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PubMed1995

A double-blind crossover trial of clomipramine for rapid ejaculation in 15 couples.

BACKGROUND: The purpose of this study was to assess the sexual and psychosocial efficacy of clomipramine for rapid ejaculation. METHODS: Fifteen physically healthy, self-selected couples (men had a mean age of 38 years) who met six eligibility criteria and did not meet five exclusion criteria participated in a variable-length, repeated measures, randomized, double-blind, placebo-controlled crossover study with a 2-month follow-up period. Sexual and psychosocial assessments were conducted at baseline, after placebo, after 25 mg/day of clomipramine, after 50 mg/day of clomipramine, and at the 2-month follow-up point. The major outcome measures included stopwatch timing of ejaculation latencies, modified Case Western Reserve University Sexual Function Questionnaire, Symptom Checklist-90-R, Dyadic Adjustment Scale, State-Trait Anxiety Inventory, and the Harder Self-Esteem Inventory. RESULTS: Baseline mean ejaculatory latency was 81 seconds; 25 mg/day of clomipramine increased it to 202 seconds and 50 mg/day of clomipramine to 419 seconds. This resulted in significantly greater sexual satisfaction scores for men and their partners (men, p < .001; women, p < .05), improvements in partner coital orgasmic attainment, and greater relationship and emotional satisfaction for the men. Withdrawal of the drug caused ejaculatory latencies to return to baseline. CONCLUSION: Clomipramine appears to be effective in significantly lengthening ejaculatory latencies and increasing sexual and relationship satisfaction. It can be a cost-effective chronic therapy for selected patients. These impressive results should not be expected in a less carefully screened population of men concerned about the timing of their orgasm during intercourse.

Adult↗
PubMed1994

[Retrograde ejaculation as a side-effect of clozapine].

3 chronic paranoid schizophrenic men, aged 29, 30 and 37 years, respectively, developed retrograde ejaculation, a rare side-effect of clozapine. It disappeared after the dose was lowered in 1 of the patients and after stopping the drug in the other 2. On rechallenging with the drug, retrograde ejaculation recurred.

Adult↗
PubMed1994

[The treatment of sterility due to retrograde ejaculation, using implantation of a pericervical sphincter prosthesis. Apropos of a case].

The authors report the case of a 26 year old man consulting for primary sterility due to retrograde ejaculation, which was associated with urinary incontinence secondary to repeated surgery to the bladder neck for neurogenic bladder in a patient with incomplete spina bifida. Pericervical implantation of an AMS 800 artificial sphincter restored perfect continence and normal ejaculation followed by a pregnancy for his wife.

Adult↗
PubMed1996

[Anatomophysiology of ejaculation].

OBJECTIVES: The present study reviews the anatomophysiological and neurological aspects of ejaculation and ejaculatory disorders. METHODS/RESULTS: The different phases of the ejaculatory process and the male genitalia are analyzed. CONCLUSIONS: Ejaculation is a complex psychobiological process whose innermost mechanisms have yet to be elucidated. Further studies are warranted to obtain further insight into ejaculatory disorders whose impact on the male population cannot be overemphasized.

Ejaculation↗
PubMedDate not supplied

Potential involvement of kallikrein hK2 in the hydrolysis of the human seminal vesicle proteins after ejaculation.

We have recently demonstrated in liquefied human seminal plasma the presence of the novel kallikrein hK2 in association with protein C inhibitor (PCI) as a 75-kDa complex. In the present study, we showed that hK2, immediately after ejaculation, was recovered only in its free form but complex formation with PCI occurred rapidly thereafter and was completed within 10 minutes. That reaction required an enzymatically active kallikrein. In order to determine the patterns of hydrolysis of major seminal vesicle proteins, semenogelins and fibronectin were exposed to hK2 and to hK3 (prostate-specific antigen or PSA) and cleavage sequences were identified by N-terminal sequencing. Free hK2 was able to hydrolyze semenogelins and fibronectin in vitro. Most of cleavage sites were at the carboxyl-side of arginyl residues. Semenogelins were hydrolyzed to a similar extent by catalytic (and similar) concentration of either hK2 or PSA though no common cleavage sites was identified for both proteinases. Unlike semenogelins, fibronectin was hydrolyzed much more efficiently by hK2 than by PSA. These results show that hK2 is enzymatically active during a short period of time after ejaculation, that major seminal vesicle proteins can be the target of this proteolytic activity, and that hK2 and PSA have different substrate specificities.

Antibody Specificity↗
PubMed1997

Transurethral incision of prostate (TUIP) and retrograde ejaculation.

