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PubMed1987

Comparison of techniques for the selection of bacteria-free sperm preparations.

The authors compared the three most commonly used sperm preparation techniques--swim-up, fall-down, and Percoll gradient--for their ability to recover highly motile sperm and minimize bacterial contamination. Eleven human semen samples collected by masturbation were used and run in parallel with the three methods. A semiquantitative bacterial analysis was performed in all samples and results expressed in colony-forming units per milliliter (CFU/ml). The Percoll gradient technique resulted in an average sperm concentration of 5.81 +/- 4.4 X 10(6) ml, and the average bacterial concentration dropped from 8.66 +/- 12.96 X 10(3) CFU/ml in semen to 0.01 +/- 0.03 X 10(3) CFU/ml. The bacterial count was not significantly different when the raw semen was compared with the swim-up or the fall-down preparations. The authors conclude that the Percoll gradient method yields an adequate sperm concentration, with high motility and improved morphology, while eliminating bacterial contamination.

Bacteria↗

PubMed1988

Sperm recuperation and cervical insemination in retrograde ejaculation.

Seven infertile patients with retrograde ejaculation, in which spermatozoa could be recuperated from the postejaculation urine, were admitted to a sperm recuperation and cervical insemination program. A noninvasive method for sperm recuperation based on urine alcalinization and serial controls to time masturbation has been used. Insemination has been timed according to BBT charts and cervical mucus characteristics. Pregnancy has been obtained in the seven couples after one to eight treatment cycles.

Cell Separation↗

PubMed1998

An electron microscope study of the axonemal ultrastructure in human spermatozoa from male smokers and nonsmokers.

OBJECTIVE: To investigate possible abnormalities or deterioration of the sperm axonemal ultrastructure in men who have smoked a large quantity of cigarettes (> 20 per day) for a prolonged period. DESIGN: Semen specimens were collected by patients via masturbation; qualitative characteristics of the sperm were assessed and ultrastructural analysis of the sperm axoneme was performed using standard operating procedures for electron transmission microscopy. SETTING: The Andrology Institute of Lexington, Lexington, Kentucky, and the Department of Histology and Embryology, University of Salonika, Greece (collaborative effort). PATIENT(S): Twenty-nine men (mean age +/- SD, 30.7 +/- 2.1 years) who smoked a mean (+/- SD) of 30.7 +/- 2.1 cigarettes per day for 10.7 +/- 0.7 years and 15 men who never smoked (mean age +/- SD, 30.4 +/- 2.2 years) participated in this study. MAIN OUTCOME MEASURE(S): Ultrastructural organization of the sperm axoneme in male smokers and nonsmokers. RESULT(S): Changes in the number and the arrangement of axonemal microtubules were noted in the smoker group when compared to the nonsmoker group. The incidence of axonemal abnormalities was higher in spermatozoa from smokers compared with that in spermatozoa from nonsmokers. CONCLUSION(S): Smoking a large quantity of cigarettes per day, under the conditions of the current study, severely affected the ultrastructure of the flagellum and, more specifically, it affected the axoneme of the human spermatozoon.

Humans↗

PubMed1998

Coculture of human sperm with bovine oviduct epithelial cells decreases sperm chromatin structural changes seen during culture in media alone.

OBJECTIVE: To compare sperm chromatin structural changes seen in media only culture or in coculture with bovine oviduct epithelial cells. DESIGN: Three freshly ejaculated and three cryopreserved sperm samples in media culture or in oviduct epithelial cell coculture. Sperm in each treatment were evaluated by the sperm chromatin structure assay during a 72-hour time course. SETTING: An academic research laboratory. PATIENT(S): Normospermic donors with children. INTERVENTION(S): Semen collection through masturbation after 48 hours of abstinence. MAIN OUTCOME MEASURE(S): The sperm chromatin structure assay using flow cytometry to detect the susceptibility of sperm in either treatment to denaturation of DNA in situ. RESULT(S): The sperm chromatin structure assay data differed for sperm type (fresh or cryopreserved), over time, and between treatments within 6 hours of culture. In oviduct epithelial cell coculture, fresh sperm chromatin structure assay values for fresh sperm were stable, whereas in control medium higher chromatin degeneration levels were seen by 10 hours. For cryopreserved sperm, chromatin degeneration had increased by 1 hour postthaw in both treatments, although levels were higher in the control treatment thereafter. CONCLUSION(S): Sperm chromatin structural changes occur over time in culture. Such changes were observed within 2 hours for cryopreserved sperm. Coculture of sperm with oviduct epithelial cells results in a stabilizing effect for sperm against chromatin changes.

