Skip to main content Accessibility help

We use cookies to distinguish you from other users and to provide you with a better experience on our websites. Close this message to accept cookies or find out how to manage your cookie settings.

Close cookie message
×
Hostname: page-component-cd9895bd7-hc48f Total loading time: 0 Render date: 2024-12-28T01:06:57.531Z Has data issue: false hasContentIssue false

Chapter 7 - Surgical and Nonsurgical Sperm Retrieval Techniques in Patients with Ejaculatory Dysfunctions

from Part II - Sperm Retrieval

Published online by Cambridge University Press:  09 April 2021

By
Omer Raheem ,
Mohamed Adnan  and
Laith M. Alzweri
Edited by
Ashok Agarwal ,
Ahmad Majzoub  and
Sandro C. Esteves
Ashok Agarwal
Affiliation:
The Cleveland Clinic Foundation, Cleveland, OH, USA
Ahmad Majzoub
Affiliation:
Hamad Medical Corporation, Doha, Qatar
Sandro C. Esteves
Affiliation:
Andrology & Human Reproduction Clinic, Sao Paulo, Brazil
Get access

Summary

There is a complex interplay between male sexual dysfunction and male factor infertility, including ejaculatory dysfunctions which are the most common male sexual dysfunction. It is divided into four categories: premature ejaculation (PE), delayed ejaculation (DE), retrograde ejaculation (RE), and anejaculation/anorgasmia (AE). Unfortunately, some of these ejaculatory dysfunctions are less studied and not as well understood. Various pharmacologic treatments and surgical procedures can be offered for patients with ejaculatory dysfunctions seeking fertility. These include the off-label use of SSRIs (selective serotonin reuptake inhibitors) for PE, surgical (testicular sperm aspiration, testicular sperm extraction, and microsurgical epididymal sperm aspiration) and nonsurgical methods (medications, positive predictive value, and electroejaculation) for patients with RE and AE. The interaction between chemical impulses and the modulation of the ejaculation process in an individual patient is necessary to conclude the clinical status of the patient and feasibility of the available treatment techniques. Ultimately, this can help in deciding the best sperm retrieval technique to increase pregnancy outcomes.

Keywords

male sexual dysfunctionmale factor infertilityejaculatory dysfunctionpremature ejaculationdelayed ejaculationretrograde ejaculationanejaculation
Type
Chapter
Information
Manual of Sperm Retrieval and Preparation in Human Assisted Reproduction , pp. 44 - 55
Publisher: Cambridge University Press
Print publication year: 2021

