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2.
Diagn. tratamento ; 25(4): 162-166, 20201200.
Article in Portuguese | LILACS | ID: biblio-1146917

ABSTRACT

A ejaculação precoce é um dos transtornos sexuais mais prevalentes na população masculina com prevalência média de cerca de 30%. Possui diversas classificações de entidades médicas e classificações internacionais de doenças, todas elas tendo em comum um reduzido tempo de latência intravaginal, incapacidade de controle ejaculatório e consequências psicológicas negativas para o indivíduo e/ou para o casal. Dentre as causas da patologia, destacam-se alterações nas vias de neurotransmissão serotoninérgica, hipersensibilidade genital e causas genéticas nas patologias primárias. Na ejaculação precoce secundária devem-se pesquisar distúrbios psicogênicos, hormonais, sintomas de trato urinário inferior e disfunção erétil. O correto diagnóstico é importante para indicação e planejamento do tratamento adequado. Em casos de ejaculação precoce primária, o tratamento preferencial é o medicamentoso. Os tratamentos medicamentosos disponíveis podem ser por via oral ou de aplicação tópica. Dentre os tratamentos orais, destacam-se os antidepressivos com ação serotoninérgica que devem ser utilizados de modo contínuo. Outras classes de medicações utilizadas são os inibidores da fosfodieterase do tipo 5 e os opioides como tramadol. Como opção às medicações orais, as medicações de aplicação tópica peniana são aplicadas sob demanda na glande um período antes do encontro sexual, cujo tempo varia conforme o medicamento escolhido, e que podem ter apresentação no formato gel ou spray, contendo primariamente uma mistura de lidocaína e prilocaína ou compostos de naturais como o SS-Cream (Severance Secret Cream).


Subject(s)
Coitus , Drug Therapy, Combination , Ejaculation , Anesthetics , Antidepressive Agents
3.
Diagn. tratamento ; 25(3): 109-115, jul.-set. 2020.
Article in Portuguese | LILACS | ID: biblio-1129414

ABSTRACT

O câncer de próstata é uma das neoplasias mais frequentes na população masculina. A prostatectomia radical está entre os principais tratamentos para essa afecção, sendo a primeira escolha para casos de doenças localizadas e localmente avançadas. Contudo, essa modalidade de tratamento cirúrgico costuma trazer grande prejuízo à função sexual masculina como um todo. Sabe-se que a disfunção erétil é uma complicação frequente e temida do tratamento cirúrgico do câncer de próstata, de forma que há diversas estratégias para prevenir e tratar tal condição. Porém, uma adequada reabilitação sexual desses pacientes envolve um atendimento global às dificuldades encontradas no restabelecimento de uma vida sexual satisfatória, não apenas focado na qualidade das ereções. Infelizmente, há uma série de problemas sexuais frequentes que são desencadeados pela prostatectomia radical, mas que ainda são extremamente negligenciados no cuidado pós-operatório. Dentre eles podemos citar: queda do desejo sexual, perda de volume peniano, desenvolvimento de deformidades penianas e distúrbios do orgasmo e da ejaculação. Neste artigo são abordados os principais efeitos sexuais da prostatectomia radical que costumam ser negligenciados no seguimento


Subject(s)
Orgasm , Prostatectomy , Rehabilitation , Ejaculation , Erectile Dysfunction
4.
Diagn. tratamento ; 25(2): 01-04, abr.-jun. 2020.
Article in Portuguese | LILACS | ID: biblio-1116057

ABSTRACT

A ejaculação retardada caracteriza-se pelo atraso acentuado da ejaculação, mesmo com estimulação sexual adequada e desejo de ejacular. A prevalência estimada é de 1% a 4%. Tentativas prolongadas para atingir o orgasmo causam exaustão e desconforto genital. Há influência de fatores biopsicossociais-comportamentais e culturais que podem desencadear, reforçar ou agravar a probabilidade de ocorrência. Pode ser desencadeada por medicações. Conduz a uma menor satisfação no relacionamento, ansiedade com o desempenho sexual, a uma atividade sexual menos frequente e problemas relacionados à saúde. Portadores sentem menos excitação sexual subjetiva, apesar da resposta erétil ser boa, e diminuição da sensibilidade peniana. A frequência de masturbação é alta, com estilo próprio e as fantasias sexuais preferidas não ocorrem no sexo com parceria. Preferem masturbação ao sexo compartilhado. Mantêm a ereção, mesmo quando perdem a excitação, aparentemente pela necessidade de satisfazer a parceria. Os fatores psicológicos incluem medos, hostilidade, ansiedade de desempenho e sentimento de culpa. O tratamento deve ser particularizado, individual ou do casal. Dados limitados apoiam psicoterapia, farmacoterapia e/ou estimulação vibratória peniana como opções de manejo. Indicadas reeducação masturbatória e aproximação das fantasias à realidade do paciente. Fantasias sexuais não convencionais são frequentes e dificultam o tratamento. A psicoterapia busca diminuir o estigma, facilitar a comunicação entre os parceiros, informar e diminuir a ansiedade relacionada à atividade sexual. Também são úteis as atividades lúdicas e as práticas sexuais alternativas. Os casos mais graves se beneficiam do tratamento medicamentoso integrado ao psicoterapêutico, mesmo havendo complicações psicossociais-comportamentais e culturais concomitantes.


