[Anejaculation: its etiology and pathogenesis, classification and clinical aspects]

43 patients suffering from anejaculation were treated in 1983-1993 in the department of andrology of the N. A. Semashko Medical Institute urological clinic. Most commonly anejaculation is caused by prostatic and bladder neck surgery (25.6%), diabetes mellitus (18.6%) and presents as retrograde ejaculation, impaired sperm emission into the urethra, aspermatism (51.2, 27.9, 20.9% of patients, respectively). The leading pathogenetic factors are peripheral neuropathy, surgical injury to the bladder internal sphincter, psychosexual disorders. The authors propose classification and algorithm of the patients' examination to facilitate and enhance diagnosis. Special attention should be given to the presence or absence of orgasm, after-orgasm occurrence of spermatozoa in urine. Anejaculation treatment outcomes remain unsatisfactory. Good responses were achieved with selective adrenomimetic gutron, laser therapy and electrovibration. Prevention of anejaculation should be given more attention.