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PubMed1976

Marital sexual dysfunction: ejaculation disturbances.

The three clinically encountered disturbances of the male orgasmic phase--that is, premature ejaculation, inability to ejaculate, and retrograde ejaculation--are discussed. The problem of defining premature ejaculation is explained and the possible pathogenic mechanisms of its origin are reviewed. The classic premature ejaculator is described. Also included are an elaboration of the newer therapeutic approaches to the problem and a suggested clinical protocol for screening patients. The other two, less common dysfunctions are briefly discussed.

Ejaculation↗
PubMed1999

Effect of repeated ejaculation on semen quality in spinal cord injured men.

PURPOSE: We evaluate the effect of repeated ejaculations on semen quality in spinal cord injured men. MATERIALS AND METHODS: The study included 19 spinal cord injured men with anejaculation. Semen was obtained by penile vibratory stimulation in the clinic and patients were instructed in the technique. Optimized vibration parameters were used (2.5 mm. amplitude at 100 Hz.). Penile vibratory stimulation was performed at least once a week for 12 months. Semen quality was examined at baseline and every 3 months during the 1-year study period. Hormonal assays were also performed at each visit. In 9 patients unilateral testicular biopsy was done at baseline and at the end of the 12 months. RESULTS: Normal sperm counts and low motility were seen at baseline. No semen parameter significantly changed during the 12 months of repeated ejaculation. All hormonal assays during the entire study were within normal range and no significant change was observed. Of the 9 biopsies 6 (67%) showed normal spermatogenesis at baseline and no convincing qualitative changes in testicular histology were seen after repeated ejaculation. CONCLUSIONS: Repeated ejaculation in spinal cord injured men does not change the typically poor semen quality. Therefore, stagnation in the seminal ducts due to infrequent ejaculation is not the etiology of the poor semen quality in these patients.

Adult↗
PubMed1999

Molecular detection of prostate cells in ejaculate and urethral washings in men with suspected prostate cancer.

PURPOSE: To determine whether prostatic cells were normally present in ejaculate and if the sensitivity and specificity of the detection of malignant prostate cells in ejaculate and urethral washings from men with suspected prostate cancer could be improved using the more sensitive molecular technique of reverse transcriptase-polymerase chain reaction (RT-PCR). MATERIALS AND METHODS: RT-PCR for prostate-specific antigen (PSA), prostate-specific membrane antigen (PSM) and Apoliprotein D (3 putative prostate-specific and/or cancer-specific markers) was performed on RNA extracts of ejaculate (80) and urethral washings (52) from 77 men with suspected prostate cancer and 12 young controls (<30 years of age) and urines from 5 men who had radical prostatectomies and 10 women. RESULTS: PSA, PSM and Apolipoprotein D expression was detected in ejaculates and urethral washings from both patient and control groups. No differences were observed in the results obtained for 58 men with suspected or 19 men with confirmed prostate cancer or the 18 vasectomized men within the patient group. Urines from the 5 men who had radical prostatectomies and 10 women were all negative for PSA, but PSM was detected in 2 female urines and in 3 radical prostatectomy samples. As few as 10 LNCaP prostate tumor cells could be detected by PSA RT-PCR when added to female urine. CONCLUSION: We have established a sensitive method of detecting prostatic cells in ejaculate and urethral washings and shown that PSA RT-PCR is a reliable indicator of prostate cells in these samples. However, RT-PCR for PSA, PSM and Apoliprotein D were not useful for discriminating malignant from non-malignant prostate cells.

Adult↗
PubMed1999

Treatment of premature ejaculation with paroxetine hydrochloride as needed: 2 single-blind placebo controlled crossover studies.

