What is Situational an ejaculation ?

Men who suffer from situational anejaculation cannot consciously ejaculate during sexual activity but are often able to have normal erections, ejaculate during masturbation or have nocturnal emissions.

Can it be treated?

​Treatments that have been shown to be effective for psychogenic anejaculation include sex therapy, vibrator stimulation, and electroejaculation.

What is the mechanism of normal ejaculation?

​It has two phases. In the first phase, the vas deferens (the tubes that store and transport sperm from the testes) contract to squeeze the sperm toward the base of the penis and the prostate gland and seminal vesicles release secretions to make semen. At this stage, the ejaculation is unstoppable

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Normal antegrade ejaculation is a highly coordinated physiological process with emission and expulsion phases being under the control of autonomic and somatic nervous systems respectively.

What is total anejaculation?

Total anejaculation is the condition where the man is never able to ejaculate semen consciously, either during intercourse or by masturbation.

Total anejaculation is further divided into anorgasmic anejaculation and orgasmic anejaculation

What is anorgasmic anejaculation?

Anorgasmic anejaculation the man is never able to reach an orgasm in the waking state (either by masturbation or by intercourse) and does not ejaculate. This failure to reach an orgasm is sometimes attributed to psychological inhibitions, as was previously mentioned. Some may need a high amount of stimulation before they reach orgasm and do not get this stimulation during intercourse or masturbation. Low serum testosterone levels or psychotropic medications may also prevent men from reaching orgasm and ejaculation

What is orgasmic anejaculation?

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Orgasmic anejaculation reach and experience orgasm but they do not ejaculate semen, either because there is failure of emission of semen due to a block in the ejaculatory ducts or damage to ejaculatory nerves. Examples of conditions that cause this situation are diabetes, after trans-urethral (laser) resection of the prostate and following pelvic surgery for prostate, bladder or testicular cancer. Anejaculation must not be confused with retrograde ejaculation (flow of semen back into the bladder due to weakness or surgery of the bladder neck).

 

What is retrograde ejaculation ?

Flow of semen back into the bladder due to weakness or surgery of the bladder neck). This occurs in men taking medications such as alpha-blockers (Flomax) that prevent closure of the bladder neck during orgasm. Another situation where retrograde ejaculation may be observed is in men following trans-urethral resection (TURP) or laser surgery of the prostate.

How  is retrograde  ejaculation tested?

​ A simple analysis of post orgasmic urine specimen will differentiate between retrograde and an ejaculation. The presence of sperm in the urine specimen supports the diagnosis of retrograde ejaculation. Total absence of sperm in urine would indicate complete lack of ejaculation or an ejaculation.

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Primary Anejaculation