Research on Anejaculation Caused by Fibrosis
There is no current research specifically investigating anejaculation caused by fibrosis anywhere in the world based on available medical literature. The provided evidence focuses entirely on neurogenic causes of anejaculation (spinal cord injury, diabetes, surgical nerve damage) and treatment methods like electroejaculation, with no mention of fibrotic etiology 1, 2, 3, 4, 5.
Current Understanding of Anejaculation Etiology
The medical literature identifies several well-established causes of anejaculation, but fibrosis is notably absent:
Documented Causes
- Neurogenic causes are most common, including spinal cord injury (the predominant cause), diabetes mellitus with peripheral neuropathy, and multiple sclerosis 1, 5
- Surgical injury accounts for 25.6% of cases, primarily from prostatic and bladder neck surgery causing damage to the internal bladder sphincter or sympathetic nerve pathways 5
- Retroperitoneal lymph node dissection for testicular cancer frequently causes anejaculation through sympathetic nerve disruption 1
- Psychogenic anejaculation represents another category, particularly in men who retain nocturnal emissions 2
Pathophysiological Mechanisms
- The primary mechanisms involve peripheral neuropathy, surgical nerve injury, and psychosexual disorders—not fibrotic processes 5
- Anejaculation manifests as retrograde ejaculation (51.2%), impaired sperm emission into the urethra (27.9%), or complete aspermatism (20.9%) 5
Why Fibrosis Is Not Addressed
The absence of fibrosis-related anejaculation research likely reflects that this is not a recognized pathophysiological mechanism for ejaculatory dysfunction. While the provided evidence extensively discusses fibrosis in other organ systems (liver, lung, heart), none connect fibrotic processes to ejaculatory pathway dysfunction 6, 7.
Clinical Implications
If you suspect fibrosis is causing anejaculation in a specific patient, this would represent an unusual presentation requiring investigation for:
- Retroperitoneal fibrosis potentially affecting sympathetic nerve pathways
- Seminal vesicle or ejaculatory duct obstruction from fibrotic changes
- Post-inflammatory or post-infectious fibrosis affecting reproductive tract structures
Standard diagnostic evaluation should include post-orgasmic urine analysis for spermatozoa (to distinguish retrograde ejaculation), transrectal ultrasound to evaluate ejaculatory ducts and seminal vesicles, and assessment for underlying systemic conditions 5
Current Treatment Landscape
Electroejaculation remains the primary treatment for anejaculation regardless of etiology, with success rates of 75% in spinal cord injury patients and 87% in post-surgical patients for obtaining viable sperm samples 1. However, pregnancy rates remain suboptimal at 35% per couple, with significant asthenozoospermia being a major limiting factor 1, 3.