Male Methods
Sujoy K. Guba in Bioengineering in Reproductive Medicine, 2020
Disorders of semen ejaculation is one of the causes of male infertility. The problems fall into four major groups: retrograde ejaculation; premature ejaculation; ejaculatory duct obstruction and ejaculatory failure. 1 In retrograde ejaculation the seminal fluid travels to the bladder instead of being voided anteriorly via the urethra. Premature ejaculation involves seminal evacuation prior to vaginal intromission. Obstruction of the seminal flow pathways may be congenital or acquired and may result in reduced total spermatozoa count in the ejaculate or aspermia. Ejaculatory failure is on account of some abnormality in the activation and effectiveness of the propulsion mechanism. The first three types of problems are dealt with by drug therapy, surgery and psychiatric counselling. Technology has a role in the management of the fourth category, i.e., ejaculatory failure. Physical modalities to induce ejaculation have been developed.
Seminal Vesicle Disease
Robert G. Moore, Jay T. Bishoff, Stefan Loenig, Steven G. Docimo in Minimally Invasive Urological Surgery, 2005
The seminal vesicles (SV) are two elongated, convoluted glands lying between the fundus of the bladder and the rectum, just above the prostate (Figure 52.1). Each SV is pyramidal in form, the broad end being directed cephalad and posteriolaterally. It is usually about 7.5 cm long, but varies in size, not only in different individuals but also in the same individual on the two sides. The anterior surface is in contact with the fundus of the bladder, extending from near the termination of the ureter to the base of the prostate. The posterior surface rests upon the rectum, from which it is separated by the rectovesical fascia. The upper extremities of the two vesicles diverge from each other, are in close relation with the ductus deferentes and the terminations of the ureters, and are partly covered by peritoneum. The lower extremities are pointed, and converge toward the base of the prostate, where each joins with the corresponding ductus deferens to form the ejaculatory duct. Along the medial margin of each vesicle runs the ampulla of the ductus deferens. When uncoiled, the tube is about the diameter of a quill, and varies in length from 10 to 15 cm: it ends posteriorly in a cul-de-sac; its anterior extremity becomes constricted into a narrow straight duct, which joins with the corresponding ductus deferens to form the ejaculatory duct. Blood supply for the SV is provided by the vesicodeferential arteries, the inferior vesical arteries and the superior and middle rectal arteries. Venous drainage is guaranteed by a rich venous plexus located posteriorly, which drains into the vesicodeferential vein and into the inferior vesical plexus. Lymphatics drain into the hypogastric lymph nodes. Adrenergic innervation is provided by nerve branches arising from the hypogastric plexus.
Ejaculatory Duct Obstruction after Transurethral Resection of the Prostate
Published in Acta Chirurgica Belgica, 2009
S.-M. Kuo, T.-L. Cha, G.-H. Sun
Transurethral resection of the prostate is currently the most commonly employed surgical procedure for benign prostatic hyperplasia. Although several complications after the procedure have been well documented, ejaculatory duct obstruction is a rare complication. We describe this unusual complication in a 77-year-old male who presented with severe pain and a feeling of fullness in the lower abdomen and with dry ejaculate on three occasions after undergoing post-transurethral resection of the prostate. The patient’s post-ejaculatory urinalysis demonstrated no sperm. Transrectal ultrasonography also showed no dilatation of the bilateral seminal vesicles or ejaculatory ducts. However, ejaculatory duct obstruction was finally diagnosed on vasovesiculography. The patient was successfully treated with transurethral resection of the ejaculatory duct and remained asymptomatic 6 months postoperatively. Although transrectal ultrasonography is currently widely used to evaluate ejaculatory duct obstruction, we suggest that vasovesiculo-graphy is still a feasible and useful tool that provides detailed anatomic information for the advanced confirmation of ejaculatory duct obstruction in patients with a high suspicion of ejaculatory duct obstruction who have normal transrectal ultrasonography findings.
Clinical and Radiological Evaluation of Ejaculatory Duct Obstruction
Published in Archives of Andrology, 2007
Mehmet Ruhi Onur, Ýrfan Orhan, Fatih Fýrdolaþ, Rahmi Onur, Ercan Kocakoç
Ejaculatory duct obstruction (EDO) is a rare but surgically correctable cause of male infertility. With the advent and increased use of transrectal ultrasonography and magnetic resonance imaging, abnormalities of the ejaculatory duct (ED) related to infertility have been diagnosed more frequently. Recently, with the increased awareness of functional obstruction of ED, reports have been focusing on the diagnosis of partial or functional EDO. We present 2 review of the ED pathologies, imaging modalities and treatment options.
Postmating Change in Physiology of Male
Published in Journal of Neurogenetics, 2010
Katie Norville, Sean T. Sweeney, Christopher J. H. Elliott
Abstract: Sex peptides transferred during mating from male to female fly profoundly influence the female's behavior and physiology, including an increase in the movement of eggs along the oviduct. In the male ejaculatory duct, the authors have identified peristaltic waves that travel distally with an average frequency of 0.6 Hz. The frequency of peristalsis is increased by 0.1 μM serotonin (5-HT) and completely blocked by 5-HT antagonists (IC50< 1 μM). The authors also report that mating affects the male reproductive tract; peristaltic waves along the ejaculatory duct are significantly reduced postcopulation by 30%. Serotonergic neurons innervate the ejaculatory duct, but their genetic ablation does not prevent peristalsis. The authors propose that peristalsis may be modulated by serotonin circulating in the hemolymph. As serotonin is linked with attentiveness in both flies and mammals, this bioassay suggests reduced behavioral sensitivity of the male fly after mating.
Related Knowledge Centers
- Anatomy
- Prostate
- Semen
- Ejaculation
- Urethra
- Vas Deferens