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PubMed1991

Retrograde ejaculation.

Failure of the normal ejaculatory mechanism may lead to retrograde ejaculation. This occurs most commonly as a result of transurethral prostatectomy, retroperitoneal lymph-node dissection and diabetic neuropathy. The diagnosis is based on the absence of sperm in the antegrade ejaculate and the presence of sperm in the post-masturbatory urine. If pharmacologic attempts to restore antegrade ejaculation fail, sperm recovery from the urine and intrauterine insemination are usually indicated. Surgical alternatives are discussed.

Ejaculation↗
PubMed1988

A comparative analysis of ejaculate and hormonal characteristics of the captive male cheetah, tiger, leopard, and puma.

Male cheetahs, tigers, leopards, and pumas maintained under the same conditions were anesthetized and 1) serially bled before, during, and after electroejaculation (EE); 2) serially bled only (AO); or 3) serially bled before and after receiving adrenocorticotropin hormone (ACTH). Ejaculates from leopards contained higher (p less than 0.05) sperm concentrations than cheetahs and pumas but lower (p less than 0.05) sperm motility ratings than all other species. Tigers produced a larger seminal volume and the greatest number of motile sperm/ejaculate (p less than 0.05). The percentage of morphologically abnormal spermatozoa was greater (p less than 0.05) in cheetahs (64.6%), leopards (79.5%), and pumas (73.5%) than in tigers (37.5%). The most prevalent spermatozoal deformities included a tightly coiled or bent flagellum, a deranged midpiece, or a residual cytoplasmic droplet. Mean baseline serum cortisol concentrations in leopards were 2- and 4-fold greater (p less than 0.05) than in tigers and cheetahs, respectively. Basal cortisol concentrations in pumas were similar to those of tigers, but irrespective of treatment increased 2-fold (p less than 0.01) during the bleeding period. An acute rise and fall in cortisol attributable to EE was observed only in cheetahs. In tigers and leopards, mean peak cortisol concentrations after ACTH were similar to maximal values observed after EE. However, peak cortisol levels in cheetahs and pumas after ACTH were greater (p less than 0.01) than the concentrations measured after EE, indicating that these manipulatory procedures were not eliciting a maximal adrenal response. In the EE groups, luteinizing hormone (LH) and testosterone levels in cheetahs were lower (p less than 0.05) than in other species, whereas levels of both hormones were comparable (p greater than 0.05) in tigers, leopards, and pumas. Elevated cortisol levels in cheetahs and pumas had no discernible effect on LH/testosterone patterns; however, the results were equivocal in tigers, and, among leopards, testosterone concentrations consistently declined over time. In this study, using a standardized approach, we identify different ejaculate and endocrine characteristics of captive cheetahs, tigers, leopards, and pumas. The data extend earlier observations and demonstrate that some, but not all, Felidae species ejaculate high numbers of pleiomorphic spermatozoa. However, inter-species differences in sperm integrity do not appear related to inter-species variations in cortisol, LH, or testosterone. The observation of continuously declining testosterone concentrations only in leopards after AO, EE, or ACTH treatment suggests that rising and/or elevated cortiso

Acinonyx↗
PubMed1999

Effects of fenfluramine on ejaculatory function, luteinizing hormone and testosterone levels in men with hypogonadotropic hypogonadism and premature ejaculation.

Serotonergic neurotransmission is associated with the regulation of aggressive behaviour, anxiety and affect. Serotonin (5-HT) reuptake inhibitors (SRIs) have been extensively utilized in the treatment of affective disorders; however, their use often results in ejaculatory inhibition. Serotonin appears to modulate male sexual function through its influence on luteinizing hormone (LH) secretion but only when the steady state is altered. Premature ejaculation (PME) is defined as persistent or recurrent ejaculation with minimal sexual stimulation (DMS-III-R). While the aetiology of PME remains unclear, an underlying anxiety disorder may be a major contributing factor. It has been recently suggested that patients with premature ejaculation (PME) have an associated hypogonadotropic hypogonadism. This study was undertaken to determine whether the administration of the SRI fenfluramine would result in changes in PME (inhibitory effect) and release of LH which could be indirectly measured through an increase in the production of testosterone (disinhibitory effect). Six patients with PME and hypogonadotropic hypogonadism were treated with fenfluramine (20 mg). Both inhibition of PME (based on graded couple's responses) and increased plasma LH and testosterone levels occurred following treatment. These observations strongly suggest a role for serotonergic modulation in the occurrence of PME.

