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Premature ejaculation (PE) is important in the sexual relations of couples. After emphasizing that certain PE are of curable etiology (eg. short frenum of prepuce), the different stage of PE are analyzed and classified as a function of the severity, and in consequence the reversibility, of the repercussions of the life of couples. A therapeutic technic is described that is based on the target proposed by Masters and Johnson.
Specific antisera have been obtained against the purified human sperm protamine HP1b. The specificity of antibodies was assessed in dot-blot and western-blot assays. Antibodies showed high binding to protamine HP1 group. Nevertheless cross-reactivity between HP1 and the other protamines (HP2 - HP3 - HP4) could not be excluded. Immunohistochemical studies revealed that protamines HP1 were detected in nuclei of ejaculated sperm after chromatin decondensation. In testis, they appeared in nuclei of elongating spermatids.
Six baboons (Papio ursinus) males were immobilised on five occasions at intervals of two weeks using a combination of ketamine hydrochloride and xylazine. The animals were subsequently successfully electro-ejaculated. No semen was obtained from animals when azaperone was used instead of xylazine, despite the use of a successful standardised method of electrical stimulation.
From a group of 100 patients with more than 5% round-head spermatozoa in their ejaculate a comparism was set up against another control group in order to show the special relationships to the other morphological parameters. Emphasis is laid on the detailed morphological differentiation. Demonstration of four characteristic cases of interest.
Acrosin and hyaluronidase demonstrated different release patterns following treatment of living spermatozoa with the Ca2+-ionophore A 23187. One hour after the acrosomal reaction about 50% of the acrosin was still associated with the spermatozoal membranes, while hyaluronidase could no longer be detected in the spermatozoal remnants. Strong fixation conditions with acrolein and glutaraldehyde were used to prevent redistribution and leakage of these sperm proteins. Lost antigenicity was restored with sodium-borohydride and pronase E treatment. Immunofluorescent localization showed hyaluronidase to be confined to the anterior portion of the acrosome. Acrosin was localized throughout the entire acrosome including the equatorial segment. By immunoelectron microscopy, hyaluronidase was exclusively found in the acrosomal matrix. The equatorial segment was devoid of hyaluronidase. Acrosin was found in the acrosomal matrix as well as on the outer acrosomal membrane. Furthermore, labeling for acrosin in the equatorial segment was clearly demonstrated. Localization of hyaluronidase was the same for epididymal and ejaculated sperm cells but in approximately 70% of the epididymal spermatozoa acrosin could not be detected in the equatorial segment. In most of these epididymal cells acrosin was confined to the anterior part of the acrosome comparable with hyaluronidase. These observations support the motion that the appearance of acrosin in the equatorial segment is part of the maturation process during passage through the epididymis.
Twenty patients, between 20 and 51 years of age suffering from bladder neck dysfunction, were treated by bladder neck incision as proposed by Turner-Warwick. Good results and only minor side-effects were noticed. There was no case of permanent retrograde ejaculation.
Spermatozoal depletion of the extra-gonadal reserve (EGR) has been monitored in 14 men by analysing ejaculates collected daily for 5 days. It has been concluded that EGR is stabilized within 2 days and that an estimate of daily spermatozoal output can be obtained either by averaging the values from days 3 to 5 or by using the day 5 value alone. This latter parameter may prove useful clinically.
An unusual case is presented of vaginal evisceration after forcible coitus in a healthy young woman with no anatomic defects or history of previous pelvic surgery. Intraabdominal ejaculation, documented cytologically, provided evidence of penile penetration of the pouch of Douglas. Etiologic mechanisms and management are discussed.
The hamster and pig zona-free eggs were successfully penetrated in vitro by boar ejaculated and washed sperm, which had been preincubated in vitro in a chemically defined medium supplemented with calf serum proteins. The fertilization results and rate of polyspermy were found to be mainly dependent on sperm concentration at preincubation and on the time of sperm preincubation and fertilization. However, the pig zona-free eggs were penetrated also by the freshly washed boar sperm, but as early as 8 hours after semination. In this case the spermatozoa probably also capacitate on the surface of the egg plasma membrane. The fertilization of zona-free eggs with preincubated sperm results in higher penetration rate and very high polyspermy as early as 4 hours after semination.
Basing themselves on 149 cases, the authors describe the spinal neurophysiology of ejaculation in spinal man, and put forward certain hypotheses. They suggest that the reflex of seminal emission is a lumbar reflex, which may be dependent on conductive factor originating in the upper neurological structures, and that the orthosympathetic system, which leaves the spinal cord through the thoracolumbar junction, could provide a highway for the psychological nerve impulses inducing seminal emission.
The contractile response of rabbit vas deferens to the field stimulation was almost equally depressed by thioridazine and chlorpromazine. Phenoxybenzamine in a dose of 10(-7) g/ml augmented the response slightly, while in a dose of 10(-6) g/ml slightly depressed. The contractile response to exogenously administered noradrenaline was remarkably depressed by thioridazine and chlorpromazine and completely abolished by phenoxybenzamine. Almost equal potencies of sympatholytic effects of thioridazine and chlorpromazine may exclude the possibility that thioridazine-induced ejaculation failure, which is higher incidence than the failure induced by chlorpromazine, is due to its inhibitory action on peripheral adrenergic mechanism.
