Management of the dry ejaculate A systematic review of aspermia and retrograde ejaculation

Capsule:
Treatment for aspermia, or a dry ejaculate, must be tailored to the individual patient and include consideration of ease of administration, degree of invasiveness, and anticipated success.

Authors:
Akanksha Mehta, M.D., Mark Sigman, M.D.

Volume 104, Issue 5, Pages 1074-1081

Abstract:

A dry ejaculate (aspermia), may occur either because of an inability to transport semen (anejaculation) or because of an inability to ejaculate in an antegrade direction (retrograde ejaculation). The treatment of aspermia varies with underlying etiology and includes medical therapy with sympathomimetics, urinary sperm retrieval, bladder neck reconstruction, prostatic massage, penile vibratory stimulation, electroejaculation, and surgical sperm retrieval. A systematic review of the current literature was performed for articles on ejaculatory dysfunction related to dry ejaculate. However, the data are insufficient to allow firm comparisons between treatment options. Treatments must be tailored to the individual patient, and treatment decisions should involve consideration of ease of administration, degree of invasiveness, and anticipated success.

  • This article provides an excellent review of the different reasons as well as the treatment modalities available to address ejaculatory dysfunction. A thorough evaluation for infertility should be conducted because sometimes a pt also has NOA on top of the ejaculatory disorder which can make the diagnosis more frustrating for the couple.

    A lot of male patients don’t seek medical attention for a lot of their health problems. I don’t know how many times I’ve diagnosed untreated diabetes in a male when trying to work up an abnormal semen analysis and find retrograde ejaculation, sugar in their office screening UA and then an elevated HbA1c.

    Excellent review

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