Animals↗

PubMed1999

Higher-quality human sperm in a sample selectively attach to oviduct (fallopian tube) epithelial cells in vitro.

OBJECTIVE: To determine if sperm attachment to oviduct epithelial cells (OEC) in vitro is selective for higher quality sperm and if the system requires homologous species OEC. DESIGN: Controlled prospective study with outcomes assayed by a technician blind to sperm treatment groups. SETTING: An academic research laboratory. PATIENT(S): Experiment 1: normospermic donors with children (4 donors, 7 ejaculates). Experiment 2: cryopreserved donor samples (4 donors). INTERVENTION(S): Semen collection by masturbation after 48 hours of abstinence. MAIN OUTCOME MEASURE(S): Experiment 1: sperm assays of motility, morphology, membrane integrity, and capacitation status. Experiment 2: sperm chromatin (DNA) integrity and condensation. RESULT(S): Experiment 1: sperm not attaching to OEC had lower motility, more membrane disruptions, and more acrosome reactions than did control sperm. This selectivity was equivalent for sperm in coculture with all OEC types. Experiment 2: sperm attached to OEC had fewer abnormalities in chromatin structure compared with sperm that were not attached. CONCLUSION(S): Selective attachment of functionally superior sperm to OEC is likely important during sperm reservoir formation in vivo and may be exploitable in vitro as a method to isolate high-quality sperm for clinical procedures. Such a system does not require human origin OEC.

Cryopreservation↗

PubMed1999

Leukocytes in semen from men with spinal cord injuries.

OBJECTIVE: To assess the leukocyte populations in semen samples from men with spinal cord injuries (SCIs) and their relation to sperm motility. DESIGN: Cross-sectional study. SETTING: A joint spinal cord injury and fertility clinic at an academic tertiary referral center for fertility treatment and a university-based department of immunology. PATIENT(S): Nine men with chronic SCIs and seven healthy sperm donors as controls. INTERVENTION(S): Semen samples were obtained by electroejaculation from men with SCIs and by masturbation from donors. MAIN OUTCOME MEASURE(S): Leukocyte populations determined by immunohistochemical techniques, bacteriologic assessment of urine, and sperm density and motility. RESULT(S): The most cellular specimens were antegrade specimens obtained from men with SCIs and coexisting urinary tract infections. The highest proportion of leukocytes occurred in retrograde samples from men with SCIs and urinary tract infections. The most predominant leukocytes in all specimens were granulocytes. Infection increased the number of T cells and the degree of cell activation. There was no significant correlation between leukocyte populations and total motile sperm counts. CONCLUSION(S): Increased numbers of leukocytes in semen samples from men with SCIs are the result of urinary tract infections. The reduced sperm motility seen in men with SCIs does not correlate with the numbers of leukocytes; therefore, other factors also contribute to the semen abnormalities in these patients.

Adult↗

PubMed1999

Detection of benzo(a)pyrene diol epoxide-DNA adducts in sperm of men exposed to cigarette smoke.

OBJECTIVE: To determine whether the adducts formed when benzo(a)pyrene, a diol epoxide derivative, binds covalently to DNA (BPDE-DNA adducts) are detectable in the sperm of men who smoke cigarettes. DESIGN: Prospective study. SETTING: The Toronto Hospital IVF-ET program. PATIENT(S): Twenty-three patients with normal seminal parameters: 11 smokers (20.6 +/- 0.7 cigarettes per day) and 12 nonsmokers. INTERVENTION(S): Semen samples obtained by masturbation. MAIN OUTCOME MEASURE(S): Seminal plasma samples were assessed for cotinine by RIA. Sperm were treated with dithiothreitol to release disulfide bonds and allow for DNA binding, then exposed to an anti-BPDE monoclonal antibody, a biotinylated antibody, and streptavidin-conjugated peroxidase. Staining intensity scores, determined in 100 cells per individual, were correlated with seminal plasma cotinine levels, a marker of smoking. RESULT(S): Cotinine levels correlated highly with the number of cigarettes smoked per day. Mean cotinine levels and mean staining intensity scores were higher in smokers than in nonsmokers. Staining intensity correlated highly with cotinine levels. CONCLUSION(S): We demonstrated, for the first time, that BPDE-DNA adducts in sperm cells are increased by smoking; we also detected comparatively high levels in nonsmokers, which indicates that environmental exposure also is substantial. The formation of adducts in spermatozoa is a potential source of transmissible prezygotic DNA damage.

7,8-Dihydro-7,8-dihydroxybenzo(a)pyrene 9,10-oxide↗

PubMed1998

Psychosocial adjustment after testicular cancer treatment.