A simple method avoiding the use of nonionogenic detergent has been developed for the isolation of two forms of boar acrosin from ejaculated sperm. Each of the two forms was electrophoretically homogeneous and showed one N-terminal sequence only; Val-Val. The two acrosin forms isolated differ in molecular mass and amino acid composition. alpha-Acrosin, the form showing a higher molecular mass (Mr approximately 50 000), is stable in acid media. When exposed to pH above 4 it is converted into beta-acrosin (Mr approximately 35 000) by autodigestion. The isolation of the alpha-form was therefore carried out below pH 4 to eliminate autodigestion to the beta-form. The beta-form is stable for a certain period at neutral pH, especially if stabilized by Ca2+ ions. The autodigestion of alpha-acrosin to beta-acrosin probably results in the liberation of the C-terminal portion of the molecule of the alpha-form; this portion is composed of roughly 85 residues and is rich in proline.
Respiration of washed ejaculated bull spermatozoa with exogenous succinate is drastically increased after a sudden cooling of spermatozoa (cold shock). Loss of intactness of the cellular membrane occurs in a small temperature range between about 16 degrees C and 8 degrees C. A low cooling rate in critical temperature range connected with a sufficient equilibration time at this temperatures strongly restricts the damage of the spermatozoal membrane.
A patient with retrograde ejaculation following a transurethral resection of the prostate was able to father a child using spermatozoa recovered from the bladder. The method of recovery of these spermatozoa is described.
Since Wegelin introduced the notion of spermatophagocytosis in 1921 numerous elaborations on this subject have been published. But up to now there is no complete agreement on the origin of the individual spermatophages. Mononuclear as well as polynuclear spermatophages have been described. While for decades it has been clear that leucocytes in the female genital tract are able to phagocyte spermatozoa, these phagocyte types have hardly been described in human ejaculates.
Leukocytospermia has been associated with notable adverse effects on semen parameters and sperm function. The present study was undertaken to identify men with leukocytospermia and prostatitis in an infertility population and assess the effects of various treatments. One million white blood cells (WBC)/ml semen was defined as leukocytospermia. An expressed prostatic fluid was analyzed for the presence of white blood cells. The presence of more than 10 WBCs/high power field on expressed prostatic secretion was needed for the diagnosis of prostatitis. Those men who had more than one million WBCs in their semen and more than 10 WBCs/high power field on expressed prostatic secretion were enrolled in this study. Of two hundred sixty-three men screened for the presence of leukocytospermia and prostatitis, forty-eight men met both criteria. They were blindly and randomly assigned to one of three groups. Group 1 received no treatment. Group 2 were treated with trimethoprim 80 mg-sulfamethoxazole 400 mg (TMP-SMX) orally twice per day for one month. Group 3 were treated not only with the same antibiotic regimen as group 2 but also were instructed to ejaculate frequently (at least once every three days) for one month. Significant resolution of leukocytospermia occurred in the order of patient groups 3 > 2 > 1 at one month. The resolution rate of leukocytospermia of each group was 76% in group 3, 56% in group 2 and 6.7% in group 1. The rates in groups 2 and 3 were significantly higher than that in group 1 (p < 0.05).(ABSTRACT TRUNCATED AT 250 WORDS)
Nine patients underwent retroperitoneal nerve-sparing lymph node dissection for bilateral nonseminomatous testicular tumours (path. St. I disease). While the isolated lumbar nerves L1, L2, L3 were electrostimulated (30 Hz, 5-20 V), the activity of these seminal vesicles, bladder neck and posterior urethra was recorded by way of suprapubic transvesical sonography and/or endoscopy. Emission started simultaneously on three different levels: contraction of the seminal vesicles in the periphery, bladder neck closure, and opening of the paracollicular space. Contraction of the seminal vesicles extends to the midline; the prostatic urethra closes, starting at the bladder neck. Secretion from the ductuli prostatici (milky) and from the ductucli ejaculatorii (transparent) follow. It was confirmed by the detection of PSA (11,000-21,000 ng/ml) in the ejaculate that prostatic secretion is also present in it. The significance of the postganglionic nerves for emission increased from L1 to L3. In three patients with salvage lymph node dissection the above-mentioned ultrasound monitoring allowed differentiate nerves relevant to emission from those not involved, allowing more comprehensive retroperitoneal resection.
There appears to be a great deal of excitement regarding the potential of clomipramine and serotonin reuptake inhibitor drugs to treat rapid ejaculation. I worry that pharmacologic intervention will be recommended indiscriminately by busy physicians unaware of the complexities of men's/couples' sexual equilibrium. Interdisciplinary teams need to develop thoughtful guidelines that address the thorny issues surrounding the evolution of this new treatment alternative.