4.

References

Nelson CJ, Ahmed A, Valenzuela R, et al. Assessment of penile vibratory stimulation as a management strategy in men with secondary retarded orgasm. Urology 2007; 69 (3): 552-5; discussion 5-6.
Laessoe L, Nielsen JB, Biering-Sorensen F, et al. Antispastic effect of penile vibration in men with spinal cord lesion. Arch Phys Med Rehabil 2004; 85 (6): 919-24.
3. Alaca R, Goktepe AS, Yildiz N, et al. Effect of penile vibratory stimulation on spasticity in men with spinal cord injury. Am J Phys Med Rehabil 2005; 84 (11): 875-9.