Premature Ejaculation Causes and Treatments

Ejaculation Guru

In This Video You'll Discover: How I personally went from lasting less than 10 seconds in bed to over 30 minutes in bed. The real reason so many men suffer from premature ejaculation. And exactly what to do about it. How long you should be lasting if you want to truly satisfy a woman This, by the way, comes from a study carried out by a major University. The number #1 thing holding most men back from getting control over their orgasms and how you can change it. (By the way, most guys don't even realize this is holding them back, but it's critical to understand if you want to learn to last long in bed) What most porn stars will Never tell you about porn and its influence on your sexual stamina. The truth about penis size and its links with how long you last. What the number #1 reason is for relationships ending. and how premature ejaculation is critically linked to it. Why you should Avoid 99% of people trying to sell you long lasting condoms, creams or pills. More here...

Ejaculation Guru Summary

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Ejaculation By Command

Everything is explained here in clear, concise and easy-to-understand instructions. The insights, tools and techniques in this program have been rigorously tried, tested and proven effective not only by me, but by thousands of other men who are now enjoying lovemaking that lasts so much longer than before. Here's a Very partial list of what you're going to learn inside this exciting new program: How to overcome mental barriers to sexual endurance develop iron-clad stamina and confidence by using these 9 specific techniques I am going to give you. A primal sexual technique that adds massive control to your arousal. and puts a woman over the edge with sexual excitement. she'll have to have you Right Then And There. and nothing will be able to stop her. 4 powerful breathing strategies that will amplify your staying power and prolong your orgasm for as long as you desire (97% of men screw up their breathing and end up ejaculating too soon) Specific guided love muscle exercises to skyrocket your ejaculatory control and your ability to withstand intense sexual stimulation (The secret is in the step-by-step process, which you'll learn in detail) The Pleasure Acclimatizing technique to train and condition your ejaculation reflexes so that you will Automatically last longer without tipping over in a hurry (this is one of the stamina secrets that Top porn actors use All The Time ) Have you ever blown your load even Before penetration starts. and wondered how the hell that happened? Here's the little-known and closely-guarded Total Immersion technique you can use to Outlast her during sex (it's much easier than you think. when you know the secret) More here...

Ejaculation By Command Summary

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Ejaculation Trainer By Matt Gorden

Sick and tired of the humiliation of premature ejaculation? Drop everything and read every word on this page. the next few minutes could change your life completely. How You Can Last 10-30 Minutes Longer In Bed Tonight & Permanently End The Pain & Embarrassment Of Premature Ejaculation. You'll learn: Last longer in bed tonight, without creams, pills, or any other lame technique that doesn't work. Get a permanent improvement in your sexual stamina, regardless of how bad your premature ejaculation is now. Finally understand the root causes of Premature Ejaculation and cure yourself completely with a little knowledge and a few simple techniques. More here...

Ejaculation Trainer By Matt Gorden Summary

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Author: Matt Gorden
Official Website: ejaculationtrainer.com
Price: $49.00

Premature Ejaculation

Although various definitions exist, premature ejaculation is ejaculation that occurs sooner than desired, either before or shortly after penetration, causing distress to either one or both partners (AUA, 2004). Sexual history, psychological history, and differentiation from ED are essential. Treatment should be tailored to the individual patient. Psychological interventions are options for willing patients. Although no medicines are U.S. Food and Drug Administration (FDA) approved for this problem, exploiting side effects of SSRIs and topical anesthetics is an option.

Female Orgasmic Disorder

The clinical history in secondary inhibited orgasm should focus on the patient's perception of this dysfunction time and circumstances of onset, possible causes, effect on relationship(s), and treatment goals. Physiologic functioning during sexual stimulation, including adequacy of lubrication and ability to sustain states of high arousal, should be explored. Contributing factors such as fatigue, depression, postpartum physical and social changes, preoccupation with other life issues, substance abuse, and other medical illnesses should be considered. Contextual and relationship issues, including lack of tenderness or interest in non-intercourse stimulation by the partner, early ejaculation, problems regarding contraceptive responsibility, lack of privacy, relationship conflicts, and the possibility of abuse, should be discussed. In most cases of orgasmic dysfunction, no specific physical examination or laboratory testing is necessary. As with other sexual dysfunctions, neurologic,...

