Ejaculatory Dysfunction and Vasodynamics

Abstract

Ejaculation is a complex biological event. It is based on a simple spinal reflex that is modulated by anatomical, cerebral, and learned behavioral events. As a consequence of these varied inputs, disordered ejaculation occurs and is divided into early, delayed, retrograde, and anejaculation. In addition, congenital and acquired causes of abnormal ejaculation include spinal cord injury, diabetes mellitus, congenital absence of the vas deferens, and ejaculatory duct obstruction. Common medications such as antidepressants, alpha-blockers used for enlarged prostates, and finasteride (prostate enlargement and male pattern baldness) can also contribute to disordered ejaculation. Using principles of evidence-based medicine, we review the diagnosis and management of known forms of disordered ejaculation.