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PubMedDate not supplied

Evoked sacral potentials in subjects with true premature ejaculation.

Evoked sacral potentials were used to study the bulbo-cavernous reflex in 85 patients with true premature ejaculation (TPE) and in 52 subjects as a control group. In the perineal and perianal recordings the amplitudes of the evoked responses (means +/- SD) were 70 +/- 91.1 microV and 35.6 +/- 36 microV in the TPE patients, and 39.2 +/- 36.8 microV and 26 +/- 21.6 microV in the controls, respectively. Both these differences resulted significant (P less than 0.01 and P congruent to 0.05, respectively). Our results suggest a reflex hyperexcitability, or an impaired "modulation" of the motor neurons of the pudendal nucleus by the regulating upper centers in the TPE patients.

Anal Canal↗
PubMedDate not supplied

The content and distribution of glycosaminoglycans in the ejaculates of normal and vasectomized men.

The glycosaminoglycans (GAGs) of sperm and seminal plasma of normal men and seminal plasma of vasectomized individuals have been identified and quantified by two dimensional (2D) electrophoresis. The sperm contains predominantly CSC and HS as well as significant amounts of DS which achieves a high level in the sperm of the youngest man, while HA and LSC are either undetectable or present in small quantities. In normal seminal plasma, characteristically, DS is essentially lacking whereas CSC is the major GAG and HA and LSC account for relatively high percentages. Interestingly, in the ejaculates of vasectomized men the DS content is relatively prominent and the HA concentration varies widely. The oversulfated chondroitin sulfates CSD/CSE were detected in 7 of the 37 specimens. Their presence in a normal human body fluid is reported for the first time and the previous observation of the youthful DS/CSC switch is expanded to this study.

Adult↗
PubMed1983

Island patch urethroplasty: effects on urinary flow and ejaculation.

Seventeen patients had a single-stage operation for urethral stricture. To avoid recurrence (which occurred in 2 patients) the urethra should be opened not only through the stricture but well beyond the pathological cavernous tissue. In 3 patients it was not possible to reconstruct the bulbocavernosus muscle over the bulb. This resulted in urethral pouching which did not interfere with micturition, except for after-dribbling, but prevented forceful ejaculation and the semen leaked slowly for several minutes. Excision of the apex of the scrotal skin flap to the island patch seems to prevent marginal skin necrosis.

Adolescent↗
PubMed1986

Leucocytes in the ejaculate from fertile and infertile men.

The presence of leucocytes and their subpopulations was studied in the ejaculate from 69 men with an infertile marriage and 12 fertile men. Monoclonal antibodies specific for human leucocytes were used in an immunoperoxidase technique. In addition to the standard sperm analysis, each specimen was also tested for sperm antibodies, aerobic and anaerobic microorganisms, Ureaplasma urealyticum and Chlamydia trachomatis. Leucocytes were found in large numbers in the fertile men compared with the patients. Lymphocytes were found in 20% of the patients. Micro-organisms were cultured from a similar proportion of both groups. We found no correlation between leucocyte counts, sperm density and motility, sperm antibodies and growth of micro-organisms. Our results cast doubt on the conventional criteria of subclinical genital tract infection, namely positive culture and excess leucocyte counts.

Ejaculation↗
PubMed1989

Retrograde ejaculation: successful treatment with artificial insemination.

Between 1977 and 1987, 14 couples in whom the male partner had retrograde ejaculation were treated with artificial insemination using the husband's sperm (AIH). There were 6 pregnancies in 4 couples, giving a cumulative probability of pregnancy at 12 months of 72%. The success rate depended on a number of factors, including semen quality, methods of sperm extraction from the urine, timing of ovulation and other complicating fertility factors.

Adult↗
PubMed2004

Topical anaesthetic use for treating premature ejaculation: a double-blind, randomized, placebo-controlled study.

OBJECTIVE: To assess the use of a topical anaesthetic mixture to improve premature ejaculation (PE), for which penile hypersensitivity might be a cause. PATIENTS AND METHODS: The study included 42 men divided in two groups; group A used a lidocaine-prilocaine solution and group B used an inert cream. The tubes of cream were distributed randomly and participants asked to note any unpleasant symptoms, difficulties and the results of each attempt at intercourse, assessed by the intravaginal ejaculatory latency time (IELT). RESULTS: There was a significant increase in the mean (sd) IELT, from 1.49 (0.9) to 8.45 (0.9) min (P < 0.001) in group A but not in group B, at 1.67 (0.7) to 1.95 (0.12) min (P > 0.05). CONCLUSION: We suggest that anaesthetic cream might be effective for treating PE.

