Treatment of Functional Retrograde Ejaculation with Acupuncture and TCM Herbal Drugs

Acupuncture at the Taichong (LR 3), Sanyinjiao (SP 6) and Ciliao (BL 32) points combined with TCM drugs for soothing the liver, replenishing the kidney, freeing the seminal passage, and eliminating the stasis showed effective for functional retrograde ejaculation in 25 cases. The total effective rate of 68.0% was significantly better than imipramine used in the control group (P<0.05).

Evaluation of Sperm Parameters of Infertile Men with Retrograde Ejaculation

Objective To investigate sperm parameters of infertile men with retrograde ejaculation. Methods Twelve infertile men with retrograde ejaculation （group A） were enrolled into this study. Sperm samples were obtained from the postejaculation urine. After sperm recovery and washing procedure, sperm parameters were assessed. Twelve semen samples from normospermic donors were Used as the control （group B）. Results In all retrograde cases, motile sperm with forward movement were observed in the medium. Motility of group A was significantly lower than that of group B （P〈0.01）. In group A, sperm motility ranged from 11% to 56%, sperm with intact both head and tail membranes was 42.2 ±12.3%, sperm count ranged （13-85）×^ 106/ml, and the sperm survival time was highly shortened. Sperm with normal morphology and intact acrosome were observed in retrograde specimens. Conclusion Sperm parameters recovered from retrograde specimens were highly variable between subjects. The toxicity of urine caused deleterious to sperm functions. Motile sperm could be collected by sperm recovery procedure. Sperm parameters could meet the requirement for the use of assisted reproductive techniques for treating infertile men with retrograde ejaculation.

Vlale sexual dysfunction and infertility associated with neurological disorders

Normal sexual and reproductive functions depend largely on neurological mechanisms. Neurological defects in men can cause infertility through erectile dysfunction, ejaculatory dysfunction and semen abnormalities. Among the major conditions contributing to these symptoms are pelvic and retroperitoneal surgery, diabetes, congenital spinal abnormalities, multiple sclerosis and spinal cord injury, Erectile dysfunction can be managed by an increasingly invasive range of treatments including medications, injection therapy and the surgical insertion of a penile implant. Retrograde ejaculation is managed by medications to reverse the condition in mild cases and in bladder harvest of semen after ejaculation in more severe cases. Anejaculation might also be managed by medication in mild cases while assisted ejaculatory techniques including penile vibratory stimulation and eiectroejaculation are used in more severe cases. If these measures fail, surgical sperm retrieval can be attempted. Ejaculation with penile vibratory stimulation can be done by some spinal cord injured men and their partners at home, followed by in-home insemination if circumstances and sperm quality are adequate. The other options always require assisted reproductive techniques including intrauterine insemination or in vitrofertilization with or without intracytoplasmic sperm injection. The method of choice depends largely on the number of motile sperm in the ejaculate.

Management of ejaculatory disorders in infertile men

Ejaculatory dysfunction is a highly prevalent clinical condition that may be classified along a continuum that ranges from premature ejaculation （PE）, through retarded or delayed ejaculation （DE）, to complete anejaculation （AE）. Retrograde ejaculation （RE） represents a distinct entity in which ejaculate is expelled either partially or completely into the bladder. While DE and PE are significant sources of sexual dissatisfaction among men and their partners, patients with these disorders retain normal fertility in most cases. Conversely, men with AE and RE are unable to deliver sperm into the female genital tract and are therefore rendered subfertile. Therefore, in reviewing ejaculatory disorders as they relate to fertility, this paper will primarily focus on the diagnosis and management of AE and RE. Physiology, diagnostic strategies, pharmacological treatments, and procedural interventions relevant to AE and RE are discussed.

Ejaculatory dysfunction in men with diabetes mellitus

Diabetes mellitus(DM)is a metabolic disorder that is characterized by elevated blood glucose levels due to absolute or relative insulin deficiency,in the background ofβ-cell dysfunction,insulin resistance,or both.Such chronic hyperglycemia is linked to long-term damage to blood vessels,nerves,and various organs.Currently,the worldwide burden of DM and its complications is in increase.Male sexual dysfunction is one of the famous complications of DM,including abnormal orgasmic/ejaculatory functions,desire/libido,and erection.Ejaculatory dysfunction encompasses several disorders related to DM and its complications,such as premature ejaculation,anejaculation(AE),delayed ejaculation,retrograde ejaculation(RE),ejaculatory pain,anesthetic ejaculation,decreased ejaculate volume,and decreased force of ejaculation.The problems linked to ejaculatory dysfunction may extend beyond the poor quality of life in diabetics as both AE and RE are alleged to alter the fertility potential of these patients.However,although both diabetes patients and their physicians are increasingly aware of diabetic ejaculatory dysfunction,this awareness still lags behind that of other diabetes complications.Therefore,all these disorders should be looked for thoroughly during the clinical evaluation of diabetic men.Besides,introducing the suitable option and/or maneuvers to treat these disorders should be tailored according to each case.This review aimed to explore the most important findings regarding ejaculatory dysfunction in diabetes from pre-clinical and clinical perspectives.