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Haim Yaffe - One of the best experts on this subject based on the ideXlab platform.
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comparison between the first and the second electroejaculate qualities obtained from neurologically intact men suffering from Anejaculation
Human Reproduction, 2005Co-Authors: Yedidya Hovav, Irit Kafka, Ohn Sibirsky, Rafael N Pollack, Galit Elgavish, Haim YaffeAbstract:BACKGROUND: Electroejaculation is an artificial method used to procure semen from neurologically intact men suffering from Anejaculation that have failed other treatments. In order to establish the consistency of semen parameters in repeated electroejaculations, we compared retrospectively the quality of the first and the second electroejaculates of anejaculatory men who were not suffering from any known neurological problems. METHODS: Between 1995 and 2004, 59 neurologically intact men suffering from Anejaculation underwent multiple electroejaculations. Sperm quality of the first and the second ejaculates was compared. RESULTS: A significant difference of 0.33 ± 0.16 ml in the volume of the antegrade portion was found (P = 0.023). The results showed no significant difference in the concentration, motility, count and total motile count of the antegrade ejaculates. In retrograde ejaculates there were no significant differences in the count, motility and total motile count. Neither was there any difference in the total count and the total motile count of both fractions. CONCLUSIONS: Electroejaculation is a reliable method for semen procurement in men suffering from Anejaculation. Since semen parameters are consistent, repeated procedures are not justified for improving the sperm quality in anejaculatory, neurologically intact men.
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short communication comparison between the first and the second electroejaculate qualities obtained from neurologically intact men suffering from Anejaculation
2005Co-Authors: Yedidya Hovav, Irit Kafka, Ohn Sibirsky, Rafael N Pollack, Galit Elgavish, Haim YaffeAbstract:BACKGROUND: Electroejaculation is an artificial method used to procure semen from neurologically intact men suffering from Anejaculation that have failed other treatments. In order to establish the consistency of semen parameters in repeated electroejaculations, we compared retrospectively the quality of the first and the second electroejaculates of anejaculatory men who were not suffering from any known neurological problems. METHODS: Between 1995 and 2004, 59 neurologically intact men suffering from Anejaculation underwent multiple electroejaculations. Sperm quality of the first and the second ejaculates was compared. RESULTS: A significant difference of 0.33 6 0.16ml in the volume of the antegrade portion was found (P 5 0.023). The results showed no significant difference in the concentration, motility, count and total motile count of the antegrade ejaculates. In retrograde ejaculates there were no significant differences in the count, motility and total motile count. Neither was there any difference in the total count and the total motile count of both fractions. CONCLUSIONS: Electroejaculation is a reliable method for semen procurement in men suffering from Anejaculation. Since semen parameters are consistent, repeated procedures are not justified for improving the sperm quality in anejaculatory, neurologically intact men.
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Nocturnal sperm emission in men with psychogenic Anejaculation.
Fertility and sterility, 1999Co-Authors: Yedidya Hovav, Mary Dan-goor, Haim Yaffe, Miriam AlmagorAbstract:Abstract Objective: To evaluate sperm characteristics and fertilization potential in sperm obtained from nocturnal emission in men with psychogenic Anejaculation. Design: Retrospective study. Setting: In Vitro Fertilization Unit, Bikur Cholim Hospital, Jerusalem, Israel. Patient(s): Six men with psychogenic Anejaculation. Intervention(s): Nocturnal emission, electroejaculation, sperm cryopreservation, and assisted reproduction technologies. Main Outcome Measure(s): Semen analysis, intracytoplasmic sperm injection (ICSI), fertilization rates. Result(s): In four patients, the concentration and motility of sperm obtained from freeze-thawed nocturnal emission were decreased compared with sperm from electroejaculation. Fertilization rates after ICSI using the nocturnal emission sperm were relatively low (45%). One clinical pregnancy was achieved after intrauterine insemination. Conclusion(s): The quality of sperm from nocturnal emissions is variable, but it can be used in assisted reproduction procedures to avoid aggressive procedures such as electroejaculation or testis biopsy.
