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PubMedDate not supplied

Diminution of ejaculatory capacity induced by frequent ejaculation in dogs: prevention and reversal by yohimbine.

The effect of yohimbine, an alpha-2 adrenoceptor antagonist, on diminished ejaculatory capacity induced by frequent ejaculation was investigated in dogs. Ejaculation was elicited by manual penile stimulation (for 5 min) 5-8 times every 30 min. The amount of ejaculate produced by the stimulation was drastically reduced during a period of frequent ejaculation in a frequency-dependent manner. When administered immediately after the first ejaculation, yohimbine (0.1 mg kg-1, i.p.) completely prevented the decrease in the amount of ejaculate produced in the succeeding ejaculation. Moreover, similar treatment with yohimbine immediately after the fifth ejaculation when the dogs displayed a greatly reduced ejaculatory capacity restored the capacity to the initial level. In addition, yohimbine increased the total number of sperm produced during a period of frequent ejaculation. These data corroborate our previous finding that yohimbine at a low dose has a stimulatory effect on ejaculatory function in dogs. The present study also indicates that an alpha-2 adrenergic mechanism may be involved in the diminution of ejaculatory capacity induced by frequent ejaculation.

Animals↗
PubMed2005

Individual differences in male rat ejaculatory behaviour: searching for models to study ejaculation disorders.

In addition to investigating sexual function in rats that display normal ejaculatory behaviour, studying rats that are either 'hyposexual' or 'hypersexual' may provide important insights into the aetiology of ejaculatory dysfunctions in men, such as premature and retarded ejaculation. To this end, rats were matched into groups of 'sluggish', 'normal' and 'rapid' ejaculators based on their ejaculation frequencies displayed in a series of weekly sexual behaviour tests. Selecting rats on this parameter revealed large and stable differences in other parameters of sexual behaviour as well, including ejaculation latency and mount frequency but not intromission frequency and mount latency, putative indices of sexual motivation. Neuroanatomically, Fos immunoreactivity as a measure of neuronal activation was increased in rapid ejaculators compared with sluggish ejaculators in ejaculation-related brain areas, presumably associated with the differences in ejaculatory behaviour. Although the total number of oxytocin neurones within subregions of the hypothalamus did not differ between groups, in the supraoptic nucleus of the hypothalamus more oxytocin neurones were activated in rapid ejaculators compared with the other groups. Apart from the differences observed in ejaculatory behaviour, groups did not differ with respect to their locomotor activity and approach-avoidance behaviour as measured in the elevated plus-maze. Finally, apomorphine-induced stereotypy was similar in sluggish and rapid ejaculators, suggesting no large differences in dopamine susceptibility. Altogether, the present results suggest stable differences in male rat ejaculatory behaviour. Further exploring the neurobiological mechanisms underlying these differences may be a promising approach to gain insights into the aetiology of sexual dysfunctions such as premature, retarded or an-ejaculation.

8-Hydroxy-2-(di-n-propylamino)tetralin↗
PubMed2006

The beneficial effect of alfuzosin 10 mg once daily in 'real-life' practice on lower urinary tract symptoms (LUTS), quality of life and sexual dysfunction in men with LUTS and painful ejaculation.

OBJECTIVE: To determine the efficacy and safety of the selective alpha(1)-blocker alfuzosin in men with lower urinary tract symptoms (LUTS) and painful ejaculation, compared with those with LUTS only, as painful ejaculation is one of the most prevalent, differentiating and bothersome symptoms in men with chronic prostatitis/chronic pelvic pain syndrome. PATIENTS AND METHODS: In all, 4857 sexually active men with LUTS had an evaluable answer to the Danish Prostate Symptom Score for Sexual Symptoms question related to pain/discomfort on ejaculation at enrolment in a 6-month open-label study with alfuzosin 10 mg once daily. Efficacy was analysed at the endpoint in the intent-to-treat population. RESULTS: Of the 4857 men, 997 (20.5%) had pain/discomfort on ejaculation and 889/997 (89.2%) considered it was a problem. At inclusion, men with painful ejaculation had more severe LUTS and bother than men with LUTS only. Erectile dysfunction (ED) and reduced ejaculation were more prevalent (74.5% and 71.9%, respectively) and bothersome in men with painful ejaculation than in those with no pain (59.6% and 57.4%, respectively). Under alfuzosin treatment, all variables in both groups significantly improved from baseline; men with painful ejaculation compared to LUTS-only had similar improvements in weighted scores for LUTS (-7.8 vs -7.7), bother (-1.7 vs -1.7), and reduced ejaculate (-0.5 vs -0.4) but greater improvements in ED (-0.6 vs -0.4; P < 0.001). The weighted score for painful ejaculation decreased from 2.2 to 0.8 (P < 0.001). Alfuzosin was well tolerated in both groups. CONCLUSIONS: This 6-month open-label study suggests that alfuzosin 10 mg once daily significantly improves LUTS, quality of life and sexual function in men with prostatitis-like symptoms, and is well tolerated.

