Latest Treatment of Premature Ejaculation
Traditionally, the detection of the enzyme amylase on vulval and vaginal swabs was considered confirmatory evidence of the presence of saliva. However, in 1992, a study conducted at the Metropolitan Police Laboratory, London, using vaginal swabs from volunteer female donors who had not participated in cunnilingus revealed high levels of endogenous amylase (82). Furthermore, amylase has been specifically isolated from cervical mucus (83). Therefore, the FSS in London no longer routinely tests for amylase in such cases. Instead, DNA analysis is undertaken on the vulval and or vaginal swabs. If the assailant's DNA profile is obtained, it can be used to support an allegation of cunnilingus, although, obviously, the precise interpretation will depend on whether the complainant was subjected to other sexual acts that could account for the presence of the DNA (e.g., ejaculation). There are no published persistence data regarding the maximum time it is possible to obtain the assailant's DNA...
From the vaginal fornices to identify motile spermatozoa on the basis that the presence and motility of spermatozoa may help determine whether recent vaginal ejaculation had occurred. However, a considerable body of opinion does not commend this practice (104). Forensic science laboratories have specialist extraction procedures, staining techniques, and microscopic equipment to maximize spermatozoa recovery and facilitate identification. A survey of 300 cases in which spermatozoa were eventually identified found that they were only detected in four of the cases in the native preparation (before the application of specialist stains) (105).
All drugs that interfere with sympathetic autonomic activity, including diuretics, can potentially interfere with male sexual function, expressed as a failure of ejaculation or difficulty in sustaining an erection. Nevertheless, placebo-controlled trials have emphasised how common a symptom this is in the untreated male population (approaching sometimes 20-30 ). It is also likely that hypertension itself is associated with an increased risk of sexual dysfunction since loss of NO production by the vascular endothelium is an early feature of the pathophysiology of this disease. Laying the blame on antihypertensive medication is probably
A parallel with the differential roles of the amygdala in male appetitive (precopulatory) versus consummatory (copulatory) sexual responses highlighted in previous animal studies is suggested by a PET study of brain activity in men during consummatory sexual behavior elicited by tactile stimulation by a female partner (Holstege et al., 2003). Relative to a resting baseline, consummatory male sexual behavior (erection and orgasm) elicited decreased activity in only one brain region, the amygdala, bilaterally during erection and in the left amygdala during orgasm. Thus, whereas viewing appetitive sexual stimuli by males in the Hamann and colleagues (2004) study elicited highly localized increases in amygdala activation, consummatory sexual behavior elicited correspondingly focal deactivations in the amygdala. In contrast to the neuroimaging studies of responses to visual sexual stimuli, where no areas of greater activation were found for females, a recent PET study of brain activation...
The prostatic urethra (1.25in (3 cm)), as its name implies, traverses the prostate. Its posterior wall bears a longitudinal elevation termed the urethral crest, on each side of which is a shallow depression, the prostatic sinus, into which the 15-20 prostatic ducts empty. At about the middle of the crest is a prominence termed the colliculus seminalis (verumontanum) into which opens the prostatic utricle. This is a blind tract, about 5 mm long, running downwards from the substance of the median lobe of the prostate. It is believed to represent the male equivalent of the vagina, a remnant of the paramesonephric duct (see page 148). On either side of the orifice of the prostatic utricle open the ejaculatory ducts, formed by the union of the duct of the seminal vesicle and the terminal part of the vas deferens.
A clear physiological association between diabetes and male sexual dysfunction is well established. In a comprehensive review of the literature, Eretekin (1998) found ample research evidence for chronic progressive impotence directly related to diabetes mellitus. It is either neuropathic or vascular, or both. In some instances impotence may lead to the discovery of the disease. Another rare sexual dysfunction affecting 1 to 2 of diabetic men is retrograde ejaculation. However, some researchers have suggested that this problem may be more common than generally believed. Psychological factors, which until recent times were seen as critical in the explanation of sexual problems associated with diabetes, have lost considerable ground as physical explanations have emerged.
After sperm are produced in the seminiferous tubules, they move into a long, coiled tube called the epididymis, where the sperm gain the ability to move themselves by using their flagellum. During ejaculation, the sperm are propelled from the epididymis to the vas deferens, a long tube that joins with the ejaculatory duct at a gland called the seminal vesicle. The seminal vesicle produces a fructose-rich fluid that helps supply the sperm with energy they will need for propelling themselves. Sperm and these associated fluids are called semen. The sperm then move along the ejaculatory duct and pass through the prostate gland located at the base of the bladder. Within the prostate gland, the ejaculatory duct merges with the urethra coming from the urinary bladder. At ejaculation, the urethra carries the semen out of the body through the penis.
Aldrich 22 documented the development of tantric cannabis usage around the seventh century as a mingling of Shaivite Hinduism and Tibetan Buddhism. Apparently, the 11th century text, Mahanirvana Tantra, is currently still consulted with regard to sexual practices, withholding of male ejaculation and promotion of sexual pleasure in both genders.