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Rosen, RC. Prevalence and risk factors of sexual dysfunction in men and women. Curr Psychiatr Rep 2000;2:189–195.Google Scholar
Porst, H, Montorsi, F, Rosen, RC, et al. The Premature Ejaculation Prevalence and Attitudes (PEPA) Survey: prevalence, comorbidities, and professional help-seeking. Eur Urol 2007;51:816–824.Google Scholar
Rowland, D, McMahon, CG, Abdo, C, et al. Disorders of orgasm and ejaculation in men. J Sex Med 2010;7:1668–1686.Google Scholar
McMahon, CG, Abdo, C, Incrocci, L, et al. Disorders of orgasm and ejaculation in men. J Sex Med 2004;1:58–65.Google Scholar
Hellstrom, WJ. Current and future pharmacotherapies of premature ejaculation. J Sex Med 2006;3(Suppl. 4):332–341Google Scholar
Bettocchi, C, Verze, P, Palumbo, F, Arcaniolo, D, Mirone, V. Ejaculatory disorders: pathophysiology and management. Nat Clin Pract Urol 2008;5:93–103.CrossRefGoogle ScholarPubMed
Giuliano, F, Clement, P. Physiology of ejaculation: emphasis on serotonergic control. Eur Urol 2005;48:408–417.Google Scholar
Pompeiano, M, Palacios, JM, Mengod, G. Distribution of the serotonin 5-HT2 receptor family mRNAs: comparison between 5-HT2A and 5-HT2C receptors. Brain Res Mol Brain Res 1994;23:163–178.CrossRefGoogle ScholarPubMed
Bitran, D, Hull, EM. Pharmacological analysis of male rat sexual behavior. Neurosci Biobehav Rev 1987;11:365–389.CrossRefGoogle ScholarPubMed
Pandey, SC, Davis, JM, Pandey, GN. Phosphoinositide system-linked serotonin receptor subtypes and their pharmacological properties and clinical correlates. J Psychiatr Neurosci 1995;20:215–225.Google ScholarPubMed
Giuliano, F, Clement, P. Serotonin and premature ejaculation: from physiology to patient management. Eur Urol 2006;50:454–466.Google Scholar
Cantor, JM, Binik, YM, Pfaus, JG. Chronic fluoxetine inhibits sexual behavior in the male rat: reversal with oxytocin. Psychopharmacology 1999;144:355–362.CrossRefGoogle ScholarPubMed
Roberts, M, Jarvi, K. Steps in the investigation and management of low semen volume in the infertile man. Can Urol Assoc J 2009;3:479–485.Google Scholar
Cooper, TG, Noonan, E, von Eckardstein, S, et al. World Health Organization reference values for human semen characteristics. Hum Reprod Update 2010;16:231–245.CrossRefGoogle ScholarPubMed
Kamischke, A, Nieschlag, E. Treatment of retrograde ejaculation and anejaculation. Hum Reprod Update 1999;5:448–474.CrossRefGoogle ScholarPubMed
Ohl, DA, Quallich, SA, Sonksen, J, Brackett, NL, Lynne, CM. Anejaculation and retrograde ejaculation. Urologic Clin North Am 2008;35:211–220.Google Scholar
Dean, RC, Lue, TF. Physiology of penile erection and pathophysiology of erectile dysfunction. Urologic Clin North Am 2005;32:379–395.Google Scholar
Everaert, K, de Waard, WI, Van Hoof, T, et al. Neuroanatomy and neurophysiology related to sexual dysfunction in male neurogenic patients with lesions to the spinal cord or peripheral nerves. Spinal Cord 2010;48:182–191.Google Scholar
Dunsmuir, WD, Holmes, SA. The aetiology and management of erectile, ejaculatory, and fertility problems in men with diabetes mellitus. Diabetic Med 1996;13:700–708.3.0.CO;2-8>CrossRefGoogle ScholarPubMed
Rassweiler, J, Teber, D, Kuntz, R, Hofmann, R. Complications of transurethral resection of the prostate (TURP): incidence, management, and prevention. Eur Urol 2006;50:969–979.Google Scholar
Hisasue, S, Furuya, R, Itoh, N, et al. Ejaculatory disorder caused by alpha-1 adrenoceptor antagonists is not retrograde ejaculation but a loss of seminal emission. Int J Urol 2006;13:1311–1316.Google Scholar
