Mini symposium: non-surgical sperm recovery: Part II. Treatment of retrograde ejaculation and anejaculation

Kamischke, Axel

doi:10.1093/humupd/5.5.448

Cited by 90 publications

(15 citation statements)

References 178 publications

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“…As Kamischke and Nieschlag noted in their review (12), neurogenic causes, such as pelvic surgery and diabetes mellitus, are responsible for a large number of RE cases. Among our patients, 60% had diabetes mellitus and 24% had undergone retroperitoneal lymph node dissection as part of surgical treatment for rectal carcinoma.…”

Section: Discussionmentioning

confidence: 99%

Randomized crossover trial of amoxapine versus vitamin B12 for retrograde ejaculation

Nagao

Tai

et al. 2017

Int. braz j urol.

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Objective To compare the efficacy and safety of amoxapine and vitamin B12 for treating retrograde ejaculation (RE).Materials and Methods Between May 2009 and November 2012, this open-label, randomized, crossover study enrolled 26 men suffering with RE at Department of Reproductive Medicine, Omori Hospital. Patients were randomly allocated into two groups (n=13 each). The amoxapine-B12 group received amoxapine (50 mg daily for 4 weeks, orally) followed (after a 1-week washout period) by vitamin B12 (500 μg three-times daily for 4 weeks). The B12-amoxapine group received the opposite regimen. All patients masturbated to ejaculation at least twice during each treatment period. The primary outcome was antegrade ejaculation of semen, as reported by the patient, on more than one occasion during either treatment period (defined as treatment success). Any adverse events were noted. Success rates were compared between treatments using Fisher’s exact test.Results One patient (B12-amoxapine group) withdrew for personal reasons (breakdown of marital relations); all other patients completed the study. Overall success rate was 88% (22/25). Success rate was higher for amoxapine than for vitamin B12 (80%, 20/25 vs 16%, 4/25; P<0.0001). 18 patients were responsive to amoxapine but not to vitamin B12, 2 patients were responsive to vitamin B12 but not amoxapine, 2 patients were responsive to both drugs, and 3 patients had no response to either drug. One patient (4%) reported sleepiness and 2 (8%) reported constipation while receiving amoxapine. No adverse events were reported during vitamin B12 treatment.Conclusions Amoxapine may be an effective, safe and well-tolerated therapy for RE.

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Section: Discussionmentioning

confidence: 99%

Randomized crossover trial of amoxapine versus vitamin B12 for retrograde ejaculation

Nagao

Tai

et al. 2017

Int. braz j urol.

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“…Gradually acidifying the pH can lead to a progressive loss of sperm motility. However, sperm velocity is slightly increased by mild alkalinization (Kamischke and Nieschlag, 1999;WHO, 1999). In the present study, the spermicidal tests of the crude extract from the root of PTW and N-9 were carried out under the original pH and the adjusted pH on the motility of sperm.…”

Section: Discussionmentioning

confidence: 99%

Effects of the crude extract of Polygala tenuifolia Willd on human sperm in vitro

Wang

Jia

et al. 2011

J. Zhejiang Univ. Sci. B

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Abstract:The aim of the present study is to analyze sperm membrane changes and the spermicidal effect in treatment with the crude extract from Polygala tenuifolia Willd (PTW) in vitro. The root of PTW was extracted in distilled water. Normal human spermatozoa were used to assess the spermicidal activity (Sander-Cramer assay) of the extract from the PTW root. The hypo-osmotic swelling (HOS) test and the eosin Y (EY) staining were used to detect the integrity of sperm membrane and vitality. The sperm chromatin dispersion (SCD) test was performed to determine sperm DNA integrity. N-9 was used as a reference standard and semen added to physiological saline was used as the control. Semen samples were donated by 42 healthy fertile men. The crude extract from the root of PTW could immobilize and kill 100% spermatozoa within 20 s in vitro at the concentrations of 20.0 and 10.0 mg/ml; at the concentration of 5.0 mg/ml, spermatozoa were immobilized in (39.5±3.2) s. In the groups of the crude extract from the root of PTW and N-9 solution, the rate of the normal HOS (tails swollen) and the white head (unstained) was 0%, and the rate of the abnormal HOS (tails unswollen) and red head (stained) was 100%. Sperm DNA fragmentation showed no change in exposure to the crude extract from the root of PTW and N-9 solution. The sperm revival test did not show any spermatozoa that recovered their motilities. The rapid spermicidal activity of the crude extract from the root of PTW in vitro may occur by the disruption of the sperm membrane integrity.

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“…Among the 825 remaining semen analyses associated with a PEU test, only the first analysis was selected for each patient, leaving 632 patients. We then excluded 28 patients because of incomplete records (missing history and/or ultrasound), 58 patients because of obstructive or non-obstructive azoospermia, as well as 139 patients who presented known causes or risk factors for retrograde ejaculation or low semen volume: hormonal causes (low androgen level, hyperprolactinemia), previous pelvic and retroperitoneal surgery, reduced secretion from one (absent) or both (utricle cyst) seminal vesicles, presence of a neurological deficit (multiple sclerosis), diabetes, or pharmacological treatments (antihypertensive agents, alpha-receptor blockers, antipsychotics, antidepressants) [10, 15, 17–19]. All previous inclusion criteria were used for selecting patients with retrospective low semen volume (< 2 mL) and prospective patients with normal semen volume (≥ 2 mL).…”

Section: Methodsmentioning

confidence: 99%

Diagnosis of Partial Retrograde Ejaculation in Non-Azoospermic Infertile Men with Low Semen Volume

et al. 2017

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In non-azoospermic patients with low semen volume (LSV), looking for partial retrograde ejaculation (PRE) by searching sperm in the postejaculatory urine (PEU) is required. The use of a retro-ejaculatory index (R-ratio) was suggested to define PRE, but none of the studies indicated a specific threshold above which PRE must be considered. Our objective was to propose a threshold value for the R-ratio as indicative of PRE in patients with LSV selected to be devoid of any known causes or risk factors for retrograde ejaculation or LSV. Among our data base (2000–2009) including 632 patients with PEU, 245 male patients from infertile couples who had had a first semen analysis with LSV (< 2mL) and a second semen analysis associated with PEU, were selected on the previous criteria. A prospective control group was randomly constituted (2007–2008) of 162 first consulting male patients from infertile couples, with a normal semen volume (≥ 2mL) on a first semen analysis and who accepted to collect PEU with their usual second semen analysis, selected on the previous criteria. To define an R-ratio threshold indicative of PRE, we used a ROC curve analysis and a regression tree based on a classification and regression tree (CART) algorithm. Of the 245 LSV patients, 146 still presented low semen volume (< 2 mL) on the second semen analysis. From the use of the CART algorithm, two low (1.5% and 2.8%) and two high R-values (7.1% and 8.3%) were defined, according to the lower reference limit for semen volume of 2.0 mL (WHO 1999) or 1.5 mL (WHO 2010) respectively. As only one or no patient with normal semen volume was observed above the two high R-values, we suggest an R-value higher than the range of [7.1–8.3]% as indicative of PRE until confirmation by a prospective multicenter study.

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Mini symposium: non-surgical sperm recovery: Part II. Treatment of retrograde ejaculation and anejaculation

Cited by 90 publications

References 178 publications

Randomized crossover trial of amoxapine versus vitamin B12 for retrograde ejaculation

Randomized crossover trial of amoxapine versus vitamin B12 for retrograde ejaculation

Effects of the crude extract of Polygala tenuifolia Willd on human sperm in vitro

Diagnosis of Partial Retrograde Ejaculation in Non-Azoospermic Infertile Men with Low Semen Volume

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