Premature Rapid Ejaculation

Premature ejaculation refers to the occurrence of male ejaculation, usually with orgasm, before desired by the individual, his partner, or both. Premature ejaculation is also referred to as rapid ejaculation or difficulty with ejaculatory control. Evaluation of premature ejaculation is by history. Onset, circumstances, and meaning (personal and relationship) of the dysfunction should be explored, as well as pertinent past sexual experiences. For example, young men whose first sexual experiences were rushed may later have difficulty establishing ejaculatory control in more relaxed contexts. Men having intercourse infrequently are more likely to ejaculate rapidly. The clinician should determine whether a patient can delay his ejaculation while masturbating. In addition, information regarding the patient's level of sexual knowledge and his partner's expectations may be significant. Behavioral techniques, such as the squeeze technique, stop and start, masturbation training, and...

Urine Formation In A Nephron

The male reproductive system produces sperm - cells that can fuse with eggs from a woman to form offspring. It also makes the male sex hormones needed for sperm production and for sexual development at puberty. The male genitals consist of the penis, the testes, and the scrotum, in which the testes are suspended. Each testis is packed with seminiferous tubules, which make sperm. The sperm are stored in the epididymis, a coiled tube that lies behind each testis. Another tube, the vas deferens, connects each epididymis to an ejaculatory duct, which in turn is connected to the urethra. Three glands - a pair of seminal vesicles and the prostate gland - secrete fluids to transport and nourish the sperm the secretions and sperm form a fluid called semen. During sexual activity, the erectile tissue in the penis fills with blood, making the penis lengthen and stiffen in order to enter the woman's vagina. At orgasm, muscular contractions force semen along each vas deferens, down the urethra,...

Nerve Sparing Retroperitoneal Lymphadenectomy

Historically, the major long-term morbidity of RPL was ejaculatory dysfunction and potential infertility resulting from damage to the sympathetic nerves during dissection. Specifically, injuring the lumbar sympathetic trunks, postganglionic sympathetic fibers, and or nerves of the hypogastric plexus risked loss of seminal emission and consequently dry ejaculation. The traditional bilateral lymphadenectomy results demonstrated a 70 to 100 risk of this complication 2 . The movement to include suprahilar dissection was short lived and this approach was abandoned when no added benefit was realized 3 . The original procedures have since been further modified such that the minimal dissection is performed to spare relevant sympathetic nerves without risking an incomplete cancer resection. The initial strategy for minimizing postoperative ejaculatory dysfunction attributable to sympathetic nerve injury was the downscaling

Laparoscopic nervesparing retroperitoneal lymphadenectomy

Intraoperative electrostimulation of sympathetic nerves has recently been applied to laparo-scopic RPL in a case series by Kaiho and colleagues 46,47 . During six laparoscopic unilateral modified template RPLs, sympathetic nerves within the field of dissection were identified and preserved. While these nerves were stimulated with bipolar electrodes through a laparoscopic port, ejaculatory function was confirmed by endo-scopic visualization of bladder neck closure and emission of semen into the posterior urethra. In summary, laparoscopic RPLs are being performed by experienced surgeons in various centers with disease control and complication rates comparable to open surgery. The literature acknowledges an overall relative lack of experience with this procedure among urologists, a technical learning curve, and the need for more long-term follow-up data. With continuing efforts to minimize surgical morbidity, the laparoscopic procedure seems to be following an analogous stepwise adoption...

What is sexual dysfunction

The term sexual dysfunction broadly encompasses trouble with any component of the sexual response cycle. The sexual response cycle in men consists of sexual desire interest (libido), sexual arousal (erection), orgasm (including emission involuntary discharge of semen from the ejaculatory duct into the urethra and ejaculation), and detumescence (return of the penis to the flaccid, nonerect state). An abnormality in one component of the sexual response cycle may not affect the remainder of the components of the cycle. For example, one may still be able to climax and ejaculate without achieving a rigid erection. Common sexual dysfunctions include problems with libido, ejaculation, and orgasm. Ejaculatory dysfunction includes premature ejaculation, retrograde ejaculation, delayed ejaculation, and anejac-ulation. Premature ejaculation means that ejaculation occurs too quickly and may occur with light stimulation before, on, or shortly after penetration, or simply before one wishes for it...

Prevalence and incidence of disturbances of sexual functioning

Over a period of one year, 13 of the 34 participants returned to their preinjury level of sexual functioning (Sabhesan & Natarajan, 1989). These 13 subjects then became controls for the remainder of the sample. The remainder demonstrated sexually inappropriate behaviour, total loss of sexual function, and sexual dysfunction. The deviant sexual behaviour included purposeful use of lewd language (9 ), frot-teurism (6 ), exhibitionism (6 ), sadism (6 ), and rape (3 ). Total loss of sexual behaviour was reported in 38 of patients. Approximately 57 of the patients reported decreased interest in sex while two reported increased interest in sex when compared with controls. Premature ejaculation was noted by 7 patients, and a similar number of patients noted postcoital symptoms. Patients with continuing sexual Erectile and ejaculatory problems were uncommon. One female participant's spouse and four male participants reported occasional erectile difficulties after as compared to before the...

