Chapter 18 – Male Sexual Dysfunction, Prostate Disease and Testicular Lumps

Ejaculatory dysfunction

Ejaculation is controlled by the ejaculation centre in the medial pre-optic nucleus of the hypothalamus.

The most common ejaculation problem in men is premature ejaculation (PE), also known as rapid ejaculation, which has a varying incidence of between 10-20 per cent.  PE is regarded as a neuro-biological condition.(4)

The incidence of inhibited ejaculation (IE), or delayed or retarded ejaculation, varies between 5-10 per cent.

Retrograde ejaculation, where the ejaculate enters the bladder due to incomplete closure of the bladder neck, often occurs after surgery for benign prostate hyperplasia. It may also occur as a result of autonomic neuropathy in men with diabetes or in neurological conditions such as multiple sclerosis (MS).

Premature and inhibited ejaculations, as well as pain associated with ejaculation, are discussed further below.

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Premature ejaculation

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ISSM definition of PE

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Classification of PE

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Treatment of premature ejaculation

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Inhibited ejaculation

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Painful ejaculation

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