Disorders of ejaculation
Disorders of ejaculation - sexual dysfunction, which is expressed in constant or occasional recurring disorder ejaculation process. Violations include accelerated ejaculation, delayed, retrograde ejaculation and lack of ejaculation (anejaculation). ejaculation disorders can be accompanied by a male anorgasmia or combined with erectile dysfunction order cheap cialis online. Diagnostic Management of ejaculation disorders include complete clinical and instrumental and laboratory examination of the patient:. Inspection, function tests, ultrasound of male sexual organs, a study of prostate secretion and urine, cystoscopy, etc. Treatment of ejaculation may include psychotherapy, behavioral therapy, medication and physical therapy of inflammatory processes urogenital tract, according to testimony - surgery.
Ejaculation Disorders - a concept that brings together different types of ejaculatory disorders (premature ejaculation, delayed ejaculation, anejaculation, retrograde ejaculation). Among the various forms of sexual dysfunction in men ejaculation disorders share accounts for about 40%. Depending on the reasons underlying abnormal ejaculation, in solving the problem may be involved experts from the field of urology, andrology, neurology, endocrinology, psychology, sexology.
Ejaculation (emission of semen through the external opening of the urethra) is a complex reflex act, which plays an important role in the sexual life of men and allows for the natural procreation. Ejaculation is a natural result of the stimulation of the penis occurs or involuntarily (pollution). It is believed that the rate of men, sexually active, ejaculation occurs after 2-3 minutes after the start of the friction period, but this figure may vary considerably according to the age, sexual experience, the psychological and physical condition of men.
Ejaculation process involves several successive stages: emission preeyakulyatsiyu and actual ejaculation, accompanied by orgasm. The phase issue is released testicular contents of the epididymis (the sperm), secretion of the prostate and seminal vesicles in the prostatic urethra. Almost simultaneously, the bladder neck is reduced, preventing retrograde to throw the semen into the bladder (preeyakulyatsiya). Then follows the expulsion phase - the release of seminal fluid from the urethra to the outside as a result of a series of rhythmic contractions of the bulbo-spongy, sciatic-cavernous and other muscles of the perineum. The process of ejaculation is provided a multilevel neural regulation, including the orderly interaction of the sympathetic (emission and preeyakulyatsiya), parasympathetic, somatic nervous system, central nervous system (ejaculation and orgasm). Violations that occur on one of the levels of regulation, cause different in its manifestations and severity of ejaculatory disorders.
Causes of ejaculation disorders
Causes of ejaculation disorders can have organic and psychogenic nature. Thus, rapid ejaculation organic genesis occurs in urological diseases (prostatitis, urethritis, kollikulit, prostate adenoma, increased sensitivity of the glans penis), anatomical anomalies (short bridle of the foreskin), neurological disorders (pelvic fractures, spinal cord injury). Psychogenic premature ejaculation is most common in sexually inexperienced males, with rare sexual intercourse, excessive sexual arousal, stress, fear of failure, and so on. D.
Psychological factors leading to delay ejaculation and aneyakultsii may constitute sexual complexes and restrictions, low sex appeal sexual partner, depression, problems in interpersonal relations with a woman. Organic substrates, causing abnormal ejaculation may be neurological (Parkinson's disease, multiple sclerosis, stroke, neuropathy), endocrine (hypothyroidism, hypogonadism), Urology (STDs, penile injury, prostate surgery, and others.) Pathology.
The causes of retrograde ejaculation are usually the pathological conditions involving violation of the innervation of the bladder neck. The development of such disorders is possible on the background of congenital anomalies of the posterior urethra and bladder, bladder neck sclerosis, diabetic neuropathy, after surgeries in the bladder and prostate. Asthenic ejaculation is usually associated with the pathology of the urethra (urethral stricture or valves, etc.) Or cause neurogenic nature (spinal cord injuries, sympathectomy, retroperitoneal lymphadenectomy, operations on the large intestine). Violation of ejaculation by type of painful ejaculation occurs in chronic prostatitis, chronic pelvic pain syndrome, urethritis, obstruction of the vas deferens.
Various abnormal ejaculation are often a side effect of certain medications (antihypertensives, diuretics, antidepressants, adrenergic blockers), developed by alcohol and drugs. In some cases, men diagnosed idiopathic ejaculation disorder, the etiological factor which can not be established.
According to WHO criteria, it is considered premature ejaculation, which came before sexual intercourse or less than 1 minute after the start, and not resulting in sexual satisfaction of one or both sexual partners. When ejaculation delay, on the contrary, man is unable to achieve ejaculation, despite the prolonged sexual stimulation. About delay ejaculation usually say, if it does not occur within 20-30 minutes after the start of frictions in spite of their mutual desire and willingness of partners to complete sexual intercourse. If retrograde ejaculation ejaculate is not ejected antegrade (from the urethra to the outside), and goes in the opposite direction (into the bladder). This seminal fluid does not stand out at all, or ejaculate volume is too small. Such abnormal ejaculation may be suspected on the allocation of turbid urine after sexual intercourse. Delayed, retrograde ejaculation, and can act anejaculation factors of male infertility.
At the heart of asthenic ejaculation ( "ejaculatory jelly" partial ejaculatory dysfunction) is a violation of rhythmic muscular contractions of smooth muscles, providing tolchkoobrazny release of seminal fluid from the urethra. This ejaculation disorder accompanied by blurred orgasmic sensations, but the quality of the ejaculate does not change, and male fertility is not affected. Painful ejaculation is often combined with dysuric disorders. In this case, ejaculation disorder is characterized by pain in the course of the urethra and perineum. Various abnormal ejaculation may cause a reduction of libido and impotence. The consequence of ejaculation disorders can be conflicts in the pair, abstaining from sex or even breakup.