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electroejaculation and assisted fertility in men with psychogenic Anejaculation
Fertility and Sterility, 1996Co-Authors: Yedidya Hovav, Haim Yaffe, Y Shotland, Miriam AlmagorAbstract:Objectives To evaluate sperm characteristics and fertility potential in ejaculates obtained after electroejaculation in men with psychogenic Anejaculation. Design Retrospective clinical study. Setting In Vitro Fertilization Unit, Bikur Cholim Hospital, Jerusalem, Israel. Patients Twenty men with psychogenic Anejaculation who underwent 55 sessions of electroejaculation and their spouses. Interventions Electroejaculation, assisted reproduction technologies. Main Outcome Measures Semen analysis, IVF, intracytoplasmic injection (ICSI), fertilization rates, and pregnancy rates. Results In all patients, sperm density and motility rates were unsatisfactory (98±127 × 10 6 with 14.6%±15% motility in the antegrade portions and 42±42 X 10 6 with 9.7%±15.6% motility in the retrograde samples). Intrauterine inseminations performed in eight couples did not result in a pregnancy. Four couples underwent IVF-ET treatments. Two pregnancies were achieved with overall success rates of 22% per cycle. Five couples were treated using the ICSI procedure. Although good quality embryos were transferred, none of the treatments resulted in a pregnancy. Conclusions Psychogenic failure to ejaculate may be treated by electroejaculation. However, the average motility of the sperm obtained is diminished. The combination of electroejaculation with IVF, including the ICSI procedure, should improve chances of fertilization and pregnancy in these cases.
Yedidya Hovav - One of the best experts on this subject based on the ideXlab platform.
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comparison between the first and the second electroejaculate qualities obtained from neurologically intact men suffering from Anejaculation
Human Reproduction, 2005Co-Authors: Yedidya Hovav, Irit Kafka, Ohn Sibirsky, Rafael N Pollack, Galit Elgavish, Haim YaffeAbstract:BACKGROUND: Electroejaculation is an artificial method used to procure semen from neurologically intact men suffering from Anejaculation that have failed other treatments. In order to establish the consistency of semen parameters in repeated electroejaculations, we compared retrospectively the quality of the first and the second electroejaculates of anejaculatory men who were not suffering from any known neurological problems. METHODS: Between 1995 and 2004, 59 neurologically intact men suffering from Anejaculation underwent multiple electroejaculations. Sperm quality of the first and the second ejaculates was compared. RESULTS: A significant difference of 0.33 ± 0.16 ml in the volume of the antegrade portion was found (P = 0.023). The results showed no significant difference in the concentration, motility, count and total motile count of the antegrade ejaculates. In retrograde ejaculates there were no significant differences in the count, motility and total motile count. Neither was there any difference in the total count and the total motile count of both fractions. CONCLUSIONS: Electroejaculation is a reliable method for semen procurement in men suffering from Anejaculation. Since semen parameters are consistent, repeated procedures are not justified for improving the sperm quality in anejaculatory, neurologically intact men.
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short communication comparison between the first and the second electroejaculate qualities obtained from neurologically intact men suffering from Anejaculation
2005Co-Authors: Yedidya Hovav, Irit Kafka, Ohn Sibirsky, Rafael N Pollack, Galit Elgavish, Haim YaffeAbstract:BACKGROUND: Electroejaculation is an artificial method used to procure semen from neurologically intact men suffering from Anejaculation that have failed other treatments. In order to establish the consistency of semen parameters in repeated electroejaculations, we compared retrospectively the quality of the first and the second electroejaculates of anejaculatory men who were not suffering from any known neurological problems. METHODS: Between 1995 and 2004, 59 neurologically intact men suffering from Anejaculation underwent multiple electroejaculations. Sperm quality of the first and the second ejaculates was compared. RESULTS: A significant difference of 0.33 6 0.16ml in the volume of the antegrade portion was found (P 5 0.023). The results showed no significant difference in the concentration, motility, count and total motile count of the antegrade ejaculates. In retrograde ejaculates there were no significant differences in the count, motility and total motile count. Neither was there any difference in the total count and the total motile count of both fractions. CONCLUSIONS: Electroejaculation is a reliable method for semen procurement in men suffering from Anejaculation. Since semen parameters are consistent, repeated procedures are not justified for improving the sperm quality in anejaculatory, neurologically intact men.
