PREMATURE EMISSION AFTER SPINAL-CORD INJURY

Physicians and psychologists almost always treat premature emission or ejaculation as a psychological problem. We report on 6 men who had su dden onset of severe premature emission after spinal cord injury. All men suffered spinal cord injury related to trauma at the T12-L1 level, and had areflexic bladders after the injury. Two men had normal penil e sensation. None of the men had premature ejaculation before injury w ith average time of intercourse of 10 to 20 minutes before orgasm. Aft er the injury they noticed emission before or at vaginal entry. Two pa tients reported emission with any sexual thoughts and 1 had emission w hen startled in a nonsexual manner. Sexual therapy using squeeze and s top/start techniques was unsuccessful in all cases. Patients were star ted on phenoxybenzamine, terazosin or prazosin and reported slight imp rovement. We believe that injury in the conus area of the spinal cord may disinhibit the ejaculatory mechanism and allow for premature emiss ion.