Although premature ejaculation (PE) is a common type of male sexual dysfunction, to date we lack a unified definition of PE. The multidimensional definition of PE has been accepted by more and more clinicians. Intravaginal ejaculatory latency time (IELT) is one of the three important dimensions (time to ejaculation, inability to control or delay ejaculation, and negative consequences) for defining PE. Rapid ejaculation is one of the core symptoms of PE and IELT is an objective measurement as well as an important tool for the evaluation of PE. This article reviews estimated IELT, stopwatch-measured IELT, the correlation between estimated and stopwatch-measured IELT, and the factors affecting IELT in the general male population, PE patients, and those complaining of PE.
Coitus ; Ejaculation ; physiology ; Humans ; Male ; Premature Ejaculation ; etiology ; physiopathology ; Reaction Time ; physiology ; Time Factors

Premature ejaculation (PE) is a most common male sexual dysfunction with complex pathogenesis. An increasing number of scholars agree that PE is a disorder associated with abnormal neurobiology, which involves the central neurotransmitter system, peripheral nerve function of the nerve tissue structure, and neurological biochemistry. This review focuses on the neurobiological mechanisms of PE, expecting to gain a deeper insight into the possible etiology, objective and reliable diagnostic methods, and individualized treatment of the disease.
Biochemical Phenomena ; Ejaculation ; Humans ; Male ; Neurotransmitter Agents ; physiology ; Peripheral Nervous System ; physiopathology ; Premature Ejaculation ; etiology

Seminal vesicles are involved in semen accumulation in the process of ejaculation, contracting and releasing seminal vesicle fluid accounting for about 50－80% of the semen, and the fructose in their secretions is an indispensable nutrient for sperm maturation. Thus, seminal vesicles are important male accessary glands closely related with the quality and quantity of sperm. In the process of semen accumulation, sympathetic and parasympathetic nerves participate in the regulation of the secretory function of seminal vesicle epithelia and the contraction of the smooth muscle layer as well as the distribution of adrenonergic, cholinergic, dopaminergic and various neurotransmitter receptors in the seminal vesicle epithelia and smooth muscle layer, which play a significant role in male fertility. This review discusses the neurophysiological effects of seminal vesicles in ejaculation.
Animals ; Ejaculation ; physiology ; Male ; Semen ; physiology ; Semen Analysis ; Seminal Vesicles ; physiology ; Spermatozoa

OBJECTIVESTo evaluate modified cystectomy with preservation of erectile and ejaculatory functions in men with nonmalignant bladder disease.

METHODSSeven cases with average age of 27 years presented with bladder disease necessitating cystectomy, including 2 cases of tuberculous contractile bladder, 1 case of extensive polypoid cystitis glandularis, 4 cases of late stage of neurogenic bladder. All patients wished to maintain erectile and ejaculatory functions after the operation. We performed a modified simple cystectomy with preservation of the vasa deferens, seminal vesicles, prostate and neurovascular bundles, as well as construction of an Indiana pouch or ileal neobladder.

RESULTSAverage operative time was 5 h 45 min without perioperative complications in this group. Follow-up ranged from 9 to 60 months. Erectile and ejaculatory functions were normal in all cases. All patients remained completely continent and no dysuria in neobladder, and there was no difficulty in inserting catheter to empty pouch. Upper urinary tract was in good condition 3 and 24 months after operation.

CONCLUSIONSModified cystectomy with preservation of the vasa deferens, seminal vesicles, prostate and neurovascular bundles is an effective and reliable option for the patients who wish to maintain their fertility and erectile function after surgery.

Adult ; Cystectomy ; methods ; Ejaculation ; physiology ; Humans ; Male ; Middle Aged ; Penile Erection ; physiology ; Urinary Bladder Diseases ; surgery

The purpose of this study was to determine the changes in sex hormone level in men after ejaculation. The serum testosterone concentrations of 28 male volunteers were investigated daily during abstinence period after ejaculation. We found that fluctuations of testosterone levels from day 2 to day 5 of abstinence were minimal. On day 7 of abstinence, a peak of serum testosterone appeared, reaching 145.7% of the baseline (P<0.01). After the peak, no regular fluctuation was observed. Ejaculation was the premise and beginning of the 7 days' periodic phenomenon. If there was no ejaculation, there was no periodical changes in serum testosterone level. These results indicate that the periodic change in serum testosterone level is caused by ejaculation.
Adult ; Ejaculation ; physiology ; Humans ; Male ; Middle Aged ; Periodicity ; Testosterone ; blood ; physiology

OBJECTIVETo study the effect of successive ejaculation on semen analysis parameters in normal men.

METHODSEight ejaculates were collected at daily intervals from 8 normal men. The semen parameters were analyzed according to WHO laboratory manual for the examination of human semen and sperm-cervical mucus interaction.