PURPOSE: We evaluate the efficacy of paroxetine hydrochloride as needed for the treatment of premature ejaculation. MATERIALS AND METHOD: Study 1 comprised 26 potent men with a mean age of 39.5 years with premature ejaculation who were randomized to receive 20 mg. oral paroxetine (group A) or placebo (group B) as needed 3 to 4 hours before planned intercourse in a controlled single-blind crossover trial. Study 2 comprised 42 potent men with a mean age of 40.5 years with premature ejaculation who were randomized to receive 10 mg. paroxetine daily for 3 weeks and then 20 mg. paroxetine as needed (group C) for 4 weeks or placebo daily for 3 weeks and then placebo as needed (group D) for 4 weeks. RESULTS: Mean pretreatment ejaculatory latency time was 0.3 minute for study 1. At 4 weeks mean ejaculatory latency time was 3.2 minutes in the paroxetine as needed and 0.45 in the placebo as needed phase for group A (p < 0.001), and 0.6 in the placebo as needed and 3.5 in the paroxetine as needed phase for group B (p < 0.001). There were no adverse effects with paroxetine or placebo in study 1. Mean pretreatment ejaculatory latency time was 0.5 minute for study 2. At 3 weeks mean ejaculatory latency time was 4.3 minutes in the paroxetine daily and 5.8 in the paroxetine as needed phase, and 0.9 in the placebo daily and 0.6 in the placebo as needed phase for group C (p < 0.001). At 3 weeks mean ejaculatory latency time was 0.8 minutes in the placebo daily and 1.1 in the placebo as needed phase, and 3.3 in the paroxetine daily and 6.1 in the paroxetine as needed phase for group D (p < 0.001). Adverse effects in 7 of 42 men (17%) given paroxetine daily included an ejaculation in 3, anorexia in 1, gastrointestinal upset in 3 and reduced libido in 2. Mean ejaculatory latency time was greater in the paroxetine as needed phase of study 2 than that of study 1 (p < 0.05), suggesting that ejaculatory control achieved with paroxetine as needed is significantly better if patients are initially treated with the drug daily. CONCLUSIONS: Paroxetine appears to be superior to placebo in the pharmacological treatment of premature ejaculation when administered on a chronic or as needed basis.

Adult↗
PubMedDate not supplied

[Clinical significance of the determination of R-proteins in the ejaculate of patients with chronic prostatitis].

Products of cell receptor (R-proteins) catabolic lysis were measured in ejaculate of 121 patients with chronic prostatitis and 15 healthy males. R-protein levels were higher in the patients (U = 172.5; p = 0.047). When immunological indices of the ejaculate (IgA, sIgA, IgG, IgM, interleukin-8) were measured, it was found that in patients with chronic prostatitis there is a positive correlation between concentration of interleukin-8 and content of R-proteins (r = 0.43; p = 0.028). Positive correlation also exists between R-protein content and prostate volume (r = 0.24; p = 0.034) while negative one--between R-proteins concentration and size of the hypoechogenic sites in the prostate (r = -0.25; p = 0.039), between R-proteins in the ejaculate and serum level of fibrinogen B (r = -0.25; p = 0.021). It is inferred that elevation of ejaculate R-protein level occurs in alteration of the prostate. The test for R-proteins in ejaculate can be helpful in detection of early stages of chronic prostatitis.

Adolescent↗
PubMedDate not supplied

[Apoptosis during spermatogenesis and in ejaculated spermatozoa: importance for fertilization].

It has become clear in recent years that programmed cell death occurs spontaneously in the cycle of the seminiferous epithelium. Induced germ cell apoptosis occurs at specific stages of the spermatogenic cycle and the existence of supracellular control of germ cell death during spermatogenesis has been documented. If apoptosis is a key phenomenon in the control of sperm production, the existence and role of apoptosis in ejaculated sperm cells remain controversial. Apoptosis - as determined by DNA fragmentation (Tunel) and ultrastructural analysis - is abnormally frequent in the sperm cells of the ejaculate of sterile men. In this review, we discuss the possible origins of DNA damage in ejaculated human spermatozoa and the consequences of these DNA damage if the apoptotic spermatozoa is used for ICSI. Percentages of DNA fragmentation in human ejaculated sperm correlated with fertilization rates after FIV or ICSI assay. Detection of DNA fragmentation in human sperm could provide additional information about the biochemical integrity of sperm and may be used in future studies for fertilization failures not explained by conventional sperm parameters. However, the analysis of other molecular markers of apoptosis (Fas, Annexine V.) is now necessary to assess the role of apoptosis in human ejaculated sperm cells.

Adult↗
PubMed2002

[Effects of Seroxat on premature ejaculation: a clinical trial].

