Ejaculatory Dysfunction

Ejaculatory Dysfunction

Male ejaculation is a highly complex process. It requires the central and peripheral nervous systems to work together for ejaculation to take place. The first stage is called emission, in which sperm from the vas deferens and fluid from the seminal vesicles and prostate gland that make up semen is pushed through the ejaculatory ducts and into the prostatic urethra. The second stage is called expulsion when the neck of the bladder closes and muscles at the base of the penis and urethra contract to propel the semen through the tip of the penis.

What are the Causes of Ejaculation Disorders?

  • Prostate or pelvic surgery (including colorectal, bladder, and retroperitoneal surgery)
  • Congenital anomalies, such as spina bifida
  • Spinal cord injury
  • Psychological disorders
  • Underlying medical problems, such as diabetes
  • Medications (side effects of medications can cause retrograde, delayed, or absent ejaculation)

Types of Ejaculation Disorders

Premature Ejaculation

Premature ejaculation is defined as an inability to delay ejaculation until it is mutually desirable for both partners, becoming a cause of stress and dissatisfaction. The classification ‘premature’ is subjective – it is not based on time, for instance, but rather on the impact the timing has on the sexual experience.

For some men who experience premature ejaculation, it is a lifelong condition that has affected them ever since they started to have orgasms, while for others it is acquired over a period of time. For some men, premature ejaculation is situational; it may occur only on some occasions. The causes and potential treatment options vary for individual patients.

Premature Ejaculation urology

Retrograde Ejaculation

Retrograde ejaculation is when the ejaculate goes backwards into the bladder instead of moving forward through the tip of the penis. Ejaculate that enters the bladder is not harmful and will eventually come out in the urine. Men with retrograde ejaculation may notice that they have cloudy urine after orgasm. This condition can often be diagnosed with a simple test known as a post-ejaculatory urinalysis. The patient is asked to provide a semen sample through masturbation followed by a urine sample to check for the presence of sperm in the urine. If sperm is found, it can be frozen and stored for future use in assisted reproduction.

Retrograde Ejaculation

Delayed Ejaculation and Anejaculation

Delayed ejaculation is when it takes an abnormally long time for ejaculation to occur. Anejaculation is when ejaculation does not occur at all. Some men have anorgasmia—the inability to have an orgasm—in addition to anejaculation, while others are able to have an orgasm but cannot ejaculate. Some men have delayed ejaculation or anejaculation only in certain situations, such as with masturbation or with intercourse.

Delayed Ejaculation and Anejaculation urologist new jersey

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