RESULTSThe semen volumes and total sperm counts decreased gradually day by day, significantly lower from the 5th to the 8th day than the 1st (P < 0.01). The sperm densities also declined day by day, but not significantly. The sperm viability and motility (a + b grade) presented an increasing trend, but with no significance except on the 7th day.

CONCLUSIONWith the increase of the ejaculatory frequency, human semen volumes and the total counts significantly decrease, while sperm viability and motility gradually increase. Successive ejaculation does not affect the quality of human semen.

Adult ; Ejaculation ; physiology ; Humans ; Male ; Semen ; physiology ; Sperm Count ; Sperm Motility

Prolactin is a polypeptide hormone which mainly acts on the reproductive system and plays an important role in penile erection and ejaculation. Prolactin receptors have a variety of short forms apart from the classic long form, which are widely expressed in male reproductive glands. High levels of prolactin can induce erectile dysfunction and results in secondary male infertility, which are mainly associated with the inhibition of dopaminergic activity, reduction of the testosterone level, and contraction of the cavernous smooth muscle. Moreover, low levels of prolactin can result in ejaculatory dysfunction. This article updates the views on the expressions of prolactin receptors in the male reproductive system, the effects of prolactin on penile erection and ejaculation, and its action mechanisms.
Ejaculation ; physiology ; Erectile Dysfunction ; Humans ; Infertility, Male ; Male ; Muscle, Smooth ; physiopathology ; Penile Erection ; physiology ; Prolactin ; physiology ; Receptors, Prolactin ; physiology ; Reproduction

Premature ejaculation (PE) is a common male sexual disorder with an incidence rate of 20-30%. Recent clinical trials have demonstrated that phosphodiesterase type 5 inhibitors (PDE5i), as the first-line drug for erectile dysfunction (ED), can improve ejaculatory function probably by acting on the peripheral and central adrenergic nerves. The possible action mechanisms of PDE5i may involve lessening of the central sympathetic output, modulation of the contractile responses from the vas deferens, seminal vesicles, prostate and urethra, induction of peripheral analgesia, and prolonging of the total erectile duration, increasing the confidence of ejaculation control, and reducing the post-ejaculation refractory time. This review discusses the possible mechanisms and clinical application of PDE5i in the treatment of PE.
Ejaculation ; drug effects ; Erectile Dysfunction ; drug therapy ; Humans ; Male ; Muscle Contraction ; Phosphodiesterase 5 Inhibitors ; therapeutic use ; Premature Ejaculation ; drug therapy ; Seminal Vesicles ; physiology ; Vas Deferens ; physiology

A collection of neurons in the upper lumbar spinal cord (lumbar segments 3 and 4) of male rats project to the lower lumbar spinal cord (lumbar segments 5 and 6) and release a gastrin-releasing peptide (GRP) to the somatic and autonomic regions, which are known to regulate male sexual reflexes. The GRP plays some special functions when bound to the specific GRP receptor (GRPR). The spinal GRP system is regulated by androgens. Accumulating evidence shows that GRP plays an important role in rat penile erection and ejaculation, and pharmacological stimulation of GRPRs with a specific agonist can restore penile reflexes and ejaculation in castrated male rats. Therefore, the GRP system appears to be a potential therapeutic target for the treatment of erectile dysfunction or ejaculatory dysfunction. The present paper briefly reviews the recent studies on the role of the spinal GRP system in regulating the sexual function of males.
Androgens ; metabolism ; Animals ; Ejaculation ; physiology ; Gastrin-Releasing Peptide ; metabolism ; physiology ; Male ; Penile Erection ; physiology ; Rats ; Spinal Cord ; metabolism

OBJECTIVETo explore the complexity of mRNA in the ejaculated sperm from healthy fertile men.

METHODSSemen samples were collected from 10 healthy fathers. The swim-up method was adopted to purify the sperm from possible contamination of somatic cells and the spermatozoal total RNA extracted by Trizol was used for SAGE library analysis.

RESULTSA totle of 21 052 SAGE raw tags were sequenced from 877 clones and 2 712 unique tags that occurred at least twice in the library were given further analysis. 19.7% of the unique tags had no match in the existing SAGE map, representing novel genes. Molecular function analysis revealed 67% of unique tags related to protein binding or nucleic acid binding categories, 41% to catalytic activity, 13% to message transducer activity, and 10% to transporter, structural and transcription regulator activity, respectively.

CONCLUSIONThere exists a complex repertoire of mRNAs in the ejaculated spermatozoa from fertile men.

Adult ; Ejaculation ; Expressed Sequence Tags ; Gene Expression Profiling ; Humans ; Male ; RNA, Messenger ; genetics ; Spermatozoa ; physiology