OBJECTIVE: Men of any age with bladder outlet obstruction and without measurable enlargement of the prostate constitute ideal candidates for TUIP. Effectiveness of any technique with respect to flow rate improvement is firmly established, indifferently whether unilateral or bilateral. But there is a wide variation in the reported incidence of retrograde ejaculation with unilateral and bilateral incision. MATERIAL AND METHODS: The retrospective analysis of our 45/57 available patients treated with this technique, between January 1993 and March 1995, does not show a major incidence of this complication for the bilateral incision, with an overall incidence of 6.6% (3/45 patients). CONCLUSIONS: Although ejaculation may be preserved, it cannot be guaranteed.

Adult↗
PubMed1997

[Retrograde ejaculation: a treatable fertility problem].

Retrograde ejaculation was diagnosed in a 32-year-old man. This condition is an uncommon cause of male infertility. In most cases the only possible treatment is recovery of spermatozoa from the urine followed by artificial insemination; the couple underwent this treatment; the women received intrauterine insemination. In order to ensure the best possible survival of the sperm cells the pH (7.2-8.2) and the osmolality (300-380 mosmol/kg) of the urine were adjusted beforehand by administering bicarbonate and water to the man a few hours before ejaculation. A successful pregnancy ensued. When the couple desired another child the semen quality had deteriorated and in-vitro fertilisation with spermatozoa collected from urine was chosen as a treatment. A second successful pregnancy developed.

Adult↗
PubMed1998

[Psychogenic erection and ejaculation disorders in a couple wanting children].

A man aged 40 and his wife aged 29, involuntarily childless due to a psychogenic disturbance of erection and ejaculation, asked for donor insemination. The man had been given psychosexual treatment without success during the preceding 4 years. Before starting donor insemination an ultimate effort to obtain an ejaculate by means of electrovibrator treatment was made, the physician handling the instrument. Two pregnancies were achieved by insemination with semen of the husband. The question is raised whether in a couple with a psychogenic coital disorder who only wish to achieve pregnancy, psychosexual therapy is indicated.

Adult↗
PubMed1998

A psychophysiological approach to assessing premature ejaculation.

A hierarchical psychophysiological model is described that provides a working framework for clinicians interested in addressing issues related to premature ejaculation (PE). Within this framework, psychophysiological laboratory analysis, used in conjunction with conventional self-report measures, has potential to contribute both to the measurement and understanding of premature ejaculation and to the assessment of treatment procedures aimed at alleviating PE.

Ejaculation↗
PubMed1989

In vitro capacitation of boar ejaculated spermatozoa: effect of conditioned media prepared from preincubated sperm suspension.

The fertilizing ability of boar ejaculated spermatozoa was examined in vitro after preincubation at a concentration of 2.5 x 10(8)/ml for 4 hr in several conditioned media (CM). For preparation of CM, boar spermatozoa were incubated in a modified Krebs-Ringer bicarbonate solution (TYH) at concentrations of 20 to 40 x 10(8)/ml for several hours up to 4 hr; then their supernatant fluids were collected by centrifugation. When boar ejaculated spermatozoa were preincubated in TYH alone, 14.1% of oocytes were penetrated by them as we reported previously. On the other hand, preincubating them with CM, their fertilizing ability was elevated according as the incubation time of CM preparation was lengthened. The fertilization rate reached 75.0%, using 4 hr-incubated CM for the preincubation medium. The effect of CM was not deteriorated by heat treatments (56 degrees C, 30 min, or 100 degrees C, 5 min). The components of CM were separated at a molecular weight of 25,000 by ultrafiltration, and high fertilization rate (69.8%) was obtained when low molecular weight fraction was used for the preincubation medium. Sperm extracts prepared from directly frozen-thawed sperm suspension and 0.1-10 mM of taurine or hypotaurine had no effect on the fertilizing ability of boar spermatozoa. These results suggest that substances stimulating boar sperm capacitation were accumulated from viable spermatozoa into the medium during incubation and that the effective substances were heat-stable and of low molecular weight and were not taurine and hypotaurine.

Animals↗
PubMed1996

In utero and lactational exposure of the male Holtzman rat to 2,3,7,8-tetrachlorodibenzo-p-dioxin: decreased epididymal and ejaculated sperm numbers without alterations in sperm transit rate.

