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Anejaculation

Pathological inability to ejaculate in males

Anejaculation is the pathological inability to ejaculate despite an erection in males, with (orgasmic) or without (anorgasmic) orgasm.

Causes

Masturbation
or coitus	Penile
vibratory
stimulation	AchE
inhibitor	Complete spinal cord injury	Incomplete spinal cord injury	Complete lesion of the
sympathetic centres (T12 to L2)	Complete lesion of the parasympathetic
and somatic centres (S2 – S4)	Complete lesion of all
spinal ejaculation centres (T12 to S5)	Complete lesion strictly
above Onuf's nucleus (S2 – S4)	Complete lesion of the S2 – S4 segments
12%	47%	55%
33%	53%	78%
	None	5%
	None	31%
	None	0%
	98%	98%
	none	none

It can depend on one or more of several causes, including:

Sexual inhibition
Pharmacological inhibition. They include mostly antidepressant and antipsychotic medication, and the patients experiencing that tend to quit them
Autonomic nervous system malfunction
Prostatectomy - surgical removal of the prostate.
Ejaculatory duct obstruction
spinal cord injurySpinal cord injury causes sexual dysfunction including anejaculation. The rate of being able to ejaculate varies with the type of lesion, as detailed in the table at right.
Old age
Diabetes mellitus

Anejaculation, especially the orgasmic variant, is usually indistinguishable from retrograde ejaculation. However, a negative urinalysis measuring no abnormal presence of spermatozoa in the urine will eliminate a retrograde ejaculation diagnosis. Thus, if the affected person has the sensations and involuntary muscle-contractions of an orgasm but no or very low-volume semen, ejaculatory duct obstruction is another possible underlying pathology of anejaculation.

Management

Anejaculation in spinal cord injury

The first-line method for sperm retrieval in men with spinal cord injury is penile vibratory stimulation (PVS). The penile vibratory stimulator is a plier-like device that is placed around the glans penis to stimulate it by vibration. In case of failure with PVS, spermatozoa are sometimes collected by electroejaculation, or surgically by percutaneous epididymal sperm aspiration (PESA) or testicular sperm extraction (TESE).

Notes

References

(March 2018). "Electroejaculation combined with assisted reproductive technology in psychogenic anejaculation patients refractory to penile vibratory stimulation". Translational Andrology and Urology.
(2013). "The spinal control of ejaculation revisited: A systematic review and meta-analysis of anejaculation in spinal cord injured patients". Human Reproduction Update.
[http://www.giovannialei.it/patologie/eiaculazione_retrograda.htm] {{Webarchive. link. (2008-02-08 {{in lang). link. (2014-01-31 {{in lang). it

Info: Wikipedia Source

This article was imported from Wikipedia and is available under the Creative Commons Attribution-ShareAlike 4.0 License. Content has been adapted to SurfDoc format. Original contributors can be found on the article history page.

male-genital-disorders ejaculation

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