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
• dospělí MeSH
• ejakulace * fyziologie   MeSH
• epidurální prostor MeSH
• erektilní dysfunkce etiologie   terapie   patofyziologie   MeSH
• hrudní obratle MeSH
• lidé MeSH
• míšní stimulace * metody   MeSH
• poranění míchy * komplikace   patofyziologie   terapie   rehabilitace   MeSH
• Check Tag
• dospělí MeSH
• lidé MeSH
• mužské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• kazuistiky MeSH

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
• ejakulace fyziologie   MeSH
• lidé MeSH
• odměna MeSH
• opioidní analgetika * MeSH
• sexuální chování zvířat * fyziologie   MeSH
• sexuální chování MeSH
• zvířata MeSH
• Check Tag
• lidé MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• zvířata MeSH
• Publikační typ
• časopisecké články MeSH
• přehledy 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
• azoospermie epidemiologie   terapie   MeSH
• ejakulace fyziologie   MeSH
• fertilizace in vitro trendy   MeSH
• indukce ovulace MeSH
• intracytoplazmatické injekce spermie MeSH
• kryoprezervace * MeSH
• lidé MeSH
• motilita spermií genetika   MeSH
• narození živého dítěte epidemiologie   MeSH
• oocyty růst a vývoj   MeSH
• oogeneze genetika   MeSH
• spermie patologie   transplantace   MeSH
• těhotenství MeSH
• Check Tag
• lidé MeSH
• mužské pohlaví MeSH
• těhotenství MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• kazuistiky MeSH

INTRODUCTION AND HYPOTHESIS: Women expel various kinds of fluids during sexual activities. These are manifestations of sexual arousal and orgasm or coital incontinence. This study is aimed at suggesting a diagnostic scheme to differentiate among these phenomena. METHODS: Web of Science and Ovid (MEDLINE) databases were systematically searched from 1950 to 2017 for articles on various fluid expulsion phenomena in women during sexual activities, which contain relevant information on sources and composition of the expelled fluids. RESULTS: An ultra-filtrate of blood plasma of variable quantity, which is composed of transvaginal transudate at sexual stimulation, enables vaginal lubrication. Female ejaculation (FE) is the secretion of a few milliliters of thick, milky fluid by the female prostate (Skene's glands) during orgasm, which contains prostate-specific antigen. Squirting (SQ) is defined as the orgasmic transurethral expulsion of tenths of milliliters of a form of urine containing various concentrations of urea, creatinine, and uric acid. FE and SQ are two phenomena with different mechanisms. Coital incontinence (CI) could be classified into penetration and orgasm forms, which could be associated with stress urinary incontinence or detrusor hyperactivity. CONCLUSION: Squirting, FE, and CI are different phenomena with various mechanisms and could be differentiated according to source, quantity, expulsion mechanism, and subjective feelings during sexual activities.

• MeSH
• ejakulace * fyziologie   MeSH
• koitus * MeSH
• lidé MeSH
• orgasmus * MeSH
• sexuální chování MeSH
• stresová inkontinence moči patofyziologie   MeSH
• tělesné sekrety fyziologie   MeSH
• uretra MeSH
• Check Tag
• lidé MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• přehledy MeSH

Autoři v článku shrnují aktuální pohled na problematiku předčasné ejakulace, která společně s erektilní dysfunkcí patří mezi nejčastější mužské sexuální dysfunkce. Důraz je kladen na farmakoterapeutické možnosti v každodenní klinické praxi.

The authors summarize the current knowledge of premature ejaculation which is together with erectile dysfunction one of the most common male sexual dysfunctions. The role of pharmacotherapy in everyday clinical practice has been emphasized.

• Klíčová slova
• IELT,
• MeSH
• anestetika lokální terapeutické užití   MeSH
• benzylaminy MeSH
• diferenciální diagnóza MeSH
• ejakulace * fyziologie   účinky léků   MeSH
• klomipramin aplikace a dávkování   škodlivé účinky   MeSH
• lidé MeSH
• naftaleny MeSH
• předčasná ejakulace * diagnóza   patologie   terapie   MeSH
• psychoterapie MeSH
• psychotropní léky škodlivé účinky   terapeutické užití   MeSH
• selektivní inhibitory zpětného vychytávání serotoninu aplikace a dávkování   škodlivé účinky   terapeutické užití   MeSH
• serotonin fyziologie   MeSH
• sexuální zdraví MeSH
• Check Tag
• lidé MeSH
• mužské pohlaví MeSH

MUDr. Luděk Daneš, CSc., předkládá poučnou publikaci, která shrnuje soudobé poznatky o definici, diagnostice a terapii opožděné ejakulace. Kniha je určena nejen sexuologům, urologům či andrologům, ale i dalším lékařům, jimž poslouží jako předatestační zdroj informací. Ocení ji také psychologové, kteří se s těmito pacienty též setkávají.

