Evidence of a new pattern of ejaculation in men with spinal cord injury: ejaculation dyssynergia and implications for fertility

Jm, Soler Fernández; Jg, Previnaire; Mieusset, R.

doi:10.1038/sc.2016.78

Cited by 16 publications

(10 citation statements)

References 22 publications

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“…Initial trials in the clinical setting can also evaluate men for possible retrograde ejaculation 57,58,72 or for the presence of sperm in the prostatic urethra as a stand-alone ejaculation, 73,74 which can be misinterpreted as a lack of ejaculation or orgasm.…”

Section: More Advanced Techniques To Attain Orgasm and Ejaculationmentioning

confidence: 99%

“…The drug is ingested 45 minutes before sexual activity with vibrostimulation; the dose is started at 5 mg and increased gradually (in separate sessions) up to 25 mg or 30 mg. According to Soler et al, 73,74 midodrine is successful in increasing ejaculation and facilitating orgasm in men with SCI.…”

Section: More Advanced Techniques To Attain Orgasm and Ejaculationmentioning

confidence: 99%

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Improving Sexual Satisfaction in Persons with Spinal Cord Injuries: Collective Wisdom

Alexander

Courtois

Elliott

et al. 2017

Topics in Spinal Cord Injury Rehabilitation

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Sexuality is an important part of life, and it is necessary for clinicians to have a specific format in which to address sexual issues with their patients. A systematic approach to working with patients with spinal cord injury (SCI) to improve their sexual functioning and response is presented. Nonjudgmental communication about sexual concerns is followed by a detailed pre-and postinjury medical, psychosocial, and sexual history. If preexisting sexual issues are present, it is recommended that the patient be referred for assessment and treatment of these separate from the patient's SCI-related concerns. Physical examination, with special attention to issues that could impact the patient's sexuality, is followed by a detailed neurologic assessment with specific attention to the T11-L2 and S3-5 spinal segments. Education of the patient with regard to his or her sexual potential and the need to be flexible in his or her sexual repertoire is followed by self-exploration and practice. Routine follow-up is suggested after patient's initial sexual exploration. Treatment of confounding and iatrogenic factors related to SCI is followed by more sexual experience. Afterwards the clinician is encouraged to use simple techniques to treat sexual issues and follow-up with the patient to assess the outcome. A structured program utilizing vibratory stimulation with or without midodrine is described as a way to achieve ejaculation and potentially orgasm, and techniques for treating severe autonomic dysreflexia are discussed. If these interventions do not alleviate the patient's sexual concerns, the clinician should refer the patient for more specialized consultation.

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Section: More Advanced Techniques To Attain Orgasm and Ejaculationmentioning

confidence: 99%

Section: More Advanced Techniques To Attain Orgasm and Ejaculationmentioning

confidence: 99%

Improving Sexual Satisfaction in Persons with Spinal Cord Injuries: Collective Wisdom

Alexander

Courtois

Elliott

et al. 2017

Topics in Spinal Cord Injury Rehabilitation

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show abstract

“…About 16% of men with SCI are able to ejaculate through sexual stimulation. 16 Many, however, require some form of assistive device. It is also important for PCPs to take a good history and ensure that alcohol and antispasticity agents (such as baclofen and diazepam) do not interfere with impaired reflex erection, ejaculation, and orgasms.…”

Section: Ejaculatory Dysfunctionmentioning

confidence: 99%

A Primary Care Provider’s Guide to Sexual Health for Individuals With Spinal Cord Injury

Hough

Cordes

Goetz

et al. 2020

Topics in Spinal Cord Injury Rehabilitation

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The collaboration with individuals regarding their sexual health is an important component of patient-centered health care. However, talking about sexual health in primary care settings is an area not fully addressed as a result of time limitations, medical task prioritization, awareness or knowledge deficit, and discomfort with the topic of sexuality. A critical shift in professional focus from disease and medical illness to the promotion of health and wellness is a prerequisite to address sexual health in the primary care setting. This article provides guidance for practitioners in primary care settings who are caring for persons with spinal cord injury. Clinicians should seize the opportunity during the encounter to reframe the experience of disability as a social construct status, moving away from the narrow view of medical condition and “find it, fix it” to a broader understanding that provides increased access to care for sexual health and sexual pleasure.

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“…Some patients may report sporadic events of nocturnal emission or ejaculation induced by severe emotional excitement unrelated to sexual activity. A second, simple approach to obtain spermatozoa from psychogenic AE is through vigorous prostatic massage [ 95 ] or prostatic urethra catheterization [ 96 ]. The presence of spermatozoa in the prostatic urethra may be due to ejaculation dyssynergia ( Fig.…”

Section: Treatmentmentioning

confidence: 99%

Delayed Ejaculation: Pathophysiology, Diagnosis, and Treatment

Abdel‐Hamid

Ali

2018

World J Mens Health

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Delayed ejaculation (DE) is a poorly defined and uncommon form of male sexual dysfunction, characterized by a marked delay in ejaculation or an inability to achieve ejaculation. It is often quite concerning to patients and their partners, and sometimes frustrates couples' attempts to conceive. This article aims to review the pathophysiology of DE and anejaculation (AE), to explore our current understanding of the diagnosis, and to present the treatment options for this condition. Electronic databases were searched from 1966 to October 2017, including PubMed (MEDLINE) and Embase. We combined “delayed ejaculation,” “retarded ejaculation,” “inhibited ejaculation,” or “anejaculation” as Medical Subject Headings (MeSH) terms or keywords with “epidemiology,” “etiology,” “pathophysiology,” “clinical assessment,” “diagnosis,” or “treatment.” Relevant sexual medicine textbooks were searched as well. The literature suggests that the pathophysiology of DE/AE is multifactorial, including both organic and psychosocial factors. Despite the many publications on this condition, the exact pathogenesis is not yet known. There is currently no single gold standard for diagnosing DE/AE, as operationalized criteria do not exist. The history is the key to the diagnosis. Treatment should be cause-specific. There are many approaches to treatment planning, including various psychological interventions, pharmacotherapy, and specific treatments for infertile men. An approved form of drug therapy does not exist. A number of approaches can be employed for infertile men, including the collection of nocturnal emissions, prostatic massage, prostatic urethra catheterization, penile vibratory stimulation, probe electroejaculation, sperm retrieval by aspiration from either the vas deferens or the epididymis, and testicular sperm extraction.

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Evidence of a new pattern of ejaculation in men with spinal cord injury: ejaculation dyssynergia and implications for fertility

Cited by 16 publications

References 22 publications

Improving Sexual Satisfaction in Persons with Spinal Cord Injuries: Collective Wisdom

Improving Sexual Satisfaction in Persons with Spinal Cord Injuries: Collective Wisdom

A Primary Care Provider’s Guide to Sexual Health for Individuals With Spinal Cord Injury

Delayed Ejaculation: Pathophysiology, Diagnosis, and Treatment

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