Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C1323099 (sympathomimetic)
 2,957 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The ejaculatory process consists of two stages. During the first stage the semen is pumped into the posterior urethra and during the second stage the semen is propelled via the urethra through the external meatus. A pathologic second stage may lead to retrograde ejaculation of the semen into the urinary bladder. Attempts to achieve fertility in such patients can be made in two ways; namely through procedures to restore antegrade ejaculation (mainly using alpha-sympathomimetic agents) and procedures to regain viable and fertile sperm from the urinary bladder after sexual intercourse, with subsequent artificial insemination. The latter way of treatment was used in two patients who were referred for infertility and in whom retrograde ejaculation had been diagnosed. Postcoital urinary specimens were obtained by micturition and centrifuged. In one patient the sediment was washed with a nutrient solution; the other patient received alkalizing agents prior to intercourse in order to neutralize the urinary pH. The wives were inseminated on appropriate days and conceived. Both delivered healthy babies after uneventful pregnancies.
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PMID:Retrograde ejaculation: pathophysiologic aspects and report of two successfully treated cases. 95 48

Pharmacotherapy of male reproductive disorders is applicable to the majority of men seeking treatment for infertility. Since a favorable prognosis is associated with specific medical measures directed toward enhancing sperm quality, a comprehensive clinical and laboratory assessment of the infertile male is essential. This treatment may consist of replacement therapy for pituitary or hypothalamic dysfunction (i.e., exogeneous gonadotropins or GnRH), suppression of prolactin excess, antimicrobial therapy, sympathomimetic agents for ejaculatory disorders, or immunosuppressive treatment of sperm autoimmunity. Finally, the possibility of multiple causes of male reproductive dysfunction and their specific forms of treatment should be considered.
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PMID:Pharmacologic therapy of male infertility: specific treatment. 267 Apr 13

After an appropriate clinical and laboratory assessment of a patient's fertility status, the clinician must often decide whether specific and empiric treatment is indicated. Specific treatment may take the form of replacement therapy (exogenous gonadotropins or GnRH) for pituitary or hypothalamic failure, inhibition of prolactin secretion, antimicrobial therapy, or immunosuppressive therapy for demonstrable immunologic infertility. Finally, ejaculatory dysfunction often requires sympathomimetic agents. Alternatively, in the normogonadotropic oligospermic patient, the major form of empiric therapy relies on the enhancement of physiologic hormone levels that influence spermatogenesis. Such "stimulation" therapy may be achieved by GnRH analogues, antiestrogens, exogenous gonadotropins, or androgens.
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PMID:Medical treatment of male infertility. 355 93

We studied the return of ejaculation in 31 patients who had undergone retroperitoneal lymphadenectomy for stage I or II nonseminomatous germ cell testicular cancer. Ejaculation returned spontaneously in 13 patients and was restored by sympathomimetic drugs in 5 of 8 patients treated. Both patients known to have tried to father a child succeeded. We also studied the effects of chemotherapy (vinblastine and bleomycin with or without cisplatin) in 34 patients, 24 of whom also had undergone retroperitoneal lymphadenectomy. Although chemotherapy profoundly depressed spermatogenesis during treatment 75 per cent of the patients tested 18 months or more after completion of treatment had some return of function, as evidenced by normal follicle-stimulating hormone levels and/or the presence of live sperm in the ejaculate. We concluded that it is possible to perform a therapeutically sound retroperitoneal lymphadenectomy for low stage nonseminomatous testicular cancer that permits return of ejaculation in many patients and that spermatogenesis recovers in a significant number of patients treated for this cancer with modern chemotherapy. Thus, traditional beliefs that operative and drug treatment of nonseminomatous testicular cancer invariably causes infertility must be revised.
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PMID:Return of fertility after treatment for nonseminomatous testicular cancer: changing concepts. 630 57

Insertion of Silastic rods containing the directly acting sympathomimetic drug, methoxamine, adjacent to the epididymis of rats caused a temporary reduction in fertility with no loss of ability to mate. This effect lasted up to 3 weeks. At the time of the maximal antifertility action (3-7 days after insertion), the number of spermatozoa in the ejaculate fell to almost zero, and there was a reduction in the total number of spermatozoa in the epididymis resulting from a significant drop in the number present in the cauda. Methoxamine also caused immotility and decapitation of the remaining epididymal spermatozoa. The indirectly acting sympathomimetics, tyramine and norephedrine, did not affect fertility. It is postulated that methoxamine acts to induce infertility principally by bringing about a reduction of sperm numbers in the ejaculate. This could have been produced either by a failure of the vas and cauda to contract normally at copulation or because the sperm store in the cauda had fallen below a critical threshold level.
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PMID:Effect of local application of sympathomimetic drugs to the epididymis on fertility in rats. 735 77

Three patients presenting with infertility were found to have low volume azoospermia. All 3 were taking sympatholytic medications; 2 were taking antipsychotics and 1 was taking an alpha-blocker. Low volume azoospermia may result from the use of sympatholytic medications, which cause aperistalsis of the adrenergically innervated vas deferens and seminal vesicles. Two patients had normal spermatogenesis on biopsy and were unobstructed on vasography. In 1 patient, biopsy and vasography were avoided. Pseudoephedrine, a sympathomimetic agent, was given to all 3 patients, resulting in marked improvement in semen analysis parameters. A trial of pseudoephedrine can obviate the need for biopsy and vasography in such patients.
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PMID:Azoospermia due to aperistalsis of the vas deferens: successful treatment with pseudoephedrine. 993 69

The only safe method of male contraception is vasectomy, with high reversibility secured by microsurgery. Italy, however, suffers from a lack of regulations on this subject. Hormonal treatment (testosterone plus progestational hormones) is far from providing reliability and safety, while some perspectives, theoretical only for the time being, are offered by studies on functional infertility induced by either speeding up (ganglioplegic, sympathomimetic, parasympatholytic, oxytocin, endothelin, angiotensin) or inhibiting (sympatholytic) the sperm transport through the epididymis, or altering the epididymal environment (alpha-chloridin, chlorodeoxyglucose).
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PMID:[Male contraception]. 1553 63

Many aspects of fertility rely on intact neurologic function and thus neurologic diseases can result in infertility. While research into general female fertility and alterations in male semen quality is limited, we have an abundance of knowledge regarding ejaculatory dysfunction following nerve injury. Normal ejaculation is the result of coordinated reflex activity involving both the sympathetic and somatic nervous systems. Nerve injury can result in retrograde ejaculation, and anejaculation. With retrograde ejaculation, the ejaculate is propelled into the bladder instead of out through the urethra. In mild cases this condition can be reversed by sympathomimetic medications and, in more severe cases, sperm cells can be extracted from the bladder following ejaculation. With anejaculation, the ejaculatory reflex is not activated by normal sexual stimulation. In such cases, the first choice of treatment is assisted ejaculation, preferably by penile vibratory stimulation. If vibratory stimulation is unsuccessful, then ejaculation can almost always be induced by electroejaculation. In cases where assisted ejaculation fails, sperm can be retrieved surgically from either the epididymis or from the testis. Once viable sperm cells have been obtained, these are used in assisted reproductive techniques, including intravaginal insemination, intrauterine insemination, and in vitro fertilization/intracytoplasmic sperm injection.
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PMID:Management of male neurologic patients with infertility. 2600 59