• MeSH
• ejakulace fyziologie   účinky léků   MeSH
• farmakoterapie klasifikace   metody   MeSH
• komorbidita MeSH
• sexuální dysfunkce fyziologická diagnóza   epidemiologie   etiologie   farmakoterapie   MeSH
• Publikační typ
• monografie MeSH

• Konspekt
• Patologie. Klinická medicína
• NLK Obory
• andrologie

Článek shrnuje nové možnosti léčby poruch erekce a ejakulace.

The article summarizes new treatment options of erectile dysfunction and ejaculation.

• Klíčová slova
• avanafil, dapoxetin,
• MeSH
• aplikace orální MeSH
• benzylaminy aplikace a dávkování   farmakokinetika   terapeutické užití   MeSH
• cyklické nukleotidfosfodiesterasy, typ 5 aplikace a dávkování   farmakokinetika   terapeutické užití   MeSH
• dospělí MeSH
• ejakulace fyziologie   účinky léků   MeSH
• erekce penisu fyziologie   účinky léků   MeSH
• erektilní dysfunkce * etiologie   farmakoterapie   MeSH
• inhibitory fosfodiesterasy 5 terapeutické užití   MeSH
• lidé MeSH
• naftaleny aplikace a dávkování   farmakokinetika   terapeutické užití   MeSH
• předčasná ejakulace * etiologie   farmakoterapie   MeSH
• pyrimidiny aplikace a dávkování   farmakokinetika   terapeutické užití   MeSH
• rizikové faktory MeSH
• selektivní inhibitory zpětného vychytávání serotoninu aplikace a dávkování   farmakokinetika   terapeutické užití   MeSH
• Check Tag
• dospělí MeSH
• lidé MeSH
• mužské pohlaví MeSH
• Publikační typ
• přehledy MeSH

• Klíčová slova
• ženská ejakulace,
• MeSH
• ejakulace * fyziologie   MeSH
• emoce MeSH
• lidé MeSH
• orgasmus fyziologie   klasifikace   MeSH
• sexuální chování fyziologie   MeSH
• Check Tag
• lidé MeSH
• ženské pohlaví MeSH

• MeSH
• antidepresiva škodlivé účinky   MeSH
• čas MeSH
• ejakulace fyziologie   účinky léků   MeSH
• interpersonální vztahy MeSH
• lidé MeSH
• předčasná ejakulace * diagnóza   etiologie   patologie   terapie   MeSH
• psychoterapie MeSH
• sexuální chování MeSH
• Check Tag
• lidé MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• Publikační typ
• přehledy MeSH

In some taxa, males perform multiple ejaculations, which may function in sperm competition or in maintaining a baseline density of spermatozoa in the female reproductive tract to ensure fertilization, a process that has been termed 'topping up'. We investigated the function of multiple ejaculations in two species of bitterling, the European bitterling (Rhodeus amarus) and Chinese rose bitterling (Rhodeus ocellatus). Bitterling oviposit in living freshwater mussels, with fertilization taking place within the mussel gill cavity. Thus, although fertilization is external, the mussel is analogous to the female reproductive tract in an internally fertilizing species. We measured the frequency of ejaculations and mussel inspections by individual males of two bitterling species in 28 replicated mesocosms and examined focal male responses to rival ejaculations and the presence of females in spawning condition. We used a model of ejaculatory behaviour to simulate the temporal abundance of spermatozoa in mussels. Male R. amarus exhibited high rates of ejaculation and inspection of the siphons of mussels and increased their ejaculation rate in response to the presence of females in spawning condition. Rhodeus ocellatus showed lower overall rates of ejaculation, but significantly elevated ejaculation rate in response to rival ejaculations. The ejaculatory strategy of R. amarus is one that maintains a minimum level of spermatozoa in mussels, which is elevated when the probability of oviposition increases. In contrast, R. ocellatus engages more directly in sperm competition with rivals. We discuss these results in the context of the function of multiple ejaculations and male mating tactics.

• MeSH
• biologické modely MeSH
• Cyprinidae fyziologie   MeSH
• ejakulace fyziologie   MeSH
• kladení vajíček MeSH
• sexuální chování zvířat fyziologie   MeSH
• spermie fyziologie   MeSH
• zvířata MeSH
• Check Tag
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• zvířata MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH