(073) A Novel Method——Identifying Anejaculation or Retrograde Ejaculation by Transrectal Dynamic Ultrasound (Report of 11 Cases)

Abstract

Abstract Introduction Ejaculation is what we can see whereas orgasm is what we feel. Hence, the presence of ejaculate does not indicate the ability to experience orgasm. Having orgasm without ejaculate may be due to anejaculation (AE) or retrograde ejaculation (RE). Retrograde ejaculation is usually diagnosed by finding sperm in a urine sample after orgasm. However, it can be difficult to differentiate in cases of very low semen volume, previous vasectomy, ejaculatory duct obstruction, or azoospermia. Objective This study aims to explore the use of transrectal dynamic ultrasonographic (US) to observe the process of ejaculation, direction of seminal flow, and changes in seminal vesicles, ejaculatory ducts, and bladder neck during orgasm, providing visual differentiation between AE and RE. Methods US observations were conducted on 11 patients who experienced orgasm without ejaculate. Results Among the 11 patients (7 with diabetes, 1 with congenital megacolon surgery, 1 with urethral stricture), 3 patients had unsuccessful examinations due to discomfort or technical issues with the transrectal ultrasound probe. Successful observations were made in 8 patients, where 5 patients showed contraction of the seminal vesicles and incomplete closure of the bladder neck during orgasm, leading to RE. In 3 cases, no changes in the seminal vesicles or bladder neck were observed, and no seminal flow was seen, leading to AE. Conclusions Dynamic ultrasonographic allows for the observation of the ejaculation process and understanding of the changes in seminal vesicles and bladder neck during orgasm, enabling differentiation between AE and RE. Disclosure No.