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Éjaculation rétrograde et anéjaculation

Retrograde ejaculation and anejaculation

  • Dossier Thématique / Thematic File
  • Published:
Pelvi-périnéologie

Résumé

L’anéjaculation et l’éjaculation rétrograde font partie des dysfonctions éjaculatoires, leur fréquence est moindre que l’éjaculation prématurée. Elles peuvent être responsables d’anorgasmie et engendrer des problèmes d’infertilité. L’anéjaculation peut être congénitale ou acquise, fréquemment au décours de chirurgie prostatique ou de maladies neurologiques, en particulier médullaires. Les origines psychologiques ne doivent pas être ignorées. Les mêmes étiologies sont souvent retrouvées en cas d’éjaculation rétrograde. Différentes approches thérapeutiques existent en fonction de l’étiologie. La stimulation pénienne vibratoire (vibromassage) et la stimulation pharmacologique sympathomimétique (midodrine) représentent souvent un traitement de première intention, qui permet un recueil de sperme sans nécessité d’électroéjaculation ou de techniques chirurgicales, plus contraignantes. La psychothérapie sera proposée en cas de nécessité. Le traitement par midodrine présente une certaine efficacité dans le traitement de l’éjaculation rétrograde, par fermeture du col vésical.

Abstract

Ejaculatory disorders are common male sexual dysfunctions. Although premature ejaculation has been extensively studied, anejaculation and retrograde ejaculation are lesser known, though they have been associated with anorgasmia and reproductive disorders. Anejaculation can be congenital or acquired and is mostly seen after prostate surgery and neurological diseases (spinal cord injuries) or is related to psychogenic factors. Generally, the same causes are associated with retrograde ejaculation. The management of these disorders depends on aetiology. Penile vibratory stimulation and pharmacological stimulation, using sympathomimetic drugs, such as midodrine, are increasingly recommended as first-line treatments. Electroejaculation and surgical procedures should only be used when necessary. Behavioural therapy is sometimes indicated when psychogenic or relationship factors are identified. By inducing bladder neck closure, midodrine can prove effective in the treatment of retrograde ejaculation.

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Authors and Affiliations

  1. Département médullaire, centre Calvé, Fondation Hopale, F-62600, Berck-sur-Mer, France

    J. -G. Prévinaire, G. Lecourt & G. Stoquart

  2. Laboratoire d’urodynamique et de sexologie, centre Bouffard-Vercelli, cap Peyrefite, F-66290, Cerbère, France

    J. M. Soler

  3. Service d’urologie, CHU de Toulouse, F-31509, Toulouse cedex 09, France

    J. M. Soler & P. Plante

Authors
  1. J. -G. Prévinaire
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  2. G. Lecourt
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  3. G. Stoquart
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  4. J. M. Soler
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  5. P. Plante
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Correspondence to J. -G. Prévinaire.

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Prévinaire, J.G., Lecourt, G., Stoquart, G. et al. Éjaculation rétrograde et anéjaculation. Pelv Perineol 2, 350–355 (2007). https://doi.org/10.1007/s11608-007-0163-8

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  • DOI: https://doi.org/10.1007/s11608-007-0163-8

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