The male reproductive tract 1051 Overview

In the periods between intercourse, the sperm are produced, matured and stored in the epididymis and vas deferens, and the components of the seminal fluid are secreted and stored in the seminal vesicles and prostate. These processes are under hormonal control. For intercourse, erection is produced through a complex neuronal process using the parasympathetic nervous system as the main effector. Emission and insemination require activation of the ejaculatory reflex, which is a complicated reflex involving both somatic and autonomic effectors. To produce the seminal fluid, it uses the sympathetic nervous system to produce vigorous contraction of the smooth muscles of accessory glands and the vasa deferentia. The sequence of activation is normally that the prostate contracts first, followed by the vas deferens and then the seminal vesicles, so that the ejaculate is divided into three distinct fractions, the first rich in prostatic fluid, the middle containing most of the sperm and the...

What is a transurethral incision of the prostate TUIP

A transurethral incision of the prostate (TUIP) is exactly that an incision rather than a resection of the prostate. Using a special knife-like instrument, a Colling's knife that is placed through the same resectoscope sheath used for TURPs two incisions are made at 5 o'clock and 7 o'clock through the bladder neck and prostate to the verumontanum where the ejaculatory ducts exit.

Retroperitoneal lymph node dissection

The most consistent long-term sequela of RPLND is the loss of ejaculation, which in turn can compromise fertility. The postganglionic sympathetic fibers from T12-L3 mediate the neuro-muscular events that are responsible for antegrade ejaculation. These fibers form the hypogastric plexus near the takeoff of the inferior mesenteric artery (IMA) just above the aortic bifurcation. Based on the improved understanding of the neuroanatomy of ejaculation, the pattern and distribution of retroperitoneal lymph node metastases for right- and left-sided tumors, and surgical mapping studies, modified RPLND templates were developed initially to minimize intraoperative injury to these structures and ejaculatory rates of 51 to 88 are reported 25,35 . In general, these modified templates attempted to minimize contralateral dissection, particularly below the level of the IMA. More recently, nerve-sparing techniques have been developed whereby the sympathetic chains, the postganglionic sympathetic...

Are there different types of problems with ejaculation What causes them and how are they treated

There are three different types of ejaculatory problems that can occur premature ejaculation, retrograde ejaculation, and anejaculation. What is premature ejaculation and what causes it Premature ejaculation is ejaculation that occurs sooner than desired, either before or shortly after penetration, that causes distress to one or both partners. This condition tends to occur more frequently in younger men. Premature ejaculation is the most common form of sexual dysfunction, occurring in 21 of men ages 18 to 59 years in the United States. The condition may be lifelong (primary) or acquired (secondary). Despite its prevalence, men rarely seek help. Some men with ED may develop secondary premature ejaculation, possibly caused by either the need for intense stimulation to attain and maintain an erection or because of anxiety associated with difficulty in attaining and maintaining an erection. In these patients, treating the erectile dysfunction may lead to resolution of the premature...

Initial Evaluation of Sexual Problems

Plateau Phase

The phases illustrated are excitement, plateau, and orgasm. The length of the plateau phase is variable. Women may have a brief plateau followed by orgasm (cycle Q or a long plateau with no orgasm (cycle B). Women may have multiple orgasms before resolution, although many do not (cycle A). For men with premature ejaculation, the plateau phase is brief. After ejaculation, men enter a refractory period lasting minutes to hours during which they are unable to ejaculate. precedes both cycles in this model. The phases illustrated are excitement, plateau, and orgasm. The length of the plateau phase is variable. Women may have a brief plateau followed by orgasm (cycle Q or a long plateau with no orgasm (cycle B). Women may have multiple orgasms before resolution, although many do not (cycle A). For men with premature ejaculation, the plateau phase is brief. After ejaculation, men enter a refractory period lasting minutes to hours during which they are...