Administration, Topical↗
PubMed2006

Pharmacokinetic and pharmacodynamic features of dapoxetine, a novel drug for 'on-demand' treatment of premature ejaculation.

OBJECTIVE: To describe the relationship between the pharmacokinetic and pharmacodynamic properties of dapoxetine, a drug specifically developed for treating premature ejaculation (PE). METHODS: Data from various stages of the clinical development programme were analysed using validated methods for assessing ejaculatory latency. The clinical characteristics were then compared with the pharmacokinetic profile, determined from measured plasma drug concentrations. RESULTS: Pharmacodynamic and pharmacokinetic measurements confirm that 'on demand' dapoxetine has a rapid onset of action and is rapidly cleared after sexual intercourse. CONCLUSION: Dapoxetine may represent the first of a new category of selective serotonin transport inhibitors. Although dapoxetine has pharmacological similarities to other selective serotonin transport inhibitors, its efficacy after acute administration sets it apart and suggests a different mode of action. Its physicochemical and pharmacokinetic properties and its clinical efficacy make dapoxetine suitable for on-demand treatment of PE.

Benzylamines↗
PubMed2006

Seminal plasma magnesium and premature ejaculation: a case-control study.

OBJECTIVE: To determine the relationship between premature ejaculation (PE) and serum and seminal plasma magnesium levels, in a case-control study. PATIENTS AND METHODS: Thirty-eight patients referred to the authors' urology outpatient clinic were evaluated in two groups; cases comprised 19 men complaining of PE, defined using the Diagnostic and Statistical Manual of Mental Disorders IV criteria and an intravaginal ejaculatory latency time (IELT) of <1 min, and a control group of 19 married men with a normal IELT. All men had a history taken, a systemic physical examination and laboratory studies. After organic and psychogenic disorders were excluded, the 19 patients were included in the study. Seminal plasma and serum magnesium levels were determined using atomic absorption spectrophotometry. RESULTS: The mean (sd) plasma magnesium level was 94.7 (10.9) mg/L in the cases and 116.7 (11.6) mg/L in the controls. There was a significant relationship between seminal plasma magnesium, but not the plasma level, and PE (P < 0.001 and 0.597 respectively). CONCLUSION: PE is significantly related with a lower level of seminal plasma magnesium. The pathological physiology of this relationship requires more investigation.

Adult↗
PubMed2006

Comparison between tamsulosin and alfuzosin on the expulsion phase of ejaculation in rats.

OBJECTIVE: To investigate the effects of acute intravenous (i.v.) delivery of tamsulosin and alfuzosin on the contractions of bulbospongiosus muscles (BS) induced by central delivery of a serotonin agonist, 8-hydroxy-2-(di-n-propylamino)tetralin (8-OH-DPAT), in anaesthetized rats, as an experimental model of the expulsion phase of ejaculation. MATERIALS AND METHODS: Under urethane anaesthesia, adult male rats were implanted with a cannula into the lateral cerebral ventricle for intracerebroventricular (i.c.v.) injection, and with recording electrodes in the BS for electromyogram (EMG) monitoring. Tamsulosin (1 microg/kg) and alfusozin (10 microg/kg) were injected i.v. and 15 min later 8-OH-DPAT (20 microg) was delivered i.c.v. BS-EMG recording was continued for 30 min after i.c.v. 8-OH-DPAT. The area under the curve (AUC) of the BS cluster of contractions was determined as reflecting the energy of BS contractions. RESULTS: After i.c.v. delivery of 8-OH-DPAT, there were rhythmic BS contractions in the form of clusters of bursts in vehicle-, tamsulosin- and alfuzosin-treated rats. The number of BS clusters was not altered by the alpha1-blockers as compared with vehicle, but the AUC was significantly less in tamsulosin-treated rats than in vehicle- or alfuzosin-treated (both P < 0.05) rats. CONCLUSION: Systemic injection of tamsulosin impaired BS contractile capacity whereas alfuzosin did not. This might explain anejaculation in men treated with tamsulosin.

8-Hydroxy-2-(di-n-propylamino)tetralin↗
PubMed1994

A case of successful use of reproductive technology for a couple with subfertility due to retrograde ejaculation, where artificial insemination had failed.