Adrenergic alpha-Antagonists↗
PubMed1990

Changes in accessory sex glands of stallions after sexual preparation and ejaculation.

Ultrasonographic images of the accessory sex glands of 8 stallions were recorded immediately prior to sexual preparation, immediately after sexual preparation, and immediately after ejaculation. Relative size changes, determined by measurements of ultrasonograms of accessory sex gland, were contrasted. Length and width of the bulbourethral glands increased significantly (P less than 0.05) after sexual preparation and decreased significantly (P less than 0.05) after ejaculation. The increase in bulbourethral gland volume following sexual preparation was correlated significantly (P less than 0.01) with the number of false mounts attempted by stallions during sexual preparation. Diameter of the pelvic portion of the urethra did not change significantly (P greater than 0.05) after sexual preparation or after ejaculation. Prostate gland lobular and isthmic thickness increased significantly (P less than 0.05) after sexual preparation and decreased significantly (P less than 0.05) after ejaculation. Total and lumenal diameter of the ampullae increased significantly (P less than 0.05) after sexual preparation and decreased significantly (P less than 0.05) after ejaculation. Diameter of the ampulla wall did not change significantly (P greater than 0.05) after sexual preparation or ejaculation. Reduction of the lumenal area of the ampullae after ejaculation was not correlated (P greater than 0.05) to concentration of spermatozoa or total spermatozoa per ejaculate. Total and lumenal diameters of the vesicular glands increased significantly (P less than 0.05) after sexual preparation and decreased significantly (P less than 0.05) after ejaculation. Diameter of the vesicular gland wall did not change significantly (P greater than 0.05) after sexual preparation or ejaculation.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMed1996

Clomipramine and sexual function in men with premature ejaculation and controls.

PURPOSE: We determined whether clomipramine taken as needed increases ejaculation latency in men with premature ejaculation and controls. MATERIALS AND METHODS: The study included 8 patients with primary premature ejaculation, 6 with premature ejaculation and erectile dysfunction, and 8 controls. A prospective, double-blind, placebo controlled, crossover design was used that included 2, 3-week periods with clomipramine and placebo. During treatment phases subjects took either 25 mg. clomipramine or placebo as needed, that is 12 to 24 hours before anticipated sexual activity (coitus or masturbation). Subjects also visited the laboratory during these phases for evaluation of sexual response using visual erotic stimulation with and without vibration to the penis. Daily logs of sexual activities were maintained during treatment phases. RESULTS: Clomipramine significantly increased the latency to ejaculation during sexual activity (coitus or masturbation) from approximately 2 to 8 minutes in men with primary premature ejaculation. There were no significant effects in controls and men with premature ejaculation plus erectile dysfunction. Laboratory assessment indicated that men with primary premature ejaculation were better able to control ejaculatory response with clomipramine therapy. In these men clomipramine also resulted in increased satisfaction with sex life and relationship. Clomipramine inhibited nocturnal penile tumescence in all subjects. CONCLUSIONS: Clomipramine (25 mg. as needed) effectively increases ejaculatory latency in men with primary premature ejaculation, while treatment is not effective in those with premature ejaculation and erectile dysfunction.