Subject(s)
Psychotherapy , Sexual Behavior , Coitus , Ejaculation , Masturbation
5.
Diagn. tratamento ; 25(1): 36-39, jan.-mar. 2020.
Article in Portuguese | LILACS | ID: biblio-1099976

ABSTRACT

A ejaculação precoce é uma disfunção sexual sem etiologia descrita na literatura, apesar de os primeiros relatos clínicos serem de 1890. Ao longo dos anos, foi utilizada a definição da Internacional Society for Medicine Sexual para compreensão da ejaculação precoce e dos seus critérios diagnósticos. Muitos homens acreditam que a resposta sexual é automática e nata, no entanto, o medo de falhar e a perda do mundo erótico associados à angústia, frustração e evitação da intimidade sexual são aspectos subjetivos relacionados à dificuldade de controle ejaculatório. O homem cuja parceira apresenta postura ativa e envolvimento no intercurso sexual tem o seu processo de aprendizagem facilitado, controlando, assim, a excitação e mantendo a ereção. Essa parceira, em geral, tem maior qualidade de comunicação sexual, construto associado de forma positiva à função sexual masculina (por exemplo, ao aumento da excitação e ao controle ejaculatório); diminuindo a vulnerabilidade e a predisposição ao desenvolvimento de disfunção sexual. O presente artigo versa, também, sobre a proposta de tratamento do modelo multimodal e tridimensional para a ejaculação precoce. O primeiro modelo apresenta a resposta excitatória na ejaculação por meio de um sistema de software, sistema psicológico (variável conforme o contexto e com base na experiência sexual); e um hardware, sistema biológico (com pouca variação intrínseca e determinante genética), combina farmacoterapia e psicoterapia; o segundo, tridimensional, apresenta coordenadas cartesianas para corroborar aspectos subjetivos e relacionais da ejaculação precoce, apresentando uma baixa de serotonina na fenda sináptica, impactando a sensação de controle e reflexo ejaculatório.


Subject(s)
Humans , Male , Female , Adult , Anxiety , Sexual Behavior , Sexuality , Ejaculation , Premature Ejaculation
6.
National Journal of Andrology ; (12): 888-894, 2020.
Article in Chinese | WPRIM | ID: wpr-880287

ABSTRACT

Objective@#To investigate the advantages and disadvantages of point electro-cauterization (PEC) and holmium laser cauterization (HLC) in the treatment of post-ejaculation hematuria.@*METHODS@#From January 2015 to December 2018, 73 patients with post-ejaculation hematuria, aged 24-63 (36.8 ± 4.2) years, underwent PEC (n = 35) or HLC (n = 38) after failure to respond to 3 months of conservative treatment. We compared the hospital days, total hospitalization expenses, maximum urinary flow rate (Qmax), average urinary flow rate (Qavg), Hamilton Anxiety Rating Scale (HAMA) score, postoperative duration of hematuria, and recurrence rate at 3 and 6 months after surgery.@*RESULTS@#All the patients experienced first ejaculation but no post-ejaculation hematuria at 1 month after operation. The recurrence rates were lower in the PEC than in the HLC group at 3 months (5.71% vs 2.63%, P > 0.05) and 6 months postoperatively (8.57% vs 5.26%, P > 0.05). Compared with the baseline, the Qmax was decreased from (18.56 ± 2.53) ml/s to (13.68 ± 3.31) ml/s (P < 0.05) and the Qavg from (14.35 ± 2.26) ml/s to (9.69±1.84) ml/s in the PEC group at 1 month after surgery (P < 0.01), but neither showed any statistically significant difference in the HLC group. Mild to moderate anxiety was prevalent in the patients preoperatively, particularly in those without job or regular income and those with a long disease course or frequent onset, the severity of which was not correlated with age, education or marital status. The HAMA score was decreased from18.65 ± 4.33 before to 12.35 ± 3.63 after surgery in the PEC group (P < 0.01), and from 16.88 ± 2.11 to 6.87 ± 4.36 in the HLC group (P < 0.01). The mean hospital stay was significantly longer in the former than in the latter group ([5.2 + 1.3] vs [3.4 ± 0.5] d, P < 0.01), while the total cost markedly lower ([6.35 ± 1.20] vs [12.72 ± 2.15] thousand RMB ¥, P < 0.05).@*CONCLUSIONS@#Both PEC and HLC are safe and effective for the treatment of post-ejaculation hematuria, with no significant difference in the recurrence rate at 3 and 6 months after operation, but their long-term effect needs further follow-up studies. PEC may increase the risk of negative outcomes of the postoperative urinary flow rate, while HLC has the advantages of better relieving the patient's anxiety, sooner discharge from hospital and earlier recovery from postoperative hematuria, though with a higher total cost than the former.


