Etiology

Anesthetic ejaculation is probably a rare syndrome. Only 4 publications, describing a total of 13 cases, have been published. In 1923, Stekel (98) described one case. In 1975, Dormont (99), using the term ejaculatory anhedonia, described four cases and suggested that the problem was distinctly psychological in nature but concluded that the condition is very difficult to treat. Williams (97) described seven case vignettes. He could not find any organic causative factors or common psychological dynamics. Treatment of these patients with various sex therapy procedures was ineffective. In contrast, Garippa (100) published a successful sextherapy of a man with anesthetic ejaculation.

In my opinion, it may well be possible that anesthetic ejaculation is due to a disturbance in the neural circuitry that mediates the sensation of orgasm, leaving the circuitry of ejaculation intact. One of the ways to elucidate the neurobiologi-cal cause of this syndrome is to perform a PET-scan study in these men during orgasm.

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