Ejaculatory Incompetence Research Articles

Disorders in the sexual standard from hipertensive patients attended at cardiology clinic

ABSTRACTTo identify sexual disorders from hipertensive patients attended at Clinic Cardiology from a University Hospital at Recife, Pernambuco (PE) - Brasil, was the objective of this descriptive exploratory study, from quantitative boarding. The probabilist sampling was constituted from 114 adults, who had answered a questionnaire, from May to July 2004, whose data had been analyzed descriptive, presented in numerical values in tables. As findings, the age varied from 24 to 65 years; 80,7% were married; 64,9% had informed to possess basic education; the per capita income varied from R$ 37,14 to R$ 1.300.00; bigger ratio informed the diagnosis time from 6 to 10 years; 55,7% had informed to present disorders in theirs sexual life proceeding from the diagnosis of blood hypertension: desire inhibition 25,4%; erectile dysfunction or inhibited male arousal 9,6%; sexual arousal disorder 16,6%; inhibited female orgasm 4,4%; ejaculatory incompetence 1,8%; dyspareunia 2,6%; sexual phobia 1,8%; multiple sexual phobia 8,9%. This research brings unknown aspects next to the hipertensive patients, allowing that it has a bigger deepening and development of other research focused on theirs sexuality, favoring the development education technician, the research and the assistance. Descriptors: hypertension; adult; coitus; sexuality.RESUMOIdentificar alterações sexuais em hipertensos atendidos em Ambulatório de Cardiologia de um Hospital Universitário em Recife, Pernambuco (PE) - Brasil, foi o objetivo desse estudo descritivo exploratório, de natureza quantitativa. Uma amostra de 114 adultos respondeu um questionário, entre maio a julho de 2004, cujos dados foram dispostos em tabelas e analisados descritivamente. Quanto aos resultados, a idade variou de 24 a 65 anos; 80,7% eram de casados; 64,9% informaram possuir o ensino fundamental; a renda per capita variou de R$ 37,14 a R$ 1.300,00; maior proporção informou o tempo de diagnóstico entre seis a 10 anos; 55,7% informaram apresentar alterações na sua vida sexual proveniente do diagnóstico de hipertensão arterial: inibição do desejo 25,4%; disfunção erétil ou inibição da excitação 9,6%; inibição da excitação 16,6%; inibição do orgasmo 4,4%; ejaculação precoce 1,8%; dispareunia 2,6%; fobia sexual 1,8%; fobia sexual múltipla 8,9%. Esta pesquisa traz aspectos inéditos junto aos hipertensos, permitindo que haja um maior aprofundamento e desenvolvimento de outras pesquisas enfocando sua sexualidade, favorecendo o desenvolvimento técnico do ensino, da pesquisa e da assistência. Descritores: hipertensão; adulto; coito; sexualidade.RESUMENIdentificar los transtornos sexuales en pacientes hipertensos atendidos en la Clínica de Cardiología de un Hospital Universitario en Recife, Pernambuco (PE) - Brasil, fue el objetivo de este estudio descriptivo exploratorio, de abordaje cuantitativo. La muestra probabilística se constituyó por 114 adultos, que contestaron un cuestionario, a partir de mayo a julio del 2004. Los datos fueron analizados y presentados en tablas. Entre los resultados encontrados: la edad varía de 24 a 65 años; 80,7% casados; 64,9% con educación básica; el ingreso per cápita varía de R $ 37,14 a R$ 1.300.00; con diagnóstico entre 6 a 10 años; 55,7% presentan trastornos en su vida sexual procedentes del diagnóstico de la hipertensión arterial: inhibición del deseo 25,4%; disfunción eréctil o inhibición de la excitación 9,6%; inhibición de la excitación 16,6%; orgasmo inhibido 4,4%; eyaculación precoz 1,8%; dispareunia 2,6%; fobia sexuales 1,8%; fobia sexuales múltiples 8,9%. Esta investigación aporta aspectos desconocidos de los pacientes hipertensivos, permitiendo que haya una mayor profundización y el desarrollo de otras investigaciones centradas en su sexualidad, favoreciendo el desarrollo técnico de la educación, la investigación y la asistencia. Descriptores: hipertensión; adultos; coito; sexualidad.

