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PubMedDate not supplied

Seminal parameters of ejaculates collected successively with sixty minute interval in infertile men: effect of combination of prazosin and terbutaline on these parameters.

Out of 37 infertile men, 33 who were able to give two ejaculates by masturbation successively with a sixty minute interval, were studied. There was no significant change in sperm density in the second ejaculation whereas seminal volume decreased (P less than 0.01) and sperm motility increased (P less than 0.05) significantly. After a seven-day treatment with combination of prazosin (alpha 1-blocker) and terbutaline (beta 2-stimulator), the same successive ejaculates were obtained from only 27 of these patients. In this case sperm density and motility changed insignificantly, whereas seminal volume again decreased (P less than 0.01) significantly. The changes in seminal parameters were not significant between the pre- and post-treatment second ones. In a short-term study there are not any alterations to observe. The favourable results with a long-term treatment, published by Japanese authors, require a confirmation by further studies.

Adult↗
PubMed2006

Ejaculatory disorder caused by alpha-1 adrenoceptor antagonists is not retrograde ejaculation but a loss of seminal emission.

AIM: The etiology of the ejaculatory disorder induced by alpha-1 blockers is still controversial, although it has been suggested to be retrograde ejaculation. The aim of this study was to investigate the distribution of alpha-1 adrenoceptor subtype mRNA in human seminal vesicles, and to analyze the prevalence and etiology of the disorder in healthy men. METHODS: Experimental Study. Seminal vesicles from 10 surgical specimens (eight radical prostatectomy, two radical cystectomy) were dissected. Real-time PCR was conducted for quantification of mRNA expression of each alpha-1 adrenoceptor subtype. Clinical Study. Ejaculatory disorder was investigated using 17 healthy male volunteers. Tamsulosin (0.2 mg and 0.4 mg) and naftopidil (50 mg and 100 mg) were administered in a crossover manner for 3 days. The ejaculatory volume, sperm count in midstream urine after ejaculation, and fructose concentration in seminal plasma were investigated. RESULTS: Real-time PCR revealed that alpha-1a mRNA was significantly predominant in seminal vesicles (P < 0.001; 1a, 75.0%; 1b, 11.7%; 1d, 13.3%). Ejaculatory volume (baseline 2.72 +/- 0.28 mL) significantly decreased in the tamsulosin group (0.2 mg, 1.75 +/- 0.31 mL; 0.4 mg, 1.51 +/- 0.39 mL; P < 0.05), but not in the naftopidil group (50 mg, 2.70 +/- 0.24 mL; 100 mg, 2.48 +/- 0.26 mL; P = NS). There was no sperm in midstream urine after any ejaculation. CONCLUSIONS: The current study demonstrates that alpha-1a mRNA is predominant among the adrenoceptor subtypes in human seminal vesicles. Decreased capacity of contraction of the seminal vesicles is proposed as the cause of the ejaculatory disorder induced by alpha-1 blockers.

Adrenergic alpha-1 Receptor Antagonists↗
PubMed1990

Erection and ejaculation in man. Assessment of the electromyographic activity of the bulbocavernosus and ischiocavernosus muscles.

Electromyographic (EMG) recordings were obtained by concentric needle electrodes from the bulbocavernosus (BC) and ischiocavernosus (IC) muscles in 7 human volunteers during excitement to erection and subsequent ejaculation. Simultaneous registration of the time course and volume of each expressed spurt of semen was obtained using an aluminium pan suspended in front of the subject's penis on a force transducer the output of which was charted with the EMG activity. The BC and IC muscles showed no EMG activity during erection and detumescence cycles induced by visual sex stimulation. In 5 of 7 subjects, the first EMG burst of the BC in ejaculations induced by masturbation was not correlated with an expelled spurt of semen as were subsequent bursts. However, only 26 to 60% of the total number of EMG bursts were accompanied by expulsion of a spurt of semen. There thus appears to be a large safety factor in the striated muscle expulsive mechanism. Oral phenoxybenzamine treatment in 2 subjects did not significantly affect either the number of EMG bursts of the BC or the subjective pleasure of the orgasm but did significantly reduce the volume of semen expelled. Semen volume does not appear to be a unique determinant of the pleasure felt or the trigger for ejaculation.

Adult↗
PubMed2006

Efficacy of type-5 phosphodiesterase inhibitors in the drug treatment of premature ejaculation: a systematic review.