OBJECTIVES: To evaluate the effects of antidepressant Seroxat on premature ejaculation. METHODS: After having taken Seroxat 20 mg every noon for four weeks, the patients were asked to fill the investigating questionaire about the effects and side effects before and after the treatment. RESULTS: After the treatment, 43 cases in our study had increased their ejaculation latency time, enhanced the quality of their sexy lives and their wives', and had significant difference compared with pre-treatment(P < 0.001). They had good effects on improving premature ejaculation after taking Seroxat (11.26 +/- 5.79) days; and after having stopped taking seroxat for (20.94 +/- 8.04) days, the situation of premature ejaculation in 32 cases were as same as that of before. There were seven cases whose sexuality and oomph increased, and two cases whose sexuality were decreased. A few patients had constipation, dry in mouth, insomnia and itch in skin, after taking the drugs. CONCLUSIONS: Antidepressant Seroxat has rather good effects on premature ejaculation and should be used and studied further.

Adult↗
PubMed2002

[Periodic changes in serum testosterone levels after ejaculation in men].

The purpose of this study was to determine the changes in sex hormone level in men after ejaculation. The serum testosterone concentrations of 28 male volunteers were investigated daily during abstinence period after ejaculation. We found that fluctuations of testosterone levels from day 2 to day 5 of abstinence were minimal. On day 7 of abstinence, a peak of serum testosterone appeared, reaching 145.7% of the baseline (P<0.01). After the peak, no regular fluctuation was observed. Ejaculation was the premise and beginning of the 7 days' periodic phenomenon. If there was no ejaculation, there was no periodical changes in serum testosterone level. These results indicate that the periodic change in serum testosterone level is caused by ejaculation.

Adult↗
PubMed2002

[Ejaculatory profile: a pressure of 5 meters H2O at the level of the bladder neck during ejaculation].

INTRODUCTION: The existence of a pressure gradient in order to prevent retrograde ejaculation in men with no ejaculatory disorders has always been postulated, but without any scientific evidence. MATERIAL AND METHOD: The profile of the prostatic urethra was recorded during ejaculation in 5 men with no ejaculatory disorders using a 10 F balloon catheter with 16 pressure channels, situated in pairs every 5 mm, starting just below the balloon in the bladder neck and extending as far as the external urethral sphincter. RESULTS: The pressure in the proximal part of the proximal urethra was 500 cm H2O in the five men, but this pressure did not exceed 400 cm H2O distally as far as the colliculus seminalis. CONCLUSION: The authors present a new method for recording the urethral pressure profile during ejaculation (ejaculatory profile). This study provides a better understanding of the mechanisms of normal ejaculation and could be useful for the evaluation of disorders of ejaculation.

Biophysical Phenomena↗
PubMed1990

Ejaculation and its disorders.

Ejaculation is the final link of the male sexual function chain "Libido--Erection--Penetration--Achievement of Climax--Ejaculation". Each link is highly androgen-dependent. Although the initiation of a subsequent link is normally dependent on achievement of the previous link, each link has its own mechanisms, and can be made to occur in isolation. The basic requirements for ejaculation are the production of seminal fluid (mostly from the seminal vesicles) and its propulsion. The production of a normal volume of seminal fluid requires the presence of seminal vesicles and the maintenance of their secretion by androgens. The propulsion of seminal fluid is in 3 phases: I. Contraction of seminal vesicles; II. Closure of bladder neck (both due to T9-L2 sympathetic stimulation); III. Expulsion of semen from the bulb of the urethra (due to S2-S3 somatic stimulation). The coordination of these phases is probably at hypothalamic level. Failure of ejaculation may be classified into I. Deficiency of production of seminal fluid from (1) Absence of seminal vesicles or (2) Androgen deficiency from (a) Pituitary dysfunction or (b) Testicular interstitial-cell failure from a number of causes. Correction of androgen deficiency usually restores ejaculation.

Ejaculation↗
PubMedDate not supplied

Teratospermic and normospermic domestic cats: ejaculate traits, pituitary-gonadal hormones, and improvement of spermatozoal motility and morphology after swim-up processing.