Rosen, R, Altwein, J, Boyle, P, et al. Lower urinary tract symptoms and male sexual dysfunction: the multinational survey of the aging male (MSAM-7). Eur Urol 2003;44:637–649.Google Scholar
Vernon, M, Wilson, E, Muse, K, Estes, S, Curry, T. Successful pregnancies from men with retrograde ejaculation with the use of washed sperm and gamete intrafallopian tube transfer (GIFT). Fertil Steril 1988;50:822–824.Google Scholar
Yavetz, H, Yogev, L, Hauser, R, et al. Retrograde ejaculation. Hum Reprod 1994;9:381–386.Google Scholar
Patrick, DL, Althof, SE, Pryor, JL, et al. Premature ejaculation: an observational study of men and their partners. J Sex Med 2005;2:358–367.CrossRefGoogle ScholarPubMed
Chen, J. The pathophysiology of delayed ejaculation. Transl Androl Urol 2016;5:549–562.Google Scholar
Jannini, EA, Lenzi, A. Ejaculatory disorders: epidemiology and current approaches to definition, classification and subtyping. World J Urol 2005;23:68–75.Google Scholar
Perelman, MA, Rowland, DL. Retarded ejaculation. World J Urol 2006;24:645–652.CrossRefGoogle ScholarPubMed
Waldinger, MD, Berendsen, HH, Blok, BF, Olivier, B, Holstege, G. Premature ejaculation and serotonergic antidepressants-induced delayed ejaculation: the involvement of the serotonergic system. Behav Brain Res 1998;92:111–118.Google Scholar
Corona, G, Jannini, EA, Vignozzi, L, Rastrelli, G, Maggi, M. The hormonal control of ejaculation. Nat Rev Urol 2012;9:508–519.Google Scholar
Tamam, Y, Tamam, L, Akil, E, Yasan, A, Tamam, B. Post-stroke sexual functioning in first stroke patients. Eur J Neurol 2008;15:660–666.Google Scholar
Corona, G, Jannini, EA, Mannucci, E, et al. Different testosterone levels are associated with ejaculatory dysfunction. J Sex Med 2008;5:1991–1998.CrossRefGoogle ScholarPubMed
Hatzimouratidis, K, Amar, E, Eardley, I, et al. Guidelines on male sexual dysfunction: erectile dysfunction and premature ejaculation. Eur Urol 2010;57:804–814.Google Scholar
Sadowski, DJ, Butcher, MJ, Kohler, TS. A review of pathophysiology and management options for delayed ejaculation. Sex Med Rev 2016;4:167–176.Google Scholar
Corona, G, Ricca, V, Bandini, E, et al. Selective serotonin reuptake inhibitor-induced sexual dysfunction. J Sex Med 2009;6:1259–1269.Google Scholar
Stevenson, JM, Bishop, JR. Genetic determinants of selective serotonin reuptake inhibitor related sexual dysfunction. Pharmacogenomics 2014;15:1791–1806.Google Scholar
Edwards, AE, Husted, JR. Penile sensitivity, age, and sexual behavior. J Clin Psychol 1976;32:697–700.3.0.CO;2-O>CrossRefGoogle ScholarPubMed
Tammaro, A, Parisella, FR, Cavallotti, C, Persechino, S, Cavallotti, C. Ultrastructural age-related changes in the sensory corpuscles of the human genital skin. J Biol Reg Homeos Ag 2013;27:241–245.Google ScholarPubMed
Rowland, DL. Penile sensitivity in men: a composite of recent findings. Urology 1998;52:1101–1105.Google Scholar
Rowland, DL, Greenleaf, W, Mas, M, Myers, L, Davidson, JM. Penile and finger sensory thresholds in young, aging, and diabetic males. Arch Sex Behav 1989;18:1–12.Google Scholar
Murphy, JB, Lipshultz, LI. Abnormalities of ejaculation. Urol Clin North Am 1987;14:583–596.Google Scholar
Althof, SE. Sexual therapy in the age of pharmacotherapy. Ann Rev Sex Res 2006;17:116–131.Google Scholar
Kacker, R, Morgentaler, A, Pharmacotherapy for delayed orgasm after treatment for testosterone deficiency. The New England Section of American Urological Association, 83rd Annual Meeting 2014.Google Scholar
Dording, CM, Mischoulon, D, Petersen, TJ, et al. The pharmacologic management of SSRI-induced side effects: a survey of psychiatrists. Ann Clin Psychiatr 2002;14:143–147.Google Scholar