A case history of a couple where the infertility was due to retrograde ejaculation is presented; when conventional treatment with artificial insemination using sperm isolated from postejaculatory urine failed, IVF and GIFT technology was applied. This resulted in a pregnancy which unfortunately failed at 3 months, unrelated to the method of conception. This case report highlights the possible use of IVF/GIFT for yet another type of male subfertility.

Adult↗
PubMed1996

Monoclonal antibodies reacting against capacitated but not with freshly ejaculated boar spermatozoa.

PROBLEM: The involvement of individual sperm proteins in differentiation of antigenically specific and functionally defined regions on sperm membrane has not yet been completely elucidated. METHOD: BALB/c mice were immunized with live capacitated boar spermatozoa and used for production of monoclonal antibodies (MAbs). ELISA, IIF, SDS-PAGE, IVF, and cytologic methods were used for selection and biological characterization of MAbs as well as for identification of corresponding antigens. RESULTS: MAb1F10, MAb2E2, and MAb4B12 react with antigens in the acrosome portion of live capacitated spermatozoa, MAb 1F10 reacted with human sperm cells along with those from bull, ram, mouse, dog, whereas MAb2E2--with mouse's spermatozoa and MAB4B12-with bull's, mouse's, and dog's spermatozoa. Some glycolytic enzymes seemed to reduce mildly the reactions of the MAbs with enzyme treated sperm cells; proteolytic enzymes eliminated the binding of MAbs to the sperm acrosome. These MAbs have no sperm agglutinating and/or sperm-immobilizing activities and reduced the number of spermatozoa binding to zona pellucida. CONCLUSIONS: MAb1F10, MAb2E2, and MAb4B12 seemed to recognize membrane associated antigens with potential role in the initial stages of fertilization, specific for capacitated but not for freshly ejaculated spermatozoa.

Animals↗
PubMed2007

The aetiology of premature ejaculation and the mind-body problem: implications for practice.

Recent attempts to find effective pharmacological treatments for premature ejaculation (PE) have spurred significant interest in the causes of, consequences of, and existing therapies for this common male sexual dysfunction. The recurring tendency in science and medicine, however, to dichotomise causes of such problems into either biological or psychological is not only counterproductive, it is misguided. Ejaculatory response should be viewed as a system of integrated and inseparable hardwired and softwired central and peripheral responses, some being readily modifiable, others not. Such a view argues that treatment of PE aimed at multiple levels of functioning will be self-enhancing and ultimately more effective in producing positive therapeutic outcomes than strategies relying solely on either psychological or biological approaches.

Arousal↗
PubMed2005

Psychosexual factors that differentiate men with inhibited ejaculation from men with no dysfunction or another sexual dysfunction.

AIM: Inhibited or retarded ejaculation (IE) is an uncommon male sexual dysfunction that may result in a lack of sexual fulfillment for both the man and his partner. In this study, we attempted to identify factors that differentiate men with IE from sexually functional controls or from men with other sexual dysfunctions and to specify whether such factors predict self-reported sexual arousal during psychophysiological assessment. METHODS: Each patient underwent psychophysiological assessment and a structured clinical interview based on a standardized questionnaire that included demographic information, psychosexual and medical history, and assessment of current sexual, erectile, and ejaculatory function, including relationship quality and characteristics. RESULTS: Men with IE resemble men with other dysfunctions but are differentiated from controls, in their lower level of relationship satisfaction, greater level of distress, and higher level of health-related problems. Men with IE were further characterized by lower levels of self-reported subjective sexual arousal, despite exhibiting strong penile response during psychophysiological testing and reporting high quality erections across a variety of situations. Also notable, however, were the many factors on which men with IE did not differ from controls. CONCLUSIONS: Taken together, this research helps specify directions for future investigations of men with IE.

Adult↗
PubMed2005

Prevalence of premature ejaculation: a global and regional perspective.

The effort to determine the global burden of premature ejaculation (PE) has been impeded by the lack of a clear and universally accepted definition of the condition. Current diagnostic criteria are variable and rely, to a large degree, on subjective measurements. Moreover, the absence of a clear consensus on what constitutes a normal ejaculatory latency has impeded research into the prevalence of PE, although evidence is gradually accruing that may make this definition easier. Perception of "normal" ejaculatory latency varies by country and can differ when assessed either by the patient or their partner. Despite these limitations, information from the Global Study of Sexual Attitudes and Behaviors and other sources suggests a global prevalence of PE of approximately 30% across all age groups. The etiology underpinning this prevalence remains to be clarified, but current evidence reflects a shift from psychogenic theories to more neurobiological bases. While elucidation of the etiology of PE will undoubtedly aid the development of more effective therapies, it is clear that, whatever the cause of the condition, it is associated with a significant burden on psychological and overall health.