Subject(s)
Adult , Cautery , Ejaculation , Hematuria/surgery , Holmium , Humans , Laser Therapy , Lasers, Solid-State/therapeutic use , Male , Middle Aged , Treatment Outcome , Young Adult
7.
National Journal of Andrology ; (12): 867-874, 2020.
Article in Chinese | WPRIM | ID: wpr-880284

ABSTRACT

Objective@#To explore the effects of the mu-opioid receptor (MOR) in the paraventricular nucleus (PVN) on the ejaculatory behaviors of male rats and its potential mechanisms.@*METHODS@#Male SD rats with normal ejaculation ability were mated with female ones in hormone-induced estrus. After bilateral PVN microinjection of D-Ala-2-Me-Phe-4-Gly-ol enkephalin (DAGO) or D-Phe-Cys-Tyr-D-Trp-Arg-Thr-Pen-Thr-NH2 (CTAP) with an inserted catheter, the male animals were observed for mount latency (ML), mount frequency (MF), intromission latency (IL), intromission frequency (IF), ejaculation latency (EL), ejaculation frequency (EF), post-ejaculation interval (PEI), and intromission ratio (IR). The lumbar sympathetic nerve activity (LSNA) of the rats was recorded using the PowerLab data acquisition hardware device, and the levels of norepinephrine (NE) in the peripheral plasma were measured by ELISA following microinjection of saline or different doses of DAGO or CTAP.@*RESULTS@#Neither CTAP nor DGAO significantly affected the ML of the male rats (P > 0.05). DGAO remarkably increased IF (P < 0.01) and MF (P < 0.01), prolonged IL (P < 0.01), EL (P < 0.01) and PEI (P < 0.01), and reduced EF (P <0.01) and IR (P < 0.05). On the contrary, CTAP markedly decreased IF (P < 0.01) and MF (P < 0.01), shortened IL (P < 0.01), EL (P < 0.01) and PFI (P < 0.01), and elevated EF (P < 0.01) and IR (P < 0.01). Additionally, DAGO decreased LSNA in a dose-dependent manner and reduced the NE level in the peripheral plasma. CTAP, however, not only offset the effects of DAGO on LSNA, but also significantly increased LSNA.@*CONCLUSIONS@#MOR in PVN inhibits ejaculatory behaviors in male rats by weakening LSNA, which has provided some theoretical evidence for the use of highly selective opioids in the treatment of premature ejaculation.


Subject(s)
Animals , Ejaculation , Enkephalin, Ala(2)-MePhe(4)-Gly(5)-/pharmacology , Female , Male , Paraventricular Hypothalamic Nucleus/physiology , Peptide Fragments/pharmacology , Rats , Rats, Sprague-Dawley , Receptors, Opioid, mu/physiology , Somatostatin/pharmacology , Sympathetic Nervous System/physiology
9.
Int. braz. j. urol ; 45(6): 1209-1215, Nov.-Dec. 2019. tab
Article in English | LILACS | ID: biblio-1056348

