Patient's question:
Not ejaculating for many years, with a history of masturbation. Prostate fluid is scarce, and he has never experienced nocturnal emissions. Previously, there were no obvious symptoms, but in the past two months, he has noticeably felt a slight ache in the left perineum.Doctor's answer:
1. Sex Education and Sex Psychotherapy: Most patients with functional anejaculation can achieve immediate results through explaining sexual knowledge, eliminating negative psychological effects and misconceptions, and supplemented with sexual guidance.2. Electrical Vibration and Electrical Stimulation Therapy: Approximately 50% of functional patients are cured with one treatment. Most patients can return to normal after repeated treatments. Francois and Brandley used electrical vibration to treat patients with spinal cord injuries: the success rate was 90.9% for cervical spine injuries, 67.5% for thoracic spine injuries, and only 22.2% for thoracolumbar injuries. Rectal insertion electrical stimulation treatment for anejaculation has a success rate of 60.9%.
3. Medication: Taking drugs that act on α and β receptors, such as ephedrine, one hour before intercourse can help restore ejaculation function.
4. Other Treatments: Ejaculation disorders caused by endocrine disorders or medication should be treated with appropriate hormone supplementation or discontinuation of drugs affecting ejaculation. Ejaculation duct obstruction can be treated with endoscopic incision of the ejaculation duct.