J-M Soler1,2, J G Previnaire3, R Mieusset2. 1. Laboratoire d'urodynamique et de sexologie-Centre Bouffard Vercelli-Cap Peyrefite, Cerbère, France. 2. Médecine de la reproduction Hôpital Paule de Viguier 330, Toulouse cedex 9, France. 3. Spinal Unit, Centre Calvé, Fondation Hopale, Berck sur mer, France.
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.
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: Mohamed N Momen; Ibrahim Fahmy; Medhat Amer; Mohamad Arafa; Wael Zohdy; Taha A Naser Journal: Asian J Androl Date: 2007-09 Impact factor: 3.285
Authors: Jean Marc Soler; Jean Gabriel Previnaire; Pierre Plante; Pierre Denys; Emmanuel Chartier-Kastler Journal: J Sex Med Date: 2008-04-15 Impact factor: 3.802
Authors: Sigmund Hough; Colleen Clemency Cordes; Lance L Goetz; Angela Kuemmel; Jesse A Lieberman; Linda R Mona; Mitchell S Tepper; Jithin G Varghese Journal: Top Spinal Cord Inj Rehabil Date: 2020
Authors: Roger Mieusset; Marie Walschaerts; François Isus; Thierry Almont; Myriam Daudin; Safouane M Hamdi Journal: PLoS One Date: 2017-01-06 Impact factor: 3.240