Subscribe to RSS
DOI: 10.1055/s-0029-1202307
Anejaculation: An Electrifying Approach
Publication History
Publication Date:
26 February 2009 (online)
ABSTRACT
Anejaculation within the context of a male infertility evaluation can be a distressing condition for patients. A variety of causes for anejaculation have been identified, and although the condition cannot be reversed, in many cases a minimally invasive treatment is feasible, allowing the patient to pursue his desire for children. In most cases, men suffering from anejaculation due to spinal cord injury (SCI) are excellent candidates for ejaculation induction procedures and low-level assisted reproductive techniques. In many SCI men, penile vibratory ejaculation can be performed by the patient himself and home insemination performed as a very low cost alternative. Surgical sperm retrieval and intracytoplasmic sperm injection should be first-line therapy only in non-SCI anejaculatory men.
KEYWORDS
Anejaculation - ejaculatory dysfunction - penile vibratory stimulation - electroejaculation - male infertility
REFERENCES
- 1 Thomas Jr A J. Ejaculatory dysfunction. Fertil Steril. 1983; 39 445-454
- 2 Sonksen J, Ohl D A, Wedemeyer G. Sphincteric events during penile vibratory ejaculation and electroejaculation in men with spinal cord injuries. J Urol. 2001; 165 426-429
- 3 Robert M, Gagnon C. Semenogelin I: a coagulum forming, multifunctional seminal vesicle protein. Cell Mol Life Sci. 1999; 55 944-960
- 4 Chughtai B, Sawas A, O'Malley R L et al.. A neglected gland: a review of Cowper's gland. Int J Androl. 2005; 28 74-77
- 5 Laumann E O, Paik A, Rosen R C. Sexual dysfunction in the United States: prevalence and predictors. JAMA. 1999; 281 537-544
- 6 Colpi G M, Fanciullacci F, Beretta G et al.. Evoked sacral potentials in subjects with true premature ejaculation. Andrologia. 1986; 18 583-586
- 7 Stewart D E, Ohl D A. Idiopathic anejaculation treated by electroejaculation. Int J Psychiatry Med. 1989; 19 263-268
- 8 Biering-Sorensen F, Sonksen J. Sexual function in spinal cord lesioned men. Spinal Cord. 2001; 39 455-470
- 9 Kedia K R, Markland C, Fraley E E. Sexual function following high retroperitoneal lymphadenectomy. J Urol. 1975; 114 237-239
- 10 Weinstein M H, Machleder H I. Sexual function after aorto-lliac surgery. Ann Surg. 1975; 181 787-790
- 11 Sexton W J, Jarow J P. Effect of diabetes mellitus upon male reproductive function. Urology. 1997; 49 508-513
- 12 Hellstrom W J, Sikka S C. Effects of acute treatment with tamsulosin versus alfuzosin on ejaculatory function in normal volunteers. J Urol. 2006; 176 1529-1533
- 13 Kamischke A, Nieschlag E. Treatment of retrograde ejaculation and anejaculation. Hum Reprod Update. 1999; 5 448-474
- 14 Deveci S, O'Brien K, Mulhall J P. Outcomes of post-chemotherapy retroperitoneal lymph node dissection associated-anejaculation management. J Urol. 2008; 175(Suppl) 657
- 15 Bird V G, Brackett N L, Lynne C M et al.. Reflexes and somatic responses as predictors of ejaculation by penile vibratory stimulation in men with spinal cord injury. Spinal Cord. 2001; 39 514-519
- 16 Ohl D A, Menge A C, Sonksen J. Penile vibratory stimulation in spinal cord injured men: optimized vibration parameters and prognostic factors. Arch Phys Med Rehabil. 1996; 77 903-905
- 17 Sonksen J, Biering-Sorensen F, Kristensen J K. Ejaculation induced by penile vibratory stimulation in men with spinal cord injuries. The importance of the vibratory amplitude. Paraplegia. 1994; 32 651-660
- 18 Steinberger R E, Ohl D A, Bennett C J et al.. Nifedipine pretreatment for autonomic dysreflexia during electroejaculation. Urology. 1990; 36 228-231
- 19 Brackett N L, Ead D N, Aballa T C et al.. Semen retrieval in men with spinal cord injury is improved by interrupting current delivery during electroejaculation. J Urol. 2002; 167 201-203
- 20 Ohl D A. Electroejaculation. Urol Clin North Am. 1993; 20 181-188
- 21 Buch J P, Zorn B H. Evaluation and treatment of infertility in spinal cord injured men through rectal probe electroejaculation. J Urol. 1993; 149 1350-1354
- 22 Denil J, Ohl D A, Menge A C et al.. Functional characteristics of sperm obtained by electroejaculation. J Urol. 1992; 147 69-72
- 23 Sonksen J, Lochner-Ernst D, Brackett N L et al.. Vibratory ejaculation in 169 spinal cord injured men and home insemination of their partners. J Urol. 2008; 175(Suppl) 656
- 24 Ohl D A, Wolf L J, Menge A C et al.. Electroejaculation and assisted reproductive technologies in the treatment of anejaculatory infertility. Fertil Steril. 2001; 76 1249-1255
- 25 Heruti R J, Katz H, Menashe Y et al.. Treatment of male infertility due to spinal cord injury using rectal probe electroejaculation: the Israeli experience. Spinal Cord. 2001; 39 168-175
- 26 Hultling C, Rosenlund B, Levi R et al.. Assisted ejaculation and in-vitro fertilization in the treatment of infertile spinal cord-injured men: the role of intracytoplasmic sperm injection. Hum Reprod. 1997; 12 499-502
- 27 Kafetsoulis A, Brackett N L, Ibrahim E et al.. Current trends in the treatment of infertility in men with spinal cord injury. Fertil Steril. 2006; 86 781-789
Dana A OhlM.D.
Department of Urology, University of Michigan
1500 E. Medical Center Dr., Box 0330, Ann Arbor, MI 48108
Email: daohl@umich.edu