Columbia News Service
Mar. 13, 2007 06:26 PM
Nearly 15 years ago David Bucks was extreme skiing in California when an avalanche knocked him down and threw him from a 200-foot cliff onto a rock face. Three of his vertebrae broke into 42 pieces. At 33, Bucks was completely paralyzed below the chest. Once he realized he’d live, he feared that he’d never be able to have sex again.
You’re telling me that my other legs won’t be able to walk but will little Junior?” Bucks recalled asking the doctors.
By Maria J. Amador, B.S.N., CRRNCharles M. Lynne, M.D.Nancy L. Brackett, Ph.D., HCLD
A publication funded by the Paralyzed Veterans of American Spinal Cord Injury Education and Training Foundation+
In the United States, there are 8,000 to 10,000 spinal cord injuries that occur each year. The majority of these injuries happen to men between the ages of 16 and 45 – typically the reproductive years. Many men with spinal cord injury/dysfunction (SCI/D) experience fertility problems related to their injury and want to know if they can become biological fathers.
There are two main problems men with SCI/D face when considering biological fatherhood. First
Antispastic Effect of Penile Vibration in Men With Spinal Cord Lesion
Objective: To evaluate the possible antispastic effect penile vibratory stimulation (PVS) in men with spinal cord lesionDesign:Unblinded, before-after trial.
Setting: Ambulatory care.
Participants: Nine men with SCLs from C2 to T8 were randomly allocated into 2 groups.Intervention: Twenty-four hours of electromyographic recordings from the quadriceps and tibialis anterior muscles were taken, followed by PVS or no treatment and another 24 hours of electromyographic recordings. The presence of electromyographic activity of an amplitude 4 times the baseline, with a duration of more than 5 seconds, was taken to signify a spasm. The number of spasms per hour was calculated before and after PVS and no treatment. Spasticity was evaluated by the Modiﬁed Ashworth Scale(MAS).
Main Outcome Measure: Reduction in spasticity and spasms.
Results: The electromyographic data showed a signiﬁcant reduction in the frequency of leg spasms up to 3 hours (P<.05). Signiﬁcantly decreased spasticity, as evaluated by MAS, was found immediately after vibration (P<.01).Conclusions: PVS may be useful as an antispastic therapy.
AN ANALYSIS OF 653 TRIALS OF PENILE VIBRATORY STIMULATION IN MEN WITH SPINAL CORD INJURY
The Journal of Urology Copyright © 1998 by American Urological Association, Inc.
BRACKETT, NANCY L.; FERRELL, SEAN M.; ABALLA, TEODORO C.; AMADOR, MARIA J.; PADRON,OSVALDO F.; SONKSEN, JENS; LYNNE, CHARLES M.
From the Miami Project to Cure Paralysis and Department of Urology, University of Miami School of Medicine, Miami, Florida, and Department of Urology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark Accepted for publication December 12, 1997.
Supported in part by grants from the State of Florida and The Miami Project to Cure Paralysis.(BRACKETT) Requests for reprints: The Miami Project to Cure Paralysis, University of Miami School of Medicine, P.O. Box016960, R-48, Miami, Florida 33136.
Abstract Purpose: We evaluated ejaculatory response and semen quality in 653 trials of penile vibratory stimulation in 211 men with spinal cord injury, and compared results with low versus high amplitude vibratory stimulation.
Materials and Methods: Low and/or high amplitude penile vibratory stimulation was performed 1 to 27 times in each patient, and antegrade and retrograde specimens of those who ejaculated were analyzed.
Results: Significantly more patients ejaculated using high (54.5%) versus low (39.9%) amplitude stimulation. Using either amplitude the ejaculatory success rate was highest in men with injuries at C3 to C7, followed by T1 to T5, T6 to T10 and T11 to L3. While high amplitude stimulation increased the ejaculatory success rate in each group, the highest rate occurred in men with injuries at C3 to C7 (65.6%). Ejaculation was reliable, since most men who ejaculated did so during 100% of the trials and within 2 minutes of stimulation onset. Symptoms of autonomic dysreflexia were safely managed with nifedipine. All patients who ejaculated produced antegrade specimens. With the exception of ejaculate volume, which was significantly higher with high versus low amplitude stimulation, semen parameters were similar using both vibrator amplitudes.
Conclusions: Ejaculatory success is better while semen quality is similar using high versus low amplitude penile vibratory stimulation in men with spinal cord injury. This method may be considered first line treatment for anejaculation in men with spinal cord injury. This method may be relative effectiveness, and relatively low investment of time and money.