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Surgical Management Techniques for Male Infertility
Published in Botros Rizk, Ashok Agarwal, Edmund S. Sabanegh, Male Infertility in Reproductive Medicine, 2019
Kevin C. Lewis, Scott Lundy, Sarah Vij
TRUS is indicated for patients presenting with low-volume azoospermia and normal or enlarged testicles, consistent with obstructive azoospermia (OA; Figure 16.1). Engin et al. reported a 75% diagnostic rate in low-volume azoospermic patients undergoing TRUS [3]. Alternatively, low-volume oligospermia may represent partial ejaculatory duct obstruction (EDO) and represents a relative indication for TRUS at the discretion of the provider. Other relative indications exist (painful ejaculation, severe hypospadias, anejaculation, hematospermia, etc.) and should be evaluated in the clinical context of each patient.
Male infertility
Published in C. Yan Cheng, Spermatogenesis, 2018
Ryan Flannigan, Marc Goldstein
Anejaculation occurs when the patient fails to ejaculate. This may be due to psychological stress, hyperstimulation of sexual content, chronic medical conditions such as chronic kidney disease requiring dialysis, selective serotonin reuptake inhibitor use, low testosterone, decreased penile sensation, and neurological disorders such as spinal cord injury (SCI), and some men with multiple sclerosis.58 Pelvic surgery and retroperitoneal lymph node dissection may be associated with ejaculatory dysfunction or failure of emission where sperm and semen are transported to the posterior urethra prior to ejaculation.58
Initial investigation of the infertile couple
Published in David K. Gardner, Ariel Weissman, Colin M. Howles, Zeev Shoham, Textbook of Assisted Reproductive Techniques, 2017
Isabelle Roux, Ruth Ronn, Peter T.K. Chan, Togas Tulandi, Hananel E.G. Holzer
Aspermia is the absence of semen and can be related to retrograde ejaculation or anejaculation due to psychological or neurological causes. In the case of retrograde ejaculation, a post-orgasm urine analysis may be performed, with specific preparation (such as alkalinization of urine) to evaluate sperm quality.
Sexual Dysfunction in Gay and Bisexual Prostate Cancer Survivors: A Concept Analysis
Published in Journal of Homosexuality, 2022
In order to appreciate how anejaculation is potentially experienced in a uniquely disturbing way by GBM PCa survivors it is perhaps necessary to briefly detail the significance of ejaculate in gay sex. According to Prestage, Hurley, and Brown (2013), many GBM engage in a unique group of sexual practices generally referred to as semen exchange wherein one of the partners in the dyad typically ejaculates onto the skin or anus of the other partner. For GBM, this practice derives value not only from its eroticism but also in being symbolic of intimacy and connection (Schilder et al., 2008). Indeed, within this context the ejaculate of one’s partner has been referred to as a “gift” insofar as it is symbolic of their essence, in addition to being representative of sexual fulfillment (Holmes & Warner, 2005). According to Holmes and Warner (2005), for some gay men semen exchange is the singular object of sex. When this is considered as it relates to the current literature it is not difficult to understand why as a whole the participants in the reviewed literature cited anejaculation/ ejaculatory changes as a source of distress and impediment to their sexual well-being. This notion is well summarized by Harris (2005) in stating “not ejaculating has little consequence for straight men [in older age] … for many gay men, however, watching our partners and/or ourselves having an orgasm is an integral part of our sexual experience” (p. 111).
Intercourse type of situational anejaculation or inability to ejaculate intra-vaginally: three case reports from a conservative islamic community
Published in Psychiatry and Clinical Psychopharmacology, 2018
Oguzhan Bekir Egilmez, Mehmet Hamdi Orum
Anejaculation is the inability of the ejaculation, despite the stimulation of the penis by sexual intercourse or masturbation. The term “anejaculation” (true impotentia ejaculationis) is used by Steeno et al. to describe all cases of nonejaculatory intercourse [9]. Anejaculation may be primary or secondary, total, selective, or occasional. Patients having primary selective anejaculation can masturbate but cannot ejaculate intra-vaginally and this situation is called by some authors as intercourse anejaculation. This disorder stems from unconscious conflicts or abnormal beliefs about intravaginal ejaculation [5,6].
Does Metabolic Syndrome Impair Sexual Functioning in Adults With Overweight and Obesity?
Published in International Journal of Sexual Health, 2019
Saeideh Botlani Esfahani, Sebely Pal
Currently, there is no universally recognized definition of sexual dysfunction (Boyle, Cook, Purdie, Najman, & Dunne, 2003; Lewis et al., 2004), without which accurate prevalence rates are difficult to determine (Lewis et al., 2004). To establish such a definition, an International Consultation Committee was assembled, consisting of over 200 multidisciplinary experts in urology and sexual medicine from 60 countries; these consultations resulted in the following criteria of male and female sexual dysfunction (Lewis et al., 2004):Sexual desire dysfunction: Diminished sexual interest or desire, sexual thoughts and fantasies, more common in femalesPersistent sexual arousal dysfunction: Spontaneous, intrusive, and unwanted genital arousal in the absence of sexual desire.Orgasmic dysfunction: The lack, delay, or significantly diminished quality of orgasmic sensation.Sexual aversion: Extreme disgust and/or anxiety in response to anticipated or attempted sexual activity.Sexual arousal disorder in females: The presence of genital sexual arousal dysfunction, subjective sexual arousal dysfunction, or both. Genital sexual arousal: absent or impaired genital arousal; subjective sexual arousal dysfunction: absent or diminished feelings of sexual arousal or pleasure.Dyspareunia in females: Pain that persists or recurs with complete or attempted vaginal penetration.Vaginismus in females: Persistent or recurrent difficulty with vaginal penetration, despite the willingness to do so.Erectile dysfunction in males: The inability to attain and/or maintain penile erection sufficient for sexual activity.Early ejaculation in males: Ejaculation before or shortly after sexual stimulation, and occurring earlier than desired.Delayed ejaculation in males: Unwonted delay in attaining orgasm during sexual activity.Anejaculation in males: The absence of ejaculation during sexual stimulation.