Quality of semen obtained by penile vibratory stimulation in men with spinal cord injuries : Observations and predictors

Abstract Objectives To study the semen quality and to examine prognostic factors that may affect semen quality in men with spinal cord injuries (SCI) who respond to penile vibratory stimulation (PVS). Methods Fifty-one PVS responders were prospectively examined. Penile vibratory stimulation was induced with optimized vibration parameters. Semen quality was characterized by semen analysis. The gel agglutination test for the presence of antisperm antibodies and serum hormone assays were performed. Characteristics of the spinal lesions, type of bladder management, and hormone assays were compared to semen quality and incidence of azoospermia or total lack of motility. Results The mean semen parameters were: volume−1.9 mL (range 0.2 to 7.0); total sperm-457 million (range 0 to 10,900); motility−12.6% (range 0% to 55%); total motile sperm-39.3 million (range 0 to 401); normal morphology−50.1 % (range 0% to 90%). Better sperm motility was seen in men with cervical lesions versus those with thoracic lesions (16% versus 7%) and incomplete versus complete lesions (19% versus 10%). There was a higher incidence of azoospermic specimens in men with thoracic lesions versus cervical level (26% versus 3%) and a lower incidence of finding any motile sperm in the specimen (47% versus 81%). Men voiding without catheters had a lower incidence of azoospermia (3% versus 28%). Abnormalities of hormone and antibody tests were rare. Conclusions Better sperm specimens from PVS of men with SCI may be expected from men with higher neurologic level, incomplete lesions, and those voiding without the use of a catheter. Hormonal abnormalities and immunologic causes do not explain the poor sperm quality seen in men with SCI.