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Anejaculation
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<h2 id="causes">Causes</h2> The following table shows the frequency of ability to ejaculate by type of <a href="/facts/Spinal_cord_injury/D0vo3ArR">spinal cord injury</a> and stimulation method.<a class="footnote-ref" id="fnref:2" href="#fn:2"><sup>2</sup></a><table><tbody><tr><th></th><th><a href="/facts/Masturbation/7uGXPrVc">Masturbation</a> or <a href="/facts/Sexual_intercourse/okjwpVnB">coitus</a></th><th>Penile vibratory stimulation</th><th><a href="/facts/Acetylcholinesterase_inhibitor/VbN36u7y">AchE inhibitor</a></th></tr><tr><th>Complete spinal cord injury</th><td>12%</td><td>47%</td><td>55%</td></tr><tr><th>Incomplete spinal cord injury</th><td>33%</td><td>53%</td><td>78%</td></tr><tr><th>Complete lesion of the <a href="/facts/Sympathetic_nervous_system/hs8psNRd">sympathetic</a> centres (T12 to L2)</th><td></td><td>None</td><td>5%</td></tr><tr><th>Complete lesion of the <a href="/facts/Parasympathetic_nervous_system/eNzCI8Yu">parasympathetic</a> and <a href="/facts/Somatic_nervous_system/wEIqqhg9">somatic</a> centres (S2 – S4)</th><td></td><td>None</td><td>31%</td></tr><tr><th>Complete lesion of all spinal ejaculation centres (T12 to S5)</th><td></td><td>None</td><td>0%</td></tr><tr><th>Complete lesion strictly above <a href="/facts/Onuf%2527s_nucleus/JG5fXHhr">Onuf's nucleus</a> (S2 – S4)</th><td></td><td>98%</td><td>98%</td></tr><tr><th>Complete lesion of the S2 – S4 segments</th><td></td><td>none</td><td>none</td></tr></tbody></table> <p>It can depend on one or more of several <a href="/facts/Etiology/Bz8MAeSq">causes</a>, including: </p> <ul><li><a href="/facts/Sexual_inhibition/caV2L2IX">Sexual inhibition</a></li> <li><a href="/facts/Medication/h9mhwWP2">Pharmacological</a> <a href="/facts/Reaction_inhibitor/CyRCGlMI">inhibition</a>. They include mostly <a href="/facts/Antidepressant/N62ND3Fa">antidepressant</a> and <a href="/facts/Antipsychotic/7bNTg7T3">antipsychotic</a> medication, and the patients experiencing that tend to quit them<a class="footnote-ref" id="fnref:3" href="#fn:3"><sup>3</sup></a></li> <li><a href="/facts/Autonomic_nervous_system/hdmEY1Ay">Autonomic nervous system</a> malfunction</li> <li><a href="/facts/Prostatectomy/Mxe4FC7v">Prostatectomy</a> - surgical removal of the prostate.</li> <li><a href="/facts/Ejaculatory_duct_obstruction/8senPK8B">Ejaculatory duct obstruction</a></li> <li><a href="/facts/Sexuality_after_spinal_cord_injury/eBcKqcv0">Spinal cord injury causes sexual dysfunction</a> including anejaculation. The rate of being able to ejaculate varies with the type of lesion, as detailed in the table at right.</li> <li><a href="/facts/Old_age/nEpQmo9g">Old age</a></li> <li><a href="/facts/Diabetes_mellitus/2xeHXbsI">Diabetes mellitus</a><a class="footnote-ref" id="fnref:4" href="#fn:4"><sup>4</sup></a></li></ul> <p>Anejaculation, especially the <i>orgasmic</i> variant, is usually indistinguishable from <a href="/facts/Retrograde_ejaculation/eqffEfxx">retrograde ejaculation</a>. However, a negative <a href="/facts/Urinalysis/PeS2UfIG">urinalysis</a> measuring no abnormal presence of <a href="/facts/Spermatozoon/sTG4GWc0">spermatozoa</a> in the <a href="/facts/Urine/oNUYVtvX">urine</a> will eliminate a retrograde ejaculation diagnosis. Thus, if the affected person has the sensations and involuntary muscle-contractions of an <a href="/facts/Orgasm/Dweqd5oI">orgasm</a> but no or very low-volume <a href="/facts/Semen/02mVLGfb">semen</a>, <a href="/facts/Ejaculatory_duct_obstruction/8senPK8B">ejaculatory duct obstruction</a> is another possible underlying pathology of anejaculation. </p> <h2 id="management">Management</h2> <h3>Anejaculation in spinal cord injury</h3> <p class="note">Further information: <a href="/facts/Sexuality_after_spinal_cord_injury/eBcKqcv0">Sexuality after spinal cord injury § Ejaculation and male fertility</a></p> <p>The first-line method for <a href="/facts/Semen_collection/ljt0Hhcy">sperm retrieval</a> in men with spinal cord injury is <i><a href="/facts/Vibroejaculation/N96dMRtz">penile vibratory stimulation</a></i> (PVS).