SEARCH · Search PubMed
Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.
Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.
Sperm production is regulated by inhibin. Inhibin secretion may be controlled by the number of ejaculations. The more the number of ejaculations, the less the inhibin in blood and the more the production of spermatozoa.
INTRODUCTION AND OBJECTIVES: Rapid ejaculation (RE) is the most common sexual dysfunction in males. The aim of the present study is to determine the contribution of intrapsychic, organic and relational factors to the pathogenesis of RE and the relationship between RE and erectile dysfunction (ED) in a sample of patients attending for the first time to an Outpatient Clinic for sexual dysfunction. METHODS: We studied a consecutive series of 755 patients using Structured Interview on Erectile Dysfunction (SIEDY), a brief, recently validated, multidimensional instrument specifically designed by our group for the study of pathogenetic factors of ED. RE was defined as ejaculation within 1 minute of vaginal intromission and its severity was categorized on a 4-point scale using a standard question. A complete physical examination and a series of biochemical, hormonal, psychometric, penile vascular and rigidometric evaluations were performed. RESULTS: Twenty-eight percent (n = 214) of patients attending to our sexology clinic reported RE of any degree. Patients reporting RE were younger (48.5 +/- 12.6 vs. 52.9 +/- 12.9 years old for RE and not RE respectively; p < 0.0001) and showed a higher prevalence of anxiety symptoms when compared to the rest of the sample. Among organic factors subjects with RE showed a higher prevalence of hyperthyroidism and significantly lower fasting plasma glucose (94 [87-110] and 98 [89-113] mg/dl for RE and non-RE respectively; p < 0.01). No difference among groups was observed for other hormones or clinical, biochemical and instrumental parameters. Finally RE patients showed a higher prevalence of partial erection sufficient for penetration when compared to the rest of the sample. Similar differences were observed between patients with and without RE when those without ED were excluded from the analysis. CONCLUSION: Our data suggest a minor involvement of organic factors to the pathogenesis of ED in patients with concomitant RE. On the other hand, in our sample, patients complaining about RE are younger, healthier than the rest of the sample and are characterized by high degree of anxiety symptoms and hyperthyroidism.
OBJECTIVES: This study evaluated the associated comorbidities and patient satisfaction with treatment options for premature ejaculation (PE), a common sexual dysfunction. METHODS: A comprehensive, Internet-based survey (the PE Prevalence and Attitudes [PEPA] survey) was conducted among men ages 18-70 in the United States, Germany, and Italy (n=12,133). Men were classified as having PE based on self-report of low or absent control over ejaculation, resulting in distress for them or their sexual partner or both. RESULTS: The prevalence of PE was 22.7% (24.0% in the United States, 20.3% in Germany, and 20.0% in Italy) and did not vary significantly with age among men over age 24 yr. Men with PE were more likely to self-report other sexual dysfunctions (e.g., anorgasmia, low libido, erectile dysfunction) and psychological disturbances (e.g., depression, anxiety, excessive stress) than men without PE (p<0.05 for all). Men with PE were most aware of (>70%) and most likely to have used (>50%) special positions during sex, interrupted stimulation, masturbation, and having intercourse more often than usual to manage their PE. Only 9.0% of men with PE reported having consulted a physician for the condition; 81.9% had to initiate the conversation about PE and 91.5% reported little or no improvement as a result of seeking treatment. CONCLUSION: PE is a highly prevalent sexual problem, with significant sexual and psychological comorbidities. Most men with PE do not seek assistance from their physician, and most of those who do are not satisfied with the results.
OBJECTIVE: To determine the incidence of Fas positivity and DNA double-strand breaks (DSB) as indicators of early- and late-stage apoptosis in ejaculated sperm. DESIGN: Fas positivity was assessed by flow cytometry and DSB by the neutral Comet assay. SETTING: Andrology Laboratory, Royal Maternity Hospital, Belfast, Northern Ireland, United Kingdom. PATIENT(S) AND INTERVENTION(S): Forty-five infertile men undergoing infertility investigations and 10 fertile men undergoing vasectomies. MAIN OUTCOME MEASURE(S): Percentage Fas-positive cells, percentage DNA fragmentation, olive tail moment. RESULT(S): The apoptotic marker Fas was detected in ejaculated sperm, with a higher incidence of Fas positivity in teratozoospermic and asthenozoospermic than in normozospermic semen. No Fas positivity was observed in fertile men's sperm. Deoxyribonucleic acid fragmentation (DSB) was greater in infertile than in fertile men's sperm and also greater in sperm in semen than in sperm prepared for assisted conception. There was an inverse relationship between DSB and both sperm concentration and motility. There was no relationship between Fas positivity and DNA damage. CONCLUSION(S): Fas was expressed in sperm of infertile men. In contrast, DNA fragmentation was observed in all sperm of fertile and infertile men and correlated with inadequate concentration and motility, which suggests that sperm DSB are ubiquitous and are not solely associated with apoptosis.
