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Differential Diagnosis for Decreased Ejaculate

  • Single most likely diagnosis
    • Retrograde ejaculation: This condition, where semen enters the bladder instead of exiting through the penis during ejaculation, is a common cause of decreased ejaculate volume. It can be due to various factors including diabetes, surgery, or certain medications.
  • Other Likely diagnoses
    • Ejaculatory duct obstruction: Blockage of the ejaculatory ducts can lead to a decrease in ejaculate volume. This can be caused by infection, inflammation, or congenital conditions.
    • Hypogonadism: Low testosterone levels can affect sperm production and lead to decreased ejaculate volume.
    • Medication side effects: Certain medications, such as antidepressants, antihistamines, and decongestants, can decrease ejaculate volume as a side effect.
    • Varicocele: A varicocele is a swelling of the veins that drain the testicle, which can affect sperm production and lead to decreased ejaculate volume.
  • Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
    • Testicular cancer: Although rare, testicular cancer can cause a decrease in ejaculate volume. Early detection is crucial for effective treatment.
    • Spinal cord injury: A spinal cord injury can disrupt the normal ejaculatory process, leading to decreased ejaculate volume.
  • Rare diagnoses
    • Young's syndrome: A rare condition characterized by obstructive azoospermia (blockage of the epididymis or vas deferens), chronic sinopulmonary infections, and normal testicular function.
    • Congenital absence of the vas deferens: A rare genetic condition where the vas deferens is absent or blocked, leading to decreased ejaculate volume.
    • Ejaculatory dysfunction due to neurological disorders: Certain neurological conditions, such as multiple sclerosis or Parkinson's disease, can affect the ejaculatory process and lead to decreased ejaculate volume.

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Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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