Brindley, GS. Electroejaculation: its technique, neurological implications and uses. J Neurol Neurosurg Psychiatr 1981;44:9–18.CrossRefGoogle ScholarPubMed
Brackett, NL. Semen retrieval by penile vibratory stimulation in men with spinal cord injury. Hum Reprod Update 1999;5:216–222.Google Scholar
Jefferys, A, Siassakos, D, Wardle, P. The management of retrograde ejaculation: a systematic review and update. Fertil Steril 2012;97:306–312.Google Scholar
Ohl, DA, Menge, AC, Sonksen, J. Penile vibratory stimulation in spinal cord injured men: optimized vibration parameters and prognostic factors. Arch Phys Med Rehab 1996;77:903–905.Google Scholar
Sonksen, J, Biering-Sorensen, F, Kristensen, JK. Ejaculation induced by penile vibratory stimulation in men with spinal cord injuries: the importance of the vibratory amplitude. Paraplegia 1994;32:651–660.Google Scholar
Garg, T, LaRosa, C, Strawn, E, Robb, P, Sandlow, JI. Outcomes after testicular aspiration and testicular tissue cryopreservation for obstructive azoospermia and ejaculatory dysfunction. J Urol 2008;180:2577–2580.Google Scholar
Iwahata, T, Shin, T, Shimomura, Y, et al. Testicular sperm extraction for patients with spinal cord injury-related anejaculation: a single-center experience. Int J Urol 2016;23:1024–1027.Google Scholar
Yeates, W. Ejaculatory disturbances. In Pryor, J, Lipschultz, L (eds.) Andrology. Butterworth, London, 1987, pp. 183–216.Google Scholar
Nesbakken, A, Nygaard, K, Bull-Njaa, T, Carlsen, E, Eri, LM. Bladder and sexual dysfunction after mesorectal excision for rectal cancer. Br J Surg 2000;87:206–210.Google Scholar
Tiusanen, H, Seitsalo, S, Osterman, K, Soini, J. Retrograde ejaculation after anterior interbody lumbar fusion. Eur Spine J 1995;4:339–342.CrossRefGoogle ScholarPubMed
Donohue, JP, Foster, RS. Retroperitoneal lymphadenectomy in staging and treatment: the development of nerve-sparing techniques. Urol Clin North Am 1998;25:461–468.Google Scholar
Gessa, GL, Tagliamonte, A. Role of brain monoamines in male sexual behavior. Life Sci 1974;14:425–436.Google Scholar
Clement, P, Bernabe, J, Kia, HK, Alexandre, L, Giuliano, F. D2-like receptors mediate the expulsion phase of ejaculation elicited by 8-hydroxy-2-(di-N-propylamino)tetralin in rats. J Pharmacol Exp Ther 2006;316:830–834.Google Scholar
Sabanegh, E Jr., Agarwal, A. Male infertility. In: Wein, AJ, Kavoussi, LR, Novick, A, Partin, AW, Peters, CA (ed.) Cambell-Walsh Urology. Saunders, Philadelphia, PA, 2012, pp. 616–647.Google Scholar
van der Linden, PJ, Nan, PM, te Velde, ER, van Kooy, RJ. Retrograde ejaculation: successful treatment with artificial insemination. Obstet Gynecol 1992;79:126–128.Google Scholar
Shoshany, O, Abhyankar, N, Elyaguov, J, Niederberger, C. Efficacy of treatment with pseudoephedrine in men with retrograde ejaculation. Andrology 2017;5:744–748.CrossRefGoogle ScholarPubMed
Ochsenkuhn, R, Kamischke, A, Nieschlag, E. Imipramine for successful treatment of retrograde ejaculation caused by retroperitoneal surgery. Int J Androl 1999;22:173–177.Google Scholar
Braude, PR, Ross, LD, Bolton, VN, Ockenden, K. Retrograde ejaculation: a systematic approach to non-invasive recovery of spermatozoa from post-ejaculatory urine for artificial insemination. Br J Obstet Gynecol 1987;94:76–83.Google Scholar
Reynolds, JC, McCall, A, Kim, ED, Lipshultz, LI. Bladder neck collagen injection restores antegrade ejaculation after bladder neck surgery. J Urol 1998;159:1303.Google Scholar
Dees, JE. Congenital epispadias with incontinence. J Urol 1949;62:513–522.Google Scholar
Abrahams, JI, Solish, GI, Boorjian, P, Waterhouse, RK. The surgical correction of retrograde ejaculation. J Urol 1975;114:888–890.Google Scholar
