Ejaculatory Dysfunction: Evaluation and Pathophysiology

Ejaculation is a complex process involving the nervous system, the endocrinological glands, and the contraction of various muscle groups. The culmination of this process is the expulsion of semen through the urethral meatus. Two mechanisms are responsible for provoking this expulsion: emission, followed by ejaculation. This article describes the various mechanisms controlling this process and the alterations which modify or hamper ejaculation. Any alteration in ejaculation, including anejaculation or retrograde ejaculation, may be the underlying cause of infertility. This article includes an analysis of the various treatments for ejaculatory dysfunction which allow the patient to opt for a biological paternity.