Sexual problems in male patients older than 20 years with anorectal malformations

Background/Purpose The nervi erigentes in high- and intermediate-type male anorectal malformation (ARM) runs a relatively medial course and is vulnerable in sacro-perineal dissection. These types of ARM are also associated with a high frequency of sacral anomaly, and sexual problems may be expected. However, sexual function cannot be evaluated until after the individual passes puberty. Few reports have investigated the sexual status of pubescent males with ARM. The present study evaluated sexual problems in patients with high- and intermediate-type ARM. Methods Sexual problems such as erectile dysfunction and ejaculatory incompetence were evaluated in 17 of 23 men aged more than 20 years who underwent operation for high- or intermediate-type ARM between September 1974 and January 2005. Results Erection angle was normal in 9 patients (52.9%), mild in 6 patients (35.3%), and dysfunctional in 2 patients (11.8%). Ejaculatory function was normal in 10 patients (58.8%), with ejaculatory incompetence in 5 patients (29.4%) and retrograde ejaculation in 2 patients (11.8%). Either erectile or ejaculatory dysfunction was present in 5 patients (29.4%), whereas both were present in 2 patients (11.8%). Sexual problems were identified in 7 patients (41.2%), with sacral anomalies in 5 (71.4%) of these 7 patients. Conclusions Sexual problems such as erectile and ejaculatory dysfunction are common in patients with high- or intermediate-type ARM. Patients with sexual distress require persistent follow-up and continuous counselling to support their sexual problems.

Prise en charge des troubles de l’éjaculation par chlorhydrate de midodrine (Gutron ®) per os. Étude rétrospective chez 16 sujets

Purpose. – We evaluate the efficiency and side effects of midodrine in the treatment of sperm transport disturbances. Materials and methods. – This retrospective study concerned patients addressed in Andrologia Department between 1995 and 2002 for treatment of sperm transport disturbances by administration of Midodrine per os (from 2.5 to 20 mg). Anterograde and retrogrades ejaculates (in urine sample) were examined. Results. – Sixteen patients (middle age of 36 years) were included: 12 neurologic lesions (central or peripheral, with 3 diabetes), four post-surgical (urologic and digestive) ejaculatory incompetence. One patient obtained anterior and retrograde ejaculation, two patients obtained anterior ejaculation and six retrograde ejaculations by midodrine per os. This treatment was inefficient in eight subjects. Side effects were exceptional. Discussion. – We obtained anterior or retrograde ejaculation in half of our population. The success was more important in patients with central neurologic injuries, diabetes or post-surgical troubles. In peripheral neurologic injuries, midodrine per os (maximal dose of 20 mg) was ineffective. Conclusion. – Our study demonstrates the efficiency and good tolerance of midodrine per os for treatment of sperm transport disturbances.

The Effect on Semen Quality of the Electrical Current and Heat Generated During Rectal Probe Electroejaculation

Rectal probe electroejaculation is effective in procuring sperm from spinal cord injured patients with ejaculatory incompetence. The seminal quality in these patients is usually suboptimal and the motility is almost always low. We conducted an in vitro experiment to determine whether the heat and current generated during rectal probe electroejaculation impaired sperm motility or forward progression, or if the poor semen quality is the result of existing testicular dysfunction.

Ejaculatory incompetence and infertility

Ejaculatory incompetence is a relatively uncommon cause of infertility but a potentially treatable one. We report on 11 men with anejaculation, 2 of whom presented with complaints of sexual dysfunction and 9 with infertility. Psychologic factors were considered the major cause in all patients. Sexual counseling was carried out in four couples; in three of these couples, subsequent intravaginal ejaculation occurred. Two couples achieved pregnancy by intravaginal ejaculation. Two of another three couples achieved pregnancy by artificial insemination with the husbands' semen (AIH); therefore, four of seven couples achieved pregnancy by either sexual therapy or AIH. These data indicate that ejaculatory incompetence should be inquired after in cases of infertility and that sexual therapy as opposed to prolonged psychoanalysis or AIH is an effective form of treatment.

Multiple Phobias and Grief: A Case Study

This is a report of a 29-year-old man who presented with (1) multiple phobias, including fears of eating with others, blood and injury, and fainting in crowds; (2) ejaculatory incompetence; and (3) grief unresolved five years after his first wife's death, causing distress and avoidance of grief cues. As he declined an offer of behavioural treatment for the grief, the intention of the case design was to measure changes in grief-related distress and avoidance, but not treat it. However, exposure in vivo for the largely non-grief-related phobias involved inadvertent exposure to cues for grief and the man initiated some self-directed exposure to cues for grief. Measures indicated reduction in both phobic and some grief-related symptomatology. Mechanisms possibly accounting for these changes, and difficulties encountered in trying to treat this phobia while leaving grief untreated, are discussed. It is suggested that under certain circumstances, grief pathology may reduce during behavioural treatment for related phobic problems.

Ejaculatory incompetence: A theoretical formulation and case illustration

Three theoretical formulations of ejaculatory incompetence have been proposed in the literature. They include: (1) aversive conditioned inhibition of the ejaculatory reflex, (2) an “autosexual” orientation associated with discrepant levels in the cognitive and physiological dimensions of sexual arousal, and (3) a discriminative learning model. These three models are discussed in relation to their theoretical and therapeutic implications. Clinical data supporting the discriminative view is presented.

