[show abstract][hide abstract] ABSTRACT: OPINION STATEMENT: Oncofertility as a discipline plays an important, adjunctive role in the treatment of male patients with cancer. Despite recommendations by the American Society of Clinical Oncology, many clinicians managing malignancies in males fail to consistently incorporate fertility preservation as a routine aspect of health care. Providers involved in the treatment of oncologic patients should have an awareness of the impact of their prescribed treatments on reproductive potential, just as they would be knowledgeable of the potential deleterious effects of cancer therapies on vital organs such as the kidneys, lungs, and liver. Providers should then have a discussion with their patients regarding these potential adverse therapeutic effects or consult a fertility preservation specialist to discuss these matters and fertility preservation options with the patient. Cryopreservation of sperm remains an excellent option for male fertility preservation as it is readily available and results in storage of viable gametes for future use in the event of post treatment infertility. With the use of assisted reproductive techniques (ART), cryopreserved sperm may ultimately result in successful paternity, even in the setting of very low numbers of stored sperm. While sperm cryopreservation is usually an option for adolescent and adult males, fertility preservation in pre-pubertal males presents a more challenging problem. To date, no clinically proven methods are available to preserve fertility in these males. However, some centers do offer experimental protocols under the oversight of an IRB, such as testicular tissue cryopreservation in these males. The hope is that one day science will provide a mechanism for immature germ cells from the testicular tissue of these patients to be used in vivo or in vitro to facilitate reproduction. In closing, studies have shown that the patient's regard for his provider is enhanced when the issue fertility preservation is raised. While oncologic care is often fraught with time constraints and acute medical concerns, fertility preservation care in the male can typically be administered quickly and without disruption of the overall plan of care.
Current Treatment Options in Oncology 04/2012; 13(2):146-60. · 2.42 Impact Factor
[show abstract][hide abstract] ABSTRACT: Ejaculation is a highly integrated process that involves both the sympathetic and parasympathetic neural pathways. Numerous
studies reveal that ejaculatory dysfunction is a common disorder and the source of significant bother for many of those affected.
Ejaculatory dysfunction is comprised of several different, more specific abnormalities including: premature ejaculation, inhibited
ejaculation (consisting of delayed and absent ejaculation), and painful ejaculation. The evaluation of affected patients should
include a comprehensive medical history, physical examination, and laboratory testing. Numerous therapeutic options are available
to treat ejaculatory disorders, with many of these leading to marked improvement in patients’ symptoms and associated bother.
KeywordsDesire-Arousal-Orgasm-Resolution-Emission-Expulsion-Premature ejaculation-Inhibited ejaculation-Painful ejaculation-Anejaculation