OBJECTIVE: To determine whether the extent of ongoing apoptotic cell death measured as the presence of DNA strand breaks in spermatozoa affects embryo development to the blastocyst stage in IVF. DESIGN: A prospective comparative study. SETTING: A university IVF clinic and a private IVF clinic. PATIENT(S): Men (n = 49) undergoing infertility treatment with IVF. INTERVENTION(S): After density gradient centrifugation preparation, part of the sperm sample was used for infertility treatment, and the rest was fixed in paraformaldehyde. Strand breaks in DNA that are indicative of apoptosis were detected by the in situ DNA nick end labeling (TUNEL) technique. A total of 15,000 spermatozoa from each sample were evaluated for TUNEL reactivity by flow cytometry. MAIN OUTCOME MEASURE(S): Percentage of ejaculated spermatozoa with DNA strand breaks indicative of apoptosis, blastocyst development rate, and pregnancy rate. RESULT(S): Blastocyst development showed a significant negative correlation with percentage TUNEL positivity in spermatozoa. When 20% was used as a cutoff for TUNEL positivity in sperm samples, the percentage of blastocyst development was 50% higher in the <20% TUNEL-positivity group (n = 27) compared with those with >/=20% TUNEL positivity (n = 22; 44.7% blastocyst development vs. 29.8%). Clinical pregnancy rates in these two groups were 52% vs. 44%, respectively. CONCLUSION(S): The extent of nuclear DNA fragmentation in prepared ejaculated spermatozoa used in IVF negatively correlates with blastocyst development. A larger series of patients needs to be assessed to determine whether this paternal effect on blastocyst development may also affect pregnancy outcome.
This study examines the effect of semen-collection rhythm on the sperm maturation process in boar epididymis. Three post-pubertal boars were submitted to a high semen-collection frequency (stressed boars) during 4 days, and three males were kept as a control group (control boars). Semen samples coming from six epididymal regions and from the ejaculate of each male were evaluated for sperm concentration, sperm vitality, sperm motility and sperm morphology. In each epididymal region, either fluid resorption or fluid secretion was determined from the variation in sperm concentration. The pattern of fluid resorption-secretion along the epididymal duct differed significantly between the stressed and control boars. A high semen-collection frequency also affected the development of sperm motility and the sperm cytoplasmic droplet displacement along the epididymal duct. The incidence of some sperm abnormalities was also found to be higher in some epididymal regions and ejaculates of stressed boars. From the results of this study, it can be concluded that a high semen-collection frequency brings about an altered resorption and secretion pattern of the epididymal fluid, which results in defective sperm maturation and abnormal development of sperm motility.
Sperm motility is dependent on mitochondrial ATP production that relies on the coordinated expression of the mitochondrial and nuclear genomes. It is generally accepted that mammalian ejaculated spermatozoa retain the ability to synthesize mtDNA-encoded proteins but not most of the nuclear ones. This implies an asynchronous regulation of the oxidative phosphorylation-related genes encoded by each genome. Trying to investigate this issue, we unexpectedly found that ejaculated human spermatozoa do not synthesize mtDNA-encoded proteins. Moreover, we estimated that the discrepancy between our observations and those published elsewhere was due to a chloramphenicol-sensitive protein synthesis attributed to mitochondria that instead corresponds to contaminating bacteria.