Adult↗
PubMed1995

Hand and genital sympathetic skin potentials in flaccid and erectile penile states in normal potent men and patients with premature ejaculation.

Sympathetic skin potentials were recorded from the hand and genital region in 14 normal potent men and 18 patients with premature ejaculations. With the penis flaccid the sympathetic skin potentials obtained did not differ significantly in both groups. However, when erection was induced by 50 mg. intracavernous papaverine injection, the genital sympathetic skin potentials were significantly suppressed in all but 3 normal men, while the hand potentials did not change. In subjects with premature ejaculation genital and hand sympathetic skin potentials were suppressed during erection as a generalized bodily reaction except in 1 patient. This phenomenon may indicate that the specific and regional suppression of genital sympathetic activity during erection could not be properly adjusted in patients with premature ejaculation.

Action Potentials↗
PubMed1999

Pharmacological treatment of premature ejaculation.

Ejaculatory dysfunction is the most common male sexual disorder and premature ejaculation the most common presentation of ejaculatory dysfunction. Convincing data are lacking from controlled clinical studies to support sustainable long term efficacy of psychosexual counselling in the management of premature ejaculation. The pharmacological treatment of premature ejaculation is now receiving increased attention from both physicians with an interest in sexual medicine and from the pharmaceutical industry.

Antidepressive Agents, Tricyclic↗
PubMed2005

Sexual harm reduction practices of HIV-seropositive gay and bisexual men: serosorting, strategic positioning, and withdrawal before ejaculation.

OBJECTIVE: This study assessed unprotected anal and oral sex behaviors of HIV-positive gay and bisexual men in New York City and San Francisco with their main and non-main sexual partners. Here we focus on the use of three harm reduction strategies (serosorting, strategic positioning, and withdrawal before ejaculation) in order to decrease transmission risk. METHOD: The data from a baseline assessment of 1168 HIV-positive gay and bisexual men in the two cities were utilized. Men were recruited from a variety of community-based venues, through advertising and other techniques. RESULTS: City differences were identified, with more men in San Francisco reporting sexual risk behaviors across all partner types compared with men in New York City. Serosorting was identified, with men reporting significantly more oral and anal sex acts with other HIV-positive partners than with HIV-negative partners. However, men also reported more unprotected sex with partners of unknown status compared with their other partners. Some evidence of strategic positioning was identified, although differences were noted across cities and across different types of partners. Men in both cities reported more acts of oral sex without ejaculation than with ejaculation, but the use of withdrawal as a harm reduction strategy for anal sex was more common among men from San Francisco. CONCLUSION: Overall, evidence for harm reduction was identified; however, significant differences across the two cities were found. The complicated nature of the sexual practices of gay and bisexual men are discussed, and the findings have important implications for prevention efforts and future research studies.

Adult↗
PubMed2003

Comparison of the efficacy and safety of 90 mg versus 20 mg fluoxetine in the treatment of premature ejaculation.

PURPOSE: We compare the efficacy and side effects of 90 mg fluoxetine once weekly versus 20 mg fluoxetine as single oral therapy for patients complaining of premature ejaculation without evident organic causes. MATERIALS AND METHODS: The study comprised 80 patients with a mean age of 36 years with premature ejaculation who presented to the urology clinic of 3 hospitals in Barcelona. Pretreatment evaluation included history and physical examination, International Index of Erectile Function (IIEF), Meares-Stamey test and ejaculatory latency time evaluation. The patients were randomized into treatment groups receiving 1 capsule of 90 mg fluoxetine a week (group 1) and 1 capsule of 20 mg fluoxetine a day (group 2) for 3 months. The 4-month followup included: ejaculatory latency time measurement, IIEF and partner sexual satisfaction. RESULTS: Mean pretreatment ejaculatory latency times for groups 1 and 2 were 0.48 minute (range 0 to 2.10) and 0.50 minute (0 to 2.04), respectively. After 3 months of treatment of weekly and daily administration of fluoxetine mean ejaculatory latency time was 3.57 and 3.37 minutes, respectively (p >0.01). Partner sexual satisfaction and IIEF rate were greater with 90 mg fluoxetine but no statistical difference was found. Nausea, insomnia and headache were reported side effects but no significant difference was noted between 90 and 20 mg fluoxetine. CONCLUSIONS: In men with premature ejaculation 90 mg fluoxetine weekly may be regarded as an effective and safe treatment.

Adult↗
PubMed2004

Localization of aquaporin-7 in human testis and ejaculated sperm: possible involvement in maintenance of sperm quality.