Surgical complications

Ejaculatory dysfunction Ejaculatory dysfunction and infertility following RPLND One of the most troubling long-term morbidities following RPLND is the loss of antegrade ejaculation secondary to intraoperative damage to crucial autonomic nerve fibers. Sympathetic fibers from the thoracolumbar outflow tract decussating around the aortic bifurcation are responsible for seminal emission into the posterior urethra. Ejaculation depends on both autonomic and somatic sacral and lumbar nerves that tighten the bladder neck, relax the external sphincter, and contract the bulbourethral and perineal muscles. Damage to these structures may result in loss of seminal emission or retrograde ejaculation. This loss of antegrade ejaculation is particularly morbid for this young patient population with its associated potential infertility and patients are counseled to consider sperm banking before RPLND. As our understanding of the neuroanatomy associated with ejaculatory dysfunction has evolved,...

Copulatory Pelvic Thrusting In Apes

Frequencies of copulation are also greatest in those primate species in which females mate with multiple partners during the fertile period. Although data on ejaculatory frequencies in monkeys and apes are limited, they are sufficient to show that males in multi-male multi-female groups copulate much more frequently than those which have polygynous monogamous mating systems. Large-scale surveys of human sexual behaviour conducted in North America, Europe and China confirm that for the majority of couples, frequencies of intercourse are commensurate with those that occur in polygynous or monogamous primates. Moreover, experimental studies that require men to ejaculate at artificially high daily frequencies clearly show that human extra-gonadal sperm reserves rapidly become depleted under such conditions (see Figure 5.12). Men, unlike males of multi-male multi-female species such as chimpanzees or macaques, are not physiologically adapted to sustain optimal sperm counts under conditions...

Relationship between infertility and testicular cancer

Postorchiectomy surveillance is a viable treatment option for men who have stage I testis tumors for patients who are willing to adhere to a strict follow-up regimen. Surveillance protocols allow patients to avoid post-RPLND ejaculatory disturbances and gonadotoxic therapies but approximately 20 of men relapse and ultimately require additional treatment. Men who relapse on surveillance protocols and require gonadotoxic treatments may be at greater risk for infertility than men initially treated with nerve-sparing RPLND 34 . in the pelvis. The ampullary vas deferens seminal vesicles, periurethral glands, internal sphincter, bulbourethral, and periurethral musculature receive innervation from these nerves. The surgical disruption of these nerves during RPLND or pelvic node dissection can result in retrograde ejaculation or anejaculation depending on the severity of the nerve injury. The presence or extent of retroperitoneal disease often dictates the type of lymph node dissection...

Rapid sperm transport the vas deferens and sperm competition

Gambar Vas Deferens

In all mammals, many millions of sperm must traverse the vas deferens very rapidly prior to ejaculation. In a species like the rhesus monkey, with large relative testes sizes and multiple-partner matings by females, more than 1000 million sperm are transferred to the female during the ejacula-tory mount. Interestingly, the male rhesus makes a series of mounts and intromissions prior to ejaculation. This specialized pattern of copulation is more commonly found in primates where sperm competition occurs (see Chapter 5, for a discussion of the evolution of copulatory patterns). It is not known whether spermatozoa are moved along the vas in cohorts during each mount of the series, so that numbers in the vas are maximized prior to ejaculation. This possibility requires experimental study, perhaps in a mammal such as the rat where the necessary experiments could be performed to count numbers of spermatozoa in the vas deferens. It may be that the vas deferens (and not just the cauda...

Multiple Pattern ejaculations number

It is usual for males to exhibit a period of reduced sexual arousal once orgasm has occurred this is the post-ejaculatory refractory period. Dewsbury pointed out that whereas males of some species cease to copulate for extended periods, others are capable of mating again and of having a second ejaculation within 60 min. Yet this criterion, which results in the division of eight potential copulatory patterns into sixteen, is highly problematic. Among the primates, for example, Dewsbury and Pierce (1989) could identify only four species, out of thirty-three considered, which were not capable of multiple ejaculations. Even these four examples are contentious, however, and in two cases (Otolemur crassicaudatus and Cerco-pithecus (Chlorocebus) aethiops) it is likely that ejaculation can occur more than once per hour (Dixson 1998a). The problem is that almost all primate species which have been studied adequately are capable of ejaculating more than once per hour, at least when they are...

What are the 5alpha reductase inhibitors

What are the side effects of 5-alpha reductase inhibitors Side effects found in the first year of 5-alpha reductase inhibitor use include decreased sexual drive (libido), increased ejaculatory dysfunction (such as smaller amount of semen ejaculated), difficulty getting an erection, breast tenderness or enlargement. One large study demonstrated that after a year of treatment, finasteride resulted in the same level of decreased sex drive and inability to get an erection as placebo. Ejaculatory dysfunction was higher with finasteride than with placebo.