Adult↗
PubMed2003

Immunological alterations in the ejaculate of chronic prostatitis patients: clues for autoimmunity.

The aim of this prospective study was to observe immunophenotypic patterns in the ejaculate of patients with noninflammatory chronic pelvic pain syndrome (Cat IIIB CPPS) and to test for a possible autoimmune aetiology. Thirty-five patients of a total of 88 patients with chronic prostatitis Cat IIIB were consecutively selected. Monthly ejaculate testing was carried out for IgG, IgA, IgM, IL-1alpha, sIL-2R and IL-6. The control group for ejaculate analysis was composed of 96 normal ejaculates (according to the WHO criteria). Immunohistochemical detection of CD3 cells (T lymphocytes) and CD20 cells (B lymphocytes) was performed in 71 biopsy cylinders of Cat IIIB CPPS patients and in 25 prostate biopsy cylinders of subjects without symptoms or obstruction. Intra-acinar T-lymphocytic infiltrates were dominated by T-cytotoxic cells (P = 0.05). Ejaculate IL-6 and ejaculate IgA increased significantly and dropped again, correlating with a release of clinical symptoms. Inflammatory ejaculate interleukin concentrations correlated with the immunohistochemical findings with presence of large numbers of T cells (all P-values < or = 0.01). Immunomodulation was performed in a pilot series of three patients by five monthly cycles of IgG (Sandoglobulin), 1 g kg-1 body weight. Immunomodulation with IgG decreased pain moderately and did not change ejaculate interleukin and immunoglobulin concentrations. In summary, interleukin and immunoglobulin determinations in the ejaculate revealed an inflammatory process even in Cat IIIB CPPS. The findings of intra-acinar T-cell rich infiltrates and the associated inflammatory reaction may indicate a possible autoimmune component in the aetiology of CPPS. Exact origin and role of interleukin changes in the ejaculate of CPPS patients need to be further evaluated. Unfortunately, pilot series with immunomodulation with IgG do not seem to provide clear clinical benefit.

Adult↗
PubMedDate not supplied

[Effect of heterologous seminal plasma on the improvement of the quality of the ejaculate].

Seminal plasma from oligozoospermic ejaculates and ejaculates with high rate of pathological spermatozoa was substituted for seminal plasma from normal ejaculates in experiments carried out in order to improve the ejaculate quality. In these experiments the improvement of ejaculate quality could not be established. The progressive increase of 20% in the motility of spermatozoa was recorded, in 4 out of 7 ejaculates with hypokinetic motility of spermatozoa where plasma was substituted, while in one case the motility remained unchanged. When plasma from normal ejaculates was substituted for plasma from ejaculates of poorer quality, the intensity of the motility of spermatozoa decreased for 10-20% in 3 of cases while in 1 it remained unchanged. Deep freezing of ejaculates after seminal plasma was substituted did not gain satisfactory results except when cases of substitution for plasma from normal ejaculates were concerned.

Freezing↗
PubMed2005

Lifelong premature ejaculation: definition, serotonergic neurotransmission and drug treatment.

The ejaculation distribution theory (EDT) postulates a biological continuum of the intravaginal ejaculation latency time (IELT) in men. Such an continuum has recently been found in two epidemiological stopwatch studies. In addition, a continuum of ejaculation latency time has also been demonstrated in laboratory rats. It is suggested that the invariable parts of ejaculation, i.e. premature and retarded ejaculation are highly influenced by genetic and neurobiological factors. In contrast, superimposed on biological roots, ejaculation of men, in the middle part of the continuum, is probably more easily influenced by environmental and psychological factors. A meta-analysis of 35 daily SSRI and clomipramine treatment studies demonstrated a similar efficacy for paroxetine, clomipramine, sertraline and fluoxetine, with paroxetine exerting the strongest effect on ejaculation. Based on fundamental insights into serotonergic neurotransmission, it is suggested that on-demand conventional SSRI treatment will not lead to similarly impressive ejaculation delay as that found after daily conventional SSRI treatment. Future studies with SSRIs with short half-lives, short T(max) and high C(max )should elucidate whether these pharmacokinetic properties are able to affect the pharmacodynamics of 5-HT neurons in such a way that immediate clinically relevant ejaculation delay occurs.

