The majority of men who have a spinal cord injury (SCI) experience the inability to get an erection and/or to ejaculate through sexual stimulus. Often, the areas responsible for the blood flow and nerve stimulation needed to get and maintain an erection are damaged, resulting in a type of erectile dysfunction.
With 12,000 new cases every year, spinal cord injury is most prevalent among young men. Besides the disruption that ejaculatory disorders can cause in intimate relationships, this dysfunction is especially problematic for couples that are trying to conceive. Fortunately, advancements in technology have given men with SCI many options that were not available just a few years ago; one of these is penile vibratory stimulation, or PVS.
How Does SCI Affect Stimulation and Ejaculatory Function?
Men with spinal cord injury have varied experiences when it comes to sexual functioning. Some are able to get an erection when sexually stimulated and ejaculate normally. Others may get an erection when aroused, but may be unable to maintain it.
Some men might suffer from anejaculation, where they are unable to ejaculate, either with an orgasm (orgasmic anejaculation) or without orgasm (anorgasmic anejaculation.) Occasionally, men with SCI have retrograde ejaculation, where semen enters the bladder via the urethra, instead of being emitted through the penis. Still others may not be able to get an erection at all.
There are various types of erections caused by different types of stimuli, and men with SCI may be affected differently based on the location of their injury:
- A reflexogenic erection, also called a reflex erection, is a spontaneous erection caused by stimulation from touch. This type of erection is induced by a nerve reaction in the lowest areas of the spinal cord, so if the spinal injury is above T10, this erectile function may not be impaired.
- A psychogenic erection results from thoughts about arousing stimuli. This type of erectile functioning may be impaired in men with a spinal cord injury at or below T11. Essentially, the connection from the brain to the sex organs is damaged or severed, so even if arousal from mental stimulation is intact, the body is unable to respond with an erection. Sometimes, men are able to get a partial psychogenic erection but not firm enough for sexual intercourse.
- A spontaneous erection, often called a nocturnal erection, happens during sleep. Many men with SCI get these types of erections, sometimes quite frequently throughout the night. A spontaneous erection can also happen when the bladder is full.
In addition to problems with ejaculation or erectile functioning, some men with SCI produce sperm with low viability or motility, affecting fertility.
Whether a man with SCI is able to get an erection but not to ejaculate or is unable to get an erection at all, we can help treat the issue with penile vibratory stimulation.
What Is PVS?
Penile vibratory stimulation is a non-invasive, non-surgical procedure to induce an orgasm with normal ejaculatory function. Many couples opt for this method, which can be combined with in vitro fertilization (IVF) or intrauterine insemination (IUI), when attempting to conceive. Once the patient’s sperm is collected, it can be processed in an IVF lab and transferred to the partner’s uterus.
Penile vibratory stimulation involves placing an FDA-approved tool with a vibrator pad at the base of the penis, either at the dorsal artery or the frenulum tissue beneath the penis. This external vibratory stimulation has a high success rate for producing both an erection and ejaculation. Occasionally, stimulation may be required at both the dorsum and frenulum simultaneously. In this case, two vibrator pads are used in these locations at the same time.
What Should I Expect During PVS?
The PVS procedure has a very high reliability rate and safety profile. The procedure is done in our office and as it is painless, it requires no anesthetic. Our doctors will assess the location of the spinal cord injury to determine both the placement of the vibratory device as well as the appropriate frequency setting.
The nerves around the base of the penis are stimulated, nitric oxide is naturally released in the body, and in most cases, the patient is able to get an erection and to ejaculate normally. The PVS tool is externally applied, and there is no internal insertion required.
There are no drugs required before, during, or after the procedure, and there is no soreness or pain requiring recovery time.
If you are a male who is struggling with erectile dysfunction, anejaculation, retrograde ejaculation, or poor semen parameters due to a spinal cord injury, call us today to make an appointment with one of our specialists. Our doctors can gather your history, talk through your options, and answer any questions you may have about the penile vibratory stimulation procedure. Whether you want to conceive or are attempting to regain normal ejaculatory function, we can work with your needs to achieve the desired outcome.