Post on behalf of Dr Lalit Shah

23 year male never ejaculated.
Dose masturbation, gets orgasm, but no ejaculation.
No sperms in post masturbation urine.
How to proceed ?


  • Lalit Shah
    Lalit Shah
    01 Feb 2020 01:53:28 PM

    Waiting for TRUS result 

  • Vinod K V
    Vinod K V
    01 Feb 2020 05:40:55 PM

    He needs sex therapy as almost all of them are psychogenic 

  • Venugopal P
    Venugopal P
    02 Feb 2020 10:15:11 AM

    Dear All,

    Lalit Shah has posed an issue on Anejaculation which most of us have insufficient knowledge.

    Of all the male sexual dysfunctions, Delayed Ejaculation (DE) is the least understood, least common and least studied. DE is one of the three conditions that fall under the classification of diminished ejaculatory disorders; the other two being retrograde ejaculation and anejaculation or Anorgasmia. Although not an ejaculatory disorder per se, men also complain of diminished force, volume and sensations with ejaculation.

    Terms used to describe an absence or delay in ejaculation/orgasm in the literature have added to the existing condition. They are Anejaculation, Delayed ejaculation, Difficult ejaculation, Ejaculatory incompetence, Idiopathic anejaculation, Inhibited ejaculation, Inadequate ejaculation, Late ejaculation.  Male orgasmic disorder, Partner Anorgasmia, Psychogenic anejaculation, Retarded ejaculation etc.

    It is clear that no one theory accounts for all the varied presentations of DE, and no theory by itself has strong empirical support. However, awareness of the diverse points of view helps clinicians conduct better assessments and broaden their understanding of the patient's ejaculatory dysfunction.

     I am providing some articles when read in tandem will help us understand DE better. There will be overlaps among the articles provided but that cannot be helped.

    To begin with I am providing an article by Amjad Alwaal*, Tom F Lue et al (2015) on ‘Normal male sexual function: emphasis on orgasm and ejaculation’

    The article by Louis Revenig, Wayland Hsiao* et al (2014) on ‘Ejaculatory physiology and pathophysiology’ is worth understanding

    This is followed by the article of Lawrence C Jenkins and John P Mulhall (2015) on ‘Delayed Orgasm and Anorgasmia’

    This is followed by the article of John P Wincze (2015) on ‘Psychosocial aspects of ejaculatory dysfunction’

    Finally I am providing an article by Marisa Gray, Ryan P Smith* et al (2018) on ‘Contemporary management of ejaculatory dysfunction’

    As mentioned when these articles are read together, though there will be overlaps, will help us to understand this less understood subject better.

    With warm regards,



  • Dr Prashant Mulawkar
    Dr Prashant Mulawkar
    18 Mar 2020 11:08:00 PM

    This is orgasmic anejaculation. The treatment is need based

    What does he want?
    Intercourse he can have
    He can get married
    If he wants fertility: short course of alpha adrenergic drugs or instillation of IVF media in bladder >> masturbation >> collection of sample from bladder >> IUI >> This should suffice
    If this does not work >> TESA >> ICSI >> IVF (I have done one such case)
    It has no effect on woman's orgasm
    It is not a valid point to make marriage null and void
    It does not come under unconsumated marriage
    TRUS usually does not help.
    Last thing: any neurological history, if yes >> Electroejaculation

  • Ravindra Sabnis
    Ravindra Sabnis
    29 Mar 2020 05:34:19 PM

    Very sorry for delayed replay - better than no reply. Similar to Delayed ejaculation is better than no ejaculation. 

    few things according to me are important in this case 
    He has never ejaculated, there has never been night fall, He reaches orgasm, does masturbation. Many people do not understand what is orgasm But he seems to be very clear about it. Also post masturbation urine does not show sperms. 
    As Mulawkar has stated I agree that this is orgasmic ejaculation. This needs ejaculation. 
    This can happen in organic obstruction. Hence TRUS is mandatory in this situation, it could be EJD obstruction. TRUS will give idea. This obst can be 2 types - fibrous obst or cystic obstruction. FIbrous obst - TRUS will be normal. In cystic obst - If cystic EJD obst - it can be treated. Also on TURS check if SV are dilated or not. Which may be indirect evidence of EJD blockage. Seminal vesiculogram - by puncturing TURS guided can be done. 
    TB is reason for fibrous blockage. Old history of TB is important to elicit. This could be sequelae of old Genital TB. 

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