An ejaculatory dysfunction typically results from neurologic diseases, traumatic injury, or as a complication of surgery. Other conditions that can result in ejaculatory failure include diabetes, multiple sclerosis, syringomyelia, psychological disorders and peripheral neuropathies. In addition, an increasing number of men fail to produce sperm on the day of egg collection or IUI, commonly due to stress. Prior to this the patient may have been quite successful in obtaining an ejaculation and even a resulting pregnancy. In the past, men with ejaculatory dysfunction were considered infertile because they couldn't ejaculate and impregnate their wives even though they did produce sperm within their testicles.
Important advances in the treatment of infertility in the male neurologically impaired population have been made through the application of a new technique called electroejaculation. Specially designed rectal probes are inserted into the rectum next to the prostate. A current generated by the machine is applied to stimulate the nerves and produce contraction of the pelvic muscles causing erection and resulting in an ejaculation. Erection and ejaculation occur in most cases between 5-12 volts and the stimulation period is approximately 3-4 minutes. The semen specimen is collected and processed in the andrology laboratory where it can be used in several artificial reproductive techniques such us intrauterine insemination (IUI), IVF or ICSI. Good quality samples are frozen for future use as a backup. However, a fresh specimen is usually preferred at the time of the women's ovulation. Electroejaculation must be performed under general anaesthesia in all patients who have abdominal and perirectal sensation. Anaesthesia is not required for spinal cord injured men who have high level injuries and are without sensation.
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