Delayed Ejaculation: Pathophysiology, Diagnosis, and Treatment
- PMID: 29299903
- PMCID: PMC5756804
- DOI: 10.5534/wjmh.17051
Delayed Ejaculation: Pathophysiology, Diagnosis, and Treatment
Abstract
Delayed ejaculation (DE) is a poorly defined and uncommon form of male sexual dysfunction, characterized by a marked delay in ejaculation or an inability to achieve ejaculation. It is often quite concerning to patients and their partners, and sometimes frustrates couples' attempts to conceive. This article aims to review the pathophysiology of DE and anejaculation (AE), to explore our current understanding of the diagnosis, and to present the treatment options for this condition. Electronic databases were searched from 1966 to October 2017, including PubMed (MEDLINE) and Embase. We combined "delayed ejaculation," "retarded ejaculation," "inhibited ejaculation," or "anejaculation" as Medical Subject Headings (MeSH) terms or keywords with "epidemiology," "etiology," "pathophysiology," "clinical assessment," "diagnosis," or "treatment." Relevant sexual medicine textbooks were searched as well. The literature suggests that the pathophysiology of DE/AE is multifactorial, including both organic and psychosocial factors. Despite the many publications on this condition, the exact pathogenesis is not yet known. There is currently no single gold standard for diagnosing DE/AE, as operationalized criteria do not exist. The history is the key to the diagnosis. Treatment should be cause-specific. There are many approaches to treatment planning, including various psychological interventions, pharmacotherapy, and specific treatments for infertile men. An approved form of drug therapy does not exist. A number of approaches can be employed for infertile men, including the collection of nocturnal emissions, prostatic massage, prostatic urethra catheterization, penile vibratory stimulation, probe electroejaculation, sperm retrieval by aspiration from either the vas deferens or the epididymis, and testicular sperm extraction.
Keywords: Anejaculation; Delayed ejaculation; Diagnosis; Physiopathology; Therapy.
Copyright © 2018 Korean Society for Sexual Medicine and Andrology.
Conflict of interest statement
The authors have no potential conflicts of interest to disclose.
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References
-
- Munjack DJ, Kanno PH. Retarded ejaculation: a review. Arch Sex Behav. 1979;8:139–150. - PubMed
-
- Shull GR, Sprenkle DH. Retarded ejaculation reconceptualization and implications for treatment. J Sex Marital Ther. 1980;6:234–246. - PubMed
-
- Segraves RT. Considerations for a better definition of male orgasmic disorder in DSM V. J Sex Med. 2010;7:690–695. - PubMed
-
- American Psychiatric Association. Diagnostic and statistical manual of mental disorders. 5th ed. Washington, DC: American Psychiatric Association; 2013.
-
- Rowland D, McMahon CG, Abdo C, Chen J, Jannini E, Waldinger MD, et al. Disorders of orgasm and ejaculation in men. J Sex Med. 2010;7:1668–1686. - PubMed
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