The method of assisted ejaculation affects the outcome of semen quality studies in men with spinal cord injury: A review

The methods of penile vibratory stimulation (PVS) and rectal probe electroe jaculation (EEJ) are widely used to obtain semen from anejaculatory men wit h spinal cord injury. This paper reviews evidence that the semen quality re sulting from PVS versus EEJ is different, and these methods should be used as variables in studies of men with spinal cord injury. The following evide nce is reviewed. PVS and EEJ stimulate ejaculation by different mechanisms. In humans and monkeys, semen quality is different when obtained by PVS ver sus EEJ of the same group of subjects. In neurologically intact men, EEJ re sults in low sperm motility. Markers of accessory gland function are differ ent in ejaculates obtained by PVS versus EEJ. For scientific studies, it is recommended that whenever possible, antegrade specimens obtained by PVS be used. For clinical applications, such as obtaining sperm for assisted repr oductive procedures, the choice is less critical, however, PVS offers advan tages over EEJ.