Coital Premature Ejaculation with Masturbatory Ejaculatory Incompetence

ABSTRACTTwo cases of coexisting coital premature ejaculation and masturbatory ejaculatory incompetence are presented. Prescribed penile self-manipulation exercises failed to produce sensations premonitory to ejaculation. For one subject, this was also true for partner manipulation. The other subject received partner manipulation concurrent with stimulating body contact, but not as an isolated exercise. Both men experienced high levels of arousal and ejaculated during non-manipulative extravaginal partner stimulation. Combined penile stimulation therapy and marital therapy eventually led to improved ejaculatory control. Some of the previously proposed causative mechanisms for premature ejaculation are briefly reviewed and some implications of our observations for these proposed mechanisms are discussed. A modification of penile stimulation therapy for premature ejaculation when associated with masturbatory ejaculatory incompetence is suggested.

Ejaculatory incompetence in Chinese men.

Ejaculatory incompetence in Chinese men.

A case of absolute ejaculatory incompetence treated without extra-vaginal ejaculation

In a case of absolute ejaculatory incompetence, a covert self-modelling procedure was used to overcome inhibition of ejaculation. This was combined with instructions on modification of position and techniques of intercourse in order to increase penile stimulation. The patient achieved normal functioning without being required to pass through the usual intermediary stage of extra-vaginal ejaculation by masturbation. The improvement was maintained fifteen months after termination of treatment.

Treatment of recalcitrant ejaculatory incompetence

Treatment of recalcitrant ejaculatory incompetence

A case of ejaculatory incompetence treated with a mechanical aid

A case of ejaculatory incompetence was successfully treated by means of a penile vibrator. Initially the patient had been treated by a Masters and Johnson (1970) approach, which had to be abandoned because of the wife's refusal to co-operate. Follow-up over 18 months indicated that the improvement was maintained.

Sexual Difficulties and the Importance of the Relationship

This article defines and discusses six common sexual dysfunctions: premature ejaculation, i?npotence, and ejaculatory incompetence of the male; and orgasmic difficulties, dyspareunia, and vaginismus of the female. The importance of viewing the dysfunction in terms of the relationship is stressed. How the “uninvolved” partner may contribute to the dysfunction and bow the dysfunction may affect the uninvolved partner is also discussed.

Treatment of erectile failure and ejaculatory incompetence of homosexual etiology

The treatment of a case of impotence related to homosexual orientation is described. In addition to the usual anxiety reduction procedures an arousal reconditioning procedure was employed. The latter consisted of introducing heterosexual stimuli at chosen times in the arousal induced by homosexual fantasies during masturbation and also during heterosexual activity. The homosexual arousal was later phased out of the treatment.

Ejaculatory incompetence treated by deconditioning anxiety

A case of ejaculatory incompetence (inability to ejaculate intravaginally) associated with coital anxiety was resolved in five sessions of behavior therapy. Because it was seen to be mediated by anxiety, the problem was treated by systematic desensitization and in vivo techniques.

3. Behavior therapy of impotence

Behavior Therapy consists of a number of treatment methods derived from experimental psychology, particularly the application of learning principles, both classical and operant. These techniques constitute a break with traditional insight therapy, emphasizing symptoms rather than personality review and change. They do not handle unconscious dynamic factors; the symptoms, or behavior as a whole, are considered the disease, but cognizance is taken of the person behind the symptom, and consideration is given to values, attitudes and beliefs. Neurosis is defined by Wolpe (1958) as learned behavior which is persistent and unadaptive, and which is acquired anxiety-generating situations. Historically, symptoms arise by training or trauma, by purpose or accident, during the life span of the individual who is more or less predisposed toward them. Included the behavioral therapies are systematic desensitization, active, graded therapy, assertive techniques, sexual responses, operant approaches, and numerous others. These approaches require four essentials: (1) contact with the feared object, situation, or feeling, (2) a graduated approach to the contact, (3) motivation of the patient to make this contact on a regular basis, and (4) fear reduction, induced by reassurance, relaxation training, medication, distraction, hypnosis, or other technical means. Additionally, these are preceded by a proper behavioral diagnosis, order to target in upon the symptom. Systematic desensitization is done through visual imagery the doctor's office, having the patient live through his fears and anxieties while a relaxed state. Active, graded therapy requires contact with the feared object, situation, or feeling a realistic manner. Male sexual inadequacy includes premature ejaculation, erective impotence, orgastic impotence, i.e., ability to perform but not to enjoy coitus (the frigid man), and retarded ejaculation, i.e. inability to reach ejaculation during coitus (ejaculatory incompetence of Masters and Johnson [1970]). I shall limit my discussion to the first two problems.