PURPOSE: The high cure rate in testicular cancer has provoked investigations relating to the quality of life in long-term survivors. We determine the psychosocial consequences of the disease especially in regard to sexual and professional performance. MATERIALS AND METHODS: Among the testicular cancer patients treated with various treatment modalities 140 rendered free of disease for at least a year were included in this study. General Health Questionnaire 28 and a general survey were used to determine quality of life issues. RESULTS: Regarding the sexual life of these patients, problems related to libido, erection and ejaculation increased significantly during treatment and subsequently recovered but did not return to baseline after treatment. During treatment the frequency of sexual intercourse and/or masturbation decreased significantly in all patients. Of the single patients 35% thought that medical history would be a concern for the potential spouse. Regarding professional lives, 22.4% thought that they had better performance after treatment compared to before therapy, whereas only 6.1% reported it to be worse. When professional performance was analyzed according to the treatment modalities those who had received radiotherapy did worse. General Health Questionnaire scores indicated that patients with this disease had a positive view of life compared to that of the normal population. CONCLUSIONS: Although we observed a substantial recovery in sexual life after treatment, it was evident that therapy did have a negative effect on sexual functions. There was no effect on occupational performance and perspective of life, which may be related to the fact of having overcome a life threatening disease.

Adaptation, Psychological↗

PubMed2002

Blunt, penetrating and ischemic injuries to the penis.

PURPOSE: We describe our experience with treating a series of 40 penile injuries, including 2 gunshot wounds, 1 stab wound, 1 zipper injury and 34 penile fractures, of which 29 were corrected surgically and 5 were managed conservatively, as well as 2 cases of glandular gangrene at 3 large inner city medical centers in a 12-year period. We describe our standard diagnostic and therapeutic modalities, which have evolved with time. MATERIALS AND METHODS: Between 1989 and 2000, 34 patients were evaluated after blunt trauma to the erect penis resulted in penile fracture. Four patients had penetrating trauma to a flaccid penis and 2 had localized penile gangrene. Of the patients with blunt trauma 32 were injured during sexual intercourse and 2 were injured during masturbation. A single gunshot wound occurred during a crime, 2 penetrating traumas were intentionally inflicted and the remaining penetrating injury was due to a zipper. The 2 patients with penile gangrene had diabetes and were on dialysis. RESULTS: A total of 32 patients were treated with surgery using a degloving incision. The corpora and urethra were evaluated with radiography or injection of saline intraoperatively. Five patients were treated conservatively for presumed penile fracture after they refused diagnostic confirmation and/or surgery, and the 2 with localized glandular gangrene were also treated conservatively. At followup 35 of the 40 patients available reported erection adequate for intercourse without erectile or voiding dysfunction. Two patients had mild curvature. CONCLUSIONS: In our experience a degloving procedure provided the best exposure for blunt and penetrating trauma. All penetrating injuries were débrided before repair. Saline injection showed additional corporeal body and/or urethral pathology, and also assessed the integrity of repair. Distal amputation in patients with localized glandular gangrene may result in sloughing and further complications. However, hyperbaric oxygen and local wound care may be adequate if there is no progression of gangrene.

Adolescent↗

PubMed1993

Phallic construction in prepubertal and adolescent boys.

During the last 10 years we performed microsurgical phallic reconstruction in 7 prepubertal and 4 adolescent boys. Indications for surgery included post-traumatic amputation, circumcision accident, developmental anomalies and micropenis. In addition, we performed phalloplasty on 5 other patients 18 to 24 years old. Total phallic reconstruction consisted of 1-stage microsurgical tissue transfers that included urethral reconstruction, coaptation of erogenous nerves, aesthetic refinement and, in some cases, scrotal reconstruction. All postpubertal patients recovered erogenous sensibility in the reconstructed phallus and the ability to masturbate. Surgical indications, techniques and results are discussed.

Adolescent↗

PubMed1989

Sexual function and fertility in patients treated for posterior urethral valves.

We interviewed 21 men treated in infancy for posterior urethral valves about their sexual function. Of the men 10 provided semen samples (1 of which was incompletely analyzed) and 7 provided urine voided after masturbation. Erections and orgasm were normal in 20 men and 1 had lifelong impotence. Nine men had slow or dry ejaculation. There was no evidence on urinalysis of retrograde ejaculation except in 1 patient. Semen counts were within the fertile range. Of 9 patients 5 had viscous semen with a pH of more than 8.0. Three patients had initiated pregnancies.

