Abstract
BackgroundIt is well known that the use of the α-adrenergic receptor antagonists in the BPH therapy may induce ejaculatory disorder. A review of clinical literature shows a greater incidence of ejaculatory disorder during the use of tamsulosin compared with alfuzosin. Anejaculation has been until now referred to retrograde ejaculation due to relaxation of prostatic and bladder neck smooth muscle tone. In a recent researches was evaluated the effect of tamsulosin and alfuzosin on rat vas deferent "in vitro", concluding that tamsulosin may "cause ejaculatory dysfunction by altering the progression and emission of sperm". An abnormal increase of contraction would be the cause of ejaculatory disorder. The aim of our paper is to compare human and rat vas deferens contractile activity and to evaluate with a clinical study if tamsulosin causes retrograde ejaculation disorder.MethodsWe have revaluated the human and rat vas deferens contractile activity in vitro according to our experience and literature. We have also performed a clinical study on 10 patients (48–72 y) affected by anejaculation. Post-coital urine was examined to search spermatozoa.ResultsHuman and rat vas deferens activity is not comparable. Contractile activity induced by norepinephrin after tamsulosin incubation in rat prostatic vas deferens strips is similar to the contractile activity evoked by norepinephrin in human strips. Spermatozoa were found in post coital urine of 6 patients.ConclusionIn our opinion the treatment with tamsulosin may induce retrograde ejaculation but not other ejaculatory disorder due to abnormal sperm progression.
Highlights
It is well known that the use of the α-adrenergic receptor antagonists in the BPH therapy may induce ejaculatory disorder
The typical response of the prostatic deferent duct has been characterized by an initial tonic-phasic mixed activity, immediately followed by a phasic activity marked by rapid strong "twitch-like" contractions. These latter may suggest the presence of a mechanism recruiting muscle cells, as if the vas deferens has a pace-maker action which is morphologically quite similar to the "twitch" that can be highlighted by electric stimulation [Fig. 2]
TbisFmtehirgemeounnetrgycdephi"aiat2ctwreaalicytrctefhosr-lpilziokewend"seebcdyoobnafytntrhaaiencpitt"hiipoarsnloistcsotanacitctiic-vp"ithdyaesmfiecarr"emknetidxdebudyc"traahcpatisvdity, The typical response of the "prostatic" deferent duct has been characterized by an initial tonic-phasic "mixed" activity, immediately followed by a phasic activity marked by rapid strong "twitch-like" contractions
Summary
It is well known that the use of the α-adrenergic receptor antagonists in the BPH therapy may induce ejaculatory disorder. In a recent researches was evaluated the effect of tamsulosin and alfuzosin on rat vas deferent "in vitro", concluding that tamsulosin may "cause ejaculatory dysfunction by altering the progression and emission of sperm". The aim of our paper is to compare human and rat vas deferens contractile activity and to evaluate with a clinical study if tamsulosin causes retrograde ejaculation disorder. Researches have identified different receptor subpopulations and more and more selective alpha antagonist drugs have been developed, acting on the lower urinary tract with lower effects on the cardiovascular system. Recent in vitro researches [2,4] on rats' deferent ducts have suggested that the ejaculatory disorder would be secondary to anomalies in sperm progression due to the alteration in the contractile mechanism of the vas deferens
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
