BACKGROUND: The recovery of autonomic functions and the ability to reproduce in particular is of the highest priority to individuals with spinal cord injury (SCI). The potential of epidural spinal cord stimulation (ESCS) for promoting recovery of sensorimotor functions in the chronic phase of SCI has long been studied. In recent years, several studies have emerged confirming the positive effect of ESCS also on the cardiovascular system and neurogenic bladder and bowel. However, the potential of ESCS in restoring sexual function, especially ejaculation, has not yet been addressed. CASE REPORT: Two cases of people with chronic sensorimotor complete SCI in the 4th thoracic spinal segment are presented. Both men were also diagnosed with severe erectile dysfunction and anejaculation. Thanks to ESCS, Participant 1 successfully restored the ejaculatory reflex using PVS in his home environment. His outcome was subsequently verified under clinical conditions. During ESCS, Participant 1 was also able to achieve ejaculation by masturbation; moreover, he conceived a child naturally without the need for IVF. In Participant 2, we then demonstrated the same effect of ESCS on the restoration of the ejaculatory reflex when targeting the stimulation to the same spinal segment. CONCLUSION: This is the first report on the potential of ESCS for restoring the ability to ejaculate in individuals with complete SCI. Confirmation of these results could significantly reduce the need for assisted reproduction and improve the quality of life of men after SCI in the future.
- MeSH
- Adult MeSH
- Ejaculation * physiology MeSH
- Epidural Space MeSH
- Erectile Dysfunction etiology therapy physiopathology MeSH
- Thoracic Vertebrae MeSH
- Humans MeSH
- Spinal Cord Stimulation * methods MeSH
- Spinal Cord Injuries * complications physiopathology therapy rehabilitation MeSH
- Check Tag
- Adult MeSH
- Humans MeSH
- Male MeSH
- Publication type
- Journal Article MeSH
- Case Reports MeSH
Sialic acids are negatively charged carbohydrates that are components of saccharide chains covalently linked to macromolecules. Sialylated glycoproteins are important for most biological processes, including reproduction, where they are associated with spermatogenesis, sperm motility, immune responses, and fertilization. Changes in the glycoprotein profile or sialylation in glycoproteins are likely to affect the quality of ejaculate. The aim of this study was to determine differences in the degree of sialylation between normozoospermic ejaculates and ejaculates with a pathological spermiogram using two lectins, Sambucus nigra (SNA) and Maackia amurensis (MAL II/MAA) recognizing α-2,6 or α-2,3 linkage of Sia to galactosyl residues. Our results show a close relationship between seminal plasma (SP) sialoproteins and the presence of anti-sperm antibodies in the ejaculate, apoptotic spermatozoa, and ejaculate quality. Using mass spectrometry, we identified SP sialoproteins such as, semenogelins, glycodelin, prolactin-inducible protein, lactotransferrin, and clusterin that are associated with spermatozoa and contribute to the modulation of the immune response and sperm apoptosis. Our findings suggest a correlation between the degree of SP glycoprotein sialylation and the existence of possible pathological states of spermatozoa and reproductive organs. Glycoproteins sialylation represents a potential parameter reflecting the overall quality of ejaculate and could potentially be utilised in diagnostics.
- MeSH
- Semen Analysis methods MeSH
- Apoptosis MeSH
- Ejaculation MeSH
- Glycodelin metabolism MeSH
- Glycoproteins metabolism MeSH
- Clusterin metabolism MeSH
- Sialic Acids metabolism MeSH
- Lactoferrin metabolism MeSH
- Lectins metabolism chemistry MeSH
- Humans MeSH
- Sperm Motility MeSH
- Seminal Plasma Proteins metabolism MeSH
- Seminal Vesicle Secretory Proteins metabolism MeSH
- Semen * metabolism chemistry MeSH
- Spermatozoa * metabolism MeSH
- Check Tag
- Humans MeSH
- Male MeSH
- Publication type
- Journal Article MeSH
Sexuální dysfunkce (SD) znamená kvantitativní nebo kvalitativní poruchu, která znemožňuje vést uspokojivý sexuální život. I když je někdy možné prokázat jednoznačně organickou nebo psychogenní etiologii, většinou mají multifaktoriální původ. Primární SD se vyskytuje u pacienta od začátku pohlavního života, sekundární SD se objeví po určitém delším časovém období bezporuchového stavu. Generalizovaná SD není vázaná na aktuální partnerský vztah, selektivní je vázaná na určitý partnerský vztah a jeho kvalitu. Prevalence SD v populaci není přesně známá, ve výzkumu sexuálního chování reprezentativního vzorku české populace z roku 2008 uvedlo shodně 20 % mužů i žen, že někdy trpěli určitou sexuální dysfunkcí.
Sexual dysfunction (SD) means a quantitative or qualitative disorder that makes it impossible to have a satisfying sex life. Although it is sometimes possible to prove a clearly organic or psychogenic etiology, they usually have a multifactorial origin. Primary SD occurs in the patient from the beginning of sexual life, secondary SD appears after a certain longer trouble- free period. Generalized SD is not tied to the current partnership, selective is tied to a particular partnership and its quality. The prevalence of SD in the population is not exactly known; in a survey of the sexual behavior of a representative sample of the Czech population in 2008, 20 % of men and women alike stated that they sometimes suffered from a certain sexual dysfunction.