Animals↗
PubMed1997

Demonstration of ejaculation-induced neural activity in the male rat brain using 5-HT1A agonist 8-OH-DPAT.

Previous studies from our laboratory indicated that existence of ejaculation-related neural activation within the circuitry underlying mating behavior in the male rat. Clusters of Fos-immunoreactive neurons were present only following ejaculations and not after intromissions. However, it was not clear if this pattern of neural was specific to ejaculation or a result of summation of sexual activity preceding ejaculation. In the present study, the facilitative effect of the 5-HT1A receptor agonist 8-OH-DPAT on ejaculatory behavior was used to analyze the pattern of Fos immunoreactivity ejaculation preceded by minimal sexual activity. Male rats treated with 8-OH-DPAT (0.4 mg/kg) achieved ejaculation after a shortened latency and low numbers of mounts and intromissions. Ejaculation-induced Fos immunoreactivity was present in clusters of neurons in the lateral part of the posterodorsal medial amygdala, in two subregions of the posteromedial bed nucleus of the stria terminalis, in the posterodorsal preoptic nucleus, and in the parvicellular part of the subparafascicular thalamic nucleus. Males that ejaculated with the first intromission and were treated with a higher dose of 8-OH-DPAT (0.8 mg/kg) exhibited similar clusters of Fos-positive neurons in all areas except the posterodorsal preoptic nucleus. The results demonstrate the existence of a specific ejaculation-related subcircuit within a larger neural circuitry involved in male sexual behavior.

8-Hydroxy-2-(di-n-propylamino)tetralin↗
PubMed2001

Prevalence of chronic prostatitis in men with premature ejaculation.

OBJECTIVES: To investigate the prevalence of chronic prostatitis in men with premature ejaculation. The etiology of premature ejaculation is currently considered psychological in nature. However, the possibility that urologic, hormonal, or neurologic factors may contribute to this condition should be considered in its management. METHODS: We evaluated segmented urine specimens before and after prostatic massage and expressed prostatic secretion specimens from 46 patients with premature ejaculation and 30 controls by bacteriologic localization studies. The incidence of premature ejaculation in the subjects with chronic prostatitis was also evaluated. RESULTS: Prostatic inflammation was found in 56.5% and chronic bacterial prostatitis in 47.8% of the subjects with premature ejaculation, respectively. When compared with the controls, these novel findings were statistically significant (P <0.05). CONCLUSIONS: Considering the role of the prostate gland in the mechanism of ejaculation, we suggest a role for chronic prostate inflammation in the pathogenesis of some cases of premature ejaculation. Since chronic prostatitis has been found with a high frequency in men with premature ejaculation, we stress the importance of a careful examination of the prostate before any pharmacologic or psychosexual therapy for premature ejaculation.

Adult↗
PubMed1998

Morphology of spermatozoa in the cauda epididymidis before and after electroejaculation and a comparison with ejaculated spermatozoa in the domestic cat.

When 2 ejaculates are collected by electroejaculation from the domestic cat within a period of 10 min the first ejaculate has a higher proportion of abnormal spermatozoa than the second. The reason for this difference is not known for the domestic cat, but in other species long-term epididymal storage results in a higher proportion of abnormal spermatozoa. The aims of this study were to determine the proportions of abnormal spermatozoa in the cauda epididymidis and to ascertain if electroejaculation affects this proportion. Therefore the proportions of spermatozoa in the cauda epididymidis with different morphological abnormalities were compared before and after ejaculation. In addition, the proportion of morphologically abnormal spermatozoa in the epididymis was compared with that in the ejaculate. Nine privately-owned domestic cats were anesthetized, and one testicle was surgically removed. An ejaculate was collected by electroejaculation, after which the remaining testicle was ectomized. There were no significant differences in the proportions of different sperm abnormalities between the cauda epididymidis removed before ejaculation and the one removed after ejaculation. A significantly (P = 0.009) higher proportion of spermatozoa with tail abnormalities was found in the ejaculates compared with the cauda epididymides (11.1 and 1.6%, respectively), while, as expected, there was a lower proportion of spermatozoa with distal droplets in the ejaculates than in the cauda epididymides (35.1 and 75.9%, respectively). This new information contributes to the understanding of the etiology of sperm defects in the domestic cat, and is of importance when evaluating a semen sample in this species.

