Perineal Ultrasound a “Promising Platform” for Evaluation of Ejaculatory Dysfunction

Perineal ultrasound could be useful in the assessment of some ejaculatory disorders, according to a recent Sexual Medicine Reviews study.

The procedure, which involves placing a probe in the perineum (the area between the anus and scrotum) is less invasive than its transrectal counterpart, in which a probe is placed into the rectum, the authors report.

Ejaculation, associated with male orgasm, is a process comprised of two phases: emission and expulsion, the authors explained. Problems in any of these processes can lead to ejaculatory dysfunction. Patients might be concerned about changes in ejaculate volume, color, or consistency. They may also worry that the time it takes for them to ejaculate has changed, or the quality of their orgasm has become less intense.

An estimated 21% of men experience premature ejaculation (climaxing before they intend to) at some point in their lives. About 10% may have other ejaculatory disorders; examples include retrograde ejaculation (when semen travels to the bladder instead of out the urethra), painful ejaculation (genital or pelvic pain during or after ejaculation), and anhedonic ejaculation (orgasm without feelings of pleasure).

Other examples are anejaculation (when no semen is ejaculated), delayed ejaculation (when climax takes longer than a man would like), anorgasmia (inability to reach orgasm), and hypohedonic orgasm (when orgasms are less pleasurable than previously experienced).

During perineal ultrasound, clinicians should be able to view the bulbospongiosal, bulbocavernosal, pelvic floor, and bladder neck muscles. The procedure also allows clinicians to measure muscle contractions, ejaculation latency time, number of semen expulsions, and the force of the ejaculate.

While perineal ultrasound is less invasive than transrectal ultrasound, the latter has been more widely discussed in medical literature with respect to ejaculatory dysfunction.

“Nevertheless, perineal ultrasound is a promising platform to aid in the objective evaluation of men with ejaculatory and orgasmic dysfunction for both research and the diagnosis and treatment of ejaculatory dysfunction,” the authors wrote.

Noting the need for further research, they concluded that “perineal (ultrasound) for men with delayed ejaculation or anejaculation, painful ejaculation, or retrograde ejaculation may be helpful in select cases.”

Resources

Sexual Medicine Reviews

Forbes, Connor M., MD, et al.
“Perineal Ultrasound: A Review in the Context of Ejaculatory Dysfunction”
(Full-text. Published online: February 17, 2018)
https://www.smr.jsexmed.org/article/S2050-0521(18)30007-6/fulltext