Decreased daily sperm production (DSP) and cauda epididymal sperm number (CESN) are some of the most sensitive effects of in utero and lactational 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD) exposure. The reduction in CESN cannot be fully accounted for by decreased spermatogenesis. To explain the decrease in CESN it was hypothesized that TCDD exposure increases the rate of sperm transit through the excurrent duct system, thereby decreasing the number of sperm in the system at any given time. Pregnant Holtzman rats were administered a single dose of TCDD (1.0 microgram/ kg,po) or vehicle on gestation day 15 and offspring were weaned on postnatal day (PND) 21. On PND 50, testicular sperm were labeled in five males per litter, from 30 control and 26 TCDD-exposed litters, by injecting 15 microCi [3H]thymidine into each testis, under general anesthesia. Sperm movement through the excurrent duct system was monitored daily 35-64 days post [3H]thymidine injection. On PNDs 92-93, TCDD exposure significantly decreased DSP/testis, corpus and cauda epididymis sperm numbers, vas deferens sperm number, and ejaculated sperm number by 28, 30, 36, 39, and 46%, respectively. The decreases in sperm number in the distal excurrent duct system were greater than the decrease in DSP, consistent with the hypothesis that TCDD exposure causes an effect other than decreased DSP that reduced epididymal and ejaculated sperm numbers. However, in utero and lactational TCDD exposure did not alter radiolabeled sperm transit time through the whole epididymis (15 days). With TCDD exposure causing no obvious alteration in sperm transit rate, a plausible explanation for the sperm loss is an increase in sperm phagocytosis in the excurrent duct system.

Animals↗
PubMed1986

Ofloxacin: concentration in human ejaculate and influence on sperm motility.

The concentration of ofloxacin was measured in both fractions of split-ejaculate from five volunteers treated with ofloxacin 400 mg/day for 3.5 consecutive days. Concentrations in both fractions were equal, 2.44 mg/l and 2.5 mg/l, respectively indicating that the penetration of ofloxacin into the prostate gland and into the vesical glands are of the same magnitude. Sperm motility was not affected by ofloxacin in a concentration of 4.5 mg/l as tested on fresh ejaculate of 29 andrologic patients. Thus ofloxacin proves to be useful as a potent antibiotic in clinical care for andrologic patients.

Adult↗
PubMed1996

In vitro fertilization of in vitro matured pig oocytes: effects of boar and ejaculate fraction.

Ejaculates from 3 young boars were collected on 4 occasions as a series of separate 15-ml fractions. The contribution of different fractions of these ejaculates to observed variability in the quality of the semen when used for IVF was then determined. On the basis of sperm concentration, 3 fractions representing the first peak concentration (Fraction 1), the lowest sperm concentration after Fraction 1 (Fraction 2), and the second peak concentration (Fraction 3) were selected for analysis in vitro. Oocyte-cumulus-granulosa cell complexes were obtained by dissection from slaughterhouse ovaries. In vitro matured oocytes were randomly assigned for fertilization by the 3 semen samples from each boar. Sperm concentration was the same in all the samples during prefertilization incubation, while the final concentration for fertilization was 5 x 10(5) sperm/ml. Data were analysed using ANOVA for a split-plot design. In the presence of fraction effects, Student-Newman-Keuls (SNK) test was used for multiple comparison of treatment means. Oocyte penetration rates differed among fractions (P = 0.001) and varied from 69 to 100% (mean 95.7%) for Fraction 1, from 0 to 100% (mean 53.3%) for Fraction 2, and from 50to 100% (mean 89.9%) for Fraction 3. There were also differences in male pronuclear formation rate (P = 0.028; mean 27.6, 9.3 and 16.4% for Fractions 1, 2 and 3, respectively); in the rate of polyspermy (P = 0.0001; mean 92.3, 31.9 and 76.3% for Fractions 1, 2 and 3, respectively); and in the number of penetrated spermatozoa per oocyte P = 0.002; mean 5.58, 1.94 and 4.07 for Fractions 1, 2, and 3, respectively). The first peak concentration of semen (Fraction 1) showed superiority in fertilizing ability and less variability in penetration rate from replicate to replicate compared with the other 2 fractions. By multiple comparison, Boar 1 showed higher rates of penetration (P < 0.05), male pronuclear formation (P < 0.05) and polyspermy (P < 0.05) than the other 2 boars. There was no fraction-by-boar interaction. The IVM-IVF system adopted proved to be a promising method for boar semen evaluation.

Journal Article↗
PubMed1976

Movements of sodium and potassium into ejaculated boar spermatozoa suspended in seminal plasma and a biological salt solution.

Uptake of 22Na and 42K into ejaculated boar spermatozoa was measured in vitro. Cells were suspended either in seminal plasma or in a biological salt solution of essentially the same composition as boar seminal plasma. Samples were incubated at 30 degrees C. Correction was made for extracellular space in the centrifuged sperm pellet. This was determined as 22Na-space, which was less (P less than 0.001) than [14C] carboxyinulin space. Large differences were observed among individual ejaculates. The half-time for potassium uptake into the spermatozoa averaged 11.5 min, which is much faster than that for leukocytes or erythrocytes. When the spermatozoa were suspended in the biological salt solution, the initial rate of 42K uptake was significantly decreased. This may be due to disturbances of the protein components of the sperm membrane. The uptake of 22Na into the spermatozoa was slow. Sodium and potassium transport appeared not to be coupled in the 3/2 ratio which has been reported for erythrocyte membranes. The average concentration of sodium was 108 mM in seminal plasma and 26 mM in the spermatozoa (112 mmol/kg water and 38 mmol/kg water, respectively). The corresponding figures for potassium were 26 mM and 51 mM (27 mmol/kg water and 74 mmol/kg water). The random error for a single determination for the various methods used varied between 2.4 and 13.3% of the mean.

