Treatment Of Anejaculation Research Articles

Low-frequency neuromuscular electrical stimulation as a treatment for anejaculation caused by iatrogenic injury of the abdominal aorta: a case study

Anejaculation is the inability to ejaculate during sexual activity, either in an antegrade or retrograde fashion. Both anejaculation following an iatrogenic injury of the abdominal aorta and the efficacy of low-frequency neuromuscular electrical stimulation (NMES) in treating anejaculation have been reported rarely. In this case report, we describe a patient who experienced anejaculation following an iatrogenic injury to the abdominal aorta and eventually regained normal ejaculation ability following treatment with NMES. The patient, a 23-year-old Chinese man, underwent laparoscopic varicocele ligation on both sides, during which he sustained a ruptured wound in the abdominal aorta from a 10-mm trocar. To stop the bleeding, he underwent abdominal aortic balloon catheter dilatation combined with covered stent implantation. However, 10 days after the endovascular interventions, the patient developed hemorrhagic shock and underwent emergency exploratory laparotomy and adventitial suture of the abdominal aorta. Despite normal erectile function since a week after the last surgery, the patient complained of aejaculation for a year during intercourse or masturbation. After receiving NMES treatment for over two months, the patient reported successful intravaginal ejaculation during intercourse, and the improvement persisted for a month after treatment. Altogether, these findings suggest that NMES could be a feasible, safe, and cost-effective treatment method for improving anejaculation and provides a novel option for patients with this condition.

Sexual concerns after Spinal Cord Injury: An update on management.

Spinal Cord Injury (SCI) causes neurological impairment with resultant neurogenic sexual dysfunction which can compound preexisting psychological and medical sexual concerns. Understanding these concerns is important in managing the lifelong needs of persons with SCIs. To provide an overview of the impact of SCI on sexuality along with a framework for treatment of sexual concerns. To briefly review male infertility and its treatments and pregnancy in females after SCI. Interdisciplinary literature review and synthesis of information. The average age at SCI is increased, thus persons with SCIs may have preexisting sexual concerns. Sexual activity and satisfaction are decreased after SCI. Psychogenic sexual arousal is related to remaining sensation in the T11-L2 dermatomes. Orgasm occurs in approximately 50% of persons with SCIs with all injuries except subjects with complete lower motor neuron (LMN) injuries affecting the lowest sacral segments A structured approach to treatment including assessing preinjury function, determining the impact of injury, education, assessing and treating iatrogenic sexual dysfunction and treatment of concomitant problems is recommended. Basic and advanced methods to improve sexual arousal and orgasm are discussed and treatment of anejaculation and issues associated with pregnancy and SCI are reviewed. Sexual satisfaction is impaired after SCI; however, education and new therapies can improve responsiveness. Future research is warranted to improve sexual function and fertility potential in persons with SCIs.

Midodrine in patients with spinal cord injury and anejaculation: A double-blind randomized placebo-controlled pilot study

ObjectiveThe objective of this study is to evaluate the efficacy of midodrine in the treatment of anejaculation in men with spinal cord injury (SCI).Study designProspective, double-blind, randomized, placebo-controlled pilot study.MethodMen with anejaculation associated with SCI (level of injury above T10) of more than 1 year in duration were approached. Those with no ejaculatory response to one penile vibratory stimulation (PVS) trial were assigned in a double-blind manner to one of the two following interventions once a week for a maximum of 3 weeks or until ejaculation occurred: oral administration of flexible midodrine (7.5–22.5 mg max) followed by PVS (group M), or oral administration of flexible sham-midodrine (placebo) followed by PVS (group P). Sociodemographic data, medical characteristics, and plasma desglymidodrine concentration were collected for all participants.Outcome measureEjaculation success rate in each group.ResultsAmong the 78 men approached, 23 participants (level of SCI: C4–T9) were randomized. Three participants abandoned the study and 20 completed the study; 10 were assigned to group M, 10 to group P. Ejaculation was reached for one participant of group M and for two participants of group P. Autonomic dysreflexia associated to PVS occurred in three patients.ConclusionIn this small sample study, treatment of anejaculation after SCI with midodrine and PVS did not result in a better rate of antegrade ejaculation in 10 men than in 10 men treated with a placebo and PVS.

Treatment of Infertility in Men with Spinal Cord Injury: Medical Progress and Ethical Considerations

Spinal cord injury (SCI) occurs most often in young men at the peak of their reproductive health. Following SCI, most men require medical assistance to reproduce. Recent improvements treating male factor infertility in general have led to a problem for men with SCI. Often, their ejaculates are not examined as a source of sperm for assisted reproductive technology (ART). Instead, sperm are retrieved surgically from their testes or epididymes as a first line of treatment for anejaculation. This development has resulted in many centers performing expensive and invasive ART to overcome the low sperm numbers typically obtained with surgical sperm retrieval (SSR). Expensive and invasive ART, however, is often unnecessary. Ninety-five percent of men with SCI respond to semen retrieval by penile vibratory stimulation (PVS) or electroejaculation (EEJ) and do not require SSR. Compared to SSR, PVS and EEJ usually result in higher yields of total motile sperm, thus increasing potentials for simpler, less expensive op...

Successful combination of transrectal electroejaculation and intracytoplasmic sperm injection in the treatment of anejaculation

We describe the case of a couple whose infertility was caused by the absence of seminal emission following retroperitoneal surgery for testicular cancer. Ejaculate could be retrieved from the husband by rectal probe electroejaculation (RPE) but sperm quality was so poor that conventional in-vitro fertilization was impossible. With intracytoplasmic sperm injection of spermatozoa retrieved by RPE - a combination not reported previously - we were able to induce a pregnancy with successful outcome.

Treatment of anejaculation in the total paraplegic by subcutaneous injection of Physostigmine.

The authors describe a new therapy for paraplegic anejaculation. Sub-cutaneous injection of Physostigmine with certain precautions and with selected methods of application can be used for patients where there is the same indication for the use of an intrathecal injection of Neostigmine. The T12-L2 myelomeres must be intact. The new treatment is easier to perform, and when the patient has experimented with three tests in our hospital without any problems, he is granted permission to apply this treatment at home, without any medical supervision.