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Ejaculatory Disorders

Payam Sazegar, MD, CCFP Reviewed 06/2019
 


BASICS

DESCRIPTION

  • Group of dysfunctions involving altered time and control (premature ejaculation [PE], delayed ejaculation [DE]), presence (anejaculation [AE]), direction (retrograde ejaculation [RE]...

DIAGNOSIS

Start by asking if ejaculation occurs before individual wishes OR does not occur following normal stimulation (including masturbation). 

HISTORY

Detailed sexual history, including: 
  • Time frame ...

TREATMENT

GENERAL MEASURES

  • Identifying any medical cause (even if not reversible) helps patient accept condition.

  • Improve partner communication.

  • Psychological counseling for patient and partner

  • Reduce per...

ONGOING CARE

PATIENT EDUCATION

See “General Measures.” 

PROGNOSIS

Often improves with therapy and counseling 

COMPLICATIONS

Psychological impact on some males: signs of severe inadequacy, self-doubt, addit...

REFERENCES

1
Pastore A, Palleschi G, Fuschi A, et al. Pelvic muscle floor rehabilitation as a therapeutic option in lifelong premature ejaculation: long-term outcomes. Asian J Androl.  2018;20(6):...

ADDITIONAL READING

  • Jiann B. The office management of ejaculatory disorders. Transl Androl Urol.  2016;5(4):526–540. [View Abstract on OvidMedline]

  • Mehta A, Sigman M. Management of the dry ejaculat...

CODES

ICD10

  • F52.4 Premature ejaculation

  • N53.11 Retarded ejaculation

  • N53.14 Retrograde ejaculation

  • N53.13 Anejaculatory orgasm

  • F52.8 Oth sexual dysfnct not due to a sub or known physiol cond

  • N53.12 Painful e...

CLINICAL PEARLS

  • If erectile dysfunction is contributing to ejaculatory difficulty, management of erectile dysfunction should precede attempted management of ejaculatory disorders.

  • Medications should al...

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