Vibroejaculation, also known as penile vibratory stimulation (PVS), is a medical procedure that induces ejaculation by applying controlled vibration to the penis. It is primarily used to obtain sperm from individuals who are unable to ejaculate through conventional means. It offers a non-invasive approach for sperm retrieval.
Understanding Vibroejaculation
Vibroejaculation stimulates the ejaculatory reflex arc through mechanical vibration. A specialized vibrating device is placed on the glans penis. These vibrations activate sensory nerves, sending signals through the nervous system to trigger reflex pathways in the spinal cord that control ejaculation.
When the ejaculatory reflex arc is successfully activated, it leads to contractions of the seminal vesicles, vas deferens, and prostate, which propel sperm and seminal fluid into the urethra. Then, rhythmic contractions of the pelvic floor muscles facilitate the expulsion of semen. The effectiveness of this stimulation depends on the integrity of the neurological pathways involved in the ejaculatory reflex.
Primary Uses and Candidates
Vibroejaculation is primarily used in male fertility treatment for individuals with anejaculation (the inability to ejaculate). This condition is common in men with spinal cord injuries (SCI), where the nerve pathways responsible for ejaculation may be disrupted. Approximately 80% of men with spinal cord injuries above the T10 level with an intact ejaculatory reflex can achieve antegrade ejaculation with PVS.
Men with neurological conditions like multiple sclerosis or diabetic neuropathy may also be candidates. It is considered a first-line treatment for anejaculation in men with SCI due to its non-invasive nature and ease of use compared to other methods like electroejaculation. The retrieved sperm is used in assisted reproductive technologies.
The Procedure and Important Considerations
During vibroejaculation, a specialized mechanical vibrator is applied to the glans penis. The device is set at a specific frequency and amplitude (often 100-110 Hz with 2.5 mm amplitude) to maximize stimulation. The procedure, performed in a clinical setting, is considered painless and often requires no anesthesia or sedation.
Patient preparation may involve ensuring a full bladder, as retrograde ejaculation into the bladder can occur, and sometimes pre-medication to adjust urine pH to protect sperm. For men with SCI, the success rate can be as high as 88% for injuries at or above the T10 level. Potential side effects can include autonomic dysreflexia in individuals with SCI, a sudden and dangerous spike in blood pressure. Monitoring blood pressure and heart rate is important during the procedure.
The retrieved sperm is processed by an IVF laboratory. It is used for various assisted reproductive technologies, including intrauterine insemination (IUI), where processed sperm is placed directly into the female partner’s uterus. If sperm quality is poor, as can be the case with SCI, in vitro fertilization (IVF) with intracytoplasmic sperm injection (ICSI) may be used, where a single sperm is injected into an egg.