This review examines the role of nitric oxide (NO) as a neurotransmitter involved in the central and peripheral control of ejaculation, the methods of phosphodiesterase type 5 inhibitor (PDE5I) drug treatment studies for premature ejaculation (PE), the adherence of methods to the contemporary consensus of ideal PE drug trial design, the impact of methods on treatment outcomes and the role of PDE5Is in the treatment of PE. NO/cGMP transduction is involved in both the central and peripheral control of emission, but evidence for a direct central or peripheral effect of PDE5Is on ejaculation is speculative. Thirteen of the 14 studies reviewed failed to fulfil the evidence-based medicine criteria for ideal PE drug trial design. Limitations of the studies include inadequately defined study populations, the lack of a double-blind placebo-controlled study design, and the absence of consistent objective physiological measures or sensitive, validated outcome assessment instruments as study endpoints. The broad range of intravaginal ejaculatory latency time (IELT) fold-increases reported with PDE5Is, on-demand selective serotonin re-uptake inhibitor (SSRI) drugs, and combined PDE5I/on-demand SSRIs is testament to the unreliability of data and conclusions from methodologically flawed studies. The one study that fulfilled the evidence-based medicine criteria of an ideal clinical trial design reported that treatment with sildenafil failed to significantly increase baseline IELT, supporting our conclusion that there is no convincing evidence to support any role for PDE5Is in the treatment of men with lifelong PE and normal erectile function. However, there is limited evidence to support a potential role for PDE5Is alone or combined with daily or on-demand SSRIs in the treatment of acquired PE in men with comorbid erectile dysfunction. Further controlled studies adhering to the contemporary consensus of ideal clinical trial design are required to clarify the role of PDE5Is in this subgroup of men with acquired PE.

Ejaculation↗
PubMed1987

Retrograde ejaculation: a systematic approach to non-invasive recovery of spermatozoa from post-ejaculatory urine for artificial insemination.

Retrograde ejaculation is an uncommon but treatable form of male infertility. Successful recovery of live spermatozoa from the post-ejaculatory urine for artificial insemination is dependent on careful regulation of pH and osmolarity of the urine into which ejaculation takes place, and separation of the motile spermatozoa from the debris and cells which are found in these samples. Three pregnancies established by artificial insemination of spermatozoa recovered by noninvasive means from the bladders of men suffering from retrograde ejaculation are described. The techniques for preparing the urine for spermatozoal survival, and for removal of cells and debris by sedimentation or buoyant density centrifugation are discussed.

Adult↗
PubMed1990

HLA expression on human ejaculated sperm.

The expression of human leukocyte antigen (HLA) on human ejaculated sperm has been investigated by using cellular binding radioimmunoassay (CB-RIA) with sperm samples purified by Percoll discontinuous gradient and monoclonal antibodies specific to the frame work of HLA molecules. The results in packed sperm obtained from ten healthy males indicated that HLA class II and its subclasses, DP, DQ, and DR, were expressed at a low level on human ejaculated sperm, while HLA class I was not detected. Furthermore, we could not detect the individual variation of HLA expression on ejaculated sperm in the cases of twenty healthy males. K562, which is B lymphoid cell line and lacks HLA class I molecules, showed detectable amounts of HLA class I molecules after exposure to interferon gamma (IFN-gamma) and/or tumor necrosis factor alpha (TNF-alpha). However, the treatment of sperm with IFN-gamma and/or TNF-alpha had no effect on the expression of HLA class I and class II molecules.

Antibodies, Monoclonal↗
PubMed2004

Self-reported premature ejaculation and aspects of sexual functioning and satisfaction.

BACKGROUND: Although premature ejaculation (PE) is a common male sexual dysfunction, its relevant parameters have not been adequately studied in large community-based samples. OBJECTIVE: To examine the diagnostic utility of two self-report questions based on the DSM-IV-TR definition of PE and to investigate the relationship between self-identified PE, sexual functioning, and sexual satisfaction in men. METHODS: An Internet survey of general health and aspects of sexual functioning and satisfaction was conducted in 2,056 males. Subjects were classified as having "probable" or "possible" PE, or as "non-PE" by survey responses. RESULTS: A total of 1158 men met the selection criteria (sexually active in a stable heterosexual relationship), and 189 (16.3%) were classified as having probable PE by reporting they ejaculated before they wished and indicating it was "very much" or "somewhat" a problem. Another 188 (16.2%) men reported ejaculating before they wished but rated their distress lower and were classified as having possible PE. Compared to non-PE men, those with probable and possible PE reported significantly worse sexual functioning in 6 of 8 study measures. Concern about partner satisfaction was high in all groups. The importance of ejaculatory control and the ability to have intercourse for the desired time was significantly higher in men with PE as compared to non-PE men (P < 0.01). CONCLUSIONS: PE was a common problem, was characterized by a lack of ejaculatory control, and was associated with significant effects on sexual functioning and satisfaction. Additional research on the sensitivity and specificity of these self-report questions should be pursued.