Animals↗
PubMed2001

Oral imipramine and intravenous xylazine for pharmacologically-induced ex copula ejaculation in stallions.

This study is part of ongoing work toward developing pharmacological methods for enhancing and inducing ejaculation in stallions with ejaculatory dysfunction or disabilities that interfere with normal breeding behavior. The objective was to evaluate a treatment regimen involving oral imipramine followed by intravenous xylazine that, in uncontrolled field clinical trials, had shown promise for a higher rate of ejaculation and fewer side effects using a more easily obtained and administered form of imipramine. Eight stallions each underwent eight trials in which treatment consisted of imipramine hydrochloride (3mg/kg, orally in a small portion sweet feed) followed 2h later by xylazine hydrochloride (0.66 mg/kg, intravenously). Trials were conducted with the stallion in a stall. Semen was collected using a collection bag secured over the prepuce with a girth band. Overall, 44 of the 64 attempts (68%) resulted in ejaculation. Within-stallion ejaculation rate ranged from 3 of 8 to 7 of 8 attempts. Interval from xylazine treatment to ejaculation ranged from 1.2 to 14 min. As is typical for induced ejaculations in which imipramine is included in the treatment regimen, ejaculates were of low volume, high sperm concentration, and with a higher total number of sperm than for in copula ejaculates of these stallions. These results represent a modest improvement in rate of ejaculation over previous treatment regimens.

Administration, Oral↗
PubMed2001

Reflexes and somatic responses as predictors of ejaculation by penile vibratory stimulation in men with spinal cord injury.

STUDY DESIGN: Retrospective chart review. OBJECTIVE: To identify factors in addition to level of injury (LOI) that may predict ejaculation by penile vibratory stimulation (PVS) in spinal cord injured males. SETTING: Major urban medical school and teaching hospital. MATERIALS AND METHODS: Presence of a bulbocavernosus response (BCR) and a hip flexor response (HR) before PVS (n=123 patients), and somatic responses during PVS (n=204 trials performed on a subset of 44 patients) were evaluated for their frequency of occurrence on trials with and without ejaculation. RESULTS: Overall ejaculation success rates for cervical, T1-T6, and T7-T12 LOI were 71%, 73%, and 35%, respectively. Eighty per cent of patients who were positive for both BCR and HR ejaculated with PVS, while only 8% of patients who were negative for both BCR and HR ejaculated with PVS. For cervical injuries, BCR and HR were no more predictive of ejaculation by PVS than LOI alone. T1-T6 patients were more likely to ejaculate when at least one reflex was present. T7-T12 patients with no BCR were unlikely to ejaculate by PVS. Except for abdominal contractions, somatic responses were not present in the majority of PVS trials. When they were present, however, they occurred in a high percentage of ejaculation trials: withdrawal response (hip flexion, knee flexion and thigh adduction) (90%), piloerection (84%), extremity spasms (83%), thigh abduction (80%), and thigh adduction (72%). CONCLUSION: We recommend that patients with cervical injuries initially undergo PVS. Patients with T1-T6 LOI with at least one reflex present, and patients with T7-T12 LOI with both reflexes, or only BCR present, may undergo PVS. Certain somatic/autonomic responses, when seen, may help in deciding whether to continue with a given trial, or give a repeat trial, of PVS. SPONSORSHIP: The Miami Project to Cure Paralysis and the State of Florida Specific Appropriations.

Adult↗
PubMed1993

Penile sensitivity in men with premature ejaculation and erectile dysfunction.