Very little is known about the meaning of pubertal changes for boys. In a small qualitative study, middle adolescent boys were interviewed about their reactions to their first ejaculation (spermarche), their preparedness for the event and sources of information, and the extent to which they discussed this with friends (Gaddis & Brooks-Gunn, 1985). Responses from boys were more positive than negative, although two-thirds of the boys reported being a little frightened, which is comparable to girls' reactions to menarche. The boys were very reluctant to discuss their experience of first ejaculation with parents or peers. This secrecy may stem in part from spermarche's link with masturbation. Although studies have not focused on boys' responses to increases in height and weight during puberty, these are most likely positive changes for boys. However, it has been suggested that media images of men are becoming as unrealistic and unattainable as media images of women (Leit, Gray, & Pope,...
Show hyaluronan located mainly on the lower basolateral surface, but with little on the apical surface (Fig. 2c-f) (38). In these epithelia, the location of CD44 correlates with that of hyaluronan on the basolateral surfaces. This distribution suggests that hyaluronan is mostly synthesized and remains bound on the basal side of the adjacent epithelial cells. However, the lumen of the seminal vesicle, prostate and Cowper's gland (Fig. 2c-e) contain hyaluronan, suggesting that it is either secreted from the apical surface, or passes the cell junctions in the lateral sides of the cells. There is an extensive pool of hyaluronan in the underlying stroma of these glands, a potential source of the epithelial and lumenal hyaluronan. Interestingly, testis seems almost devoid of hyaluronan (38), perhaps a finding related to the high level of hyaluronidase in the sperm cells. At ejaculation, the hyaluronan in the product of the accessory sex glands comes in contact with sperm cells.
Because reproductive problems may affect men as well as women, a brief review of the normal male reproductive physiology is warranted. Men continually produce mature sperm cells in the seminiferous tubules of the testes, with the highest num-ejaculation - ejection of sperm bers around 72 hours after the last ejaculation. Sperm production occurs under cells and seminal fluid at the complex interaction of hormonal signals similar to the female reproductive
To the ischial tuberosity then turns medially to the base of the bladder. Here it joins the more laterally placed seminal vesicle to form the ejaculatory duct which traverses the prostate to open into the prostatic urethra at the veru-montanum on either side of the utricle.
If the prevalence of sexual dysfunction in the general population were the result of a communicable disease, it would have been declared a major public health crisis. In a review of 23 studies of sexual dysfunction of the general population, community samples revealed a prevalence of 5 to 10 for inhibited female orgasm, 4 to 9 for inhibited male orgasm, and 36 to 38 for premature ejaculation (Spector and Carey, 1990). However, this review identified a number of methodological shortcomings related to sampling issues, such as the difficulties associated with representative samples of the different ethnic groups in the American population, and the problems related to the lack of a uniform operational definition of sexual dysfunction. ejaculations were functions of increasing age. Prostate problems accounted for much of the erectile problems in men, whereas premature ejaculation was strongly correlated with anxiety. Marital difficulties accounted for much of the orgasmic and enjoyment...
After actual or possible oral ejaculation, the sample is initially examined microscopically to identify spermatozoa (see Subheading 18.104.22.168.) followed by DNA analysis. Rapid retrieval of the forensic samples from the oral cavity is of paramount importance because of the limited period that spermatozoa remain in this orifice. Even though the maximum persistence of spermatozoa in the oral cavity is recorded as 28-31 hours, only a few spermatozoa are detected unless the sample is taken within a few hours of ejaculation (71). Consequently, the forensic exhibits must be collected as soon as an allegation of nonconsensual fellatio is made, and law enforcement agencies should be instructed accordingly. In the United Kingdom, an early evidence kit is available for use by the first response police officer this is particularly beneficial in cases where there may be a time delay before a medical examination can occur.
In exceptional circumstances (e.g., genital injury or age of the examinee), it may not be possible to pass a speculum to obtain the high vaginal and endocervical swabs. On these occasions, two dry swabs should be inserted sequentially into the vagina under direct vision, avoiding contact with the vestibule and hymen. An attempt should then be made to comprehensively sample the vagina by gently rotating and moving each swab backward and forward. These swabs should be labeled vaginal swabs . Unfortunately, in such circumstances, it is impossible to be certain that the high vaginal swab was not contaminated from semen in the low vagina, which could be there because of drainage from external ejaculation.
The FSS is currently researching the use of FISH technology to identify small amounts of male epithelial cells that subsequently can be isolated to enable STR DNA profiling to be conducted on the recovered material (108110). This will be useful where the offender is suspected to be oligospermic or aspermic or when only minimal amounts of male epithelial cells have been deposited Y chromosome-positive cells have been isolated from vaginal swabs taken immediately after intercourse where no ejaculation had occurred.
In traditional Mohammedan medicine, or Tibbi, the properties of cannabis have been described as promoting insanity, causing unconsciousness, weakening the heart, annulling pain, inhibiting secretion of semen and enabling the individual to gain control over ejaculation (Chopra and Chopra, 1957).
The seminal vesicle is formed by 20 secretory cells. Spermatocytes enter the vesicle and undergo two meiotic divisions to form mature spermatozoa. Spermatozoa are stored in the seminal vesicle. The vas deferens is comprised of 30 cells and functions as a valve that controls the release of sperm during ejaculation.
