What is the reason for not achieving ejaculation?

Patient's question:

During sexual activity without ejaculation, there is a slight bloating sensation below the abdomen, and after a few movements, there is a feeling of needing to urinate. What could be the reason for this?

Doctor's answer:

Psychogenic anejaculation should undergo psychological counseling. Insufficient sexual knowledge should be provided with necessary information about erection and ejaculation, and positions that facilitate easy ejaculation should be taught to enable substantial and rapid thrusting during intercourse to achieve ejaculation. Anejaculation caused by medication can be discussed with a specialist physician to determine if the medication can be discontinued or replaced with an alternative. Anejaculation caused by brain lesions or spinal cord injuries is more difficult to treat. For the purpose of conception for the wife, electroejaculation can be used to obtain the husband's semen for artificial insemination.

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