Surgery, drugs, and the male orgasm

BMJ 1997; 314 doi: https://doi.org/10.1136/bmj.314.7077.319 (Published 01 February 1997) Cite this as: BMJ 1997;314:319

Informed consent can't be assumed unless effects on orgasm have been discussed

  1. William D Dunsmuir, Research fellow,a,
  2. Mark Emberton, Senior registrarb
  1. a Department of Urology, St George's Hospital, London SW17 0QT
  2. b Institute of Urology and Nephrology, London W1P 7PN

    Although probably essential for the survival of the species, very little is known about the male orgasm. What is known is at best confusing and provides more questions than answers. Recent studies (all observational) have been useful in two ways. Firstly, they have helped to define the anatomical and physiological changes that occur during orgasm, using modern imaging techniques on the brain and prostate. Secondly, and perhaps more important, they have documented the effect on male orgasm of certain operations (mainly prostatic) and drugs (mainly inhibitors of serotonin reuptake).

    Gil-Vernet and colleagues used transrectal (endorectal) ultrasound in four volunteers to generate the first dynamic images of the events occurring in the genitourinary tract during ejaculation.1 The first detectable changes were rhythmic contractions of the prostate gland, seminal vesicles, and muscles of the perineal floor. Just before ejaculation, both preprostatic and postprostatic sphincters contracted, followed by descent of the ejaculatory ducts and a probable increase in pressure within the prostatic urethra. Relaxation of the voluntary postprostatic sphincter, together with further prostatic contractions, resulted in ejaculation. This final event was associated with the sensation of …

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