Semen specimens from 33 donors were analyzed intermittently between 1 and 24 hours after ejaculation. Motility was determined objectively by analyzing still-camera photomicrographs taken with the aid of the new multiple exposure photography (MEP) technique, from which the following information was obtained: the percentage of motile spermatozoa, the average velocity and frequency distribution of spermatozoal velocities, and index of motility as well as sperm concentration. From curves drawn for each of the 33 analyzed specimens, these conclusions were drawn: 1. The percentage of motile spermatozoa decreases progressively, beginning 1 hour after ejaculation, at a rate of about 5% to 10%/hour. 2. In the majority of cases, sperm velocity increases for the first 4 hours and then decreases gradually. 3. There is no unique pattern of sperm motility and velocity with time for all specimens, especially during the first 4 hours. However, three typical curves of motility change were found during the first 4 hours: increase in motility, moderate decline in motility, and rapid loss of motility. 4. The frequency distribution of velocities of motile spermatozoa revealed typical normal curves at all times, but these curves became flatter as time elapsed. An explanation for these divergent patterns and the possible role of these findings in some physiologic and clinical problems are discussed.
The prolactin concentration in human seminal plasma and in human epididymal cauda fluid was assessed by radioimmunoassay. The prolactin concentration in cauda plasma was found to be similar to that found in male blood serum (5.5 to 9.1 ng/ml) and significantly lower than the concentration of the hormone found in seminal plasma obtained either from euspermic (48 +/- 12 ng/ml) or from vasectomized volunteers (50 +/- 10.2 ng/ml) (P less than 0.001). Calcium binding and/or transport in ejaculated spermatozoa were found to be little (0.29 +/- 0.08 nmoles/10(8) cells) and dependent on a quickly saturable process. The addition of 200 ng of human prolactin/ml induced a 60% increase in this parameter, while 50 ng of prolactin/ml were ineffective. Epididymal human spermatozoa differ from ejaculated sperm cells in showing greater, time-dependent, calcium binding and/or transport under basal conditions (2.00 +/- 0.35 nmoles/10(8) cells/hour), and in being more susceptible to the stimulating action of prolactin (4.4 +/- 0.68 nmoles/10(8) cells/hour in the presence of 50 ng of prolactin/ml).
Total lipids, phospholipids, and cholesterol are present in greater amounts in fraction I of split ejaculates of normal healthy volunteers than in other fractions. Glyceride concentrations are higher in fraction III. The cholesterol-phospholipid ratio varies significantly in different fractions. The free ester-cholesterol ratio is also altered in different fractions. The relative importance of these findings in relation to sperm survival and motility is discussed. In whole ejaculates of patients with Klinefelter's syndrome, glyceride concentrations are higher, phospholipid concentrations are lower, and cholesterol concentrations remain unaltered as compared with samples from normal healthy volunteers.
Seven of 12 patients with retrograde ejaculation, who had at least occasional samples with reasonable sperm numbers and motility, underwent a protocol including luteinizing hormone-timed, intrauterine insemination with washed sperm recovered from the urine. Seven pregnancies have occurred to date in six patients; the one other patient is still early in the protocol period. The described technique for collecting sperm, ovulation timing, sperm recovery, and washing and intrauterine insemination are relatively simple and cost-effective and appear to be effective in contributing to pregnancies in many couples with retrograde ejaculation.
OBJECTIVE: Men with premature ejaculation (PE) exhibit diminished control over and short latency to ejaculation. The present study attempted to delineate further characteristics of men with PE and to address a number of presumed hypotheses regarding the etiology of this disorder. METHODS: Twenty-six men with PE were compared with an age-matched group of 13 sexually functional men on multiple indices of erectile and ejaculatory response during coital and masturbatory activities. These data were collected through retrospective, prospective, and laboratory methods. RESULTS: Psychophysiological testing indicated greater ejaculatory vulnerability to penile stimulation, although not visual erotic stimulation, in PE men than functional controls. PE men also showed subtle anomalies in the way they perceived their somatic response. The correlation between measures of ejaculatory latency and control was positive and high for intercourse, but low or even negative for masturbation. Whereas functional men showed consistency in ejaculatory latency over coital and masturbatory activities, PE men exhibited much shorter latencies during coitus than masturbation. Data collected under various methodologies (retrospective, prospective, and laboratory) showed greater consistency among sexually functional subjects; and preliminary analysis of laboratory data suggests psychophysiological methodology is as effective in differentiating dysfunctional from functional men as prospective and retrospective methodologies. CONCLUSION: Although ejaculatory latency and control tend to be related, these measures are not always stable over different kinds of sexual activity or using different methods of data collection. Psychophysiological methodology is effective in differentiating group membership (PE vs. control), but does not predict individual ejaculatory responses measured prospectively.