<a class="footnote-ref" id="fnref:5" href="#fn:5"><sup>5</sup></a> The penile vibratory stimulator is a plier-like device that is placed around the <a href="/facts/Glans_penis/Fw1W4sQc">glans penis</a> to stimulate it by vibration. In case of failure with PVS, spermatozoa are sometimes collected by <a href="/facts/Electroejaculation/B5YE1rnc">electroejaculation</a>, or surgically by <a href="/facts/Per_cutaneous_epididymal_sperm_aspiration/pnE0gETy">percutaneous epididymal sperm aspiration</a> (PESA) or <a href="/facts/Testicular_sperm_extraction/VPJLgoyx">testicular sperm extraction</a> (TESE).<a class="footnote-ref" id="fnref:6" href="#fn:6"><sup>6</sup></a> </p> <h2 id="notes">Notes</h2> <h2 id="references">References</h2> <ol> <li id="fn:1"><p>Meng, Xianghu; Fan, Longchang; Wang, Tao; Wang, Shaogang; Wang, Zengjun; Liu, Jihong (March 2018). "Electroejaculation combined with assisted reproductive technology in psychogenic anejaculation patients refractory to penile vibratory stimulation". Translational Andrology and Urology. 7 (S1): S17 – S22. doi:10.21037/tau.2018.01.15. PMC 5881218. PMID 29644166. <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5881218" target="_blank">https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5881218</a> <a href="#fnref:1" class="footnote-back-ref">↩</a></p></li> <li id="fn:2"><p>Chehensse, C.; Bahrami, S.; Denys, P.; Clément, P.; Bernabé, J.; Giuliano, F. (2013). "The spinal control of ejaculation revisited: A systematic review and meta-analysis of anejaculation in spinal cord injured patients". Human Reproduction Update. 19 (5): 507–526. doi:10.1093/humupd/dmt029. PMID 23820516. <a href="https://doi.org/10.1093%2Fhumupd%2Fdmt029" target="_blank">https://doi.org/10.1093%2Fhumupd%2Fdmt029</a> <a href="#fnref:2" class="footnote-back-ref">↩</a></p></li> <li id="fn:3"><p>[1] Archived 2008-02-08 at the Wayback Machine (in Italian) and [2] Archived 2014-01-31 at the Wayback Machine (in Italian) <a href="http://www.giovannialei.it/patologie/eiaculazione_retrograda.htm" target="_blank">http://www.giovannialei.it/patologie/eiaculazione_retrograda.htm</a> <a href="#fnref:3" class="footnote-back-ref">↩</a></p></li> <li id="fn:4"><p>Meng, Xianghu; Fan, Longchang; Wang, Tao; Wang, Shaogang; Wang, Zengjun; Liu, Jihong (March 2018). "Electroejaculation combined with assisted reproductive technology in psychogenic anejaculation patients refractory to penile vibratory stimulation". Translational Andrology and Urology. 7 (S1): S17 – S22. doi:10.21037/tau.2018.01.15. PMC 5881218. PMID 29644166. <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5881218" target="_blank">https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5881218</a> <a href="#fnref:4" class="footnote-back-ref">↩</a></p></li> <li id="fn:5"><p>Chehensse, C.; Bahrami, S.; Denys, P.; Clément, P.; Bernabé, J.; Giuliano, F. (2013). "The spinal control of ejaculation revisited: A systematic review and meta-analysis of anejaculation in spinal cord injured patients". Human Reproduction Update. 19 (5): 507–526. doi:10.1093/humupd/dmt029. PMID 23820516. <a href="https://doi.org/10.1093%2Fhumupd%2Fdmt029" target="_blank">https://doi.org/10.1093%2Fhumupd%2Fdmt029</a> <a href="#fnref:5" class="footnote-back-ref">↩</a></p></li> <li id="fn:6"><p>Chehensse, C.; Bahrami, S.; Denys, P.; Clément, P.; Bernabé, J.; Giuliano, F. (2013). "The spinal control of ejaculation revisited: A systematic review and meta-analysis of anejaculation in spinal cord injured patients". Human Reproduction Update. 19 (5): 507–526. doi:10.1093/humupd/dmt029. PMID 23820516. <a href="https://doi.org/10.1093%2Fhumupd%2Fdmt029" target="_blank">https://doi.org/10.1093%2Fhumupd%2Fdmt029</a> <a href="#fnref:6" class="footnote-back-ref">↩</a></p></li> </ol>