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Evidence of a new pattern of ejaculation in men with spinal cord injury: ejaculation dyssynergia and implications for fertility.
Spinal Cord. 2016 Dec; 54(12):1210-1214.SC

Abstract

OBJECTIVES

To describe the presence of sperm in the prostatic urethra as a stand-alone ejaculation entity and to assess its characteristics.

METHODS

Thirty-three patients with anejaculation during sexual stimulation were enroled. Penile vibratory stimulations were carried out following bladder catherization and instillation of a pink buffering medium (Ferticult). Two-step catheterisation was then performed: a catheter was inserted through the urethral sphincter into the prostatic urethra to aspirate its content, and then bladder catheterisation was performed to collect the Ferticult. The procedure was repeated in some patients after at least 1 week. The characteristics of the semen collected from each organ were analysed and compared.

RESULTS

A total of 42 trials were obtained from 22 patients. Sperms were found in the prostatic urethra in 21 samples (50%) from 12 patients (11 with spinal cord injury, 1 with diabetes). The colour of all 21 prostatic urethra sperm samples differed from the Ferticult. Sperm motility was greater in 8 samples, sperm count was higher in 10 and pH was different in 10, compared with the bladder samples. The higher overall quality of the sperm allowed cryopreservation in 10 prostatic urethra samples compared with only 5 bladder samples. Four of the five patients who underwent repeated trials had a reproducible pattern of prostatic urethra ejaculation.

CONCLUSION

The presence of sperm in the prostatic urethra most probably results from 'ejaculation dyssynergia', a lack of coordination between bladder neck and external sphincter. Sperm from the prostatic urethra should be systematically sought to improve the outcome of assisted reproduction.

Authors+Show Affiliations

Laboratoire d'urodynamique et de sexologie-Centre Bouffard Vercelli-Cap Peyrefite, Cerbère, France. Médecine de la reproduction Hôpital Paule de Viguier 330, Toulouse cedex 9, France.Spinal Unit, Centre Calvé, Fondation Hopale, Berck sur mer, France.Médecine de la reproduction Hôpital Paule de Viguier 330, Toulouse cedex 9, France.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

27324318

Citation

Soler, J-M, et al. "Evidence of a New Pattern of Ejaculation in Men With Spinal Cord Injury: Ejaculation Dyssynergia and Implications for Fertility." Spinal Cord, vol. 54, no. 12, 2016, pp. 1210-1214.
Soler JM, Previnaire JG, Mieusset R. Evidence of a new pattern of ejaculation in men with spinal cord injury: ejaculation dyssynergia and implications for fertility. Spinal Cord. 2016;54(12):1210-1214.
Soler, J. M., Previnaire, J. G., & Mieusset, R. (2016). Evidence of a new pattern of ejaculation in men with spinal cord injury: ejaculation dyssynergia and implications for fertility. Spinal Cord, 54(12), 1210-1214. https://doi.org/10.1038/sc.2016.78
Soler JM, Previnaire JG, Mieusset R. Evidence of a New Pattern of Ejaculation in Men With Spinal Cord Injury: Ejaculation Dyssynergia and Implications for Fertility. Spinal Cord. 2016;54(12):1210-1214. PubMed PMID: 27324318.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Evidence of a new pattern of ejaculation in men with spinal cord injury: ejaculation dyssynergia and implications for fertility. AU - Soler,J-M, AU - Previnaire,J G, AU - Mieusset,R, Y1 - 2016/06/21/ PY - 2015/11/03/received PY - 2016/03/24/revised PY - 2016/04/26/accepted PY - 2016/6/22/pubmed PY - 2017/3/14/medline PY - 2016/6/22/entrez SP - 1210 EP - 1214 JF - Spinal cord JO - Spinal Cord VL - 54 IS - 12 N2 - OBJECTIVES: To describe the presence of sperm in the prostatic urethra as a stand-alone ejaculation entity and to assess its characteristics. METHODS: Thirty-three patients with anejaculation during sexual stimulation were enroled. Penile vibratory stimulations were carried out following bladder catherization and instillation of a pink buffering medium (Ferticult). Two-step catheterisation was then performed: a catheter was inserted through the urethral sphincter into the prostatic urethra to aspirate its content, and then bladder catheterisation was performed to collect the Ferticult. The procedure was repeated in some patients after at least 1 week. The characteristics of the semen collected from each organ were analysed and compared. RESULTS: A total of 42 trials were obtained from 22 patients. Sperms were found in the prostatic urethra in 21 samples (50%) from 12 patients (11 with spinal cord injury, 1 with diabetes). The colour of all 21 prostatic urethra sperm samples differed from the Ferticult. Sperm motility was greater in 8 samples, sperm count was higher in 10 and pH was different in 10, compared with the bladder samples. The higher overall quality of the sperm allowed cryopreservation in 10 prostatic urethra samples compared with only 5 bladder samples. Four of the five patients who underwent repeated trials had a reproducible pattern of prostatic urethra ejaculation. CONCLUSION: The presence of sperm in the prostatic urethra most probably results from 'ejaculation dyssynergia', a lack of coordination between bladder neck and external sphincter. Sperm from the prostatic urethra should be systematically sought to improve the outcome of assisted reproduction. SN - 1476-5624 UR - https://www.unboundmedicine.com/medline/citation/27324318/Evidence_of_a_new_pattern_of_ejaculation_in_men_with_spinal_cord_injury:_ejaculation_dyssynergia_and_implications_for_fertility_ L2 - https://doi.org/10.1038/sc.2016.78 DB - PRIME DP - Unbound Medicine ER -