ABSTRACT

ABSTRACT Purpose: To compare the efficacy and safety of available selective serotonin reuptake inhibitors (SSRIs) in order to find the most effective drug with the least number of side effects in treatment of premature ejaculation (PE). Materials and Methods: This study was a randomized clinical trial. Four hundred and eighty patients with PE in the 4 groups referred to Imam Reza hospital Tehran, Iran from July 2018 to February 2019 were enrolled in the study. The patients received sertraline 50mg, fluoxetine 20mg, paroxetine 20mg and citalopram 20mg, every 12 hours daily. The intravaginal ejaculatory latency time (IELT) before treatment, fourth and eighth weeks after treatment was recorded by the patient's wife with a stopwatch. Results: Mean IELT before, 4 and 8 weeks after treatment in four groups were: sertraline 69.4±54.3, 353.5±190.4, 376.3±143.5; fluoxetine 75.5±64.3, 255.4±168.2, 314.8±190.4; paroxetine 71.5±69.1, 320.7±198.3, 379.9±154.3; citalopram 90.39±79.3, 279.9±192.1, 282.5±171.1 seconds, respectively. The ejaculation time significantly increased in all groups (p <0.05), but there was no significant difference between the groups (P=0.75). Also, there was no significant difference in drugs side effects between groups (p >0.05). The most common side effects were drowsiness and dyspepsia, which were not severe enough to cause discontinuation of the drug. Conclusions: All available SSRIs were effective and usually had no serious complications. In patients who did not respond to any of these drugs, other SSRI drugs could be used as a salvage therapy.


Subject(s)
Humans , Male , Adult , Aged , Young Adult , Citalopram/therapeutic use , Fluoxetine/therapeutic use , Serotonin Uptake Inhibitors/therapeutic use , Paroxetine/therapeutic use , Sertraline/therapeutic use , Premature Ejaculation/drug therapy , Reaction Time/drug effects , Time Factors , Treatment Outcome , Ejaculation/drug effects , Middle Aged
10.
Int. braz. j. urol ; 45(6): 1216-1226, Nov.-Dec. 2019. tab, graf
Article in English | LILACS | ID: biblio-1056333

ABSTRACT

ABSTRACT Introduction and Objective: Several studies have focused on the treatment and recurrence of urethral diverticulum (UD). However, few investigations have addressed sexual function in patients with UD. Therefore, we sought to examine sexual function in women affected by UD. Materials and Methods: There were 108 accepted cases involving transvaginal diverticulectomy at our institution. Ultimately, 83 women were included for further analysis, only 61 of these women had sexual partners. We collected data for the Female Sexual Function Index (FSFI) from the female patients and the Male Sexual Health Questionnaire (MSHQ) from their male partners before and after surgery. Results: Preoperatively, the UD size affected the female patient's arousal and lubrication (p=0.04), and the UD location affected their satisfaction. However, no significant between-group differences were found in the total FSFI score. For all women, sexual activity improved after surgery (p=0.0087). In addition to improvements in arousal for women with a large UD, improvements in lubrication were affected by the UD size, number and shape, increases in satisfaction scores were impacted by the UD location and shape, and pain relief was linked to the UD number and shape. Analysis of the MSHQ results revealed no between-group differences among the male partners. Conclusion: Only the UD size and location affected sexual function in women with a small UD. Surgery could improve female sexual function but did not affect the sexual function of the patient's partners.


Subject(s)
Humans , Male , Female , Adult , Postoperative Complications/etiology , Sexual Dysfunction, Physiological/etiology , Urethral Diseases/surgery , Diverticulum/surgery , Postoperative Complications/physiopathology , Reference Values , Sexual Dysfunction, Physiological/physiopathology , Urethral Diseases/physiopathology , Sexual Partners , Sex Factors , Surveys and Questionnaires , Retrospective Studies , Risk Factors , Patient Satisfaction , Diverticulum/physiopathology , Ejaculation/physiology , Middle Aged
11.
Article in Korean | WPRIM | ID: wpr-766597

ABSTRACT

Male sexual dysfunction refers to a phenomenon in which a man experiences difficulty at any stage during the process of sexual intercourse. In general, erectile dysfunction is regarded as the most representative form of sexual dysfunction, but various other diseases can also be categorized as male sexual dysfunction, including sexual arousal disorder, decreased libido, ejaculation disorder, and Peyronie's disease. Causes of sexual dysfunction include chronic diseases, such as diabetes, hypertension, dyslipidemia, and obesity. In addition, some medications, surgical procedures, and traumas can cause sexual dysfunction. However, aging is the most important cause of male sexual dysfunction. To diagnose and treat elderly patients who complain of male sexual dysfunction, it is first necessary to become familiar with the characteristics of sexual dysfunction in elderly men. The prevalence rates of metabolic syndrome, hypertension, diabetes, dyslipidemia, coronary artery disease, stroke, and depression are higher among elderly men than among younger men; furthermore, the elderly are at a higher risk for the development of kidney, hepatic, spinal cord, and neurological diseases. Notably, anti-hypertensive agents can affect erectile function in elderly men: sexual dysfunction may be severe or the response to treatment may be poor. For satisfactory treatment, spousal factors should also be considered.