Previous research indicates that penile sensitivity is typically lower in men with erectile dysfunction than in age-matched controls. On the assumption that sensitivity might be greater in men with short ejaculation latency (premature ejaculation), the present research investigated penile threshold (sensitivity) to vibrotactile stimulation in men with premature ejaculation, erectile dysfunction, or a combination of the two. Premature ejaculators showed thresholds commensurate with controls, while men with erectile dysfunction, or combined erectile dysfunction and premature ejaculation, showed significantly elevated thresholds. Although premature ejaculators did not show penile hypersensitivity, there was a significant correlation in this group between ejaculation latency and threshold. Overall, these findings argue against a primary role for penile sensitivity in ejaculation latency, and suggest that other somatic factors or cognitive factors may play the more critical role in premature ejaculation.

Adult↗
PubMed1977

Lectin-binding sites on the plasma membranes of rabbit spermatozoa. Changes in surface receptors during epididymal Maturation and after ejaculation.

MODIFICATIONS IN RABBIT SPERM PLASMA MEMBRANES DURING EPIDIDYMAL PASSAGE AND AFTER EJACULATION WERE INVESTIGATED BY USED OF THREE LECTINS: concanavalin A (Con A); Ricinus communis I (RCA(I)); and wheat germ agglutinin (WGA). During sperm passage from caput to cauda epididymis, agglutination by WGA drastically decreased, and agglutination by RCA(I) slightly decreased, although agglutination by Con A remained approximately unchanged. After ejaculation, spermatozoa were agglutinated to a similar degree or slightly less by Con A, WGA, and RCA(I), compared to cauda epididymal spermatozoa. Ultrastructural examination of sperm lectin-binding sites with ferritin- lectin conjugates revealed differences in the densities of lectin receptors in various sperm regions, and changes in the same regions during epididymal passage and after ejaculation. Ferritin-RCA(I) showed abrupt changes in lectin site densities between acrosomal and postacrosomal regions of sperm heads. The relative amounts of ferritin-RCA(I) bound to heads of caput epididymal or ejaculated spermatozoa. Tail regions were labeled by ferritin RCA(I) almost equally on caput and cauda epididymal spermatozoa, but the middle-piece region of ejaculated spermatozoa was slightly more densely labeled than the principal-piece region, and these two regions on ejaculated spermatozoa were labeled less than on caput and cuada epididymal spermatozoa. Ferritin-WGA densely labeled the acrosomal region of caput epididymal spermatozoa, although labeling of cauda epidiymal spermatozoa was relatively sparse except in the apical area of the acrosomal region. Ejaculated spermatozoa bound only a few molecules of ferritin-WGA, even at the highest conjugate concentrations used. Caput epididymal, but not cauda epididymal or ejaculated spermatozoa, bound ferritin-WGA in the tail regions. Dramatic differences in labeling densities during epididymal passage and after ejaculation were not found with ferritin-Con A.

Animals↗
PubMed2003

Retrograde ejaculation after anterior lumbar interbody fusion: transperitoneal versus retroperitoneal exposure.

STUDY DESIGN: In this multicenter, prospective, 2-year study, 146 male patients underwent a single-level anterior lumbar interbody fusion with a tapered threaded titanium fusion device. All the patients were advised before surgery of the risk for retrograde ejaculation. After surgery, any case of retrograde ejaculation was recorded as an adverse event, and the patient was observed up for the remainder of the study. OBJECTIVE: To determine the incidence of retrograde ejaculation in male patients treated for single-level degenerative lumbar disc disease at L4-L5 or L5-S1 with a stand-alone anterior interbody fusion using tapered, threaded titanium fusion cages. SUMMARY OF BACKGROUND DATA: The incidence of retrograde ejaculation in men after anterior lumbosacral spinal surgery has been reported to range from 0.42% to 5.9%. Various risk factors that increase the chance of retrograde ejaculation have been proposed. METHODS: In this prospective study, 146 male patients underwent an open surgical exposure of the lumbosacral junction and a single-level interbody fusion at either L4-L5 or L5-S1. Assessment of a patient's clinical outcome was based on written questionnaires at 6 weeks and then 3, 6, 12, and 24 months after surgery. Patients were questioned about adverse events at each of these assessments, and any case of retrograde ejaculation was recorded and followed. RESULTS: Retrograde ejaculation developed in 6 of the 146 men after open anterior lumbar interbody fusion surgery. Two cases (1.7%; 2/116) involved patients who underwent a retroperitoneal surgical exposure. Four cases (13.3%; 4/30) involved patients who had a transperitoneal surgical exposure. This difference is statistically significant according to Fisher's exact test (P = 0.017). At 12 months after surgery, 2 patients had resolution of their symptoms: 1 in the retroperitoneal approach group and 1 in the transperitoneal group. At the final 2-year follow-up, no changes in symptoms were reported. One patient in the retroperitoneal approach group (0.86%) and three patients in the transperitoneal group (10%) reported permanent retrograde ejaculation (P = 0.027). CONCLUSIONS: A transperitoneal approach to the lumbar spine at L4-L5 and L5-S1 has a 10 times greater chance of causing retrograde ejaculation in men than a retroperitoneal approach.