Adult↗
PubMed2005

Premature ejaculation: an observational study of men and their partners.

INTRODUCTION: Premature ejaculation (PE) is the most common male sexual dysfunction affecting men and their partners. Lack of community-based data describing this condition limits understanding of PE and its outcomes. AIM: To characterize PE in a large population of men with and without PE using patient-reported outcome (PRO) measures elicited from men and their partners. METHODS: 4-week, multicenter, observational study of males (> or =18 years) and their female partners in monogamous relationships (> or =6 months). Screening, baseline, and follow-up visits scheduled at 2-week intervals. Clinicians diagnosed PE utilizing DSM-IV-TR criteria. Intravaginal ejaculatory latency time (IELT), measured by a stopwatch held by the partner, was recorded for each sexual intercourse experience. Subject and partner independently assessed PROs: control over ejaculation and satisfaction with sexual intercourse (0 = very poor to 4 = very good), personal distress and interpersonal difficulty (0 = not at all to 4 = extremely), and severity of PE (0 = none to 3 = severe). Results. Of the total study population (N = 1,587), 207 subjects were diagnosed with PE and 1,380 were assigned to the non-PE group. Median IELT (min) was 1.8 (range, 0-41) for PE and 7.3 (range, 0-53) for non-PE subjects (P < 0.0001). More PE vs. non-PE subjects gave ratings of "very poor" or "poor" for control over ejaculation (72% vs. 5%; P < 0.0001) and satisfaction with sexual intercourse (31% vs. 1%; P < 0.0001). More subjects in the PE vs. non-PE group gave ratings of "quite a bit" or "extremely" for personal distress (64% vs. 4%; P < 0.0001) and interpersonal difficulty (31% vs. 1%; P < 0.0001). Subject and partner assessments showed similar patterns and correlated moderately (0.36-0.57). CONCLUSIONS: PE subjects reported significantly shorter IELT. Overlap in IELT distributions was observed between the PE and non-PE groups, indicating the need for additional PRO measures to characterize PE. Shorter IELT was significantly associated with reduced ejaculatory control and sexual satisfaction and increased distress and interpersonal difficulty.

Adult↗
PubMed1985

Nuclear zinc in human epididymal and ejaculated spermatozoa.

Sperm nuclear zinc content (expressed as zinc/phosphorus and zinc/sulphur ratios) was determined with X-ray microanalysis in individual, air-dried, epididymal spermatozoa from elderly men, and in ejaculated spermatozoa from healthy donors. Ejaculated sperm nuclei contained (also after treatment with sodium dodecyl sulphate) more zinc than epididymal spermatozoa. The results indicate that the human spermatozoon accumulates zinc from the prostatic fluid upon ejaculation.

Adult↗
PubMed2005

D2-like receptors mediate the expulsion phase of ejaculation elicited by 8-hydroxy-2-(di-N-propylamino)tetralin in rats.

