BURKI’S MANEUVRE FOR DELAYING EJACULATION

MOHAMMAD HARIS BURKI (M.B.B.S., Ph.D.)
ABSTRACT

BACKG ROUND :
Orgasmic dysfunctions are the commonest sexual problems encountered. Before the introduction of SSRIs, behavioral techniques were the mainstay for the management of premature ejaculation. Pause method, pubococcygeal muscle training, cognitive and behavior pacing strategies and squeeze technique figure prominently amongst them. But the popularity of behavioral technique declined sharply after the dawn of SSRI era. However, SSRIs have certain side effects especially anorgasmia and erectile dysfunction. A strong need was felt to develop a more effective and self administrable technique.

METHOD :
An extensive electronic search was made regarding techniques for delaying premature ejaculation on various database websites. Manual search for such material from various journals and books was also made. Orgasm was studied in detail; anatomically and physiologically.

RESULTS:
In the first stage the basis of emission was understood to be as follows:
First is the contraction of vasa efferentia of testis. Secondary contraction travel along epididymis to vas deferense and finally these pulsate in close conjunction with seminal vesicles. Regular prostatic contractions are recorded during the process. Prostatic fluid is poured into urethra. Later secretion stored in ampullae and seminal vesicle is discharged into prostatic urethra. Spermatic cords appear to be most strategic point as nerve impulse for initiating orgasm passes down and emission reflex passes upward through them.

CONCLUSION:
Considering the anatomy and physiology of orgasm, a simple method to block orgasm has been developed. Sympathetic impulses for orgasm and sub threshold orgasmic impulses prior to emission can be blocked by compressing two spermatic cords simultaneously at upper half of right and left folds or margin of scrotum close to deeper part of penis. These spots can be pressed firmly by middle and ring finger with penis in the cleft between index and middle finger. If penis is thicker, cleft between middle and index finger can be used. That is what has been termed as Burki’s maneuver.

BURKI, S CLINICAL MODELOF SEXUAL RESPONSE CYCLE

BACKGROUND:
Four phases of sexual response depict sequence of events during sexual intercourse or masturbation. It does not take into account etiology and pathophysiology of various sexual disorder.

METHOD:
An electronic search was done at various database websites, followed by manual study of magazine and books of sexual health to study sexual response cycle.

RESULTS:
A clinical model was designed which could address clinical issues. First of libidinous impulse coming from CNS is conceived which travel via autonomic nervous system to reach sexual organ. It is supposed that sexual apparatus is composed of two chambers erectile and orgasmic chambers. .In erectile chamber parasympathetic nerve supply dominate and orgasmic chamber has rich sympathetic nerve supply. It is conceived that erectile chamber has erectile capacity which depend upon its anatomic constitution. Once capacity is full sympathetic activity takes over causing detumesences. Biochemical bases are the facilitatory or resistance factors which modulate functioning of chamber.
Orgasmic chamber has fix capacity for holding sympathetic discharge. Beyond this capacity parasympathetic system initiates ejaculation reflex. Orgasmic chamber has its own resistance and facilitatory factors that modulate sympathetic activity. Transition period of switching from sympathetic to parasympathetic mode is the plateau phase. Two chambers and CNS form integrated system.

DISCUSSION:
Most of the sexual dysfunctions and their subtypes can be explained on bases of this model. A clinical model can help sexologist in selection of treatment options..

CONCLUSION:
.Burki,s model provides frame work for application of modern knowledge on sexual dysfunction


Thanks for enter our website and visit it and have complete details of products whatever you need and dont heasitate to contect our team member for good and best openion and answers of your questions. WELCOME again.