Penile Vibratory Stimulation (PVS) is considered first line treatment of inability to ejaculate in men. Common reasons for utilizing PVS may be spinal cord injuries, diabetes mellitus, or medication-induced ejaculatory dysfunction. PVS is an office procedure that is painless and requires no anesthetic or sedation. The procedure involves a specially designed mechanical vibrator being placed at the head penis (called glans) and set to a certain frequency and amplitude for periods of 2-3 minutes or until ejaculation occurs. There is a resting time of 1-2 minutes between stimulation periods. The entire procedure can take up to 30-45 minutes. The goal of PVS is to stimulate the ejaculatory reflex. While the procedure is being performed, it is not uncommon for the patient to experience reactions such as erections, abdominal muscle contractions, or leg spasms. Side effects of the procedure may include autonomic dysreflexia in patients with spinal cord injuries at or above the T6 level which presents as headache, skin flushing, sweating, chest tightness, uncontrolled blood pressure, and decreased pulse. If enough sperm is collected in the ejaculate, they are washed and processed by the In vitro fertilization (IVF) lab and can be used for intrauterine insemination (IUI).
Melatonin and Sperm Quality
While the beneficial nature of melatonin, an endogenous anti-oxidant, has been known for decades, the investigation into the role of melatonin in fertility treatments, in