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Nocturnal sperm emission in men with psychogenic Anejaculation.
Fertility and sterility, 1999Co-Authors: Yedidya Hovav, Mary Dan-goor, Haim Yaffe, Miriam AlmagorAbstract:Abstract Objective: To evaluate sperm characteristics and fertilization potential in sperm obtained from nocturnal emission in men with psychogenic Anejaculation. Design: Retrospective study. Setting: In Vitro Fertilization Unit, Bikur Cholim Hospital, Jerusalem, Israel. Patient(s): Six men with psychogenic Anejaculation. Intervention(s): Nocturnal emission, electroejaculation, sperm cryopreservation, and assisted reproduction technologies. Main Outcome Measure(s): Semen analysis, intracytoplasmic sperm injection (ICSI), fertilization rates. Result(s): In four patients, the concentration and motility of sperm obtained from freeze-thawed nocturnal emission were decreased compared with sperm from electroejaculation. Fertilization rates after ICSI using the nocturnal emission sperm were relatively low (45%). One clinical pregnancy was achieved after intrauterine insemination. Conclusion(s): The quality of sperm from nocturnal emissions is variable, but it can be used in assisted reproduction procedures to avoid aggressive procedures such as electroejaculation or testis biopsy.
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antisperm antibodies in men with psychogenic Anejaculation
Archives of Andrology, 1998Co-Authors: Miriam Almagor, Yedidya Hovav, Mary Dangoor, Irit Kafka, Y ShotlandAbstract:Antisperm autoantibodies were determined in 16 men suffering from psychogenic Anejaculation who underwent assisted reproduction treatments. Blood and semen samples were collected after transrectal electroejaculation and antisperm antibodies in serum and on the surface of motile spermatozoa were measured using the direct and indirect immunobead binding test. Five men (31%) were found positive for antisperm antibodies. The majority of antibodies were directed against the sperm heads. Surface antibodies were mainly IgA isotype whereas serum antibodies were IgG isotype. These results suggest that psychogenic Anejaculation might be associated with increased incidence of antisperm autoimmunity.
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electroejaculation and assisted fertility in men with psychogenic Anejaculation
Fertility and Sterility, 1996Co-Authors: Yedidya Hovav, Haim Yaffe, Y Shotland, Miriam AlmagorAbstract:Objectives To evaluate sperm characteristics and fertility potential in ejaculates obtained after electroejaculation in men with psychogenic Anejaculation. Design Retrospective clinical study. Setting In Vitro Fertilization Unit, Bikur Cholim Hospital, Jerusalem, Israel. Patients Twenty men with psychogenic Anejaculation who underwent 55 sessions of electroejaculation and their spouses. Interventions Electroejaculation, assisted reproduction technologies. Main Outcome Measures Semen analysis, IVF, intracytoplasmic injection (ICSI), fertilization rates, and pregnancy rates. Results In all patients, sperm density and motility rates were unsatisfactory (98±127 × 10 6 with 14.6%±15% motility in the antegrade portions and 42±42 X 10 6 with 9.7%±15.6% motility in the retrograde samples). Intrauterine inseminations performed in eight couples did not result in a pregnancy. Four couples underwent IVF-ET treatments. Two pregnancies were achieved with overall success rates of 22% per cycle. Five couples were treated using the ICSI procedure. Although good quality embryos were transferred, none of the treatments resulted in a pregnancy. Conclusions Psychogenic failure to ejaculate may be treated by electroejaculation. However, the average motility of the sperm obtained is diminished. The combination of electroejaculation with IVF, including the ICSI procedure, should improve chances of fertilization and pregnancy in these cases.
Miriam Almagor - One of the best experts on this subject based on the ideXlab platform.
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Nocturnal sperm emission in men with psychogenic Anejaculation.
Fertility and sterility, 1999Co-Authors: Yedidya Hovav, Mary Dan-goor, Haim Yaffe, Miriam AlmagorAbstract:Abstract Objective: To evaluate sperm characteristics and fertilization potential in sperm obtained from nocturnal emission in men with psychogenic Anejaculation. Design: Retrospective study. Setting: In Vitro Fertilization Unit, Bikur Cholim Hospital, Jerusalem, Israel. Patient(s): Six men with psychogenic Anejaculation. Intervention(s): Nocturnal emission, electroejaculation, sperm cryopreservation, and assisted reproduction technologies. Main Outcome Measure(s): Semen analysis, intracytoplasmic sperm injection (ICSI), fertilization rates. Result(s): In four patients, the concentration and motility of sperm obtained from freeze-thawed nocturnal emission were decreased compared with sperm from electroejaculation. Fertilization rates after ICSI using the nocturnal emission sperm were relatively low (45%). One clinical pregnancy was achieved after intrauterine insemination. Conclusion(s): The quality of sperm from nocturnal emissions is variable, but it can be used in assisted reproduction procedures to avoid aggressive procedures such as electroejaculation or testis biopsy.
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antisperm antibodies in men with psychogenic Anejaculation
Archives of Andrology, 1998Co-Authors: Miriam Almagor, Yedidya Hovav, Mary Dangoor, Irit Kafka, Y ShotlandAbstract:Antisperm autoantibodies were determined in 16 men suffering from psychogenic Anejaculation who underwent assisted reproduction treatments. Blood and semen samples were collected after transrectal electroejaculation and antisperm antibodies in serum and on the surface of motile spermatozoa were measured using the direct and indirect immunobead binding test. Five men (31%) were found positive for antisperm antibodies. The majority of antibodies were directed against the sperm heads. Surface antibodies were mainly IgA isotype whereas serum antibodies were IgG isotype. These results suggest that psychogenic Anejaculation might be associated with increased incidence of antisperm autoimmunity.
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electroejaculation in combination with intracytoplasmic sperm injection in patients with psychogenic Anejaculation results in lower fertilization rates
Fertility and Sterility, 1998Co-Authors: M Yedidya D Hovav, Mary Dangoor, M Irit D Kafka, M Haim D Yaffe, Miriam AlmagorAbstract:Abstract Objective: To evaluate the outcome of intracytoplasmic sperm injection (ICSI) with sperm obtained by electroejaculation in men with psychogenic Anejaculation. Design: Retrospective clinical study. Setting: In Vitro Fertilization Unit, Bikur Cholim Hospital, Jerusalem, Israel. Patient(s): Seven men with psychogenic Anejaculation who underwent 16 sessions of electroejaculation in combination with ICSI. Intervention(s): Electroejaculation, ICSI. Main Outcome Measure(s): Semen analysis, ICSI, fertilization rates. Result(s): All patients had poor sperm motility. One hundred forty-seven oocytes were injected, with a fertilization rate of 27% (39/142). One ongoing pregnancy was achieved. Conclusion(s): Sperm obtained by electroejaculation have low motility and reduced fertilization potential. Nevertheless, ICSI should be offered to improve the possibility of successful pregnancy.
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electroejaculation and assisted fertility in men with psychogenic Anejaculation
Fertility and Sterility, 1996Co-Authors: Yedidya Hovav, Haim Yaffe, Y Shotland, Miriam AlmagorAbstract:Objectives To evaluate sperm characteristics and fertility potential in ejaculates obtained after electroejaculation in men with psychogenic Anejaculation. Design Retrospective clinical study. Setting In Vitro Fertilization Unit, Bikur Cholim Hospital, Jerusalem, Israel. Patients Twenty men with psychogenic Anejaculation who underwent 55 sessions of electroejaculation and their spouses. Interventions Electroejaculation, assisted reproduction technologies. Main Outcome Measures Semen analysis, IVF, intracytoplasmic injection (ICSI), fertilization rates, and pregnancy rates. Results In all patients, sperm density and motility rates were unsatisfactory (98±127 × 10 6 with 14.6%±15% motility in the antegrade portions and 42±42 X 10 6 with 9.7%±15.6% motility in the retrograde samples). Intrauterine inseminations performed in eight couples did not result in a pregnancy. Four couples underwent IVF-ET treatments. Two pregnancies were achieved with overall success rates of 22% per cycle. Five couples were treated using the ICSI procedure. Although good quality embryos were transferred, none of the treatments resulted in a pregnancy. Conclusions Psychogenic failure to ejaculate may be treated by electroejaculation. However, the average motility of the sperm obtained is diminished. The combination of electroejaculation with IVF, including the ICSI procedure, should improve chances of fertilization and pregnancy in these cases.
Jens Sonksen - One of the best experts on this subject based on the ideXlab platform.
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a step wise approach to sperm retrieval in men with neurogenic Anejaculation
Nature Reviews Urology, 2015Co-Authors: Mikkel Fode, Dana A. Ohl, Jens SonksenAbstract:Normal fertility is dependent on intravaginal delivery of semen through ejaculation. This process is highly dependent on an intact ejaculatory reflex arc, which can be disrupted through any type of trauma or disease causing damage to the CNS and/or peripheral nerves. Neurogenic Anejaculation is most commonly associated with spinal cord injury. This aetiology is especially relevant because most men with spinal cord injuries are injured at reproductive age. Assisted ejaculation in the form of penile vibratory stimulation is the first choice for sperm retrieval in such patients because it is noninvasive and inexpensive. In patients in whom vibratory stimulation fails, electroejaculation is almost always successful. When both methods of assisted ejaculation are unsuccessful, sperm retrieval by aspiration from either the vas deferens or the epididymis, or by testicular biopsy or surgery are reasonable options. In such cases the most inexpensive and least invasive methods should be considered first. The obtained semen can be used for intravaginal or intrauterine insemination or in vitro fertilization with or without intracytoplasmic sperm injection.
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Anejaculation an electrifying approach
Seminars in Reproductive Medicine, 2009Co-Authors: Dana A. Ohl, Jens Sonksen, Susanne A Quallich, Nancy L Brackett, Charles M LynneAbstract: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.
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Anejaculation and retrograde ejaculation
Urologic Clinics of North America, 2008Co-Authors: Dana A. Ohl, Jens Sonksen, Susanne A Quallich, Nancy L Brackett, Charles M LynneAbstract:Anejaculatory infertility is a challenge for the treating physician. Accurate diagnosis and choice of treatment plan must carefully proceed to maximize success rates while maintaining cost-effectiveness. In this article the authors review ejaculatory infertility evaluation and treatment.