PURPOSE: We have previously reported the expression of aquaporin-7 (AQP7) in the rat testis and cloned human AQP7 from the testicular cDNA library. However, to our knowledge the spatial expression pattern and biological roles of AQP7 remain to be elucidated in humans. MATERIALS AND METHODS: We investigated AQP7 expression in the human testis and ejaculated sperm from fertile men and from infertile patients. RESULTS: AQP7 was expressed at the tail of spermatids and spermatozoa in the human testis. AQP7 protein was also detected at the middle piece and the anterior tale portion of ejaculated sperm. However, some infertile patients lacked AQP7 expression in ejaculated sperm, although all fertile men expressed AQP7 protein. The motility rate of AQP7 negative sperm was significantly lower than that of AQP7 positive sperm, while the sperm concentration was not different between AQP7 positive and negative subjects. CONCLUSIONS: AQP7 shows a spatial expression pattern in the human testis. AQP7 may be involved in the maintenance of sperm motility. Furthermore, a lack of AQP7 expression in sperm may be an underlying mechanism of male infertility.

Aquaporins↗
PubMed2003

Aromatase inhibition for the treatment of idiopathic hypogonadotropic hypogonadism in men with premature ejaculation.

BACKGROUND: Idiopathic hypogonadotropic hypogonadism (IHH) has been observed to occur in men with premature ejaculation (PE). Common IHH therapies include testosterone replacement, which increases testosterone levels but suppresses gonadotropin release; and gonadotropin-releasing hormone supplementation, which restores gonadotropin levels but is impractical for chronic use. Hormonal imbalances associated with IHH/PE are thought to be related to hyperactivity of the cytochrome P-450 enzyme aromatase. METHODS: Ten male patients with a diagnosis of IHH/PE were treated with the aromatase inhibitor anastrazole (1 mg/d orally). Levels of free and total testosterone, luteinizing hormone, follicle-stimulating hormone, prolactin, and estradiol were determined at baseline and after 2 weeks of therapy. RESULTS: After 2 weeks of therapy with anastrazole, levels of testosterone, luteinizing hormone, and estradiol had returned to normal. No effect was noted on premature ejaculation. CONCLUSION: These results suggest that aromatase inhibition with anastrazole may provide a practical and efficacious alternative for the treatment of IHH but is not effective in preventing premature ejaculation.

Adult↗
PubMed1998

Inbreeding, fluctuating asymmetry, and ejaculate quality in an endangered ungulate.

An ever-increasing number of species are suffering marked reductions in population size as a consequence of human activities. To understand the impact of these changes it is essential to assess how small population size affects individual fitness and the viability of populations. This issue acquires special relevance among endangered species in which numbers have decreased to such an extent that captive breeding must be established with a few founders. A major risk associated with small population size is inbreeding depression. The effects of inbreeding upon male reproductive traits are the subject of an ongoing controversy, since the evidence linking lack of genetic variability and poor ejaculate quality at the population level has been criticized recently by several authors. We report that among Gazella cuvieri males, inbreeding coefficient shows a strong inverse relationship with ejaculate quality. Furthermore, the degree of fluctuating asymmetry is positively related to the coefficient of inbreeding and negatively related to the proportion of normal sperm, suggesting that it is a reliable indicator of genetic stress and of ejaculate quality.

Animals↗
PubMed1980

Increase in oxytocin secretion at ejaculation in male.

In this study changes in plasma oxytocin levels were determined before and after ejaculation in patients with abnormal spermatogenesis. Plasma oxytocin levels rose significantly after ejaculation (P < 0.001, n = 17). There was no obvious correlation between plasma oxytocin levels and sperm count, sperm motility or the number of abnormal forms. Oxytocin may play a role in the precipitation of ejaculation in males.

Ejaculation↗
PubMed1984

Seminal plasma characteristics during frequent ejaculation.

Seven young men provided a semen sample every 8 h for 2 days. Citric acid, zinc, acid phosphatase , spermine, fructose and protein were measured in the samples. Despite a dramatic reduction in semen volume, the concentration of the majority of the parameters remained constant during the period of study. The protein profile of the ejaculates, as assessed by 2-dimensional electrophoresis, also did not change. Levels of citric acid, zinc and acid phosphatase were closely correlated, while spermine, which is also believed to be of prostatic origin, showed no correlation with these other parameters. The spermine concentration of the ejaculates increased significantly during the period of high ejaculation frequency and returned to normal levels after a 3 day abstinence period. In view of the fact that spermine accumulation in tissues appears to be associated with growth and protein synthesis this increase in seminal spermine may reflect a stimulation of prostatic cell activity.