Electroejaculate traits, testicular volume, and circulating FSH, LH, and testosterone concentrations were compared between two populations of domestic cats consistently producing either a high (greater than 60%, normospermic) or low (less than 40%, teratospermic) incidence of structurally normal spermatozoa/ejaculate. The effects of semen dilution in Biggers, Whitten and Whittingham (BWW) or modified Krebs Ringer bicarbonate (mKRB) medium and swim-up processing on sperm viability and duration of motility in vitro also were assessed. Ejaculate volume, percent sperm motility, sperm progressive motility, motile spermatozoa/ejaculate, testes volume, and mean serum FSH and LH concentrations were similar (P greater than 0.05) between normospermic and teratospermic cats. However, sperm concentration/ml of ejaculate was greater and circulating testosterone levels were lower in teratospermic males. Swim-up processing increased (P less than 0.05) percent sperm motility, progressive motility, and the number of structurally normal sperm cells recovered and also prolonged the duration of sperm motility in both cat populations. In teratospermic ejaculates, swim-up separation increased the proportion of morphologically normal spermatozoa recovered by more than two-fold. Diluting cat semen with either BWW or mKRB increased flagellar bending in both normospermic and teratospermic cats. The sperm motility characteristics of only the teratospermic ejaculates were influenced by medium type; mKRB increased percent sperm motility and progressive motility whereas BWW had no effect. Compared with undiluted raw ejaculates, the duration of sperm motility was improved 18- to 24-fold by diluting semen in either BWW or mKRB medium followed by swim-up processing. This study demonstrates that the electroejaculate characteristics of domestic cats vary markedly and that some males consistently produce high proportions of morphologically abnormal spermatozoa. Diminished serum testosterone concentrations and normal pituitary secretion of FSH and LH in teratospermic males suggest that there is an inverse relationship between gonadal androgen production and pleiomorphic spermatozoa in the domestic cat. The swim-up procedure is effective for recovering motile, structurally normal spermatozoa from teratospermic cats.

Animals↗
PubMed1979

Effects of age and frequency of ejaculation on sperm production and extragonadal sperm reserves in stallions.

Extragonadal reserves totalled 89 X 10(9) spermatozoa for 5--16-year-old sexually rested stallions and 60 X 10(9) for 2--4-year-olds. Regardless of age, the cauda epididymidis contained 62% of the total reserves and the vas deferens, including the ampulla, contained 7% of the total reserves of spermatozoa. The caput plus corpus epididymidis from 5--16-year-old stallions (N = 41) contained 14.9 X 10(9) spermatozoa per side as compared (P less than 0.01) to 8.5 X 10(9) for 2--4-year olds (N = 30). Frequency of ejaculation did not influence the number of spermatozoa found in caput plus corpus epididymidis. Across all ages, the number of spermatozoa potentially available for ejaculation from the cauda epididymidis and vas deferens on each side totalled 54 X 10(9). Collection of 5 successive ejaculates from sexually rested stallions removed 40--60% of the available spermatozoa while ejaculation every 2nd day reduced (P less than 0.05) the number of spermatozoa potentially available for ejaculation by 27%. Nevertheless, sufficient spermatozoa are produced daily (6.4 and 4.2 X 10(9) for 5--16-and 2--4-year-olds) to permit use of an average stallion once or twice daily, during spring and summer, providing sexual behaviour is adequate.

Aging↗
PubMed1982

[Ejaculation inadequacy in sexual disorders].

Sixteen men with missing ejaculation were observed as outpatients in our department within the past years. Among these, four patients with retrograde ejaculation are included. Possible reasons for the missing ejaculation are operations in the genital region or the pelvis, and spinal cord injuries. Endocrine disorders, diabetes mellitus, drug dependence, and psychogenic alterations have to be discussed as etiologic factors. Secondary lack of ejaculation, which is acquired in later years of life, seems to have a poorer prognosis than the primary disease, which begins with puberty. This group of patients is well responsive to psychotherapy. Other therapeutic approaches are hormonal substitution, care of drug dependence, and treatment with sympathicomimetica in some cases of retrograde ejaculation.

Adolescent↗
PubMed1995

Efficacy of prilocaine-lidocaine cream in the treatment of premature ejaculation.

PURPOSE: We evaluated the efficacy of a new lidocaine-prilocaine cream in preventing premature ejaculation. MATERIALS AND METHODS: An open pilot, unblinded study was done using lidocaine-prilocaine cream in 11 healthy, married men with premature ejaculation without organic or erectile problems. The patients were instructed to apply 2.5 gm. of the cream 30 minutes before sexual contact and to cover the penis with a condom. Patients were asked to grade the effect of the cream on ejaculation after each application. RESULTS: There was a significant improvement in premature ejaculation statistically and clinically. Five patients graded the result as excellent compared to baseline, 4 graded it as better and 2 claimed to have no change compared to ejaculation before use of the cream. No adverse effects were noted. CONCLUSIONS: These promising results should prompt a large double-blind placebo-controlled trial. If confirmed, this therapy may be a breakthrough in the treatment of the most common form of male sexual dysfunction.

