Skip to main content Accessibility help
×
Hostname: page-component-78c5997874-fbnjt Total loading time: 0 Render date: 2024-11-10T05:40:18.310Z Has data issue: false hasContentIssue false

Chapter 7 - Ejaculation and Sperm Transport

Physiology and Clinical Concerns

from Section 2 - The Biology of Male Reproduction and Infertility

Published online by Cambridge University Press:  06 December 2023

Douglas T. Carrell
Affiliation:
Utah Center for Reproductive Medicine
Alexander W. Pastuszak
Affiliation:
University of Utah
James M. Hotaling
Affiliation:
Utah Center for Reproductive Medicine
Get access

Summary

Ejaculation is a complex physiologic phenomenon and may have been historically necessary to achieve pregnancy. The advent of successful assisted reproductive technologies (ART), such as intracytoplasmic sperm injection and surgical sperm removal, have become an area of interest in reproductive medicine research. As such, interest has shifted away from ejaculatory disorders in part due to the tremendous success of assisted reproduction. Ejaculatory disorders are poorly understood and frequently misdiagnosed. While sperm retrieval procedures are highly effective in achieving the goal of reproduction, accurate diagnoses and management of these disorders to minimize complexity of ART are required. Additionally, many of these symptoms induce distress in patients, despite having any concerns involving fertility, resulting in significant quality of life implications for them. The evaluation of this entity requires a careful and appropriate treatment strategy. A carefully planned workup is needed to determine an accurate diagnosis and treatment that can result in high levels of patient satisfaction.

Type
Chapter
Information
Men's Reproductive and Sexual Health Throughout the Lifespan
An Integrated Approach to Fertility, Sexual Function, and Vitality
, pp. 61 - 66
Publisher: Cambridge University Press
Print publication year: 2023

