Medical therapy is indicated for patients with specific disorders such as ejaculatory dysfunction, hormonal abnormalities, and infections. Ejaculatory dysfunction may take the form of complete failure to emission and/or retrograde ejaculation. Causes of ejaculatory dysfunction include spinal-cord injury, diabetes mellitus, retroperitoneal surgery, multiple sclerosis, bladder-neck and prostate surgery, psychogenic, and idiopathic. Medical therapy for ejaculatory dysfunction may be initiated. When medical therapy fails or is not indicated, ejaculatory dysfunction is often successfully treated with vitratory stimulation of electroejaculation. Electroejaculation, the application of transrectal electrical current to stimulate the pelvic nerves, results in approximately 90% of patients producing a retrograde and/or antegrade semen specimen. These specimens are often suboptimal in quality and are then used in conjunction with intrauterine insemination or more advanced assisted reproductive technology.
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