Although mechanisms of mate preference are thought to be relatively hard-wired, experience with appetitive and consummatory sexual reward has been shown to condition preferences for partner related cues and even objects that predict sexual reward. Here, we reviewed evidence from laboratory species and humans on sexually conditioned place, partner, and ejaculatory preferences in males and females, as well as the neurochemical, molecular, and epigenetic mechanisms putatively responsible. From a comprehensive review of the available data, we concluded that opioid transmission at μ opioid receptors forms the basis of sexual pleasure and reward, which then sensitizes dopamine, oxytocin, and vasopressin systems responsible for attention, arousal, and bonding, leading to cortical activation that creates awareness of attraction and desire. First experiences with sexual reward states follow a pattern of sexual imprinting, during which partner- and/or object-related cues become crystallized by conditioning into idiosyncratic "types" that are found sexually attractive and arousing. These mechanisms tie reward and reproduction together, blending proximate and ultimate causality in the maintenance of variability within a species.
- MeSH
- Ejaculation physiology MeSH
- Humans MeSH
- Reward MeSH
- Analgesics, Opioid * MeSH
- Sexual Behavior, Animal * physiology MeSH
- Sexual Behavior MeSH
- Animals MeSH
- Check Tag
- Humans MeSH
- Male MeSH
- Female MeSH
- Animals MeSH
- Publication type
- Journal Article MeSH
- Review MeSH
Women expel fluids of various quantities and compositions from the urethra during sexual arousal and orgasm. These are classified as either female ejaculation (FE) or squirting (SQ). The aim of our analysis was to present evidence that FE and SQ are similar but etiologically different phenomena. A review of studies was performed on fluids expelled from the urogenital tract during female sexual activities using the Web of KnowledgeTM (Web of Science Core Collection) and MEDLINE (Ovid) databases from 1946 to 2021. Until 2011, all female orgasmic expulsions of fluids were referred to as FE. The fluid was known to be either from the paraurethral glands or as a result of coital incontinence. At present, SQ is considered as a transurethral expulsion of approximately 10 milliliters or more of transparent fluid, while FE is considered as a secretion of a few milliliters of thick fluid. The fluid in SQ is similar to urine and is expelled by the urinary bladder. The secretion in FE originates from the paraurethral glands and contains a high concentration of prostate-specific antigen. Both phenomena can occur simultaneously. The mechanisms underlying SQ and FE are entirely different. SQ is a massive transurethral orgasmic expulsion from the urinary bladder, while FE is the secretion of a very small amount of fluid from the paraurethral glands.
Delayed ejaculation belongs to the group of sexual disorders in men. The causes of delayed ejaculation or anejaculation are not exactly known. It is assumed that it can be caused by psychogenic or organic influences or their combinations. One of the causes of delayed ejaculation may be elevated prolactin levels, which may be increased by psychosocial stress, pituitary disorders or also treatment with selective serotonin reuptake inhibitors in the treatment of depression. We tested a selected group of 50 men who were diagnosed with a depressive disorder and whose antidepressant treatment lasted for at least 24 weeks. These patients reported long-term delayed ejaculation or, in some cases, anejaculation as comorbidity. The results showed significant Spearman's correlation between elevated prolactin levels and intravaginal ejaculation latency values (R = 0.45), as well as between Beck's Depression-II inventory and intravaginal ejaculation latency and latency values (R = 0.48).
- MeSH
- Depressive Disorder * MeSH
- Ejaculation MeSH
- Humans MeSH
- Premature Ejaculation * etiology MeSH
- Prolactin MeSH
- Selective Serotonin Reuptake Inhibitors pharmacology therapeutic use MeSH
- Sexual Dysfunction, Physiological * etiology MeSH
- Check Tag
- Humans MeSH
- Male MeSH
- Publication type
- Journal Article MeSH
Recent findings indicate that men with premature ejaculation report more frequent sexual problems associated with increased anxiety and interpersonal difficulties. Bearing this in mind, the neuroendocrine changes were examined in men with premature ejaculation and compared to other indicators of stressful experiences to see whether there can be any correlation which could indicate how these factors may contribute to the aetiology of premature ejaculation. Our study comprised 60 male outpatients diagnosed as having secondary premature ejaculation. Clinical examinations were focused on biochemical analysis of cortisol and psychometric scoring using a diagnostic tool for premature ejaculation, traumatic stress and somatoform dissociation. The control group consisted of a 60 healthy men. The results showed significant Spearman correlations of the Premature Ejaculation Diagnostic Tool score with Trauma Symptom Checklist score (R = .86), cortisol level (R = .47) and Somatoform Dissociation Questionnaire score (R = .61). In the control group, the results did not reach statistical significance. Spearman correlations of the Premature Ejaculation Diagnostic Tool score with Trauma symptoms checklist score was (R = .21), cortisol (R = .27) and with Somatoform dissociation questionnaire score (R = .25). These results represent the first reported findings documenting the relationship of traumatic stress indicators with the experience of secondary premature ejaculation and cortisol levels.
