Andrology Unit, Department of Clinical and Molecular Medicine, University of Rome "Sapienza", Sant'Andrea Hospital, via di Grottarossa 1038, University of Rome 'Sapienza', Rome.
Unit of Endocrinology and Diabetes, Department of Medicine, Campus Bio-Medico University of Rome, Rome, Italy.
Clin Ter. 2020 Nov-Dec;171(6):e523-e527. doi: 10.7417/CT.2020.2267.
The aim of this study was to evaluate: 1) the prevalence of male infertility due to ejaculatory dysfunction (premature ejaculation-PE, intravaginal ejaculatory dysfunction-IVEjD, anejaculation-AE, and retrograde ejaculation-RE); and 2) the hormonal profile and semen characteristics of such subjects.
N.3280 subjects who were referred to our andrology unit for infertility were studied. Exclusion criteria: the presence of known causes of male infertility and erectile dysfunction. In all subjects were performed: medical history and andrological physical examination; hormonal profile; semen analysis or centrifugation/resuspension of post-orgasmic urine; IIEF-5 questionnaire for the diagnosis of ED; PEDT questionnaire for the diagnosis of EP.
the prevalence of ejaculatory dysfunctions in infertile males was 1.8% (59/3280). The causes were: a) absence of ejaculation in 37/3280 subjects (1.1%); among them, 23/3280 (0.7%) subjects showed a condition of RE and 14/3280 (0.4%) of AE; b) PE in 16/3280 subjects (0.5%); and c) IVEjD in 6/3280 subjects (0.2%). Hormonal values and seminal parameters (when semen analysis was possible) were within the normal ranges in all the cases. In subjects with RE, sperm recovery was possible in 69.9% (16/23) subjects after centrifugation and resuspension of post-orgasmic urine.
The prevalence of male infertility due to ejaculatory dysfunctions is overall just under 2%. The main cause is retrograde ejaculation; psychogenic origins could also have an important role. It is important to identify the cause of ejaculatory dysfunction in order to decide upon correct management (PE treatment, centrifugation and resuspension of post-orgasmic urine, penile vibratory stimulation, and psychological counselling).
本研究旨在评估：1）射精功能障碍（早泄、阴道内射精障碍、不射精和逆行射精）导致男性不育的患病率；2）此类患者的激素水平和精液特征。
对 3280 名因不育问题而前往我院男科就诊的患者进行了研究。排除标准：存在已知男性不育和勃起功能障碍的原因。所有患者均进行了：病史和男科体格检查；激素水平检查；精液分析或离心/重悬射精后尿液；IIEF-5 问卷评估勃起功能障碍；PEDT 问卷评估早泄。
不育男性射精功能障碍的患病率为 1.8%（59/3280）。病因如下：a）37/3280 名患者（1.1%）存在不射精，其中 23/3280（0.7%）患者存在逆行射精，14/3280（0.4%）患者存在不射精；b）16/3280 名患者（0.5%）患有早泄；c）6/3280 名患者（0.2%）患有阴道内射精障碍。所有患者的激素水平和精液参数（在可行精液分析的情况下）均处于正常范围内。在存在逆行射精的患者中，69.9%（16/23）患者经射精后尿液离心/重悬后精子可被回收。
射精功能障碍导致的男性不育患病率总体略低于 2%。主要病因是逆行射精；精神因素也可能起着重要作用。确定射精功能障碍的病因对于决定正确的治疗方法（早泄治疗、射精后尿液离心/重悬、阴茎振动刺激和心理辅导）非常重要。
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