Anejaculation: An Electrifying Approach

 

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ABSTRACT

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.

REFERENCES

• 1 Thomas Jr A J. Ejaculatory dysfunction.  Fertil Steril. 1983;  39 445-454
  PubMedGoogle Scholar
• 2 Sonksen J, Ohl D A, Wedemeyer G. Sphincteric events during penile vibratory ejaculation and electroejaculation in men with spinal cord injuries.  J Urol. 2001;  165 426-429
  CrossrefPubMedGoogle Scholar
• 3 Robert M, Gagnon C. Semenogelin I: a coagulum forming, multifunctional seminal vesicle protein.  Cell Mol Life Sci. 1999;  55 944-960
  CrossrefPubMedGoogle Scholar
• 4 Chughtai B, Sawas A, O'Malley R L et al.. A neglected gland: a review of Cowper's gland.  Int J Androl. 2005;  28 74-77
  PubMedGoogle Scholar
• 5 Laumann E O, Paik A, Rosen R C. Sexual dysfunction in the United States: prevalence and predictors.  JAMA. 1999;  281 537-544
  CrossrefPubMedGoogle Scholar
• 6 Colpi G M, Fanciullacci F, Beretta G et al.. Evoked sacral potentials in subjects with true premature ejaculation.  Andrologia. 1986;  18 583-586
  PubMedGoogle Scholar
• 7 Stewart D E, Ohl D A. Idiopathic anejaculation treated by electroejaculation.  Int J Psychiatry Med. 1989;  19 263-268
  PubMedGoogle Scholar
• 8 Biering-Sorensen F, Sonksen J. Sexual function in spinal cord lesioned men.  Spinal Cord. 2001;  39 455-470
  CrossrefPubMedGoogle Scholar
• 9 Kedia K R, Markland C, Fraley E E. Sexual function following high retroperitoneal lymphadenectomy.  J Urol. 1975;  114 237-239
  PubMedGoogle Scholar
• 10 Weinstein M H, Machleder H I. Sexual function after aorto-lliac surgery.  Ann Surg. 1975;  181 787-790
  CrossrefPubMedGoogle Scholar
• 11 Sexton W J, Jarow J P. Effect of diabetes mellitus upon male reproductive function.  Urology. 1997;  49 508-513
  CrossrefPubMedGoogle Scholar
• 12 Hellstrom W J, Sikka S C. Effects of acute treatment with tamsulosin versus alfuzosin on ejaculatory function in normal volunteers.  J Urol. 2006;  176 1529-1533
  CrossrefPubMedGoogle Scholar
• 13 Kamischke A, Nieschlag E. Treatment of retrograde ejaculation and anejaculation.  Hum Reprod Update. 1999;  5 448-474
  CrossrefPubMedGoogle Scholar
• 14 Deveci S, O'Brien K, Mulhall J P. Outcomes of post-chemotherapy retroperitoneal lymph node dissection associated-anejaculation management.  J Urol. 2008;  175(Suppl) 657
  PubMedGoogle Scholar
• 15 Bird V G, Brackett N L, Lynne C M et al.. Reflexes and somatic responses as predictors of ejaculation by penile vibratory stimulation in men with spinal cord injury.  Spinal Cord. 2001;  39 514-519
  CrossrefPubMedGoogle Scholar
• 16 Ohl D A, Menge A C, Sonksen J. Penile vibratory stimulation in spinal cord injured men: optimized vibration parameters and prognostic factors.  Arch Phys Med Rehabil. 1996;  77 903-905
  CrossrefPubMedGoogle Scholar
• 17 Sonksen J, Biering-Sorensen F, Kristensen J K. Ejaculation induced by penile vibratory stimulation in men with spinal cord injuries. The importance of the vibratory amplitude.  Paraplegia. 1994;  32 651-660
  PubMedGoogle Scholar
• 18 Steinberger R E, Ohl D A, Bennett C J et al.. Nifedipine pretreatment for autonomic dysreflexia during electroejaculation.  Urology. 1990;  36 228-231
  CrossrefPubMedGoogle Scholar
• 19 Brackett N L, Ead D N, Aballa T C et al.. Semen retrieval in men with spinal cord injury is improved by interrupting current delivery during electroejaculation.  J Urol. 2002;  167 201-203
  CrossrefPubMedGoogle Scholar
• 20 Ohl D A. Electroejaculation.  Urol Clin North Am. 1993;  20 181-188
  PubMedGoogle Scholar
• 21 Buch J P, Zorn B H. Evaluation and treatment of infertility in spinal cord injured men through rectal probe electroejaculation.  J Urol. 1993;  149 1350-1354
  PubMedGoogle Scholar
• 22 Denil J, Ohl D A, Menge A C et al.. Functional characteristics of sperm obtained by electroejaculation.  J Urol. 1992;  147 69-72
  PubMedGoogle Scholar
• 23 Sonksen J, Lochner-Ernst D, Brackett N L et al.. Vibratory ejaculation in 169 spinal cord injured men and home insemination of their partners.  J Urol. 2008;  175(Suppl) 656
  PubMedGoogle Scholar
• 24 Ohl D A, Wolf L J, Menge A C et al.. Electroejaculation and assisted reproductive technologies in the treatment of anejaculatory infertility.  Fertil Steril. 2001;  76 1249-1255
  CrossrefPubMedGoogle Scholar
• 25 Heruti R J, Katz H, Menashe Y et al.. Treatment of male infertility due to spinal cord injury using rectal probe electroejaculation: the Israeli experience.  Spinal Cord. 2001;  39 168-175
  CrossrefPubMedGoogle Scholar
• 26 Hultling C, Rosenlund B, Levi R et al.. Assisted ejaculation and in-vitro fertilization in the treatment of infertile spinal cord-injured men: the role of intracytoplasmic sperm injection.  Hum Reprod. 1997;  12 499-502
  CrossrefPubMedGoogle Scholar
• 27 Kafetsoulis A, Brackett N L, Ibrahim E et al.. Current trends in the treatment of infertility in men with spinal cord injury.  Fertil Steril. 2006;  86 781-789
  CrossrefPubMedGoogle Scholar

Dana A OhlM.D. 

Department of Urology, University of Michigan

1500 E. Medical Center Dr., Box 0330, Ann Arbor, MI 48108

Email: daohl@umich.edu