Abstract
Ejaculation begins approximately 12 months after the onset of puberty in the male. While its importance to reproductive fitness is clear, current knowledge of the physiology of ejaculation is limited. This chapter reviews the events of ejaculation, its anatomic and neuroanatomic underpinnings, the range of ejaculatory disorders, and clinical methods for evaluating and treating ejaculatory disorders. Our current understanding of reproductive tract physiology and function as well as ejaculatory duct obstruction is also reviewed.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
References
Master VA, Turek PJ. Ejaculatory physiology and dysfunction. Urol Clin North Am. 2001;28:363–75.
Yang CC, Bradley WE. Somatic innervation of the human bulbocavernosus muscle. Clin Neurophysiol. 1999;110:412.
Brackett NL, Ohl DA, Sønksen J, Lynne CM. Abnormalities of ejaculation. In: Lipshultz LI, Howards SS, Niederberger CS, editors. Infertility in the male. 4th ed. New York: Cambridge University Press; 2009. p. 454–73.
Benson GS. Erection, emission and ejaculation: physiologic mechanisms. In: Lipshultz LI, Howards SS, editors. Infertility in the male. 3rd ed. St. Louis: Mosby; 1997. p. 155.
Eisenberg M, Walsh TJ, Garcia M, et al. Ejaculatory duct manometry in normal men and in patients with ejaculatory duct obstruction. J Urol. 2008;180:255–60.
Jarvi K, Zielenski J, Wilschanski M, et al. Cystic fibrosis transmembrane conductance regulator and obstructive azoospermia. Lancet. 1995;345:1578.
Thorpe AC, Cleary R, Coles J, et al. Written consent about sexual function in men undergoing transurethral prostatectomy. Br J Urol. 1994;74:479.
Dunsmuir WD, Emberton M, Neal DE. On behalf of the steering group of the National Prostatectomy Audit. There is significant sexual dissatisfaction following TURP. Br J Urol. 1996;77:161A.
Lue TF, Giuliano F, Montorsi F, et al. Summary of the recommendations on sexual dysfunctions in men. J Sex Med. 2004;1:6–23.
Purohit RS, Wu DS, Shinohara K, Turek PJ. A prospective comparison of 3 diagnostic methods to evaluate ejaculatory duct obstruction. J Urol. 2004;171:232–5, discussion 235–36.
Hendry WF. Disorders of ejaculation: congenital, acquired and functional. Br J Urol. 1998;82:331.
Hendry WF, Pryor JP. Mullerian duct (prostatic utricle) cyst: diagnosis and treatment in subfertile males. Br J Urol. 1992;69:79.
Turek PJ. Seminal vesicle and ejaculatory duct surgery. In: Graham S, editor. Glenn’s urologic surgery. 6th ed. Philadelphia: Lippincott, Williams & Wilkins; 2006. p. 439–45.
Nguyen HT, Etzell J, Turek PJ. Normal human ejaculatory duct anatomy: a study of cadaveric and surgical specimens [see comments]. J Urol. 1996;155:1639.
Jarow JP. Seminal vesicle aspiration in the management of patients with ejaculatory duct obstruction. J Urol. 1994;152:899.
Bird VG, Brackett NL, Lynne CM, et al. Reflexes and somatic responses as predictors of ejaculation by penile vibratory stimulation in men with spinal cord injury. Spinal Cord. 2001;39:514–9.
Brackett NL. Semen retrieval by penile vibratory stimulation in men with spinal cord injury. Hum Reprod Update. 1999;5:216–22.
Momose H, Hirao Y, Yamamoto M, et al. Electroejaculation in patients with spinal cord injury: first report of a large-scale experience from Japan. Int J Urol. 1995;2:326.
Brinsden PR, Avery SM, Marcus S, et al. Transrectal electroejaculation combined with in-vitro fertilization: effective treatment of anejaculatory infertility due to spinal cord injury. Hum Reprod. 1997;12:2687.
Schatte EC, Orejuela FJ, Lipshultz LI, et al. Treatment of infertility due to anejaculation in the male with electroejaculation and intracytoplasmic sperm injection. J Urol. 2000;163:1717.
Ohl DA. Electroejaculation. Urol Clin North Am. 1993;20:181.
Vanderschueren D, Spiessens C, Kiekens C, et al. Successful treatment of idiopathic anejaculation with electroejaculation after microsurgical vas aspiration. Hum Reprod. 1998;13:370.
Vinik AI, Maser RE, Mitchell BD, Freeman R. Diabetic autonomic neuropathy. Diabetes Care. 2003;26:1553–79.
Dunsmuir WD, Holmes SA. The aetiology and management of erectile, ejaculatory, and fertility problems in men with diabetes mellitus. Diabet Med. 1996;13:700.
Sexton WJ, Jarow JP. Effect of diabetes mellitus upon male reproductive function. Urology. 1997;49:508.
Hojo K, Vernava III AM, Sugihara K, et al. Preservation of urine voiding and sexual function after rectal cancer surgery. Dis Colon Rectum. 1991;34:532.
Nesbakken A, Nygaard K, Bull-Njaa T, et al. Bladder and sexual dysfunction after mesorectal excision for rectal cancer. Br J Surg. 2000;87:206.
Turek PJ, Lowther DN, Carroll PR. Fertility issues and their management in men with testis cancer. Urol Clin North Am. 1998;25:517.
Holman E, Kovacs G, Flasko T, et al. Hand-assisted laparoscopic retroperitoneal lymph node dissection for nonseminomatous testicular cancer. J Laparoendosc Adv Surg Tech A. 2007;17:16–20.
Neyer M, Peschel R, Akkad T, et al. Long-term results of laparoscopic retroperitoneal lymph-node dissection for clinical stage I nonseminomatous germ-cell testicular cancer. J Endourol. 2007;21:180–3.
Styblo K, Bossers GT, Slot GH. Osteotomy for kyphosis in ankylosing spondylitis. Acta Orthop Scand. 1985;56:294.
Berger Y, Blaivas JG, Oliver L. Urinary dysfunction in transverse myelitis. J Urol. 1990;144:103.
Decter RM, Furness III PD, Nguyen TA, et al. Reproductive understanding, sexual functioning and testosterone levels in men with spina bifida. J Urol. 1997;157:1466.
Sønksen J, Ohl DA. Penile vibratory stimulation and electroejaculation in the treatment of ejaculatory dysfunction. Int J Androl. 2002;25:324–32.
Kafetsoulis A, Brackett NL, Ibrahim E, et al. Current trends in the treatment of infertility in men with spinal cord injury. Fertil Steril. 2006;86:781–9.
Sønksen J. Assisted ejaculation and semen characteristics in spinal cord injured males. Scand J Urol Nephrol Suppl. 2003;213:1–31.
Kennedy SH, Dickens SE, Eisfeld BS, et al. Sexual dysfunction before antidepressant therapy in major depression. J Affect Disord. 1999;56:201.
Seidman S. Ejaculatory dysfunction and depression: pharmacological and psychobiological interactions. Int J Impot Res. 2006;18 Suppl 1:S33–8.
Hellstrom WJ, Sikka SC. Effects of acute treatment with tamsulosin versus alfuzosin on ejaculatory function in normal volunteers. J Urol. 2006;176:1529–33.
Sharlip ID, Hellstrom WJG, Broderick GA. The ISSM definition of premature ejaculation: a contemporary, evidence-based definition. J Urol. 2008;179(Suppl):340.
Read S, King M, Watson J. Sexual dysfunction in primary medical care: prevalence, characteristics and detection by the general practitioner. J Public Health Med. 1997;19:387.
Rowland DL, Haensel SM, Blom JH, et al. Penile sensitivity in men with premature ejaculation and erectile dysfunction. J Sex Marital Ther. 1993;19:189.
Biri H, Isen K, Sinik Z, et al. Sertraline in the treatment of premature ejaculation: a double-blind placebo controlled study. Int Urol Nephrol. 1998;30:611.