Subject(s)
Aged , Aging , Antihypertensive Agents , Chronic Disease , Coitus , Coronary Artery Disease , Depression , Diagnosis , Dyslipidemias , Ejaculation , Erectile Dysfunction , Eunuchism , Humans , Hypertension , Kidney , Libido , Male , Obesity , Penile Induration , Prevalence , Sexual Dysfunction, Physiological , Sexual Dysfunctions, Psychological , Spinal Cord , Stroke , Testosterone
12.
Article in English | WPRIM | ID: wpr-763489

ABSTRACT

The objective of this study was to assess the association between dietary antioxidant intake and semen quality parameters in infertile men. In this cross-sectional study, dietary antioxidant intake was evaluated in 175 infertile Iranian men by a validated dish-based 106-item semi-quantitative food frequency questionnaire. Men were asked to abstain from ejaculation for at least 72 hours before sample collection. Semen parameters were assessed by a sperm counting chamber and Terminal deoxynucleotidyl transferase dUTP nick end labeling assay methods. Linear quantile regression was used to determine the associations between antioxidant nutrient intake and semen quality parameters (including total sperm count, sperm density, total motility, DNA damage and DNA fragmentation). Mean age of study participants was 32.19 ± 2.34 years. Compared with the lowest quartile, men in the highest quartile of dietary β-carotene and vitamin C intake had lower sperm DNA fragmentation index (Ptrend = 0.042 and Ptrend = 0.03, respectively). Also, dietary intake of beta-cryptoxanthin had a positive association with sperm density (Ptrend = 0.02), and dietary lutein was associated with total sperm count (P(trend) = 0.045). Dietary intake of other antioxidants did not significantly correlate with the indicators related to the quantity and quality of sperm (p > 0.05). These data suggest that dietary intake of some of the antioxidants is associated with semen related parameters.


Subject(s)
Antioxidants , Ascorbic Acid , Cross-Sectional Studies , Cryptoxanthins , DNA , DNA Damage , DNA Fragmentation , DNA Nucleotidylexotransferase , Ejaculation , Humans , Infertility , Lutein , Male , Oxidative Stress , Semen Analysis , Semen , Sperm Count , Spermatozoa
13.
Article in English | WPRIM | ID: wpr-742365

ABSTRACT

Leukocytospermia is an ill-defined and poorly understood condition affecting up to 30% of male factor infertility. Current guidelines on leukocytospermia vary significantly, although it has been linked to increased rates of infertility, uncertainty about its clinical significance, diagnosis, and treatment remains. The guidelines are conflicting with sparse data scattered across different specialties and continents. This study aims to compare and contrast available international guidelines and recommendations. In addition to these guidelines, we sought to consolidate the findings of trials over the last several decades. English language articles on human observational studies, retrospective, prospective, clinical trials and randomized control trials were searched for using the following terms: “leukocytospermia, pyospermia, and male infertility.” Articles about treatment and management of leukocytospermia that were published between January 2010 and April 2018 were included, as well as four articles referenced in best practice and guideline statements from urological and andrological associations. Disagreements on this topic are highlighted as some guidelines describe no correlation between leukocytospermia and infertility while others show that treatment leads to improvement of sperm quality by many measures including improved pregnancy rate. Various treatments have been suggested including antibiotics, anti-inflammatory medications, and frequent ejaculation. There is a need for definitive characterization of Leukocytospermia as an infectious or inflammatory marker and a re-evaluation of the leukocyte concentration threshold. Additional studies investigating rates of conception as a measure of outcome are needed, to provide greater level of evidence and generalizability of leukocytopsermia management.


