Why can't a man ejaculate during coitus but can do so with his hands, and what happens when he can't?

Patient's question:

During coitus, my husband couldn't ejaculate, and pulling the urethral meatus would cause pain. He could ejaculate with his hand, and the pain would subside afterward. Previously, during coitus, we used withdrawal method, and usually, we would use our hands after a while. Coitus wasn't frequent.

Doctor's answer:

Hello, based on your description, it is likely caused by inflammation, which is generally related to local pathogenic infection. You can try taking Amoxicillin and Metronidazole orally for treatment. Make sure to rest, avoid foods, drink plenty of water, and it will gradually improve.