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Other Complications of Diabetes
Published in Jahangir Moini, Matthew Adams, Anthony LoGalbo, Complications of Diabetes Mellitus, 2022
Jahangir Moini, Matthew Adams, Anthony LoGalbo
Erectile dysfunction (ED) is the inability to attain or sustain an erection for sexual intercourse. It is a complication of diabetes as well as vascular, neurologic, psychologic, and hormonal disorders. Retrograde ejaculation involves semen being ejaculated backward into the bladder instead of outward through the penis. Decreased vaginal lubrication is another condition related to diabetes, which results in vaginal dryness.
Prescribing for a first episode of schizophrenia-like psychosis
Published in Kathy J Aitchison, Karena Meehan, Robin M Murray, First Episode Psychosis, 2021
Kathy J Aitchison, Karena Meehan, Robin M Murray
Erectile dysfunction occurs in 23-54% of men on antipsychotics. Other side-effects affecting sexual function include ejaculatory disturbances in men and loss of libido or anorgasmia in women and men; these are thought to be due to antiadrenergic and antiserotonergic effects, and possibly hyper-prolactinaemia. In addition, specific antipsychotics (eg thioridazine and risperidone) may cause retrograde ejaculation. Twenty per cent of males on sertindole in trials had reduced or no ejaculate.141
Azoospermia
Published in Botros Rizk, Ashok Agarwal, Edmund S. Sabanegh, Male Infertility in Reproductive Medicine, 2019
Medhat Amer, Emad Fakhry, Botros Rizk
Low-volume ejaculate may be caused by testosterone deficiency, which can cause NOA. Retrograde ejaculation as another cause of low-volume semen can be diagnosed by the presence of sperm in the urine analysis after ejaculation, ruling out the diagnosis of azoospermia. Retrograde ejaculation occurs when there is disruption of the sympathetic innervation of the bladder neck impairing its resistance to the high pressure generated by the pelvic floor muscles during ejaculation. This would lead to redirection of semen into the bladder. The cause may be pharmacologic, from alpha sympatholytic action at the bladder neck (alpha blockers, antipsychotics, ganglion blockers); or surgical, from disruption of the sympathetic pathways that potentiate bladder neck contracture (retroperitoneal pelvic lymph node dissection, spinal cord injury, transurethral resection of the prostate). Long-standing diabetes is another etiology, causing 30% incidence of retrograde ejaculation among those with diabetes [20].
Is azoospermia the appropriate standard for post-vasectomy semen analysis? Or an unachievable goal of best practice laboratory guidelines
Published in Human Fertility, 2020
Mathew Tomlinson, Karen Pooley, Tracey Kohut, Melanie Atkinson
Samples were analysed no more than 2 hours post-collection. Seminal volume was measured using a graduated serological pipette and a 10 µl aliquot placed on a plain glass slide (22 × 22 mm coverslip) which was scanned systematically using phase-contrast microscopy at ×200 magnification. If no sperm were observed, 1 mL semen was centrifuged at 1500g for 10 minutes, followed by examination of 10 µl of pellet (effectively a 20-fold concentration of sample) in line with current WHO guidance (WHO, 2010). If sample volume was <0.5 ml, surgical providers are informed that ‘retrograde ejaculation’ cannot be ruled out and that a confirmatory test should be performed alongside a (post-ejaculatory) urine analysis. If motile sperm were observed then a standard sperm concentration and motility was performed according to WHO guidelines (WHO, 1999, 2010), although in the last 5 years, motile samples were analysed and recorded using computer-assisted semen analysis (CASA) (Procreative-Diagnostics, Staffordshire UK) which provides a ‘hard copy’ recording should this be required as more tangible evidence of possible failure (Tomlinson et al., 2010).
Limited post-chemotherapy retroperitoneal resection of residual tumour in non-seminomatous testicular cancer: complications, outcome and quality of life
Published in Acta Oncologica, 2018
Anna Hartmann Schmidt, Morten Høyer, Bent Frode Skov Jensen, Mads Agerbaek
Loss of antegrade ejaculation is a well-known complication experienced after surgery in the retroperitoneal space [26]. In all, we found that 80% of the operated patients maintained antegrade ejaculation. Three controls and one patient reported retrograde ejaculation, the latter reporting presence of the condition before surgery. This demonstrates that chemotherapy might play a role in losing the ability to have antegrade ejaculation. Cisplatin is known to cause peripheral neuropathy, but the effects on the autonomic nervous system are controversial [27,28]. Retrograde ejaculation due to cisplatin has, to our knowledge, not previously been described. Two operated patients in our study have successfully used Imipramine to restore retrograde ejaculation. There are reports on Imipramine used to restore antegrade ejaculation [29], and the achievement in our study confirms the relevance of this drug.
Efficacy and safety of tamsulosin 0.4 mg single pills for treatment of Asian patients with symptomatic benign prostatic hyperplasia with lower urinary tract symptoms: a randomized, double-blind, phase 3 trial
Published in Current Medical Research and Opinion, 2018
Jae Hoon Chung, Cheol Young Oh, Jae Heon Kim, U-Syn Ha, Tae Hyo Kim, Seung Hwan Lee, Jun Hyun Han, Jae Hyun Bae, In Ho Chang, Deok Hyun Han, Tag Keun Yoo, Jae Il Chung, Sae Woong Kim, Jina Jung, Yong-Il Kim, Seung Wook Lee
A few phase 3 studies have been conducted on tamsulosin 0.4 mg. Abrams and colleagues reported that the intake of tamsulosin 0.4 mg improved Qmax to 1.4 mL/s and the Boyarsky symptom score to 3.4 points in 313 patients with LUTS/BPH. They also reported no significant adverse reactions compared with placebo treatment13. Lepor compared placebo, tamsulosin 0.4 mg and tamsulosin 0.8 mg in 756 patients with BPH and reported that both 0.4 mg and 0.8 mg showed a significant improvement of urination14. In their study, TEAEs occurred in 73% of the subjects in the tamsulosin 0.8 mg group, in 65% in the tamsulosin 0.4 mg group and in 59% in the placebo group. The author reported that the incidence of TEAEs was higher in the tamsulosin 0.8 mg administration group than in the placebo group, but no significant difference in terms of TEAEs was found between the tamsulosin 0.4 mg group and the placebo group. They concluded that both tamsulosin 0.4 mg and 0.8 mg were safe and effective in the treatment of LUTS/BPH, although adverse reactions occurred more frequently in the 0.8 mg group. In this study, tamsulosin 0.2 mg and 0.4 mg was safe and effective in improving urination symptoms in LUTS/BPH patients when compared with placebo. In addition, the safety profile of tamsulosin 0.4 mg was similar to that of tamsulosin 0.2 mg, and urination symptoms sufficiently improved in those with tamsulosin 0.4 mg. In this study, the incidence of TEAEs and adverse drug reactions was somewhat higher in the tamsulosin 0.4 mg group, but the incidence of each event was very low and the severity of the symptoms was mild. In particular, the incidence of retrograde ejaculation and ejaculatory dysfunction was much lower in this study than in previous studies15–17. This may be the result of selection bias because the average age of patients enrolled was 63.05 years. Therefore, there were a large number of patients who were not sexually active and subsequent adverse drug reactions were difficult to detect by medical interview. Based on these findings, we may conclude that it is safe to administer tamsulosin 0.4 mg for LUTS/BPH treatment in the Asian population.