Deliberate prevention of fertilization and or pregnancy, usually without hindering otherwise normal sexual activity. Includes preventing sperm entry by use of a condom, a protective sheath over the penis preventing access of sperm to the cervix by means of a diaphragm placed over it manually before copulation (later removed) preventing implantation by means of an intrauterine device (IUD), a-plastic or copper coil inserted under medical supervision into the uterus and the contraceptive pill, withdrawal of the penis prior to ejaculation (coitus interruptus) is not an , effective method. Abstention during the phase in the menstrual c y cle when fertilization is likely is a further method. Use of condoms is fairly effective, with the added, advantage of reducing the , risk of infection by microorganisms during intercourse., I U Ds can cause extra bleeding during menstruation and may-not be- tolerated by some women
Some cord-injured men already in the intensive care unit ask about their ability to have an active sex life and become fathers. The erectile dysfunction in men after spinal cord injury has different characteristics depending on level of lesion, and mainly follows the pattern of bladder dysfunction. The person with an upper motor neuron lesion usually has the capacity for reflex erection by tactile stimulation. The person with a lower motor neuron lesion has loss of all erectile function. The capacity of psychogenic erection is lost in all cord-injured men with a complete lesion. Retrograde ejaculation is the rule when there is an ejaculation at all. Today, we can offer drugs and different stimulations in order to improve erectile function and to produce an anterograde ejaculation. Vibration and electro-stimulation need careful monitoring of blood pressure since these methods readily evoke autonomic dysreflexia. By the means of vibration and electro-stimulation in combination with...
The detrusor, whose smooth muscle fibres comprise the body of the bladder, is innervated mainly by parasympathetic nerves which are excitatory and cause the muscle to contract. The internal sphincter, a concentration of smooth muscle at the bladder neck, is well developed only in the male and its principal function is to prevent retrograde flow of semen during ejaculation. It is rich in o -adrenoceptors, activation of which causes contraction. There is an abundant supply of oestrogen receptors in the distal two-thirds of the female urethral epithelium which degenerates after the menopause causing loss of urinary control.
Long (6m in man) convoluted tube, one attached to each testis in amniotes. Receives sperm from seminiferous tubules and houses them during their maturation, reabsorbing them if they are not ejaculated (in four weeks in man). Peristaltic contractions of the epididymides propel sperm into the sperm duct during ejaculation. Derived embryologically from the mesonephric (Wolffian) duet.
From the en bloc procedure that led to a high incidence of emission failure and retrograde ejaculation. Dissection of the major vessels and sympathetic nerves, along with a directed approach, is now employed. As the pattern of metastasis is usually on the ipsilateral side (95 ), lymph node dissection with sparing of the contralateral sympathetic nerves can be employed. The pattern of metastasis becomes less certain with bulky disease and the procedure is less valuable in such patients. As a staging procedure, RPLND is more accurate than CT scan (false negative rate 15-20 , false positive rate 15-23 ). However, since 80-85 of patients with a negative CT scan will not have disease and those who recur are highly curable with chemotherapy, to operate on 100 patients to potentially help 15-20 may not be the best approach for the majority of stage I patients. In an effort to improve the chances that RPLND may be helpful, risk factors for metastasis have been identified. These include the...
Sexual function has been studied extensively in survivors. During treatment and soon thereafter, approximately one-third of survivors report sexual dysfunction and or dissatisfaction with level of sexual activity. However, this effect does not seem to be permanent in the majority of cases and studies indicate the level of dysfunction returns to baseline by 3 years after completion of therapy. The sexual dysfunction of some patients at the time of diagnosis, due to testicular atrophy and to the presence of disease, must be taken into account. The complications of RPLND and ejaculation have been well documented and have decreased with improved surgical techniques.
SYMPTOMS Common symptoms of prostate cancer are a need to urinate frequently, especially at night difficulty starting urination or holding back urine inability to urinate weak or interrupted flow of urine painful or burning urination difficulty in having an erection painful ejaculation blood in urine or semen or, in advanced stages, frequent pain or stiffness in the lower back, hips, or upper thighs.
It has been observed that spermatozoa can be isolated for longer periods in the endocervix. Graves et al. (114) report that spermatozoa were isolated from the endocervix 17 days after intercourse. Studies that compared paired swabs from the vagina and cervix have found that 2 days or more after vaginal ejaculation there is a larger quantity of spermatozoa on endocervical swabs compared with the vaginal swabs (115). Therefore, it is recommended that if a complainant presents 48 hours or more after alleged vaginal intercourse, an endocervical swab be taken in addition to the swabs from the vagina. Although seminal choline has only been found on vaginal swabs up to 24 hours after vaginal ejaculation (116), using FISH technology, Y-chromosome-intact cells have been identified on postcoital vaginal swabs 7 days after sexual intercourse with ejaculation (117).
5 Secrets to Lasting Longer In The Bedroom
How to increase your staying power to extend your pleasure-and hers. There are many techniques, exercises and even devices, aids, and drugs to help you last longer in the bedroom. However, in most cases, the main reason most guys don't last long is due to what's going on in their minds, not their bodies.