Male Genital Organs And Glands

A thick-walled tube in the spermatic cord that transports sperm from the epididymis to the ejaculatory ducts in the prostate gland. The ductus deferens traverses the superficial inguinal ring, coursing through the inguinal canal, and enters the pelvis through the deep inguinal ring lateral to the inferior epigastric artery. En route to the ejacu-latory duct, the ductus deferens crosses the medial side of the umbilical artery and the obturator neurovascular structures. Sympathetic nerves from the inferior hypogastric plexus cause peristaltic contractions in the thick smooth muscle wall and propel sperm during ejaculation. Ejaculatory ducts. Formed by the union of the ductus deferens and ducts from the seminal vesicles. The ejaculatory ducts open into the prostatic urethra. Seminal vesicles. Lobular glands located on the base of the bladder. During emission and ejaculation, the seminal vesicles empty their secretions (e.g., fructose, citric acid, prostaglandins, and...

Components of the tract and their innervation

Structure Corpora Cavernosa

Each vas deferens is a continuation of the duct of the epididymis. Initially, the vas deferens is tortuous, but it becomes straighter as it passes back along the testis and up through the spermatic cord and the inguinal canal into the pelvic cavity. Here it runs between the peritoneum and the lateral wall of the pelvis, from whence it runs backwards, downwards and medially, crossing the ureter to run behind the bladder, approaching its pair between the seminal vesicles at the base of the bladder. Here the tube swells into the wider ampulla of the vas deferens. On each side, the vas deferens then begins to penetrate into the substance of the prostate, and joins the duct from the seminal vesicle to form an ejaculatory duct. These ducts run through the prostate and open upwards into the prostatic urethra on the top of the urethral crest, close to the openings of the prostatic utricle. These paired organs do not in fact store sperm (they are stored in the epididymis and vas deferens), but...

Spermatic Cord

During ejaculation, functions to transport sperm from the testes, through the spermatic cord and inguinal canal to the ejaculatory duct in the prostate. Much of the ductus deferens is composed of smooth muscle and, as a result, feels rigid and hard to the touch. Therefore, the duc-tus deferens is easy to palpate in the spermatic cord.

Copulatory durations

A genital lock is the mechanical tie which occurs between the penis and the vagina during mating in some mammals. In dogs, for example, the distal portion of the penis swells markedly once intromission has occurred, so that it becomes firmly lodged within the vagina. If dogs are castrated, their capacity to maintain a genital lock gradually diminishes (Beach 1970). In the hopping mouse, by contrast, it is the presence of large, androgen-dependent penile spines, rather than tumescence of the glans penis which facilitates a genital lock during mating (Dewsbury and Hodges 1987). Genital locks are rare among the primates. Some of the nocturnal prosimians, such as the galagos, have greatly enlarged penile spines and it is likely that a genital lock occurs in certain species (Dixson 1989). Among the anthropoids, the stump-tail macaque is unusual in having a greatly elongated, lanceolate glans penis this forms a complementary fit with the narrow vaginal opening of the female. Stump-tails...

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Male strategies to manage the premature ejaculation. The squeeze technique is the most common technique used to treat premature ejaculation. The male is instructed to interrupt sexual relations when he feels that he is about to experience premature orgasm and ejaculation. He or his partner then squeezes the shaft of the penis between a thumb and two fingers, applying light pressure for about 20 seconds, then letting go and resuming sexual relations. Behavioral therapy is successful in 60 to 90 of men with premature ejaculation, however, it requires the cooperation of both partners. Although pharmacologic therapy is used in men with premature ejaculation, none of the medications currently used in the management of premature ejaculation have been approved by the FDA for this specific indication. Premature ejaculation can be treated effectively with serotonin reuptake inhibitors (SRIs) or topical anesthetics (Table 17). A variety of SRIs including fluoxetine, paroxetene, sertaline, and...

Infertility

ED is the inability of a man to achieve or maintain an erection sufficient to accomplish coitus. ED may be either erectile or ejaculatory. This inability may also be partial or complete. Men may complain of difficulty in achieving or maintaining an erection or of premature ejaculation. The prevalence of some degree of ED ranges from 20 to 30 of the married population. As a man ages, there is a natural loss of both libido and potency. In general, this does not occur before 50 years of age. Some men remain sexually vigorous well into old age. If a patient suffering from ED has occasional erections or can achieve orgasm during masturbation, he may have a primarily emotional problem. In almost 90 of patients complaining of ED, the inadequacy is found to be caused by emotional rather than anatomic factors. Some men may be able to maintain erections but have difficulty in ejaculation. They may become physically exhausted and have to stop intercourse before ejaculating. The ejaculatory ducts...