Subject(s)
Andrology , Anti-Bacterial Agents , Diagnosis , Ejaculation , Fertilization , Humans , Infertility , Infertility, Male , Leukocytes , Male , Male , Practice Guidelines as Topic , Pregnancy Rate , Prospective Studies , Retrospective Studies , Semen , Spermatozoa , Uncertainty
14.
Article in English | WPRIM | ID: wpr-742362

ABSTRACT

Finasteride is primarily used to treat benign prostatic hyperplasia (BPH) and male androgenetic alopecia (MAA). Five-alpha reductase inhibitors (5α-RIs) could induce male sexual dysfunction due to their effects on testosterone and dihydrotestosterone. There is evidence suggesting that 5α-RIs may independently increase the risk of erectile dysfunction (ED). However, many investigators believe that side effects of 5α-RIs will disappear with continuous treatment. Considerable controversy exists regarding the severity and persistence of side effects of finasteride on ED. The aim of this review was to summarize current research studies on finasteride associated with ED. The search strategy used each term of finasteride and ED against PubMed database to identify related studies. ED data reported from available trials for finasteride were summarized and reviewed. Although there is not enough evidence to prove the relationship between finasteride and ED, most studies in this review found that finasteride for BPH was correlated with ED. However, most studies included in this review revealed that finasteride for MAA was not correlated with ED. On the other hand, some studies reported side effects of finasteride associated with sexual dysfunction, including ED, male infertility, ejaculation problem, and loss of libido, even in MAA patients. Well-designed randomized controlled trials are needed to further determine the mechanism and effects of finasteride on ED. However, physicians should discuss with their patients possible long-term effects of finasteride on sexual function, although we do not have evidence showing that adverse events of sexual dysfunction are absolutely associated with 5α-RIs.


Subject(s)
Alopecia , Dihydrotestosterone , Ejaculation , Erectile Dysfunction , Finasteride , Hand , Humans , Infertility, Male , Libido , Male , Male , Oxidoreductases , Prostatic Hyperplasia , Research Personnel , Testosterone
15.
Article in English | WPRIM | ID: wpr-742355

ABSTRACT

PURPOSE: To determine the role of metabolic syndrome (MetS) as a risk factor for acquired premature ejaculation (PE) after considering the various risk factors, such as lower urinary tract symptoms, erectile dysfunction, hypogonadism, and prostatitis. MATERIALS AND METHODS: From January 2012 to January 2017, records of 1,029 men were analyzed. We performed multivariate analysis to identify risk factors for PE, including the covariate of age, marital status, International Prostate Symptom Score, International Index of Erectile Function (IIEF) score, National Institutes of Health-Chronic Prostatitis Symptom Index (NIH-CPSI) score, serum testosterone levels, and all components of MetS. Acquired PE was defined as self-reported intravaginal ejaculation latency time ≤3 minutes, and MetS was diagnosed using the modified National Cholesterol Education Program Adult Treatment Panel III criteria. RESULTS: Of 1,029 men, 74 subjects (7.2%) had acquired PE and 111 (10.8%) had MetS. Multivariate analysis showed that the IIEF overall satisfaction score (odds ratio [OR]=0.67, p<0.001), NIH-CPSI pain score (OR=1.07, p=0.035), NIH-CPSI voiding score (OR=1.17, p=0.032), and presence of MetS (OR=2.20, p=0.022) were significantly correlated with the prevalence of acquired PE. In addition, the Male Sexual Health Questionnaire for Ejaculatory Dysfunction scores and ejaculation anxiety scores progressively decreased as the number of components of MetS increased. CONCLUSIONS: MetS may be an independent predisposing factor for the development of acquired PE. Effective prevention and treatment of MetS could also be important for the prevention and treatment of acquired PE.


Subject(s)
Academies and Institutes , Adult , Anxiety , Causality , Cholesterol , Education , Ejaculation , Erectile Dysfunction , Humans , Hypogonadism , Lower Urinary Tract Symptoms , Male , Marital Status , Multivariate Analysis , Obesity , Premature Ejaculation , Prevalence , Prostate , Prostatitis , Reproductive Health , Risk Factors , Testosterone
16.
Biociencias ; 14(1): 51-64, 2019.
Article in Spanish | LILACS | ID: biblio-1006771