Adult↗

PubMed1990

Treating erectile dysfunction with external vacuum devices: impact upon sexual, psychological and marital functioning.

We evaluated prospectively the medical, sexual and psychosocial outcome of external vacuum devices in the treatment of erectile dysfunction. A total of 29 men regularly used such a device for 6 months and reported statistically significant improvements in erectile quality, frequency of intercourse attempts, frequency of orgasm and sexual satisfaction, as well as decreased psychiatric symptomatology, increased self-esteem and a trend toward improved marital satisfaction. Of the partners 18 reported improved sexual functioning, including increased frequency of orgasm, decreased masturbation and greater sexual satisfaction, with no changes in psychosocial parameters. The vacuum device was effective in producing erections in 89% of the men. Dropout, only 19% within 6 months, was primarily due to insufficient or pivoting erections and bruising. The most frequent adverse effects were blocked ejaculation and physical discomfort. Vacuum devices appear to provide a safe, effective, inexpensive, noninvasive treatment for erectile failure that enjoys high patient and partner acceptance.

Adult↗

PubMed1980

Daily spermatozoal production and epididymal spermatozoal reserves of the human male.

Testicular and epididymal spermatozoal reserves were determined for 11 healthy men, a vasectomized man and 12 other men. For healthy men testis weight (19 testes) averaged 16.9 plus or minus 1.2 gm. and daily spermatozoal production was 4.25 times 10(6) per gm. (range equals 1.4 to 6.3 times 10(6) per gm.). Based on our total sample (23 patients) 67 per cent of the men 20 to 50 years old probably produce between 45 times 10(6) and 207 times 10(6) spermatozoa per day. Daily spermatozoal production was normal in 1 vasectomized man. Epididymal reserves of healthy men totaled 182 times 10(6) spermatozoa per epididymis, of which 26 per cent were in the caput, 23 per cent in the corpus and 52 per cent in the cauda. The interval between any previous ejaculation and death was unknown but we assumed that these values are typical for men copulating or masturbating every 1 to 7 days. Extragonadal spermatozoal reserves totaled approximately 440 times 10(6), of which less than 225 times 10(6) would be available for ejaculation in the ductuli deferentia and caudae epididymides. Transit time of spermatozoa through the caput, corpus and cauda epididymidis was estimated as 0.72, 0.71 and 1.76 days. In a vasectomized man extragonadal reserves totaled 7 times 10(9) spermatozoa or about 75 days of production by the testes. Thus, spermatozoal production in man is much less efficient than in other mammals, the extragonadal reserves of spermatozoa are small and maturation of spermatozoa in the caput plus corpus epididymidis occurs in less than 2 days. In terms of these quantitative characteristics the reproductive capacity of man is considerably less than that of a rhesus monkey.

Animals↗

PubMed2003

Sexual activities and attitudes of women with vulvar dysesthesia.

OBJECTIVE: To assess the relationship between sexual activities and attitudes of women with and without vulvar dysesthesia. METHODS: Women with vulvar dysesthesia, 18-60 years old, and ethnically matched women without this disorder were enrolled in this cross-sectional study, completed a 27-page questionnaire, and had a physical examination. We compared sexual activities and attitudes between patients and controls using univariate and multivariable analyses. RESULTS: Between January 21, 2001, and December 12, 2002, we enrolled 63 women with vulvar dysesthesia and 62 controls who reported having a current sexual partner. Women with vulvar dysesthesia were less likely than controls to have had, during the previous month, intercourse (66.7% versus 83.9%, P =.03) and orgasms (57.6% versus 78.7%, P =.02), although the association with intercourse was no longer statistically significant after controlling for age, education, and smoking status (P =.07). Of those having had intercourse in the past month, the frequency of this activity was less among patients (3.0 +/- 2.7 versus 6.2 +/- 4.5 episodes, P <.001). Frequencies of orgasms, fellatio, cunnilingus, and masturbation did not significantly differ between patients and controls. Patients rated sex less important and rated themselves more negatively as sexual people than did controls (P <.001). CONCLUSION: Women with vulvar dysesthesia are similar to those without in many sexual activities but are less likely to have had an orgasm in the past month or to have had intercourse at the same frequency as controls. Although some attitudes were similar, sexual interest and self-concept were decreased among those with this disorder.

Adult↗

PubMed1994

Imipramine and xylazine-induced ex copula ejaculation in stallions.