The feasibility of sparing postganglionic fibers of lumbar sympathetic nerves during the course of retroperitoneal lymphadenectomy has been investigated at our university medical center beginning in 1978. We selected 75 patients for nerve-sparing retroperitoneal lymphadenectomy in an effort to preserve ejaculatory function postoperatively. This cohort of patients was selected on the basis of clinical stage. Of the 75 patients 73 had clinical stage I disease. However, 14 of these 73 patients had pathological stage II cancer. No patient was treated with adjuvant chemotherapy after nerve-sparing retroperitoneal lymphadenectomy. Of these 14 patients with pathological stage II disease 4 had relapse: 1 with proved retroperitoneal recurrence, and 3 with serological elevations of tumor markers and questionable clinical findings as to anatomical site of relapse. All 4 patients are free of disease after chemotherapy and/or surgical (1) rescue. There were no local recurrences in the 61 patients with negative nodes. All 75 patients ejaculate and had no evidence of disease more than 2 years after nerve-sparing retroperitoneal lymphadenectomy. It is clear that nerve-sparing retroperitoneal lymphadenectomy is a feasible technique. As noted, it can even be applied to selected patients with low volume positive nodes, yet maintaining relapse and survival figures that are acceptable. Ejaculation is reliably preserved when this nerve-sparing technique is applied accurately in retroperitoneal lymphadenectomy.
We report a case of retrograde ejaculation caused by ectopic erectile tissue in the posterior urethra. Transurethral resection of the tissue resulted in antegrade ejaculation.
More than 90 per cent of complete spinal cord injury patients have major fertility problems, depending upon the site and type of injury. During the last 5 years 34 patients were treated by vibratory and/or electrostimulation at our center, and semen was produced in all but 5. In 8 patients ejaculation was attempted by vibratory stimulation alone and in 22 electrostimulation also was used. Vibratory stimulation is the easier and less cumbersome of the 2 methods. No major side effects were noted with either technique. Stimulation was performed by a rectal electrode incorporated in a silicone finger glove with a current of 0.1 msec. in duration, a frequency of 30 Hz. and an average of 60 volts. Vibratory stimulation was applied to the frenulum and/or glans penis with a specially constructed vibrator at a frequency of 80 Hz. and a peak-to-peak oscillation of 1.6 to 2.4 mm. Semen obtained during the first 6 months after injury was not of a quality consistent with successful fertilization owing to poor motility. However, semen quality and motility were better in patients who had been injured for more than 6 months. Repeated electro-ejaculation did not improve the quality of semen. The effects of bladder outlet surgery and autonomic blockers were noted in 5 patients.
Infertility in a patient on pharmacological agents with sympatholoytic activity was found to be caused by ejaculatory failure owing to absent contraction of the seminal vesicle, ampulla and ductus deferens, rather than the previously accepted reason of retrograde ejaculation. These findings suggest that pharmacological agents producing alpha-adrenergic blockage may produce temporary interference with ejaculation, suggesting investigation of their use as reversible male contraceptives.
Two patients with retrograde ejaculation subsequent to Y-V plasty of the bladder neck underwent a surgical procedure to reconstruct the internal vesical sphincter and correct the phenomenon. The approach is transvesical and the internal vesical sphincter is reconstructed to the diameter of a No. 16 Foley catheter. The normal muscle of the bladder neck is approximated after the mucosa and scar tissue are excised. Both patients now have normal ejaculation and one has fathered a child.
The present study investigates the effects induced by sildenafil (1 mg/kg, p.o.) and the dopamine agonist, SND 919 (0.1 mg/kg, i.p.) on copulatory behaviour of male rats, categorized, on the basis of seven consecutive mating pre-tests, as sluggish and normal ejaculators (SE and NE, respectively). The data obtained show that sildenafil modifies both sexual arousal and ejaculatory mechanisms of copulation. It appears that, although it induced a facilitatory effect on ejaculation of all rats, similarly to SND 919, the lowering of ejaculatory threshold was achieved by means of a reduction of mount frequency and intromission frequency in SE and NE groups, respectively. Differently from SND 919, sildenafil increased sexual arousal, diminishing post ejaculatory interval in SE animals and inter-intromission interval in both SE and NE rats. As the dopamine antagonist, (-)eticlopride (0.02 mg/kg, s.c.), significantly inhibited sildenafil-induced enhancement of sexual arousal in SE rats, it is suggested that the drug acts both peripherally and centrally.