ABSTRACT

Introducción:La eyaculación femenina es un fenómeno caracterizado por la salida de un líquido, diferente a la orina, a través de la uretra, en el momento del orgasmo.Objetivos: Determinar la prevalencia de la eyaculación femenina, en un grupo de trabajadoras sexuales, y evaluar las características físicoquímicasdel fluido uretral expulsado.Materiales y métodos: Estudio descriptivo de corte transversal y prospectivo. Se enrolaron mujeres entre 18 y 39 años, atendidas en la consulta del investigador entre enero del 2012 y junio del 2016, en la consulta externa de una clínica privada de Armenia. Se incluyeron trabajadoras sexuales, sin incontinencia urinaria, sin infecciones de transmisión sexual o vaginosis, y no gestantes ni en puerperio. Se midió la prevalencia de la eyaculación femenina (expulsión de fluido a través de la uretra, durante la excitación y el orgasmo), y se evaluaron las características físicoquímicasde dicha secreción (ácido cítrico, fosfatasa ácida, fructosa, PSA, densidad, osmolaridad, pH, viscosidad y volumen).Resultados: Se evaluaron un total de 78 mujeres. La edad promedio fue de 32,6±8,2 años. La prevalencia de la eyaculación femenina fue del 69,23%. El volumen promedio deleyaculado fue de29,73±7,08 ml(rango entre 0 y 57 ml). En el análisis físico químico del líquido uretral se encontró que el color varió entre nacarado y gris opalescente, con una osmolaridad de 269,3±3,57 mOsm/Kg, pH de 5,4, densidad de 1.032 g/L, la viscosidad fue de 12,75 mm para el filamento y un volumen promedio de 29,73 cc; las sustancias más comunes fueron PSA 0,75 ng/ml con una concentración promedio de fructosa de 12 mmol/L y de ácido cítrico de 729 mg/L.Conclusión: La eyaculación femenina es una realidad en nuestra población, alrededor de dos de cada tres mujeres la presentan.


Introduction:Female ejaculation is a phenomenon characterized by the exit of a liquid, different fromurine, through the urethra, at the moment of orgasm.Objetives:To determine the prevalence of female ejaculation, in a group of sex workers, and to evaluate the physical and chemical characteristics of the ejected urethral fluid.Materials and methods: Descriptive study of cross section and prospective. Women between 18 and 39 years of age were enrolled, assisted in the researcher's consultation between January 2012 and June 2016, in the outpatient clinic of a private clinic in Armenia. Sex workers were included, without urinary incontinence, without sexually transmitted infections or vaginosis, and not pregnant or in puerperium. The prevalence of female ejaculation (expulsion of fluid through the urethra during excitement and orgasm) was measured and thephysical and chemical characteristics of this secretion were evaluated (citric acid, acid phosphatase, fructose, PSA, density, osmolarity, pH, viscosity and volume).Results: A total of 78 women were evaluated. The average age was 32.6 ± 8.2 years. The prevalence of female ejaculation was 69.23%. The average volume of the ejaculate was 29.73 ml. In the physical-chemical analysis of the urethral fluid it was found that the color varied between pearly and opalescent gray, with an osmolarity of 269.3 ± 3.57 mOsm / Kg, pH of 5.4, density of 1.032 g / L, viscosity it was 12.75 mm for the filament and an average volume of 29.73 cc; the most common substances were PSA 0.75 ng / ml with an average fructose concentration of 12 mmol / L and citric acid of 729 mg / L.Conclusión: Female ejaculation is a reality in our population, about two out of three women present it.


Subject(s)
Female , Orgasm , Ejaculation
17.
Int. braz. j. urol ; 44(5): 972-980, Sept.-Oct. 2018. tab, graf
Article in English | LILACS | ID: biblio-975624

ABSTRACT

ABSTRACT Purpose: To evaluate the impact of overactive bladder disorder on patients diagnosed with retrograde ejaculation. Materials and Methods: Retrospective analysis of prospective collected database made. Questionnaires conducted in urology polyclinics in five different centers. Main Outcome Measure(s): International Index of Erectile Function - 5 (IIEF - 5), Overactive Bladder 8 - Question Awareness Tool (OAB - V8), urodynamics, semen analysis. The participants of the study were n = 120 patients. There was retrograde ejaculation (RE) in only n = 47 patients (non / minimal symptomatic patients), n = 73 patients had RE and overactive (OAB) complaints (symptomatic patients) and received anticholinergic treatment (trospium), n = 37 control group patients who only had OAB and received an anticholinergic. Results: While no difference was observed in overactive bladder examination and urodynamic values between the non / minimal symptomatic group and the symptomatic group (p > 0.05), sperm was detected and identified as fructose positive in post - ejaculation urine in the symptomatic group. Thus, it was possible to demonstrate the differences between symptomatic patients and non - symptomatic patients. Consequently, following three - month daily treatment with trospium 30 mg 2 x 1 in the control group and the symptomatic group, it was observed that an evident increase was observed in the sperm count and ejaculate volume in the symptomatic group and that no change was observed in the control group (p < 0.05). Conclusion: This clinical study is the first of its kind in terms of revealing the coexistence of RE with OAB upon performing urodynamics and showing that treatment is possible in selected patients.


