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Male Methods
Published in Sujoy K. Guba, Bioengineering in Reproductive Medicine, 2020
Electroejaculation is the technique of electrically stimulating one or more of the following nerve centers to initiate the reflex of ejaculation: preganglionic efferent sympathetic fibers from the spinal cord; ganglia in the sympathetic trunks; peripheral plexuses and their postganglionic extensions to the prostate, seminal vesicles and vasa deferentia; and afferent nerves in the penis. In veterinary practice this technique has been used for more than 50 years to collect semen for artificial insemination. Electroejaculation was found to be a valuable alternative to ejaculation produced by an artificial vagina and by manual manipulation of the animal penis. Bensman and Kottke4 trace the history of animal electroejaculation to the work of Gunn5 in which ejaculating the sheep was induced by applying a 50-Hz AC voltage to a probe placed in the rectum. This method of stimulation to obtain semen was found to be highly successful in animal husbandry.
Investigations in infertility
Published in David J Cahill, Practical Patient Management in Reproductive Medicine, 2019
A minority of men are anejaculatory because they have had a spinal cord injury with disruption of the nerve supply supporting erection and ejaculation, easily managed by electro-ejaculation or needle aspiration of the epididymis (see Section 4.6.2 for more details).
Sex and Disability
Published in Philipa A Brough, Margaret Denman, Introduction to Psychosexual Medicine, 2019
The first line of treatment may be with a medical vibrator, in a clinic or hospital environment (although sometimes patients purchase and trial their own high-frequency vibrators at home). The aim is to stimulate the dorsal nerve of the penis by applying the vibrator to the glans penis; sometimes if an enhanced effect is needed a vibrator is used which ‘sandwiches’ the penis. Careful monitoring for possible AD will be maintained throughout, including continuous blood pressure monitoring. With spinal cord injuries above T10 most men will achieve an ejaculation, however it is much less likely with lower injuries because of the loss of an intact sympathetic ejaculatory pathway. For lower-level lesions, or when penile vibratory stimulation fails, electroejaculation may be offered. This uses electrical stimulation via the rectum, delivered with the patient lying on their side, sometimes using sedation, sperm collected by another clinician milking the urethra. If retrograde ejaculation, rather than anterograde ejaculation, is thought to be likely the patient may be catheterised first, with a sperm washing buffer instilled in the bladder just before the procedure, and urine then collected and centrifuged. For a small number of men surgical sperm retrieval may be necessary, and there are different ways of achieving this.
Sperm preservation by electroejaculation before anticancer therapy
Published in Scandinavian Journal of Urology, 2018
M. Skott, H. Schrøder, J. Hindkjaer, HJ Kirkeby
Transrectal electroejaculation (EEJ) (Seager Model 14 Electroejaculator, Dazell Medical Systems, The Plains, VA) was performed under general anaesthesia by inserting a transrectal probe with electrodes in contact with rectal mucosa in the area of the prostate and the seminal vesicles [5]. The patient was placed in the lateral decubitus position and a pulsatile pattern was used, with an initial stimulation of 3 volts. The voltage was gradually increasing until ejaculation or a total of 25 stimulations, each of 10 seconds (maximum voltage 20 volts/2–500 mA) were given. The antegrade fraction of the ejaculate was obtained by manual expression of seminal fluid along the urethra and collected in a sterile container. No retrograde ejaculate was retrieved. The bladder was emptied by catheterization prior to EEJ.
Proteomic insight of seminal plasma in spinal cord injured men submitted to oral probenecid treatment for improved motility
Published in The Journal of Spinal Cord Medicine, 2021
Mariana Camargo, Emad Ibrahim, Teodoro C. Aballa, Karina H. M. Cardozo, Valdemir M. Carvalho, Charles M. Lynne, Nancy L. Brackett, Ricardo P. Bertolla
Nine SCI subjects initiated a phase I treatment with 500 mg daily of oral probenecid (Watson Farma Inc Corona, CA) for one week, followed by phase II with 1000 mg per day of the medication for 3 weeks. All semen samples were obtained using the standard methods of Penile Vibratory Stimulation (PVS) or Electroejaculation (EEJ), as described elsewhere.20 In most cases, subjects had numerous semen collections prior to participation in this study (mean ± standard error of the mean of 20 ± 7.7, range 2–79 semen collections per subject). Semen was collected within 7 days prior to initiation of treatment and again within 4 weeks after finishing the treatment.
Oral probenecid improves sperm motility in men with spinal cord injury
Published in The Journal of Spinal Cord Medicine, 2018
Emad Ibrahim, Teodoro C. Aballa, Charles M. Lynne, Nancy L. Brackett
All patients were anejaculatory. Semen was obtained by the standard methods of penile vibratory stimulation (PVS, n = 14 subjects) or electroejaculation (EEJ, n = 6 subjects).14 Antegrade fractions only (no retrograde fractions) were used in the study. The same method of semen collection (either PVS or EEJ) was used for all semen collections of an individual patient.