- MeSH
- Ejaculation MeSH
- Humans MeSH
- Premature Ejaculation * diagnosis epidemiology MeSH
- Surveys and Questionnaires MeSH
- Anxiety MeSH
- Check Tag
- Humans MeSH
- Male MeSH
- Publication type
- Journal Article MeSH
The most common reason for in vitro fertilization (IVF) cycle cancelation is a lack of quality gametes available for intracytoplasmic sperm injection (ICSI). Here we present the successful fertility treatment of the couple affected by obstructive azoospermia combined with suboptimal response to controlled ovarian stimulation. Since the conventional approach appeared ineffective to overcome both partners' specific problems, the targeted interventions, namely, (1) pharmacological enhancement of sperm motility and (2) polarized light microscopy (PLM)-guided optimization of ICSI time, were applied to rescue the cycle with only immature oocytes and immotile testicular sperm retrieved. The treatment with theophylline aided the selection of viable spermatozoa derived from cryopreserved testicular tissue. When the traditional stimulation protocol failed to produce mature eggs, non-invasive spindle imaging was employed to adjust the sperm injection time to the maturational stage of oocytes extruding a polar body in vitro. The fertilization of 12 late-maturing oocytes yielded 5 zygotes, which all developed into blastocysts. One embryo was transferred into the uterus on day 5 post-fertilization, and another 3 good quality blastocysts were vitrified for later use. The pregnancy resulted in a full-term delivery of a healthy child. This case demonstrates that the individualization beyond the standard IVF protocols should be considered to maximize the chance of poor-prognosis patients to achieve pregnancy with their own gametes.
- MeSH
- Azoospermia epidemiology therapy MeSH
- Ejaculation physiology MeSH
- Fertilization in Vitro trends MeSH
- Ovulation Induction MeSH
- Sperm Injections, Intracytoplasmic MeSH
- Cryopreservation * MeSH
- Humans MeSH
- Sperm Motility genetics MeSH
- Live Birth epidemiology MeSH
- Oocytes growth & development MeSH
- Oogenesis genetics MeSH
- Spermatozoa pathology transplantation MeSH
- Pregnancy MeSH
- Check Tag
- Humans MeSH
- Male MeSH
- Pregnancy MeSH
- Female MeSH
- Publication type
- Journal Article MeSH
- Case Reports MeSH
One of the most common sexual dysfunctional diseases in adult males is premature ejaculation. So far, there is no evidence of how premature ejaculation is associated with psychosocial stress. We tested the relationship between neuroendocrine changes in patients with premature ejaculation and indicators of stress experience as a new psychosomatic hypothesis where psychosocial stress may significantly contribute to the aetiology of premature ejaculation. A total of 55 patients with premature ejaculation were included in the study. The control group consisted of 55 healthy men. The diagnosis of premature ejaculation was confirmed by a sexology examination, a history of patients and the values of the premature ejaculation diagnostic tool questionnaire. Comprehensive biochemical serum analysis was focused on the values of total testosterone, free testosterone, luteinising hormone, thyroid-stimulating hormone, dehydroepiandrosterone sulphate, sex hormone-binding globulin and a premature ejaculation diagnostic tool score with trauma symptom checklist and somatoform dissociation questionnaire. The results show significant Spearman correlations of trauma symptom checklist with the premature ejaculation diagnostic tool score (R = 0.84) and free testosterone (R = 0.62) and somatoform dissociation questionnaire with the premature ejaculation diagnostic tool score (R = 0.53) and free testosterone (R = 0.57). Spearman correlations of trauma symptom checklist with somatoform dissociation questionnaire show significant correlation (R = 0.54).
- MeSH
- Dissociative Disorders * complications MeSH
- Adult MeSH
- Ejaculation MeSH
- Humans MeSH
- Luteinizing Hormone MeSH
- Premature Ejaculation * diagnosis psychology MeSH
- Surveys and Questionnaires MeSH
- Stress, Psychological * complications MeSH
- Testosterone * blood MeSH
- Check Tag
- Adult MeSH
- Humans MeSH
- Male MeSH
- Publication type
- Journal Article MeSH
Operační léčba urologických onemocnění může vést k poruchám sexuálních funkcí, zejména poruchám erekce a ejakulace. Je důležité znát mechanismus vzniku těchto následků a pacienty o možných komplikacích řádně informovat. Součástí urologické péče je léčba a zvládání pooperačních dopadů na sexuální život pacientů.
Urological surgery can lead to a sexual dysfunction as an erectile dysfuncion or disorders of ejaculation. It is very important to understand these consequences and to discuss it with the patient. The management of postoperative sexual dysfuncions is also very important part of urological care.
- MeSH
- Ejaculation MeSH
- Penile Erection MeSH
- Erectile Dysfunction * pathology MeSH
- Humans MeSH
- Postoperative Complications * physiopathology pathology MeSH
- Preoperative Care MeSH
- Risk Factors MeSH
- Urologic Surgical Procedures, Male adverse effects MeSH
- Urologic Surgical Procedures * adverse effects MeSH
- Check Tag
- Humans MeSH