Haensel SM, Klem TM, Hop WC, et al. Fluoxetine and premature ejaculation: a double-blind, crossover, placebo-controlled study. J Clin Psychopharmacol. 1998;18:72.
Kara H, Aydin S, Yucel M, et al. The efficacy of fluoxetine in the treatment of premature ejaculation: a double-blind placebo controlled study [see comments]. J Urol. 1996;156:1631.
Kim SC, Seo KK. Efficacy and safety of fluoxetine, sertraline and clomipramine in patients with premature ejaculation: a double-blind, placebo controlled study. J Urol. 1998;159:425.
McMahon CG, Touma K. Treatment of premature ejaculation with paroxetine hydrochloride as needed: 2 single-blind placebo controlled crossover studies. J Urol. 1999;161:1826.
Waldinger MD, Hengeveld MW, Zwinderman AH. Ejaculation-retarding properties of paroxetine in patients with primary premature ejaculation: a double-blind, randomized, dose-response study. Br J Urol. 1997;79:592.
Berkovitch M, Keresteci AG, Koren G. Efficacy of prilocaine-lidocaine cream in the treatment of premature ejaculation [see comments]. J Urol. 1995;154:1360.
Andersen KH. A new method of analgesia for relief of circumcision pain. Anaesthesia. 1989;44:118.
Choi HK, Jung GW, Moon KH, et al. Clinical study of SS-cream in patients with lifelong premature ejaculation. Urology. 2000;55:257.
Annon J. The behavioral treatment of sexual problems, vol. 1. Honolulu: Enabling Systems; 1974.
Hendry WF, Rickards D, Pryor JP, et al. Seminal megavesicles with adult polycystic kidney disease. Hum Reprod. 1998;13:1567.
Turek PJ, Magana JO, Lipshultz LI. Semen parameters before and after transurethral surgery for ejaculatory duct obstruction. J Urol. 1996;155:1291.
Turek PJ, Aslam K, Younes AK, et al. Observations on seminal vesicle dynamics in an in vivo rat model. J Urol. 1998;159:1731.
Sandler B. Idiopathic retrograde ejaculation. Fertil Steril. 1979;32:474.
Van der Linden PJQ, Nan PM, te Velde ER, et al. Retrograde ejaculation: successful treatment with artificial insemination. Obstet Gynecol. 1992;79:126.
Kim SW, Paick JS. Short-term analysis of the effects of as needed use of sertraline at 5 PM for the treatment of premature ejaculation. Urology. 1999;54:544.
Hovav Y, Dan-Goor M, Yaffe H, et al. Nocturnal sperm emission in men with psychogenic anejaculation. Fertil Steril. 1999;72:364.
Geboes K, Steeno O, De Moor P. Primary anejaculation: diagnosis and therapy. Fertil Steril. 1975;26:1018.
Denil J, Kupker W, Al-Hasani S, et al. Successful combination of transrectal electroejaculation and intracytoplasmic sperm injection in the treatment of anejaculation. Hum Reprod. 1996;11:1247.
Acknowledgments
The authors would like to acknowledge the contributions of Melody Lowman MA of San Francisco, California, to this chapter. As a psychotherapist with 45 years of experience, her knowledge and experience in reproductive psychology has been invaluable to us.
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2012 Springer Science+Business Media, LLC
About this chapter
Cite this chapter
Ignatov, A.P., Turek, P.J. (2012). Ejaculatory Dysfunction and Vasodynamics. In: Parekattil, S., Agarwal, A. (eds) Male Infertility. Springer, New York, NY. https://doi.org/10.1007/978-1-4614-3335-4_26
Download citation
DOI: https://doi.org/10.1007/978-1-4614-3335-4_26
Published:
Publisher Name: Springer, New York, NY
Print ISBN: 978-1-4614-3334-7
Online ISBN: 978-1-4614-3335-4
eBook Packages: MedicineMedicine (R0)