Ejaculation↗
PubMed2003

Antidepressants and ejaculation: a double-blind, randomized, fixed-dose study with mirtazapine and paroxetine.

A double-blind, fixed-dose study in healthy men with lifelong early ejaculation was performed to evaluate potential differences in their effects on ejaculation latency, between clinically relevant doses of the selective serotonin reuptake inhibitor paroxetine and the noradrenergic and specific serotonergic antidepressant mirtazapine. Twenty-four men with an intravaginal ejaculation latency time (IELT) less than 1 minute were randomly assigned to paroxetine (20 mg/d) or mirtazapine (30 mg/d) for a period of 6 weeks; half the dosage was given in the first week. During the preceding 1-month baseline and 6-week treatment period, intravaginal ejaculation latency times were measured at home using a stopwatch procedure. The trial was completed by 18 men. Analysis of variance revealed a between-group difference in the development of the delay in intravaginal ejaculation latency time over time (P < 0.001); the intravaginal ejaculation latency time after paroxetine and mirtazapine gradually increased from 15 to 119 s and from 23 to 28 s, respectively, after 6 weeks. Paroxetine 20 mg/d exerted a strong delay (maximum 5.7-fold increase), whereas mirtazapine 30 mg/d did not delay ejaculation (0.9-fold increase). These results confirm earlier findings that paroxetine, but not mirtazapine, significantly delays orgasm and ejaculation in men with early ejaculation, whereas mirtazapine is devoid of any effect on it.

Adolescent↗
PubMed2003

Effects of ejaculation by penile vibratory stimulation on bladder capacity in men with spinal cord lesions.

PURPOSE: We examined the effects of ejaculation by penile vibratory stimulation on bladder capacity in men with spinal cord lesions. MATERIAL AND METHODS: Included in our study were 14 men with spinal cord lesions from C4 to T7 with detrusor hyperreflexia. Cystometry was performed before and immediately after ejaculation by penile vibratory stimulation to establish baseline conditions and repeated after 1 month of ejaculation by penile vibratory stimulation every third day. The third cystometry study was done after 1 month of ejaculation by penile vibratory stimulation every third day at home to determine any long-term effects of treatment. This third cystometry was performed 72 hours after the last ejaculation to exclude any acute effects of ejaculation by penile vibratory stimulation on detrusor hyperreflexia. In addition, 1 to 3 days later ejaculation was induced by penile vibratory stimulation and immediately followed by cystometry to examine whether it was possible to achieve an acute effect as well as a potential long-term effect. RESULTS: Baseline urodynamic investigations revealed bladder hyperreflexia and external sphincter dyssynergia in all individuals. There was no statistically significant difference in bladder capacity at leak point before and immediately after ejaculation by penile vibratory stimulation. However, after 4 weeks of frequent penile vibratory stimulation treatment bladder capacity at leak point increased significantly from a median of 190 ml. (range 17 to 700) at baseline to 293 (range 30 to 700) (Wilcoxon signed rank test p = 0.03). Furthermore, there was a trend toward decreased intravesical pressure during the filling phase. CONCLUSIONS: Ejaculation by penile vibratory stimulation was associated with a significant increase in bladder capacity at leak point after 4 weeks of frequent treatment. This finding may have implications in the management of incontinence in men with spinal cord lesions.

Adult↗