Adult↗
PubMed1995

Treating premature ejaculation in the multi-modal therapeutic framework: a single case study.

Generally, premature ejaculation is caused by organic, psychological, interpersonal factors and lay beliefs. It is defined as a lack of adequate voluntary ejaculatory control with the result that a patient climaxes involuntarily. An ejaculatory control may be said to be established when the patient can tolerate high levels of excitement which characterise the plateau stage of the sexual response cycle without ejaculating reflexly. The most effective treatment for premature ejaculation so far is the stop-start exercises that aim to help patients tolerate a prolonged period of intense pleasurable arousal and to enjoy sexual sensation before ejaculation. However, the stop-start exercises would be more effective if they are employed in a multi-modal therapeutic framework. This is because cases of premature ejaculation differ in terms of the aetiology, pathological patterns, and the patients' personal characteristics and background. A case is presented to illustrate how the conventional stop-start exercises are prescribed in this multi-modal framework.

Ejaculation↗
PubMed1996

The efficacy of fluoxetine in the treatment of premature ejaculation: a double-blind placebo controlled study.

PURPOSE: The efficacy of the selective serotonin re-uptake inhibitor fluoxetine in the treatment of premature ejaculation was examined. MATERIALS AND METHODS: The study comprised 17 patients with premature ejaculation who presented to the urology clinic of our medical school. In this double-blind study the patients were randomized into treatment groups receiving 20 mg. fluoxetine daily for 1 week and 40 mg. daily afterward (group 1) or 1 capsule placebo daily for 1 week and 2 capsules daily afterward (group 2). The groups were evaluated according to the latent period of intravaginal ejaculation. RESULTS: The latent period of intravaginal ejaculation in group 1 was significantly longer than that in group 2. Nausea, headache and insomnia were reported side effects. CONCLUSIONS: Fluoxetine may be regarded as a safe and effective alternative in the treatment of premature ejaculation.

Adolescent↗
PubMed1998

Human ejaculate. Effects on the biomechanical properties of the human chorioamniotic membranes.

OBJECTIVE: To determine the effects of human ejaculate on the biomechanical properties of the human chorioamniotic membranes. STUDY DESIGN: Equivalent strips of chorioamniotic membranes were obtained from 30 term, uncomplicated pregnancies immediately after delivery and incubated for 0, 1 and 24 hours with either ejaculate or pseudoamniotic fluid. Three biomechanical properties--rupture tension, strain to rupture and work to rupture--were compared. RESULTS: One hour of incubation with pseudoamniotic fluid alone did not significantly change the membrane biomechanical parameters, but these parameters were reduced after one hour of exposure to ejaculate (P < .05). Twenty-four hours of incubation decreased all three properties in both the ejaculate and control groups without any significant difference between the two groups. CONCLUSION: In vitro exposure to human ejaculate for one hour significantly weakens the human chorioamniotic membranes.

Amnion↗
PubMed1982

Influence of inbreeding on reproductive performance, ejaculate quality and testicular volume in the dog.

An established foxhound colony employing an outbreeding and inbreeding program was evaluated to assess the influence of increased homozygosity on overall reproductive performance and ejaculate quality. A total of 14 outbred and four inbred male dogs were naturally bred to 544 outbred and 51 inbred bitches, respectively. Mean conception rate and total number of puppies whelped and number born alive were greater (P<0.01) in outbred compared to inbred lines. Duration of gestation and number of puppies surviving from birth to weaning were not different between outbred and inbred groups. Ejaculate quality of studs also appeared affected by genotype with outbred males producing a greater (P<0.025) average sperm count/ejaculate and sperm count/ml of ejaculate. Ejaculate volume, % motility of spermatozoa and testes volume, although not significantly different, also favored the outbred compared to inbred sires. These results: 1) indicate that a breeding program utilizing dogs with inbreeding coefficients ranging from .125-.558 can experience reduced reproductive performance; 2) suggest that a portion of the infertility associated with conception may be attributed to the male, since inbred studs produced lower quality ejaculates compared to outbred counterparts.

Journal Article↗