“Ejaculatory dysfunction” is a common sexual complaint for men that is often undertreated due to both patient embarrassment as well as poor physician knowledge of treatment options. This condition typically results from neurologic diseases, traumatic injury, as a complication or known side effect of surgery, or for no known reason.
The nerves responsible for normal ejaculation are most commonly injured after spinal trauma resulting in paraplegia or quadriplegia, major bowel or vascular surgery, or surgery for testicular cancer. Prostate surgery can also lead to a specific ejaculatory issue called retrograde ejaculation, in which the ejaculate travels back into the bladder at climax. Other conditions that can result in ejaculatory failure include diabetes, multiple sclerosis, and psychological disorders, as well as the use of many common medications.
Many of the above conditions can be treated in order to improve overall sexual function. This can be done with removal or change in medications or treatment of the an underlying issue. Additionally, in the past, men with ejaculatory dysfunction were considered infertile because they could not ejaculate and impregnate their wives, even though they usually produce sperm within their testicles. In theses men, sperm can often be obtained through simple in office procedures that “induce” ejaculation either in a normal direction or at the very least into the bladder where the sperm can be “used” for insemination or IVF procedures.