Penile Vibratory Stimulation for Semen Collection in Patients with Ejaculatory Disorders
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Abstract
Background: Ejaculation is a complex physiological process that is mediated by interwoven neurological and hormonal pathways. Any interference with those pathways may cause a wide range of ejaculatory disorders including delayed ejaculation (DE) anejaculation or premature ejaculation. The aim of this study is to assess the efficacy of penile vibratory stimulation using a vibrator for semen collection in patients with DE or anejaculation for seminal fluid analysis or assisted reproductive technique. Materials and method: The study was a combined retrospective and prospective study on which demographic information, risk factors for DE/anejaculation, history of prior ejaculation and outcome of vibration were all retrieved from the clinic register for the retrospective component; these were combined with those documented from the prospective component. All the Patients were trained on how to place and maintain the erect penis on the vibrator and stimulated for initially less than 30mins which may be extended to 60mins. The findings will then be recorded. Results: The age of the patients ranged between 23 to 89 years with a mean age of 39 ±9.7 years. The risk factors for the DE among our patients were diabetes mellitus (28.1%), prolong penile stimulation requirement (24.5%) and spinal cord injury (19.3%) among others. Patients with lifelong (primary) DE accounted for 19.3% and acquired (Secondary) DE accounted for 80.7%. Following the procedure, the semen yield based on the duration of the vibratory stimulation (<30mins vs 30-60mins) was statistically significant (P=0.0022). Conclusion: The success of semen yield with PVS improves with increasing duration of vibratory stimulation and the procedure is largely safe in majority of the patients Recommendation: Penile Vibratory stimulation can be recommended for patients unable to produce semen for the purpose of conducting seminal fluid analysis (SFA) or use in assisted reproductive technique (ART).
