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Transl Androl Urol
v.5(4); 2016 Aug
PMC5002007
Transl Androl Urol. 2016 Aug; 5(4): 592–601.
1 University College London Hospitals, London, UK;
2 Bagcilar Training & Research Hospital, Istanbul, Turkey
Contributions: (I) Conception and design: All authors; (II) Administrative support: EC Serefoglu; (III) Provision of study materials or patients: None; (IV) Collection and assembly of data: None; (V) Data analysis and interpretation: A Parnham; (VI) Manuscript writing: All authors; (VII) Final approval of manuscript: All authors.
Correspondence to: Ege Can Serefoglu, MD, FECSM. Cinnah Caddesi No. 47, 06680, Cankaya, Ankara, Turkey. Email: moc.liamtoh@ulgoferesnacege .
Received 2016 Apr 28; Accepted 2016 Apr 28.
Copyright 2016 Translational Andrology and Urology. All rights reserved.
Keywords: Dysorgasmia, ejaculatory dysfunction, ejaculatory pain, hematospermia, painful ejaculation, retrograde ejaculation
Centrifugation and resuspension: in order to improve the ambient conditions for the sperm, the patient is asked to either increase their fluid intake or to take sodium bicarbonate to dilute or alkalise the urine respectively. Afterwards, a post orgasmic urine sample is collected by either introducing a catheter or spontaneous voiding. This sample is then centrifuged and suspended in a medium. The types of suspension fluids employed are heterogeneous and can include bovine serum albumin, human serum albumin, Earle’s/Hank’s, phosphate buffered medium and the patients urine to name but a few. The resultant modified sperm mixture can then be used in assisted reproductive techniques. A systematic review of the literature in couples with the male partner suffering from retrograde ejaculation found a 15% pregnancy rate per cycle (0–100%) based on 15 articles ( 2 );
Hotchkiss method: the Hotchkiss and modified Hotchkiss method involves emptying the bladder prior to ejaculation using a catheter and then washing out and instilling a small quantity of Lactated Ringers to improve the ambient conditions of the bladder. The patient then ejaculates and semen is retrieved by catheterisation or voiding ( 16 ). Modified Hotchkiss methods involve a variance in the instillation medium. Pregnancy rates per cycle were 24% per cycle (0–100%) based on eight papers ( 2 );
Ejaculation on a full bladder: few papers have described results from this technique ( 17 , 18 ). The patient is encouraged to ejaculate on a full bladder and semen is suspended in Baker’s buffer. The pregnancy rate in the two studies which included only five patients in total was 60% ( 2 ).
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