Ejaculatory Disorders in Andrology – Clinical Classification and Management

Ejaculatory disorders encompass a spectrum of conditions including premature ejaculation, delayed ejaculation, retrograde ejaculation, and anejaculation. These disorders affect sexual satisfaction and reproductive potential and are often underdiagnosed.

Retrograde ejaculation, for instance, occurs when semen flows backward into the bladder due to failure of bladder neck closure. It is commonly associated with diabetes mellitus, pelvic surgery, or autonomic neuropathy. Diagnosis requires post-ejaculatory urinalysis to detect sperm presence.

Delayed ejaculation and anejaculation may have neurological, psychological, or pharmacological causes. Antidepressants, particularly selective serotonin reuptake inhibitors, are frequent contributors.

Management requires etiological identification and may involve medication adjustment, behavioral therapy, or assisted reproductive techniques. Andrology plays a critical role in differentiating functional from organic causes to guide erotic appropriate treatment.