A rare case of orgasmic disorder: psychogenic anejaculation in an adolescent

A sixteen year-old Caucasian male presented with inability to ejaculate after 40-45 minutes of masturbation. Physical and neurologic examinations were normal. Genital and rectal examination and transrectal ultrasound showed normal testicles, penis, prostate and seminal vescicles. Gonadotropins, testosterone and prolactin levels were normal. Vibratory stimulation was unsuccessful to obtain semen. The absence of retrograde ejaculation was confirmed by urine examination after vibratory stimulation and masturbation. Pshychosocial evaluation was consistent with feeling of severe anxiety related to inability to ejaculate. A diagnosis of psychogenic of anejaculation was given and consequently he was counselled to reduce anxiety. During the follow-up gradual improvement of sexual function and spontaneous normal ejaculations were achieved.