Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2014 Mar;3(1):41-9.
doi: 10.3978/j.issn.2223-4683.2014.02.02.

Ejaculatory physiology and pathophysiology: assessment and treatment in male infertility

Louis Revenig  1 , Andrew Leung  1 , Wayland Hsiao  1
Affiliations
Review

Ejaculatory physiology and pathophysiology: assessment and treatment in male infertility

Louis Revenig et al. Transl Androl Urol. 2014 Mar.

Abstract

Azoospermia is a heterogeneous condition with multiple etiologies and a variety of treatments. In this chapter we present a summary of retrograde ejaculation and anejaculation, both of which are characterized by an absence of antegrade semen propulsion through the male reproductive tract. Each of these affects fertility, but is pathophysiologically distinct disorders with differing evaluation and treatment. Retrograde ejaculation has a myriad of well-characterized causes, from pharmacologic disruption to interference of neural mechanisms by surgical intervention for a variety of diseases. Medication is the mainstay of treatment, although only a minority responds and develops antegrade ejaculation. For the men who are not responders to medical therapy, but still have fertility goals, there are a variety of sperm retrieval techniques to assist their reproductive abilities. Failure of emission is characterized by an absence of the emission phase and no antegrade or retrograde expulsion of ejaculatory products. If fertility is desired, these men must rely on assisted ejaculatory procedures, and treatment choice is guided by etiology and response. Ultimately, retrograde ejaculation and failure of emission are in a spectrum of ejaculatory disorders which impair male fertility.

Keywords: Ejaculation; anejaculation; electroejaculation (EEJ); penile vibratory stimulation (PVS); retrograde ejaculation.

PubMed Disclaimer

Conflict of interest statement

Conflicts of Interest: The authors have no conflicts of interest to declare.

Figures

Figure 1
Figure 1
Schematic showing insertion of transrectal probe for electroejaculation (EEJ). The electrodes are oriented towards the prostate and seminal vesicles.
See this image and copyright information in PMC

References

    1. Hendry WF. Disorders of ejaculation. Ann R Coll Surg Engl 1999;81:352-8. - PMC - PubMed
    1. Althof SE. Prevalence, characteristics and implications of premature ejaculation/rapid ejaculation. J Urol 2006;175:842-8. - PubMed
    1. Polakoski KL, Syner FN, Zaneveld LJ. Biochemistry of human seminal plasma. In: Hafez ES. eds. Human semen and fertility regulation in men. St. Louis: Mosby, 1976:133-43.
    1. Mann T, Lutwak-Mann C. eds. Male reproductive function and semen: themes and trends in physiology, biochemistry, and investigative andrology. Berlin/New York: Springer-Verlag, 1981.
    1. Coffey D. What is the prostate and what is its function? In: Robaire B, Pryor JL, Trasler JM, eds. Handbook of Andrology. Lawrence, KS: Allen Press, 1995:21-4.