The mechanism of action by which 8-hydroxy-2-(di-N-propylamino)tetralin (8-OH-DPAT) facilitates ejaculation in conscious rats is not clearly established. The serotonin (5-HT) 1A agonist 8-OH-DPAT may actually act on cerebral dopaminergic receptors to exert its proejaculatory effect. The present work was undertaken to clarify this issue by testing various compounds i.c.v. delivered in an experimental model of the expulsion phase of ejaculation in anesthetized Wistar rats. Intracerebroventricular delivery of 8-OH-DPAT dose-dependently (ED(50) = 17 microg) induced rhythmic contractions of bulbospongiosus (BS) muscles, which are of paramount importance for the expulsion of semen, occurring in the form of cluster of bursts evidenced by the recording of BS muscle electrical activity. The 5-HT1A antagonist WAY100635 (N-[2-[4-(2-methoxyphenyl)-1-piperazinyl]ethyl]-N-2-pyridinylcyclohexanecarboxamide) (20 microg) i.c.v. coadministered with 8-OH-DPAT (20 microg) was unable to inhibit the effect of 8-OH-DPAT on BS muscle contractile activity. Conversely, raclopride (40 microg) and spiperone (10 microg), both dopamine D2-like receptor antagonists, i.c.v. coinjected with 8-OH-DPAT (20 microg), abolished BS muscle contractions. The involvement of D2-like receptors was further supported by the fact that the D2-like agonist quinelorane (20 microg i.c.v.) also induced BS muscle rhythmic contractions. Our data demonstrate that D2-like receptors mediate the induction by 8-OH-DPAT of rhythmic BS muscle contractions and suggest that i.c.v. delivery of D2-like receptor agonists to anesthetized rats represents a relevant experimental model to study the expulsion phase of ejaculation.

8-Hydroxy-2-(di-n-propylamino)tetralin↗
PubMed1988

Neurological correlations of ejaculation and testicular size in men with a complete spinal cord section.

This study was of 135 patients with a complete spinal cord section suffered from loss of ejaculation. The spinal cord injuries were classified following the upper and the lower limits of the lesion. The volume of the testes of the patients and of 13 normal control subjects were measured. Physostigmine allowed 75 patients to ejaculate and 15 of them procreated. The possibility of ejaculation after physostigmine mainly depended on the integrity of the T12-L2 metamers. The testicular volume was significantly smaller in patients with a lesion including the T12 metamer than in patients with a lesion sparing the T12 metamer. Six patients with a lesion including the T12 metamer had testicular atrophy. This suggests that T12 segment plays a role in testicular function in paraplegic patients.

Adolescent↗
PubMed1975

Peripheral nerves controlling the closure of internal urethral orifice during ejaculation.

The peripheral nervous pathways controlling seminal emission and closure of the internal urethral orifice during ejaculation were examined experimentally using male adolescent dogs. The experimental methods were measurement of the contraction of the internal urethral orifice and measurement of the change of the posterior urethral pressure induced by selective stimulation of the nerves related to the hypogastric nerve. Further, the change of actual ejaculation caused by manual stimulation of the penis was observed after excision of the nerves. Results included the following: (1) The seminal emission and the closure of the internal urethral orifice on ejaculation were controlled by the hypogastric nerve. (2) The nerve fibers which controlled these two phenomena took different paths above the lower mesenteric plexus. (3) Seminal emission was controlled by the splanchnic nerves which originated from the lower thoracic and upper lumbar ganglia of the sympathetic trunk, and the closure of the internal urethral orifice by those which originated from the lower lumbar ganglia of the trunk.

Animals↗
PubMed1994

A new theory of micturition and urinary continence based on histomorphological studies. 5. The musculus ejaculatorius: a newly described structure responsible for seminal emission and ejaculation.

Theories of seminal emission and ejaculation based on morphology especially of the dorsal longitudinal urethral muscle system are found very infrequently in the literature. Our own examinations carried out on serial sections of the whole distal urethral complex taken from 50 male and 15 female autopsy preparations prove that the dorsal longitudinal urethral muscle system represents an independent smooth muscle. In the female, the muscle system runs outside the sphincter system. In the male, it is the direct continuation of the musculature of the ejaculatory ducts and its expansion is generally restricted to the urethra below the colliculus seminalis. Within the urethra the urethral crest is protruded. Differences in the degree of the formation of the muscle in various age groups will be described. For this newly described muscle structure, we suggest the term musculus ejaculatorius as, due to purely anatomic reasons, an involvement in the process of ejaculation seems to be conclusive. A theory of seminal emission and ejaculation is given as a mass action of the musculature of the bladder neck.

Adult↗
PubMed1983

Spontaneous ejaculation associated with anxiety: psychophysiological considerations.

The association of anxiety with sexual excitement has been noted since the early part of this century. The authors present case reports of a schizophrenic and a neurotic patient in whom no direct sexual precipitants of spontaneous ejaculation could be identified but in whom severe anxiety was evident. The central noradrenergic neurophysiology that anxiety may share with sexual excitement could provide a basis for spontaneous ejaculation during anxiety. The pharmacology of spontaneous ejaculation during opiate withdrawal is used to elaborate this central noradrenergic model.

