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Ejaculation, disorders of

Conditions in which the usual process or timing of ejaculation is disrupted.

Types

Premature ejaculation

With premature ejaculation, semen emission happens before or almost immediately following penetration.  Premature ejaculation is the most common sexual problem in men, especially in young men whom have only recently became sexually active.  It is generally due to anxiety about sexual performance or over stimulation.  If the problem recurs frequently, sexual counselling and techniques for delaying ejaculation can help.

Inhibited ejaculation

This is an unusual condition in which erection is normal, or sometimes prolonged, but ejaculation is abnormally delayed or fails to occur.  The problem can be psychological in origin, in which case counselling can help, or it may occur as a complication of a disorder such as diabetes mellitus or alcohol dependence.  Sometimes, inhibited ejaculation arises as a side effect of certain drugs, such as anti-depressant drugs and anti-hypertensive drugs. 

The cause is treated where possible; if drug treatment is suspected to be the cause, a change to a different drug can resolve the problem. 

Retrograde ejaculation

In retrograde ejaculation which usually closes during ejaculation, stays open.  As a result of this, semen is pushed backwards into the bladder and not expelled from the penis.

Retrograde ejaculation can be due to neurological disease, prostatectomy (removal of the prostate gland) or surgery on the bladder.  There is not a treatment, but sexual intercourse with a full bladder can occasionally result in normal ejaculation.  If an affected man and his partner desire to have a baby, it is occasionally possible to harvest sperm from the bladder for use in invitro fertilisation. 

 

Elephantiasis

A disease that arises in the tropics and is characterised by immense swelling of the arms, legs, and in men, the scrotum.  There is also darkening and thickening of the skin.  Most cases of elephantiasis are caused by chronic lymphatic obstruction caused by filariasis (a worm infestation).  


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