Aspermatism – Diagnosis And Treatment

Aspermatism is a condition in which ejaculation does not occur during sexual intercourse. Before proceeding to the treatment of the disease, it is necessary to differentiate various forms of aspermatism.

Forms of Aspermatism – True and False

True aspermatism is caused not so much by a violation of the ejaculatory component as by the pathology of sperm formation. In this case, the patient does not form ejaculate (testicular function) and seminal fluid to be removed during ejaculation. True aspermatism is also called anejaculatory syndrome, which is the cause of male infertility.

Signs of true aspermatism are the lack of ejaculate and orgasm.

False aspermatism is caused by a violation of the functional relationship of the neck of the bladder and vas deferens, or a violation of the patency of the urethra for the ejaculate, as a result of which the seminal fluid does not have the opportunity to go outside the urethra, and is released into the cavity of the bladder (retrograde ejaculation).

The lack of ejaculation with normal orgasm (orgasm and ejaculation in men are different processes, read more on the link “multiple orgasms in men”) indicates obstruction of the vas deferens or a defect in the contraction of the neck of the bladder, leading to retrograde ejaculation.

Signs of retrograde ejaculation – a small number of ejaculate or its complete absence, complete or partial preservation of orgasm, sperm in the urine (turbidity of the urine after intercourse).

Typical causes of retrograde ejaculation:

    • operations on the prostate and neck of the bladder, surgery on the pelvic organs;
    • spinal injuries;
    • aortic-femoral bypass or sympathectomy;
    • damage to the nervous system;
    • retroperitoneal lymphadenectomy in testicular cancer;
    • diseases of the genitourinary system (prostatitis, vesiculitis, etc.), leading to inflammatory obstruction of the ejaculatory canal;
    • taking certain medications based on alpha-1-blockers (used for hypertension, migraine).

Diagnosis of Aspermatism

First of all, the diagnosis consists in recognizing the true and false forms of aspermatism. To do this, carry out a set of necessary procedures.

Examination and medical history

At the first stage, a thorough examination of the medical history is carried out to identify:

    • transferred operations;
    • transferred injuries of the spine, pelvic organs;
    • diseases (diabetes mellitus, urination problems, past diseases of the genitourinary sphere);
    • psychological disorders at the psychological level.

Laboratory research:

    • Analysis of the secretion of the prostate and seminal vesicles – to detect infectious diseases.
    • Urine microscopy An analysis of urine taken after intercourse or masturbation is carried out for the presence of sperm in it. The presence of a certain number of sperm in the urine is evidence of retrograde ejaculation.

Special studies:

    • Transrectal ultrasound. It is used to detect abnormalities of seminal vesicles, aplasia, ectasia of the vas deferens.
    • X-ray contrast studies of the patency of the vas deferens.

Aspermatism Treatment

Drug treatment:

    • alpha-adrenomimetics (used to increase the tone of the bladder neck);
    • alpha lipoic acid (used for diabetic polyneuropathy);
    • other medicines, depending on the cause of the disease.

Surgical treatment – used for violation of patency of the seminal ducts