Age Distribution↗
PubMed2005

Diagnosis and treatment of premature ejaculation: the physician's perspective.

Premature ejaculation (PE) is a common condition associated with significant adverse effects on the sexual and overall quality of life of men with this condition. Behavioral therapies, such as the "squeeze" and "stop-start" techniques, and psychotherapy, have been the mainstay of PE management for many years. However, evidence of their short-term efficacy is limited while support for their long-term benefit is lacking. There are currently no medications licensed specifically for the treatment of PE. This paucity of pharmacological treatment may, in turn, contribute to the absence of systematic procedures for the identification, evaluation, and treatment of PE patients. Current "off-label" pharmacotherapeutic approaches include topical anesthetics, phosphodiesterase-5 inhibitors, and serotonin reuptake inhibitors. Of these, the serotonin reuptake inhibitors show the greatest efficacy and an increasing body of evidence is illuminating their mode of action. Nevertheless, all current "off-label" pharmacotherapeutic approaches fall short of the ideal therapy for PE. In the absence of a cure, such a treatment should be tolerable, inconspicuously used, effective from first dose, rapid in onset of action, and available as a prn-dosing regimen. It is anticipated that agents in development for the specific indication of PE will come closer to this ideal than existing pharmacotherapeutic approaches.

Behavior Therapy↗
PubMed1985

Sialyl glycoprotein distribution on the plasma membrane of ejaculated ram spermatozoa.

Localization of sialyl residues on unfixed ejaculated ram sperm membrane using the direct covalent probes of either ferritin hydrazide or latex hydrazide revealed a unique regional distribution on the plasmalemma covering the sperm head only. Three different labelling zones were identified based on the intensity and the nature of the sialyl glycoconjugates: a patchy-like zone which included the plasma membrane overlaying the post-nuclear cap and the convex side of the apical body of the acrosome; highly ordered heavily labelled zones including the plasmalemma adjacent to the concave apical body of the acrosome and to the posterior part of the equatorial acrosomal segment; a paucity-labelling zone which included the plasma membrane underlying the principal acrosomal region and the anterior part of the equatorial acrosomal segment. The possible physiological role of the highly ordered labelled zones is discussed.

Acrosome↗
PubMed1988

Penile hyperexcitability with recurrent ejaculations as the presenting manifestation of a case of rabies.

A patient with rabies presented with penile hypersensitivity and recurrent ejaculation. This preceded the more classical manifestations such as hydrophobia and aerophobia by approximately 8 hours. A review of the literature reveals that a variety of urogenital symptoms may rarely occur in rabies. Ours is however the first report documenting the occurrence of these symptoms at the onset of the disease in an autopsy proven case of rabies. Damage to the amygdaloid nucleus has been postulated to be the basis of these urogenital symptoms. This correlates well with our autopsy findings of extensive neuronal damage and Negri bodies in the temporal poles.

Ejaculation↗
PubMed2005

Does lidocaine ointment addition increase fluoxetine efficacy in the same group of patients with premature ejaculation?

PURPOSE: To evaluate the efficacy of fluoxetine alone and fluoxetine+lidocaine ointment in the same patient group with premature ejaculation (PE). MATERIAL AND METHODS: 78 patients with PE were given 20 mg fluoxetine by an 'as-needed treatment' 4 h before planned sexual activity for a period of 3 months. They were then told to add local lidocaine ointment to fluoxetine 30 min before sexual activity for an additional 3 months for most of their sexual attempts. They were asked to note their PE grades and intravaginal ejaculatory latency time (IELT) scores by stopwatch technique before and after each treatment modality; the results were compared statistically afterwards. RESULTS: Of 46 patients who completed the study, the mean pretreatment, fluoxetine alone and fluoxetine+lidocaine ointment treatment PE grades and IELT scores were found to be 6.52+/-1.42 and 2.58+/-0.49, 3.21+/-1.86 and 1.28+/-0.71, 2.17+/-1.56 and 1.04+/-0.72, respectively, showing a decrease in PE grades and IELT scores in combined therapy. On an individual patient basis, the total significant and moderate improvement rate of combined therapy was found to be 86.9%. Failure was observed in 6 (13.1%) patients. CONCLUSION: The effective treatment with fluoxetine+lidocaine ointment offers the advantage of an 'as-needed treatment' in PE with minimal side effects and can be used as one of the first-line alternatives in the treatment of PE.

Administration, Oral↗