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

Revenig, L, Leung, A, Hsiao, W. Ejaculatory physiology and pathophysiology: assessment and treatment in male infertility. Transl Androl Urol. 2014;3(1):4149. doi:10.3978/j.issn.2223-4683.2014.02.02Google Scholar
Althof, SE. Prevalence, characteristics and implications of premature ejaculation/rapid ejaculation. J Urol. 2006;175(3 Pt 1):842848. doi:10.1016/S0022-5347(05)00341-1Google Scholar
Giuliano, F. Neurophysiology of erection and ejaculation. J Sex Med. 2011;8 (Suppl 4):310315. doi:10.1111/j.1743-6109.2011.02450.xCrossRefGoogle ScholarPubMed
Abdel-Hamid, IA, Ali, OI. Delayed ejaculation: pathophysiology, diagnosis, and treatment. World J Mens Health. 2018;36(1):2240. doi:10.5534/wjmh.17051CrossRefGoogle ScholarPubMed
Giuliano, F, Clement, P. Neuroanatomy and physiology of ejaculation. Annu Rev Sex Res. 2005;16:190216.Google Scholar
Lipshultz, LI, Howards, SS, Niederberger, CS. Infertility in the Male. 4th ed. Cambridge University Press; 2009.Google Scholar
Hafez, ESE. Human Semen and Fertility Regulation in Men. Mosby; 1976.Google Scholar
Vaucher, L, Bolyakov, A, Paduch, DA. Evolving techniques to evaluate ejaculatory function. Curr Opin Urol. 2009;19(6):606614. doi:10.1097/MOU.0b013e3283318ee2CrossRefGoogle ScholarPubMed
Yang, CC, Bradley, WE. Innervation of the human anterior urethra by the dorsal nerve of the penis. Muscle Nerve. 1998;21(4):514518. doi:10.1002/(sici)1097-4598(199804)21:4<514::aid-mus10>3.0.co;2-x3.0.CO;2-X>CrossRefGoogle ScholarPubMed
Wieder, JA, Brackett, NL, Lynne, CM, Green, JT, Aballa, TC. Anesthetic block of the dorsal penile nerve inhibits vibratory-induced ejaculation in men with spinal cord injuries. Urology. 2000;55(6):915917. doi:10.1016/s0090-4295(99)00608-1Google Scholar
Clement, P, Giuliano, F. Physiology and pharmacology of ejaculation. Basic Clin Pharmacol Toxicol. 2016;119(Suppl 3):1825. doi:10.1111/bcpt.12546Google Scholar
Educational Committee of the ESSM. The ESSM Manual of Sexual Medicine. 2nd updated ed: Medix; 2015.Google Scholar
David Prologo, J, Snyder, LL, Cherullo, E, Passalacqua, M, Pirasteh, A, Corn, D. Percutaneous CT-guided cryoablation of the dorsal penile nerve for treatment of symptomatic premature ejaculation. J Vasc Interv Radiol. 2013;24(2):214219. doi:10.1016/j.jvir.2012.09.015Google Scholar
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(6):14231441. doi:10.1111/jsm.12524CrossRefGoogle Scholar
Patrick, DL, Althof, SE, Pryor, JL, et al. Premature ejaculation: an observational study of men and their partners. J Sex Med. 2005;2(3):358367. doi:10.1111/j.1743-6109.2005.20353.xGoogle Scholar
Lorentzen, SS, Papoutsakis, C, Myers, EF, Thoresen, L. Adopting nutrition care process terminology at the national level: the Norwegian experience in evaluating compatibility with international statistical classification of diseases and related health problems, 10th revision, and the existing Norwegian coding system. J Acad Nutr Diet. 2019;119(3):375393. doi:10.1016/j.jand.2018.02.006Google Scholar
Parnham, A, Serefoglu, EC. Classification and definition of premature ejaculation. Transl Androl Urol. 2016;5(4):416423. doi:10.21037/tau.2016.05.16CrossRefGoogle ScholarPubMed
Bernard, S. Premature ejaculation: a review of 1130 cases. J Urol. 1943:374379.CrossRefGoogle Scholar
Waldinger, MD. The pathophysiology of lifelong premature ejaculation. Transl Androl Urol. 2016;5(4):424433. doi:10.21037/tau.2016.06.04Google Scholar
Gao, J, Zhang, X, Su, P, et al. Prevalence and factors associated with the complaint of premature ejaculation and the four premature ejaculation syndromes: a large observational study in China. J Sex Med. 2013;10(7):18741881. doi:10.1111/jsm.12180CrossRefGoogle ScholarPubMed
Pereira-Lourenço, M, Brito, DVE, Pereira, BJ. Premature ejaculation: from physiology to treatment. J Family Reprod Health. 2019;13(3):120131.Google ScholarPubMed
Lindau, ST, Schumm, LP, Laumann, EO, Levinson, W, O’Muircheartaigh, CA, Waite, LJ. A study of sexuality and health among older adults in the United States. N Engl J Med. 2007;357(8):762774. doi:10.1056/NEJMoa067423Google Scholar
Oztürk, M, Koca, O, Tüken, M, Keleş, MO, Ilktaç, A, Karaman, MI. Hormonal evaluation in premature ejaculation. Urol Int. 2012;88(4):454458. doi:10.1159/000336137CrossRefGoogle ScholarPubMed
Patrick, DL, Giuliano, F, Ho, KF, Gagnon, DD, McNulty, P, Rothman, M. The Premature Ejaculation Profile: validation of self-reported outcome measures for research and practice. BJU Int. 2009;103(3):358364. doi:10.1111/j.1464-410X.2008.08041.xGoogle Scholar
Barnes, T, Eardley, I. Premature ejaculation: the scope of the problem. J Sex Marital Ther. 2007;33(2):151170. doi:10.1080/00926230601098472CrossRefGoogle ScholarPubMed
Frühauf, S, Gerger, H, Schmidt, HM, Munder, T, Barth, J. Efficacy of psychological interventions for sexual dysfunction: a systematic review and meta-analysis. Arch Sex Behav. 2013;42(6):915933. doi:10.1007/s10508-012-0062-0CrossRefGoogle ScholarPubMed
Melnik, T, Althof, S, Atallah, AN, Puga, ME, Glina, S, Riera, R. Psychosocial interventions for premature ejaculation. Cochrane Database Syst Rev. 2011;(8):CD008195. doi:10.1002/14651858.CD008195.pub2CrossRefGoogle 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(2):6090. doi:10.1002/sm2.28Google Scholar