This study is a part of our ongoing work toward developing pharmacological methods for enhancing and inducing ejaculation in stallions with ejaculatory dysfunction. We evaluated a combination treatment of imipramine hydrochloride followed 10 minutes later by xylazine hydrochloride for the induction of ex copula ejaculation. Eight pony stallions each underwent 6 treatment trials conducted at 4-day intervals. The trials were conducted in the animals' stalls, where they were observed for 90 minutes following treatment. To evaluate the effect of pretreatment sexual stimulation on the rate of ejaculation for each of the 8 stallions, 3 of the 6 trials were preceded by exposure to a restrained ovariectomized pony mare. For 7 of the 8 stallions, 1 to 4 of the 6 trials resulted in induced ejaculation, for a total of 16 ejaculations in the 48 trials. Six of the ejaculations occurred with imipramine treatment alone, before the administration of xylazine. All ejaculations were associated with erection and masturbation. Six of 24 trials (25%) preceded by sexual stimulation resulted in ejaculation, while 10 of 24 trials (42%) without sexual prestimulation resulted in ejaculation. These proportions were not different (P = 0.11). Induced ejaculates were collected into a plastic bag positioned over the prepuce by a girth strap for the comparison of semen characteristics with 2 base line ejaculates obtained in copula from these stallions during the week preceding the series of induced ejaculation trials (with similar 4-day intervals from previous ejaculation). The induced ejaculates were of lower total volume, higher concentration, lower gel volume, higher total numbers of spermatozoa, and lower pH (P < 0.05) than the base line in copula ejaculates. Together, these semen characteristics suggest increased emission of the sperm-rich fraction and reduced emission of accessory gland fluids, probably resulting from imipramine treatment.

Journal Article↗

PubMed2002

Testosterone, sexuality and antisocial personality in rapists and child molesters: a pilot study.

Morning and afternoon levels of saliva testosterone levels in Finnish imprisoned rapists (n = 10) and child molesters (n = 10) were compared to those in randomly selected control subjects (n = 31). The associations of saliva testosterone with sexual behavior and antisocial personality traits were explored in all groups. The sexual offenders and control subjects did not differ in the between-subjects main effect estimated for the averaged morning and afternoon testosterone levels. Seven rapists and three child molesters met the criteria for antisocial personality disorder (ASP). In the sexual offenders, a summed ASP index was positively correlated with mean saliva testosterone. Sexual activity as estimated from self-reports of sexual intercourse and masturbation was significantly related to testosterone in both rapists and child molesters but not in the control males. The implications of these results are discussed.

Aggression↗

PubMedDate not supplied

Hypersexuality in nursing care facilities--a descriptive study.

The continuance of sexual expression in the elderly as age advances is well recognized. Sexual disinhibition, however, in a restricted environment such as in nursing care facilities has received scant attention. We wish to describe eight patients residing in nursing care facilities who were seen because of their problematic sexually related behaviors. These behaviors include cuddling, touching of the genitals, sexual remarks propositioning, grabbing and groping, use of obscene language and masturbating without shame. In all instances concern emanated from members of the nursing staff. Other associated behaviors included aggression, agitation, and irritability amongst others. The computed tomography (CT) scan of the brain showed infarction in the frontal lobe (4), parietal lobe (1), and the caudate (1). One had severe Parkinson's Disease and one had severe dementia of the Alzheimer's disease. All ten patients had an organic basis for their symptoms. Sexually inappropriate behaviors remain highly controversial and labeling them as 'diseased' or an 'illness' may have enormous individual, cultural and medico-legal implications. The clinico-anatomical correlation are discussed.

Journal Article↗

PubMed1985

Spermarche--the age of onset of sperm emission.

Gonad maturation in boys is not characterized by a critical visible event such as menarche in girls. Establishing spermatogenesis by masturbation in maturing boys may be considered inappropriate. In order to estimate the median age of spermarche, a group of 155 normal schoolboys were examined twice (ages 12 and 13 years) for the occurrence of sperm in the first voided morning urine. The boys were requested to bring a daily sample for 10 consecutive days. Over 90% brought at least two samples and 50% brought 5-10 samples. The rate of boys with spermaturia at each age was calculated by the life-table method to adjust for the varying number of samples. New spermaturia was detected with each additional sample in the boys who brought in a greater number of samples. The urine examination carried a considerable false negative rate; even in boys who brought five or more samples, over 40% of boys positive at age 12 were negative at age 13. The rate of spermaturia at age 12 years was 37.5%, and at age 13 it was 68.9%. Our previous report showed the rate at age 11 years to be less than 1%. Because of an uncertain number of false negatives, these are probably under estimates of the true rate of spermatogenesis. The occurrence of spermarche was significantly associated with maturation of secondary sex characteristics.

Actuarial Analysis↗