Analysis of Variance↗
PubMed2004

[Proacrosin, an acrosomal marker for the detection of spermatogenic cells in ejaculates from azoospermic men].

Between January 2003 and April 2004, a prospective study was performed on ejaculates from non-obstructive azoospermic men (n = 95), for the identification of spermatogenic cells using an immunohistochemical labeling for proacrosin. 48.4% of ejaculates (46/95) displayed labeled spermatogenic cells. A 38/95 (40%) of men had testicular sperm extraction (TESE) followed by intracytoplasmic sperm injection (i.c.s.i.). Testicular spermatozoa were extracted from 21 men (52.5%). The sensitivity of detecting spermatogenic cells is 66.7% in predicting the presence of testicular spermatozoa, and its specificity is 76.5%. Compared to histopathological diagnostic testicular biopsy, the detection of spermatogenic cells using proacrosin immunohistochemical method offers a predictive parameter for successful TESE. The immunohistochemical method for proacrosin has the advantages of simplicity and low cost. It could be used to predict spermatogenesis from non-obstructive azoospermic men. Further evaluation is required with extensive results to improve sensitivity and specificity.

Acrosin↗
PubMed2005

Identification of bovine doppel protein in testis, ovary and ejaculated spermatozoa.

Doppel (Dpl) protein is a recently identified prion-like protein. Although Dpl might be expressed in the brain after prion gene deletion, in both human and mice Dpl is normally expressed only in testis and spermatozoa, where it appears to be involved in male fertility. Little information is available so far about the expression pattern of Dpl in bovines, thus, hampering possible research on the role of this protein in bovine infertility. We have thus, designed, produced and validated through Western blotting a polyclonal antibody against bovine Dpl. With this antibody we then screened bovine tissues for Dpl expression by immunohistochemistry. Ejaculated spermatozoa were screened by flow cytometry and immunocytochemistry. Bovine Dpl was expressed in all the developing stages of germinal cells, from spermatogones to ejaculated spermatozoa, in Sertoli cells and in ovarian follicles (granulosa cells and follicular fluid). Dpl immunoreactivity was also found on other tissues, where endothelial cells, peripheral nerves and scattered lymphocytes stained positive. This distribution pattern suggests that Dpl might be involved in sperm maturation/capacitation in bovines, like it might be in mice. This hypothesis needs to be verified by widespread application of the flow cytometric protocol established in this paper on spermatozoa from animals with reduced fertility.

Animals↗
PubMed1986

Cell calcium of ejaculated rabbit spermatozoa before and following in vitro capacitation.

Ejaculated rabbit spermatozoa were loaded with the calcium-selective fluorescent indicator quin-2. Measurements of trypan blue exclusion indicated that cell viability was not affected by quin-2 loading. The concentration of intracellular free calcium of quin-2 loaded sperm was calculated to be 144 +/- 14 nM. Spermatozoa capacitated in vitro either before or following quin-2 loading had intracellular free calcium levels similar to that of non-capacitated sperm. These studies indicate that the concentration of intracellular free calcium of ejaculated rabbit spermatozoa does not change as a result of in vitro capacitation.

Acrosome↗
PubMed1979

Viability of spermatozoa in the human ejaculate after vasectomy.

Ejaculates produced by 82 men between 6 and 19 days after removal of approximately 5 cm of vas deferens were assessed specifically for motility of residual spermatozoa. Several of 23 ejaculates produced 6 to 8 days after vasectomy still contained spermatozoa of the quality and number likely to produce pregnancy. By 13 to 15 days, however, all or the great majority of residual spermatozoa were dead, and in only 1 of 50 men were there numbers of motile spermatozoa possibly compatible with fertility. The results seem to justify more extensive surveys to confirm the absolute or biologic limits of the viability of spermatozoa in the terminal portion of the human male reproductive tract, anticipated here to be 16 to 18 days, as a suggested basis for a standard postvasectomy protocol. Second, these data support the choice of the 3rd postoperative week as the earliest rational moment to confirm the absence of motile spermatozoa, or in their presence to suspect an incomplete block.

Cell Survival↗