AB028. The diagnosis and treatment of ejaculatory dysfunction

Abstract: Ejaculatory dysfunction is a common disease for male and it may take several forms including premature ejaculation, delayed or anejaculation (DE/AE), retrograde ejaculation, and painful ejaculation. Ejaculation process consists of the emission of semen from seminal vesicles and prostate, followed by expulsion. Delayed ejaculation (DE) is a common form of ejaculatory dysfunction, characterized by a marked delay in ejaculation or an inability to achieve ejaculation. The pathophysiology of DE/AE includes both organic and psychosocial factors. There is currently no single gold standard for diagnosing DE/AE, as operationalized criteria do not exist. The ejaculation history of patients is the key to the diagnosis. Treatment should be cause-specific. The approaches to treatment include various psychological interventions, pharmacotherapy, and specific treatments such as transrectal electric stimulation for sperm extraction to infertile men. The effect of drug therapy is dubious. According to literatures, physicotherapeutics are effective to treatment of DE Which include Penile stimulation, acupuncture, et al. A number of approaches can be employed for infertile men, including the collection of nocturnal emissions, prostatic massage, prostatic urethra catheterization, penile vibratory stimulation, probe electroejaculation, sperm retrieval by aspiration from either the vas deferens or the epididymis, and testicular sperm extraction. Many factors disrupt centrally mediated reflex and inhibit the bladder neck (internal vesical sphincter) contraction, what may lead to retrograde passage of semen into the bladder. These can be broadly categorized as pharmacological, neurogenic or anatomic causes of retrograde ejaculation retrograde ejaculation. The analysis and confirmation of sperm in a post orgasmic urine sample is the key to diagnosis. Medical and surgical strategies are useful for the treatment of retrograde ejaculation.

Keywords: Delayed or anejaculation (DE/AE); anejaculation (AE); retrograde ejaculation