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penile vibratory stimulation yields increased spermatozoa and accessory gland production compared with rectal electroejaculation in a neurologically intact primate saimiri boliviensis
Human Reproduction, 1998Co-Authors: Richard R Yeoman, Susan V Gibson, Jens Sonksen, Botros Rizk, Christian R. AbeeAbstract:Assisted reproductive techniques require an efficient semen collection procedure in cases of ejaculatory dysfunction. Anejaculation may be of psychogenic or neurogenic origin but can be overcome with stimulatory techniques. Penile vibratory stimulation (PVS) therapy for Anejaculation has recently emerged as an alternative to rectal probe electroejaculation (RPE) and more invasive testicular procedures. Comparison of the stimulatory procedures in neurologically intact subjects is not ethically possible due to the discomfort involved with electroejaculation, and comparison in spinal cord injured men may be compromised due to the intricate effects of chronic denervation on semen quality. We have previously shown the efficacy of PVS in a non-human primate, the squirrel monkey. A cross-over study design comparing semen collected by PVS and RPE was employed during the breeding season in which 15 donor males were divided into two groups. One group received PVS and the other RPE, then, three days later, treatments were reversed. Twelve of 15 animals responded to PVS (80%), all with spermatozoa in the ejaculate. Mean volume (436 +/- 90 microl), motility (80.6 +/- 4.3%), and total spermatozoa (32.8 +/- 10.2 x 10(6)) were significantly higher than in the semen after RPE. RPE resulted in ejaculation in all 15 animals with a semen volume of 205 +/- 25 microl, but fewer samples contained spermatozoa (9/15) resulting in a low total count (0.5 +/- 0.3 x 10(6)). The motility was reduced in those samples with spermatozoa (n = 9; 44.1 +/- 11.4%). Additionally, accessory gland activity was measured via the seminal vesicle and prostrate markers, fructose and citric acid, respectively. The PVS specimens had significantly more fructose (2.9 +/- 0.7 mg/ejaculate) and citric acid (0.46 +/- 0.14 mg/ejaculate) compared to RPE collected specimens (1.2 +/- 0.3 mg/ejaculate and 0.24 +/- 0.04 mg/ejaculate, respectively). In conclusion, PVS produces a much greater sperm yield and increased accessory gland secretion compared to RPE in our neurologically intact squirrel monkey model.
Chris G Mcmahon - One of the best experts on this subject based on the ideXlab platform.
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Disorders of Orgasm and Ejaculation in Menjsm_1782 1668..1686
2016Co-Authors: David Rowl, Marcel D. Waldinger, Chris G Mcmahon, Carmita Abdo, Juza Chen, Emmanuele Jannini, Tai Young AhnAbstract:Introduction. Ejaculatory/orgasmic disorders are common male sexual dysfunctions, and include premature ejacu-lation (PE), inhibited ejaculation, Anejaculation, retrograde ejaculation, and anorgasmia. Aim. To provide recommendations and guidelines concerning current state-of-the-art knowledge for management of ejaculation/orgasmic disorders in men. Methods. An international consultation in collaboration with the major urology and sexual medicine association
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contemporary management of disorders of male orgasm and ejaculation
Urology, 2016Co-Authors: Stanley E Althof, Chris G McmahonAbstract:Ejaculatory disorders lie along a conceptual continuum with premature ejaculation anchoring one end, normal ejaculation in the center, and difficulties with delayed or Anejaculation at the opposite end. Retrograde ejaculation, painful ejaculation, and postorgasmic illness syndrome can occur at any point on the continuum. This manuscript defines the ejaculatory dysfunctions, reviews the anatomy and physiology of orgasm and ejaculation, and summarizes the pharmacological, psychological, and combined treatment approaches to ejaculatory dysfunctions.
