The purpose of this chapter is to review pharmacological effects on male erectile dysfunction. As will be documented in this chapter, a wide variety of pharmacological agents have been reported to have sexual side effects. Drugs may influence male sexual function at various levels including (1) sexual interest or desire (also termed libido), (2) the capacity to achieve and maintain an erection sufficient for coitus, (3) ejaculation, and (4) fertility. Although the issue of fertility is beyond the scope of this review, drugs that inhibit fertility often suppress hormonal secretions and may thus influence sexual behavior. This text is concerned primarly with erectile function. However, libido and ejaculation problems often coexist and interact with erectile problems. The effects of drugs on these sexual activities will also be reviewed.

Erectile Dysfunction Associated with Pharmacological Agents

Surgical aspects of infertility.

L’infertilite secondaire se definit comme l’impossibilite d’obtenir une nouvelle grossesse pour un couple ayant deja procreer dans le passe. Sur une periode de 16 ans, 49 patients sont venus consulter pour un probleme d’infertilite secondaire d’origine masculine. Un bilan clinique et para-clinique a permis de conclure sur l’origine de l’infertilite. L’âge moyen de ces patients etait de 33,6 ans (de 26 a 44 ans). Les enfants vivants obtenus auparavant dans ces couples etaient en moyenne de 1 par famille, representes par une fille deux fois sur 3, et un garcon une fois sur 3. Les resultats obtenus chez ces patients montrent que l’infertilite est due a la presence d’une varicocele pour 15 malades soit 31% des cas, la presence d’une infection pour 14 patients soit 29%, et la presence d’une varicocele associee a une infection dans 11 cas soit 22%. deux etiologies principales se degagent dans le cadre de ce bilan. Cependant, certaines causes restent evidentes, comme les interventions chirurgicales avec ablation de la prostate ou des testicules, ou certains traitement cytotoxiques.

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Etiologie des infertilités secondaires de l’homme

This is a case report of a 35-year old man whose fertility status was severely impaired by a past history of bilateral testicular torsion use of numerous psychotropic drugs and the presence of a left varicocele. A moderate improvement in the semen quality occurred following discontinuation of the medications but a significant reponse was not evident until a varicocelectomy was performed. Thereafter repeated semen analyses revealed normal findings except for a marked depression of sperm motility when the patient took Norpramin a psychoactive drug. Seminal factors were consistently normal when this medication was withheld. Ultimately when the patient agreed not to take the Norpramin for 9 months his semen quality remained normal and his wife conceived and delivered a normal male child. (authors)

Getzoff Pl

Papers

Psychotropic drug induced male infertility: a case report.

Testicular biopsy evaluation of the infertile male.