Hershlag, A, Schiff, SF, DeCherney, AH. Retrograde ejaculation. Hum Reprod. 1991;6(2):255258. doi:10.1093/oxfordjournals.humrep.a137317CrossRefGoogle ScholarPubMed
Mano, R, Di Natale, R, Sheinfeld, J. Current controversies on the role of retroperitoneal lymphadenectomy for testicular cancer. Urol Oncol. 2019;37(3):209218. doi:10.1016/j.urolonc.2018.09.009Google Scholar
Gaunay, G, Nagler, HM, Stember, DS. Reproductive sequelae of diabetes in male patients. Endocrinol Metab Clin North Am. 2013;42(4):899914. doi:10.1016/j.ecl.2013.07.003Google Scholar
Dunsmuir, WD, Holmes, SA. The aetiology and management of erectile, ejaculatory, and fertility problems in men with diabetes mellitus. Diabet Med. 1996;13(8):700708. doi:10.1002/(SICI)1096-9136(199608)13:8<700::AID-DIA174>3.0.CO;2-8Google Scholar
Hellstrom, WJ, Sikka, SC. Effects of acute treatment with tamsulosin versus alfuzosin on ejaculatory function in normal volunteers. J Urol. 2006;176(4 Pt 1):15291533. doi:10.1016/j.juro.2006.06.004Google Scholar
Hisasue, S, Furuya, R, Itoh, N, Kobayashi, K, Furuya, S, Tsukamoto, T. Ejaculatory disorder caused by alpha-1 adrenoceptor antagonists is not retrograde ejaculation but a loss of seminal emission. Int J Urol. 2006;13(10):13111316. doi:10.1111/j.1442-2042.2006.01535.xCrossRefGoogle Scholar
Gacci, M, Ficarra, V, Sebastianelli, A, et al. Impact of medical treatments for male lower urinary tract symptoms due to benign prostatic hyperplasia on ejaculatory function: a systematic review and meta-analysis. J Sex Med. 2014;11(6):15541566. doi:10.1111/jsm.12525Google Scholar
DeLay, KJ, Nutt, M, McVary, KT. Ejaculatory dysfunction in the treatment of lower urinary tract symptoms. Transl Androl Urol. 2016;5(4):450459. doi:10.21037/tau.2016.06.06Google Scholar
Rassweiler, J, Teber, D, Kuntz, R, Hofmann, R. Complications of transurethral resection of the prostate (TURP): incidence, management, and prevention. Eur Urol. 2006;50(5):969979; discussion 980. doi:10.1016/j.eururo.2005.12.042Google Scholar
Cornu, JN, Ahyai, S, Bachmann, A, et al. A systematic review and meta-analysis of functional outcomes and complications following transurethral procedures for lower urinary tract symptoms resulting from benign prostatic obstruction: an update. Eur Urol. 2015;67(6):10661096. doi:10.1016/j.eururo.2014.06.017Google Scholar
Briganti, A, Naspro, R, Gallina, A, et al. Impact on sexual function of holmium laser enucleation versus transurethral resection of the prostate: results of a prospective, 2-center, randomized trial. J Urol. 2006;175(5):18171821. doi:10.1016/S0022-5347(05)00983-3Google Scholar
Marra, G, Sturch, P, Oderda, M, Tabatabaei, S, Muir, G, Gontero, P. Systematic review of lower urinary tract symptoms/benign prostatic hyperplasia surgical treatments on men’s ejaculatory function: time for a bespoke approach? Int J Urol. 2016;23(1):2235. doi:10.1111/iju.12866CrossRefGoogle ScholarPubMed
Lebdai, S, Chevrot, A, Doizi, S, et al. Do patients have to choose between ejaculation and miction? A systematic review about ejaculation preservation technics for benign prostatic obstruction surgical treatment. World J Urol. 2019;37(2):299308. doi:10.1007/s00345-018-2368-6Google Scholar
Gil-Vernet, JM, Alvarez-Vijande, R, Gil-Vernet, A. Ejaculation in men: a dynamic endorectal ultrasonographical study. Br J Urol. 1994;73(4):442448. doi:10.1111/j.1464-410x.1994.tb07612.xGoogle Scholar
Ronzoni, G, De Vecchis, M. Preservation of anterograde ejaculation after transurethral resection of both the prostate and bladder neck. Br J Urol. 1998;81(6):830833. doi:10.1046/j.1464-410x.1998.00658.xCrossRefGoogle ScholarPubMed
Alloussi, SH, Lang, C, Eichel, R, Alloussi, S. Ejaculation-preserving transurethral resection of prostate and bladder neck: short- and long-term results of a new innovative resection technique. J Endourol. 2014;28(1):8489. doi:10.1089/end.2013.0093Google Scholar
Gilling, P, Barber, N, Bidair, M, et al. WATER: a double-blind, randomized, controlled trial of Aquablation. J Urol. 2018;199(5):12521261. doi:10.1016/j.juro.2017.12.065CrossRefGoogle Scholar
Kamischke, A, Nieschlag, E. Update on medical treatment of ejaculatory disorders. Int J Androl. 2002;25(6):333344. doi:10.1046/j.1365-2605.2002.00379.xGoogle Scholar
Jefferys, A, Siassakos, D, Wardle, P. The management of retrograde ejaculation: a systematic review and update. Fertil Steril. 2012;97(2):306312. doi:10.1016/j.fertnstert.2011.11.019Google Scholar
Brackett, NL, Ibrahim, E, Iremashvili, V, Aballa, TC, Lynne, CM. Treatment for ejaculatory dysfunction in men with spinal cord injury: an 18-year single center experience. J Urol. 2010;183(6):23042308. doi:10.1016/j.juro.2010.02.018CrossRefGoogle ScholarPubMed
Brackett, NL. Semen retrieval by penile vibratory stimulation in men with spinal cord injury. Hum Reprod Update. 1999;5(3):216222. doi:10.1093/humupd/5.3.216Google Scholar
Kathiresan, AS, Ibrahim, E, Aballa, TC, et al. Comparison of in vitro fertilization/intracytoplasmic sperm injection outcomes in male factor infertility patients with and without spinal cord injuries. Fertil Steril. 2011;96(3):562566. doi:10.1016/j.fertnstert.2011.06.078CrossRefGoogle ScholarPubMed

Save book to Kindle

To save this book to your Kindle, first ensure coreplatform@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
×