Acid Phosphatase↗
PubMed1985

Physical properties and non-enzymic components of human ejaculates. Relationship to spontaneous liquefaction.

The relationship between spontaneous liquefaction and the characteristics of ejaculated human semen has been investigated. The liquefaction time of ejaculates was found to be significantly correlated with their extent of coagulation and some non-enzymic components of seminal plasma. Human ejaculates were classified into 3 distinct groups depending on their liquefaction time, and the groups were characterized physico-chemically. The liquefaction time also revealed a low but significant negative correlation with semen volume. It is concluded that an individual's ejaculatory characteristics can be evaluated simply by determining its liquefaction time.

Adult↗
PubMed1986

Time- and temperature-related alterations in seminal plasma constituents after ejaculation.

The effects of temperature and incubation time were examined on the concentrations of the following seminal plasma constituents in ejaculates from seven healthy volunteers: prostatic acid phosphate (PAP), citric acid, testosterone, prostaglandin E (PGE), fructose, protein, putrescine and the polyamines spermidine and spermine. The results indicated that the majority of glandular products were stable up to 3 h after ejaculation when stored at room temperature, with the exception of the prostatic diamine putrescine, which appeared to undergo rapid metabolism. Prolonged periods of incubation resulted in a gradual reduction in the levels of fructose and a significant increase in the activity of PAP and the levels of spermidine. On the basis of these findings it appears that an evaluation of the functional integrity of the accessory sex glands can be carried out on semen up to 3 h after ejaculation.

Acid Phosphatase↗
PubMed2006

Treatment of premature ejaculation.

Premature ejaculation (PE) is a common problem, the treatment of which has received an increasing interest in recent years. Traditional management continues to be psychotherapy, with techniques such as the 'squeeze' and 'stop-start' most commonly employed. The application of local anaesthetics to the glans to delay ejaculation, first described over 60 years ago, continues to be used both in medical practice and as an 'over-the-counter' remedy. Over the years, a variety of psychopharmacological agents, especially antidepressants, have been described as treatments for PE. At the present time, the selective serotonin re-uptake inhibitors, licensed for other indications, emerge as the most effective agents to delay ejaculation, but none are licensed for the treatment of PE. There appears to be a high relapse rate irrespective of the mode of therapy used.

Anesthetics, Local↗
PubMedDate not supplied

Clinical report about some cases with retrograde ejaculation.

The incidence of retrograde ejaculation may be expected to increase by factors as a higher incidence of vascular- and colon-surgery, the increase of road accidents with as a result transversal lesions as well as the increased use of medicines particularly hypotensive drugs. After some remarks about the mechanism of ejaculation and the closing mechanism of the sphincter internus, some cases-histories are dealt with. After these case-histories, a survey is given about the etiology of the retrograde ejaculation. Finally some possibilities in treating this disorder are given, such as intravaginal deposit of urine after intercourse and the administration of a drug, called phenylpropanolamine, a so-called a-sympathicomimetic.

Ejaculation↗
PubMedDate not supplied

Changes of ejaculation due to suppression of noradrenaline biosynthesis by diethyldithiocarbamate in dogs: a supplemental report with reference to changes of posterior urethral pressure.

In the preceding paper (Kimura et al.-1979) it was reported that diethyldithiocarbamate suppresses ejaculation, although penile erection is maintained, and that the suppression is not mediated by the central nervous system but by the decrease of catecholamine contents in the organs relating to sperm transport. In this paper, changes of ejaculation following administration of diethyldithiocarbamate was studied with the posterior urethrogram; measurement of the posterior urethral pressure during hypogastric nerve stimulation. From the results obtained in this study the above results were confirmed. It was also confirmed that both seminal emission and ejaculation are under the influence of an alpha-adrenergic receptor mechanism. Also, a dopamine receptor mechanism was suspected to be present in the male accessory sexual glands.

Animals↗
PubMedDate not supplied

High ejaculate volume: a distinct entity?

In this study clinical, andrological and endocrinological data of a group of 101 patients with ejaculate volume of at least 8.0 ml are compared with data of 100 consecutive patients attending our infertility clinic. Within both groups correlations between different parameters are observed. Between both groups a significant difference in total sperm output is noted suggesting a 'dilution oligozoospermia' in the high ejaculate volume group. We suggest that, in order to avoid a falsely unfavourable fertility prognosis for those patients, total sperm output should be considered rather than sperm density. From the point of view of nomenclature, the term 'relative oligozoospermia' seems justified in cases with very high ejaculate volumes.

Ejaculation↗