(183) Global Trends in Prevalence and Outcomes of Penile Vibrator Stimulation: A Systematic Review
Authors: Agrawal P , Able C , Kohn T , Clifton M , Rubin R 
Published: May 2023

Abstract

Introduction
Penile vibrator stimulation is a robust and applicable treatment for various male sexual disorders including, delayed ejaculation, anejaculation, decreased penile sensation, and erectile dysfunction. Even though penile vibrators, amongst other sexual aids, are important tools for sexual function wellness, scientific literature describing the global prevalence and outcomes of penile vibrator stimulation remains sparse.

Objective
To systematically review and summarize the current literature regarding penile vibrator usage to study trends in penile vibrator stimulation and to analyze penile vibrator prevalence and satisfaction.

Methods
A systematic review of PubMed, EMBASE, CENTRAL, and ClinicalTrials.gov was performed for studies assessing trends and outcomes in penile vibrator stimulation from database inception through June 2022. The search was based on the keywords: “vibrator”, “vibration”, “sexual enrichment aids”, “sex toys”, “external penile devices”, “sexual health”, “erectile function”, “infertility”, “fertility”, “ejaculation”, “sex”, “sexual satisfaction”. 843 relevant articles were identified. Studies that met inclusion criteria: original research, male subjects, and vibrators studied for male sexual health benefits were reviewed. Studies were excluded if the study was a case report or did not report sexual health outcomes associated with vibrator use. A total of 66 studies met the criteria for full-text review (Figure 1).

Results
Thirty studies were identified during the systematic review, comprising 14,750 males reported to utilize penile vibrator stimulation from 1984 to 2021, with a steady increase in published studies over time (Figure 2). Nineteen of these studies reported penile vibrator stimulation in 1,198 males with spinal cord injuries. A total of 8 studies assessed vibrator stimulation as the primary intervention: five in men with spinal cord injuries and 3 in men without. Amongst studied in males with spinal cord injuries: sixteen assessed impacts on ejaculation, four assessed pregnancy outcomes, three assessed impacts on sperm quality, and two assessed patient satisfaction and preference. In the eleven studies assessing men without spinal cord injuries: three looked at the impact of vibrator stimulation on improving erectile function, two looked specifically at homosexual men, and three looked at the impact on ejaculation and orgasm disorders, and four looked at penile vibrator usage prevalence. Out of the thirty studies, only one study assessed the prevalence of recreational use of vibrators specifically in heterosexual men, and only three assessed personal satisfaction. Overall, an overwhelming majority of studies reported positive outcomes, including anterograde ejaculation amongst males with spinal cord injuries and erection rigidity amongst males with erectile dysfunction with vibrator utilization.

Conclusions
Penile vibratory stimulation remains a viable option for the treatment of delayed ejaculation or anejaculation following spinal cord injury. Moreover, in neurologically intact males, penile vibratory stimulation has demonstrated many benefits in the studies identified. While more research efforts are needed to fully investigate the potential of penile vibrators; in light of the many sexual wellness benefits identified, urologists should recommend them to males presenting with sexual concerns or dysfunction.

Disclosure
No