ELECTIVE
ejaculation
The emission of
semen
from the penis
at
orgasm
.
Just before ejaculation, mus-
cles around the epididymides (ducts in
w hich
sperm
are stored; see
epididymis
) ,
the
prostate gtand
,
and the
seminal vesi-
cles
contract rhythmically, forcing the
sperm from the epididymides to move
forwards and m ix with secretions from
the seminal vesicles and the prostate. At
ejaculation, this fluid is propelled out of
the body through the
urethra
.
Because both semen and urine leave
the body by the same route, the bladder
neck closes during ejaculation. This not
only prevents ejaculate from going into
the bladder but also stops urine from
contaminating
the
semen.
(See
also
reproductive system, male
. )
ejaculation, disorders of
A group of conditions in w hich the
normal process or timing of
ejaculation
is disrupted.
TYPES
Premature ejaculation
In premature ejac-
ulation, semen emission occurs before
or almost immediately following pene-
tration.
Premature
ejaculation
is
the
most common sexual problem in men,
particularly in young men who have
only recently become sexually active. It
is often due to over-stimulation or to
anxiety about sexual performance. If the
problem occurs frequently, sexual coun-
selling
and
techniques
for
delaying
ejaculation may help (see
sextherapy
) .
Inhibited ejaculation
This is a rare condi-
tion in which erection is normal, or even
prolonged, but ejaculation is abnormally
delayed or fails to occur. The problem
may
be
psychological in
origin,
in
w hich case counselling may help, or it
may arise as a complication of a disor-
der such as
diabetes mellitus
or
alcohol
dependence
.
In some cases, inhibited
ejaculation occurs as a side effect of cer-
tain drugs, such as some
antihypertensive
drugs
and
antidepressant drugs
.
The cause is treated where possible; if
drug treatment is thought to be the
cause, a change to another drug may
resolve the problem.
Retrograde ejaculation
In retrograde ejac-
ulation, the neck of the
bladder
,
w hich
normally closes during ejaculation, stays
open. As a result, semen is forced back-
wards into the bladder and none is
expelled from the penis.
Retrograde ejaculation may be due to
a neurological disease, surgery on the
bladder, or
prostatectomy
(removal of
the prostate gland). There is no treat-
ment, but sexual intercourse with a full
bladder can sometimes result in normal
ejaculation. If an affected man and his
partner wish to have a baby, it is some-
times possible to harvest sperm from
the bladder for use in
in vitro fertilization
.
(See also
azoospermia
;
psychosexual dys-
function
;
sexual problems
.)
elasticated bandage
A type of stretchable
bandage
that is
especially useful in the treatment of
joint
injuries and for swelling of the legs
due to
varicose veins
.
An elasticated ban-
dage helps to minimize swelling while
not impeding movement.
elbow
The
hinge
joint
formed
where
the
lower end of the
humerus
(upper-arm
bone)
meets the upper ends of the
radius
and
ulna
(the forearm bones).
The elbow is stabilized by
ligaments
at the front, the back, and the sides.
The elbow joint enables the arm to be
bent and straightened, and the forearm
to
be
rotated
through
almost
180
degrees around its long axis without
more than a very slight movement of
the upper arm.
DISORDERS
Disorders of the elbow include
arthritis
and various injuries to the joint and its
surrounding muscles, tendons, and liga-
ments. Repeated strain on the tendons of
the forearm muscles, where they attach
to the elbow, can result in inflammation
that is known as
epicondylitis
.
There are
two main types of epicondylitis:
tennis
elbow
and
golfer’s elbow
.
Alternatively,
a
sprain
of the ligaments around the
elbow joint may occur.
Olecranon
bursitis
develops over the
tip of the elbow in response to local
irritation. Strain on the elbow joint can
produce an
effusion
(the accumulation
of fluid in a joint) or traumatic
synovitis
(inflammation of the membranes that
line the joint capsule).
A
sharp
blow
on
the
olecranon
process (the bony tip of the elbow, also
known as the “funny bone”) may im -
pinge on the
ulnar nerve
as it passes in a
groove in this area, causing temporary
discomfort: a pins-and-needles sensa-
tion and lancing pains that shoot down
the arm into the fourth and fifth fingers.
A fall onto an outstretched hand or
onto the tip of the elbow can cause a
fracture or dislocation of the elbow.
elderly, care of the
Appropriate
care
to
help
minimize
physical and mental deterioration in the
elderly. For example, failing vision and
hearing are often regarded as inevitable
in old age, but removal of a
cataract
(loss of transparency in the lens of the
eye) or use of a
hearing-aid
can often
improve quality of life.
Isolation or inactivity leads to
depres-
sion
in some elderly people. Attending a
day-care centre can provide social con-
tact and introduce new interests.
Many elderly people are cared for by
family members. Voluntary agencies can
often provide domestic help in order to
ease the strain on carers. The option of
sheltered housing allows independence
w hile providing a degree of supervision
and assistance when it is needed. Elder-
ly people who have
dementia
(loss of
normal brain function)
or a physical
disability may require more supervi-
sion, in a residential care or hospital
setting. (See also
geriatric medicine
. )
elective
A term used to describe a procedure,
usually a surgical operation, that is not
urgent and can be performed at a sched-
uled time. Elective surgery includes the
correction of nonurgent medical con-
ditions, such as
haemorrhoids
,
and some
cosmetic procedures, such as
rhinoplasty
.
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