Antidepressants

The major side effects of the SSRIs referring to the CNS include nausea, headache, dry mouth, insomnia and somnolence, agitation, nervousness, sweating, dizziness, tremor, and sexual dysfunction.'.' Fluoxetine is often associated with anxiety, nervousness, insomnia, and anorexia. Paroxetine, fluvoxamine, and nefazodone are associated with sedation. Sexual dysfunction manifests itself as ejaculatory delay in men and anorgasmia in women. There have been reports suggesting that fluoxetine can induce or exacerbate suicidal tendencies, and several mechanisms have been proposed. However, because suicide is an important feature of depression, it is difficult to draw conclusions, whereas on the other hand, it is difficult to exclude the possibility that suicidal ideation occurs as a rare adverse reaction with some drugs.'7'

Adams Apple

Membrana Thyreoidea

Given that the larynx is markedly sexually dimorphic in adult human beings, and that testosterone stimulates laryngeal growth during puberty (Beckford et al. 1985 Hollien, Green and Massey 1994), it is important to determine whether sexual selection has influenced the evolution of these traits. Firstly, we may ask whether the human voice conveys any information concerning an individual's hormonal or physical status. The answer to these questions appears to be 'Yes'. Indeed, many years ago Eberhard Nieschlag showed that masculine vocal register, body condition, and circulating testosterone are correlated in the human male. Thus, he found that bass singers have higher testosterone oestradiol ratios and ejaculatory frequencies than tenors, as well as being, on average, taller and more athletic in their physique (Figure 8.2). Subsequently, Dabbs and Mallinger (1999) reported that men who have deeper voices also exhibit significantly higher levels of salivary testosterone. Low-pitched male...

Clinical History

Patients with gastrointestinal autonomic dysfunction have a variety of symptoms resulting from abnormal motility of the stomach and gut. The examiner should inquire about the presence of constipation, diarrhea, nausea, postprandial vomiting, bloating, belching, loss of appetite, and early satiety. Urinary bladder symptoms associated with autonomic dysfunction include hesitancy, poor stream production, increased intervals between micturition, and a sense of inadequate bladder emptying. Patients may also report symptoms associated with urinary retention and overflow incontinence. Male patients may additionally complain of impotence, which often is the earliest symptom of generalized autonomic failure. Sympathetically mediated ejaculatory failure may be an early complaint that precedes erectile failure.

The Road to Truth

Copulatory frequencies vary in primates depending upon their mating systems and the likely occurrence of sperm competition. Thus, ejaculatory frequencies are greatest in males of those species which have multi-male multi-female mating systems, such as macaques, baboons, and chimpanzees. Polygynous or monogamous species such as gorillas or marmosets copulate much less often. Again, the comparative data indicate that frequencies of human copulation are similar to those of polygy-nous or monogamous non-human primates (see Table 5.4). Moreover, men's sperm counts decline rapidly as a result of repeated ejaculations, a further indication of the limited human capacity to produce and store sperm.

Urethra

Prostatic Urethra

In the male, the urethra is often considered as comprising four sections, the preprostatic, the prostatic, the membranous and the penile urethra (Fig. 10.11). The preprostatic urethra is about 1.5 cm long, and extends from the bladder neck to the prostate. The smooth muscle is richly supplied with noradrenergic nerve fibres, and there is only a sparse cholinergic innervation. The prostatic urethra is about 3-4 cm long and runs through the substance of the prostate. It has a crescent-shaped cross-section due to the posteriorly positioned urethral crest, which protrudes into the lumen. The ejaculatory ducts open on the surface of this crest (called the verumon-tanum). On either side of the crest are the openings of the prostatic ducts. There are many mucosal glands opening around the entire circumference of the prostatic urethra. The thin smooth muscle coat of longitudinally and circularly arranged muscle bundles is continuous with the strands of smooth muscle pervading the prostate....

5 Secrets to Lasting Longer In The Bedroom

5 Secrets to Lasting Longer In The Bedroom

How to increase your staying power to extend your pleasure-and hers. There are many techniques, exercises and even devices, aids, and drugs to help you last longer in the bedroom. However, in most cases, the main reason most guys don't last long is due to what's going on in their minds, not their bodies.

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