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standard operating procedures in the disorders of orgasm and ejaculation
The Journal of Sexual Medicine, 2013Co-Authors: Chris G Mcmahon, Marcel D. Waldinger, Emmanuele Jannini, David L. RowlandAbstract:ABSTRACT Introduction Ejaculatory/orgasmic disorders are common male sexual dysfunctions and include premature ejaculation (PE), inhibited ejaculation, Anejaculation, retrograde ejaculation, and anorgasmia. Aim To provide recommendations and guidelines of the current state-of-the-art knowledge for management of ejaculation/orgasmic disorders in men as standard operating procedures (SOPs) for the treating health care professional. Methods The International Society of Sexual Medicine Standards Committee assembled over 30 multidisciplinary experts to establish SOPs for various male and female sexual medicine topics. The SOP for the management of disorders of orgasm and ejaculation represents the opinion of four experts from four countries developed in a process over a 2-year period. Main Outcome Measure Expert opinion was based on grading of evidence-based medical literature, limited expert opinion, widespread internal committee discussion, public presentation, and debate. Results PE management is largely dependent upon etiology. Lifelong PE is best managed with PE pharmacotherapy (selective serotonin reuptake inhibitors and/or topical anesthetics). The management of acquired PE is etiology specific and may include erectile dysfunction (ED) pharmacotherapy in men with comorbid ED. All men seeking treatment for PE should receive basic psychosexual education. Graded behavioral therapy is indicated when psychogenic or relationship factors are present and is often best combined with PE pharmacotherapy in an integrated treatment program. Delayed ejaculation, Anejaculation, and/or anorgasmia may have a biogenic and/or psychogenic etiology. Men with age-related penile hypoanesthesia should be educated, reassured, and instructed in revised sexual techniques which maximize arousal. Retrograde ejaculation is managed by education, patient reassurance, and pharmacotherapy. Conclusions Additional research is required to further the understanding of the disorders of ejaculation and orgasm. McMahon CG, Jannini E, Waldinger M, and Rowland D. Standard operating procedures in the disorders of orgasm and ejaculation. J Sex Med **;**:**–**.
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original researchdisorders of orgasm and ejaculation in men
The Journal of Sexual Medicine, 2004Co-Authors: Chris G Mcmahon, David L. Rowland, Carmita Helena Najjar Abdo, Luca Incrocci, Michael A Perelman, Marcel D. WaldingerAbstract:Introduction Ejaculatory/orgasmic disorders, common male sexual dysfunctions, include premature ejaculation, inhibited ejaculation, Anejaculation, retrograde ejaculation and anorgasmia.
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disorders of orgasm and ejaculation in men
The Journal of Sexual Medicine, 2004Co-Authors: David L. Rowland, Chris G Mcmahon, Carmita Helena Najjar Abdo, Juza Chen, Emmanuele Jannini, Marcel D. WaldingerAbstract:Introduction. Ejaculatory/orgasmic disorders are common male sexual dysfunctions, and include premature ejacu- lation (PE), inhibited ejaculation, Anejaculation, retrograde ejaculation, and anorgasmia. Aim. To provide recommendations and guidelines concerning current state-of-the-art knowledge for management of ejaculation/orgasmic disorders in men. Methods. An international consultation in collaboration with the major urology and sexual medicine associations assembled over 200 multidisciplinary experts from 60 countries into 25 committees. Committee members estab- lished specific objectives and scopes for various male and female sexual medicine topics. The recommendations concerning state-of-the-art knowledge of disorders of orgasm and ejaculation represent the opinion of seven experts from seven countries developed in a process over a 2-year period. Main Outcome Measure. Expert opinion was based on grading of evidence-based medical literature, widespread internal committee discussion, public presentation and debate. Results. Premature ejaculation management is largely dependent upon etiology. Lifelong PE is best managed with PE pharmacotherapy (selective serotonin re-uptake inhibitor (SSRI) and/or topical anesthetics). The management of acquired PE is etiology specific and may include erectile dysfunction (ED) pharmacotherapy in men with comorbid ED. Behavioral therapy is indicated when psychogenic or relationship factors are present and is often best combined with PE pharmacotherapy in an integrated treatment program. Retrograde ejaculation is managed by education, patient reassurance, pharmacotherapy, or bladder neck reconstruction. Delayed ejaculation, Anejaculation, and/or anorgasmia may have a biogenic and/or psychogenic atiology. Men with age-related penile hypoanesthesia should be educated, reassured, and instructed in revised sexual techniques which maximize arousal. Conclusions. Additional research is required to further the understanding of the disorders of ejaculation and orgasm. Rowland D, McMahon CG, Abdo C, Chen J, Jannini E, Waldinger MD, and Ahn TY. Disorders of Orgasm and Ejaculation in Men. J Sex Med 2010;7:1668-1686.