Subject(s)
Humans , Male , Adult , Oligospermia/complications , Cholinergic Antagonists/therapeutic use , Ejaculation/physiology , Urinary Bladder, Overactive/complications , Oligospermia/physiopathology , Oligospermia/drug therapy , Sperm Count , Case-Control Studies , Retrospective Studies , Urinary Bladder, Overactive/physiopathology , Urinary Bladder, Overactive/drug therapy
18.
National Journal of Andrology ; (12): 236-240, 2018.
Article in Chinese | WPRIM | ID: wpr-689770

ABSTRACT

<p><b>Objective</b>To investigate the diagnosis and treatment of ejaculatory duct cyst.</p><p><b>METHODS</b>This study included 2 male patients present at the hospital for hemospermia and abnormal sensation in the perineal region in July and August 2014. Both underwent transrectal ultrasonography, routine semen examination, CT, MRI, cystoscopy, and vesiculography before transurethral fenestration of the cysts and pathological examination of the cyst wall specimens. Analyses were made on the clinical presentations, imaging features, pathological characteristics, differential diagnosis and treatment of ejaculatory duct cyst and relevant literature was reviewed.</p><p><b>RESULTS</b>The cyst wall was mainly composed of smooth muscle, the inner wall lined with pseudostratified ciliated columnar epithelia, and with positive expressions of CD10 and Muc6 proteins on immunohistochemical staining, which indicated renal iatrogenic ejaculatory duct cyst. The patients were followed up for 18 and 20 months, respectively. All symptoms disappeared and no recurrence occurred after surgery. Routine semen examination for the two patients showed the semen volumes to be 3.5 and 3.1 ml, sperm concentrations 35 and 32 ×10⁶/ml, grade a sperm 32.0 and 26.0%, grade b sperm 18.0 and 31.0%, and semen liquidation time 30 and 34 minutes, respectively.</p><p><b>CONCLUSIONS</b>Pelvic cystic masses can be detected by transrectal ultrasonography, CT and MRI, but definite diagnosis relies on vesiculography, pathological examination and immunohistochemical staining. Transurethral fenestration is safe and effective for the treatment of ejaculation duct cyst.</p>


Subject(s)
Cysts , Diagnostic Imaging , Pathology , General Surgery , Ejaculation , Ejaculatory Ducts , Diagnostic Imaging , Pathology , General Surgery , Genital Diseases, Male , Diagnostic Imaging , Pathology , General Surgery , Hemospermia , Humans , Magnetic Resonance Imaging , Male , Neoplasm Recurrence, Local , Semen , Semen Analysis , Sperm Count , Spermatozoa , Tomography, X-Ray Computed , Ultrasonography
19.
National Journal of Andrology ; (12): 268-271, 2018.
Article in Chinese | WPRIM | ID: wpr-689765

ABSTRACT

Premature ejaculation (PE), as one of the most common male sexual dysfunctions, has a serious negative impact on the sexual satisfaction of the patients and their sexual partners. Lifelong PE is a most common type and a current focus of research as well. The etiology and pathogenesis of this disease are not yet clear and genetic factors are considered to be closely related to lifelong PE. Studies show that the 5-hydroxytryptamine transporter (5-HTT) gene plays an important role in the development and progression of lifelong premature ejaculation and the 5-HTT-linked polymorphic region (5-HTTLPR) has attracted much attention in recent years. This article presents an overview on the correlation between 5-HTTLPR and lifelong PE.


Subject(s)
Adult , Ejaculation , Humans , Male , Polymorphism, Genetic , Premature Ejaculation , Genetics , Serotonin Plasma Membrane Transport Proteins , Genetics
20.
National Journal of Andrology ; (12): 360-363, 2018.
Article in Chinese | WPRIM | ID: wpr-689749

ABSTRACT

Seminal vesicles are involved in semen accumulation in the process of ejaculation, contracting and releasing seminal vesicle fluid accounting for about 50-80% of the semen, and the fructose in their secretions is an indispensable nutrient for sperm maturation. Thus, seminal vesicles are important male accessary glands closely related with the quality and quantity of sperm. In the process of semen accumulation, sympathetic and parasympathetic nerves participate in the regulation of the secretory function of seminal vesicle epithelia and the contraction of the smooth muscle layer as well as the distribution of adrenonergic, cholinergic, dopaminergic and various neurotransmitter receptors in the seminal vesicle epithelia and smooth muscle layer, which play a significant role in male fertility. This review discusses the neurophysiological effects of seminal vesicles in ejaculation.


Subject(s)
Animals , Ejaculation , Physiology , Male , Semen , Physiology , Semen Analysis , Seminal Vesicles , Physiology , Spermatozoa
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