Lochner-Ernst, D, Mandalka, B, Kramer, G, Stohrer, M. Conservative and surgical semen retrieval in patients with spinal cord injury. Spinal Cord 1997;35:463–468.Google Scholar
Wagenknecht, LV, Weitze, KH, Hoppe, LP, et al. Microsurgery in andrologic urology: II. Alloplastic spermatocele. J Microsurg 1980;1:428–435.CrossRefGoogle ScholarPubMed
Wagenknecht, LV, Weitze, KH, Hoppe, LP, et al. New development in surgical andrology: alloplastic spermatocele. Investigat Urol 1980;17:432–434.Google Scholar
Brindley, GS, Scott, GI, Hendry, WF. Vas cannulation with implanted sperm reservoirs for obstructive azoospermia or ejaculatory failure. Br J Urol 1986;58:721–723.CrossRefGoogle ScholarPubMed
Berger, RE, Muller, CH, Smith, D, et al. Operative recovery of vasal sperm from anejaculatory men: preliminary report. J Urol 1986;135:948–950.Google Scholar
Rosenlund, B, Sjoblom, P, Tornblom, M, Hultling, C, Hillensjo, T. In-vitro fertilization and intracytoplasmic sperm injection in the treatment of infertility after testicular cancer. Hum Reprod 1998;13:414–418.Google Scholar
Middleton, RG, Urry, RL. The Young–Dees operation for the correction of retrograde ejaculation. J Urol 1986;136:1208–1209.CrossRefGoogle ScholarPubMed
Serefoglu, EC, McMahon, CG, Waldinger, MD, et al. An evidence-based unified definition of lifelong and acquired premature ejaculation: report of the Second International Society for Sexual Medicine Ad Hoc Committee for the Definition of Premature Ejaculation. J Sex Med 2014;11:1423–1441.Google Scholar
Althof, SE, McMahon, CG, Waldinger, MD, et al. An update of the International Society of Sexual Medicine’s guidelines for the diagnosis and treatment of premature ejaculation (PE). Sex Med 2014;2:60–90.Google Scholar
Corona, G, Petrone, L, Mannucci, E, et al. Psycho-biological correlates of rapid ejaculation in patients attending an andrologic unit for sexual dysfunctions. Eur Urol 2004;46:615–622.CrossRefGoogle ScholarPubMed
Lawall, C, Ezeh, U, Turek, PJ. How semen quality changes in hypogonadal men on clomiphene citrate. Fertil Steril 2004;82:S21.Google Scholar
Laumann, EO, Paik, A, Rosen, RC. Sexual dysfunction in the United States: prevalence and predictors. JAMA 1999;281:537–544.Google Scholar
Reading, AE, Wiest, WM. An analysis of self-reported sexual behavior in a sample of normal males. Arch Sex Behav 1984;13:69–83.Google Scholar
Spector, KR, Boyle, M. The prevalence and perceived aetiology of male sexual problems in a non-clinical sample. Br J Med Psychol 1986;59(Pt 4):351–358.Google Scholar
Basile Fasolo, C, Mirone, V, Gentile, V, et al. Premature ejaculation: prevalence and associated conditions in a sample of 12,558 men attending the andrology prevention week 2001–2014: a study of the Italian Society of Andrology (SIA). J Sex Med 2005;2:376–382.Google Scholar
Tignol, J, Martin-Guehl, C, Aouizerate, B, Grabot, D, Auriacombe, M. Social phobia and premature ejaculation: a case–control study. Depress Anxiety 2006;23:153–157.CrossRefGoogle ScholarPubMed
Kaplan, HS, Kohl, RN, Pomeroy, WB, Offit, AK, Hogan, B. Group treatment of premature ejaculation. Arch Sex Behav 1974;3:443–452.CrossRefGoogle ScholarPubMed
Schapiro, B. Premature ejaculation: a review of 1130 cases. J Urol 1943;50:374–379.Google Scholar
Waldinger, MD. The neurobiological approach to premature ejaculation. J Urol 2002;168:2359–2367.Google Scholar
Waldinger, MD, Hengeveld, MW, Zwinderman, AH, Olivier, B. Effect of SSRI antidepressants on ejaculation: a double-blind, randomized, placebo-controlled study with fluoxetine, fluvoxamine, paroxetine, and sertraline. J Clin Psychopharmacol 1998;18:274–281.Google Scholar
