Treatment of Ejaculation Disorders in Paris
Dr Adam Vardi - Urologist
Treatment of Ejaculation Disorders in Paris
Andrology in Paris
Ejaculation disorders are among the most frequent reasons for consultation in andrology. Although often taboo, they significantly impact sexual quality of life, self-esteem, and couple fertility. These disorders cover vastly different clinical realities, ranging from premature ejaculation to total absence of seminal emission.
Dr Adam Vardi offers a rigorous diagnostic approach to identify the origin of these dysfunctions — whether neurological, hormonal, anatomical or psychogenic — and to implement appropriate treatment.
Premature ejaculation
Urological Surgery in Paris & Neuilly
This is the most widespread ejaculatory disorder, affecting 20 to 30 % of men at some point in their lives. It is defined by a short ejaculatory latency (often less than one minute), an inability to delay ejaculation, and a feeling of personal distress.
Etiology and mechanisms
- Primary: present from the first sexual intercourse, often related to the hypersensitivity of serotonin receptors.
- Secondary: appearing later, it may be related to inflammation of the prostate (prostatitis), thyroid disorders, or underlying erectile dysfunction (the patient hastens ejaculation through fear of losing the erection).
Treatment of ejaculation disorders in Paris
Dr. Adam Vardi - Urologist & Andrologist
Management is often multimodal:
- Pharmacological treatments: use of selective serotonin reuptake inhibitors (SSRIs) or topical local anesthetics to reduce sensitivity of the glans.
- Behavioral approach: techniques to control the ejaculatory reflex (“stop-start” methods).
- Treatment of the underlying cause: management of a prostate infection or an associated short frenulum.
Diagnosis and management of ejaculation disorders in Paris
Urologist in Paris & Neuilly
Retrograde ejaculation
Retrograde ejaculation is characterized by the emission of semen towards the bladder rather than the urethra during orgasm. The patient experiences orgasm, but seminal emission is absent or very reduced (“dry” orgasm).
Common causes
It often results from a failure of the bladder neck to close properly at the time of ejaculation:
- Surgical: sequelae of prostate surgery (transurethral resection or laser) or bladder neck surgery.
- Pharmacological: common side effects of alpha-blockers used to treat benign prostatic hyperplasia.
- Neurological: complication of diabetes or certain nerve disorders.
Diagnosis and fertility
Diagnosis is confirmed by the presence of spermatozoa in the urine emitted immediately after orgasm. If the disorder is problematic in a pregnancy project, techniques for collecting spermatozoa from urine may be considered for assisted reproductive technology (ART).
Anejaculation and delayed ejaculation
Delayed ejaculation is a persistent difficulty in achieving ejaculation despite adequate stimulation. Anejaculation is its complete form (total absence of ejaculation, with or without orgasm).
Triggering factors
- Pharmacological: certain antidepressants or neuroleptics raise the threshold for triggering the reflex.
- Neurological: spinal cord lesions or peripheral neuropathies.
- Psychogenic: inhibition anxiety, extreme fatigue, or age-related decrease in penile sensitivity.
Management requires a hormonal work-up (testosterone, prolactin) and a neurological assessment to rule out an organic cause before considering supportive therapy or adjustment of ongoing treatments.
Painful ejaculation
Pain felt at the time of ejaculation (in the scrotum, perineum, or urethra) should always lead to a urological consultation. It is most often a sign of inflammation or infection of the genital tract:
- Chronic prostatitis: inflammation of the prostate gland.
- Vesiculitis: infection of the seminal vesicles.
- Obstruction of the ejaculatory ducts: presence of cysts or stones in the ducts carrying semen.
Treatment is based on antibiotic therapy in the event of confirmed infection, or on anti-inflammatory medication and pelvic relaxation measures in chronic forms.
Diagnostic approach and care philosophy
Each ejaculation disorder requires a personalized approach. During the consultation, Dr Vardi seeks to:
- Differentiate orgasm from ejaculation: two distinct phenomena often confused by patients.
- Analyze the medical context: surgical history, medications, and metabolic status (diabetes).
- Offer a pragmatic solution: whether pharmacological, surgical (to relieve obstruction) or sex-therapy based.
Ejaculation disorders are not inevitable. Modern treatments now allow restoration of satisfactory function or, failing that, mitigation of these disorders to enable a parental project.