Adult↗
PubMed1996

Para-chloroamphetamine (PCA)-induced ejaculation in aged rats, semen analysis and artificial insemination.

The present study was undertaken to determine sperm motility and counts in semen yielded by para-chloroamphetamine (PCA)-induced ejaculation of aged rats which had lost their reproductive ability, and to attempt artificial insemination with suspensions of spermatozoa obtained in this way. The semen yielded by PCA-induced ejaculation from aged (75-week-old) rats had average sperm counts of 0.82 +/- 0.69 x 10(7), which were much lower than the average counts (9.42 +/- 1.65 x 10(7)) for semen spontaneously ejaculated by young adult rats (14 weeks old). However, 77.5% of the spermatozoa contained in the PCA-induced semen were rated as showing the most active movement. Spermatozoa collected in this way were injected into the upper parts of both uterine horns or into both ovarian bursae. Both methods made the females pregnant, but the results were better after injection into the ovarian bursae. The offspring born to these females showed no abnormalities.

Aging↗
PubMed2005

A review of controlled trials in the pharmacological treatment of premature ejaculation.

Premature ejaculation is a common sexual problem which presents to genitourinary (GU) medicine services. Five main treatment approaches have been used in clinical trials: behavioural therapy, antidepressants, phosphodiesterase-5 (PDE5) inhibitors, topical anaesthetic agents and alpha-blockers. We have carried out a systematic review of published pharmacological trials. All antidepressants appeared to delay ejaculation to some extent at all doses. Anaesthetic creams appeared to be as successful in slowing ejaculation as antidepressants without systemic side-effects, although some patients did experience erectile problems or unpleasant local symptoms. Anecdotally, behavioural therapy is effective and appears to have long-lasting efficacy. There is a need for quality comparative trial of behavioural therapy, topical anaesthetic agents and antidepressants, including appropriate measures of relapse, follow-up and acceptability of continuing long-term treatment.

Adrenergic alpha-Antagonists↗
PubMed2003

Premature ejaculation associated with citalopram withdrawal.

OBJECTIVE: To report a case of premature ejaculation occurring subsequent to citalopram discontinuation. CASE SUMMARY: A 43-year-old white man being treated for depression with citalopram wished to discontinue treatment. Four or 5 days after stopping citalopram he reported that, during sexual intercourse, his genitals seemed to be extremely sensitive and orgasm was achieved within approximately 1 minute. These symptoms continued over the next 3-4 weeks and remitted after citalopram was restarted. Several subsequent attempts to discontinue citalopram resulted in a return of these symptoms despite using a slow tapering regimen. An objective causality assessment revealed a probable relationship between drug withdrawal and the observed symptoms. DISCUSSION: The ability of selective serotonin-reuptake inhibitors (SSRIs) to delay ejaculation has been well documented; however, discontinuation of these agents generally results in a return to baseline function. Although discontinuation of SSRI therapy has been associated with a number of withdrawal symptoms, this is the first report (MEDLINE, September 2003), to our knowledge, of the emergence of sexual adverse effects in someone with no previous history of these symptoms. CONCLUSIONS: Premature ejaculation is a possible withdrawal effect after SSRI discontinuation. Since patients are usually reluctant to spontaneously report sexual adverse effects, it is important to specifically inquire about them both when starting and stopping treatment with an SSRI.

Adult↗
PubMed1975

Components of human split ejaculates. I. Spermatozoa, fructose, immunoglobulins, albumin, lactoferrin, transferrin and other plasma proteins.

The concentrations of spermatozoa, fructose, IgG, IgA, albumin lactoferrin, transferrin, secretory piece of IgA, Beta 1C/Beta 1A-globulin (C'3-component of complement), ceruloplasmin and fibrinogen were evaluated in human split ejaculates and/or in whole human seminal plasma. The concentrations of spermatozoa, IgG, IgA, albumin and transferrin decreased from the first portion of the split ejaculate to the last, indicating that these proteins originate mostly from secretions other than the seminal vesicles. By contrast, the highest amounts of fructose and lactoferrin were present in the final portion of the split ejaculates, showing their seminal vesicle origin. No secretory piece, IgM, Beta 1C/Beta 1A-globulin, ceruloplasmin of fibrinogen could be detected in human semen. An unidentified antigen was found that has a relatively high molecular weight and shows Beta 1-mobility on immunoelectrophoresis.

Animals↗