Vandereycken, W. Towards a better delineation of ejaculatory disorders. Acta Psychiatrica Belgica 1986;86:57–63.Google Scholar
Althof, SE, McMahon, CG, Waldinger, MD, et al. An update of the International Society of Sexual Medicine’s guidelines for the diagnosis and treatment of premature ejaculation (PE). J Sex Med 2014;11:1392–1422.Google Scholar
Patrick, DL, Giuliano, F, Ho, KF, et al. The premature ejaculation profile: validation of self-reported outcome measures for research and practice. BJU Int 2009;103:358–364.Google Scholar
Masters, WH JV. Human Sexual Inadequacy. Little, Brown, Boston, MA, 1970.Google Scholar
Semans, JH. Premature ejaculation: a new approach. South Med J 1956;49:353–358.CrossRefGoogle ScholarPubMed
De Amicis, LA, Goldberg, DC, LoPiccolo, J, Friedman, J, Davies, L. Clinical follow-up of couples treated for sexual dysfunction. Arch Sex Behav 1985;14:467–489.Google Scholar
de Carufel, F, Trudel, G. Effects of a new functional-sexological treatment for premature ejaculation. J Sex Marital Ther 2006;32:97–114.CrossRefGoogle ScholarPubMed
Hawton, K, Catalan, J, Martin, P, Fagg, J. Long-term outcome of sex therapy. Behav Res Ther 1986;24:665–675.Google Scholar
Montague, DK, Jarow, J, Broderick, GA, et al. AUA guideline on the pharmacologic management of premature ejaculation. J Urol 2004;172:290–294.Google Scholar
DeVeaugh-Geiss, J, Landau, P, Katz, R. Preliminary results from a multicenter trial of clomipramine in obsessive-compulsive disorder. Psychopharmacol Bull 1989;25:36–40.Google ScholarPubMed
Kotin, J, Wilbert, DE, Verburg, D, Soldinger, SM. Thioridazine and sexual dysfunction. Am J Psychiatr 1976;133:82–85.Google Scholar
McMahon, CG, Touma, K. Treatment of premature ejaculation with paroxetine hydrochloride as needed: 2 single-blind placebo controlled crossover studies. J Urol 1999;161:1826–1830.Google Scholar
Waldinger, MD, Berendsen, HHG, Blok, BFM, Olivier, B, Holstege, G. Premature ejaculation and serotonergic antidepressants-induced delayed ejaculation: the involvement of the serotonergic system. Behav Brain Res 1998;92:111–118.Google Scholar
Waldinger, MD. Towards evidence-based drug treatment research on premature ejaculation: a critical evaluation of methodology. Int J Impot Res 2003;15:309–313.Google Scholar
Dinsmore, WW, Hackett, G, Goldmeier, D, et al. Topical eutectic mixture for premature ejaculation (TEMPE): a novel aerosol-delivery form of lidocaine–prilocaine for treating premature ejaculation. BJU Int 2007;99:369–375.CrossRefGoogle Scholar
Abdel-Hamid, IA, El Naggar, EA, El Gilany, AH. Assessment of as needed use of pharmacotherapy and the pause-squeeze technique in premature ejaculation. Int J Impot Res 2001;13:41–45.Google Scholar
Salonia, A, Maga, T, Colombo, R, et al. A prospective study comparing paroxetine alone versus paroxetine plus sildenafil in patients with premature ejaculation. J Urol 2002;168:2486–2489.Google Scholar
Kim, JJ, Kwak, TI, Jeon, BG, Cheon, J, Moon, DG. Effects of glans penis augmentation using hyaluronic acid gel for premature ejaculation. Int J Impot Res 2004;16:547–551.Google Scholar

Save book to Kindle

To save this book to your Kindle, first ensure no-reply@cambridge.org is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about saving to your Kindle.

Note you can select to save to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be saved to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

Find out more about the Kindle Personal Document Service.

Available formats
×

Save book to Dropbox

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Dropbox.

Available formats
×

Save book to Google Drive

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Google Drive.

Available formats
×