In the urology clinic, we encounter such patients. They can ejaculate during masturbation and/or wet dream, but they cannot ejaculate during intravaginal intercourse, which is clinically diagnosed as functional ejaculation. 1. What is functional ejaculation? Inejaculation refers to sexual arousal, penis can be erected and inserted into the vagina for sexual intercourse, but it is impossible to reach orgasm during intravaginal intercourse and ejaculation is not possible. Clinically, it is categorized into functional ejaculation disorder, situational ejaculation disorder, organic ejaculation disorder and pharmacological ejaculation disorder. (1) Functional ejaculation disorder: no ejaculation during vaginal intercourse, but ejaculation is possible during dreaming or masturbation. (2) situational ejaculation disorder: vaginal intercourse under special circumstances, can ejaculate or not ejaculate. Such as: with his wife vaginal intercourse can not / can not ejaculate, but and lover can vaginal intercourse can not / can not ejaculate; need to be in a special smell, screams, expressions or the presence of the scene, can vaginal intercourse ejaculation and so on. (3) Drug-induced ejaculation: after taking drugs that affect ejaculation, there is no ejaculation in the vagina. It is common to take anti-psychotics, anti-hypertensives, anti-androgens, morphine addiction and chronic alcoholism. (4) Organic ejaculation disorder: vaginal intercourse, dreaming or masturbation, are not ejaculation. It is common in neurological disorders, such as brain lesions, spinal cord and peripheral nerve damage. Functional ejaculation accounts for most of them. 2.What is the pathogenesis? The pathogenesis of functional ejaculation is unknown, but it is speculated that it may be related to the following points: (1) cerebral cortex inhibits the ejaculatory center of the brain and spinal cord (emotional disharmony, sexual fear, etc.); (2) spinal ejaculatory center has a higher threshold of excitement (long-term masturbation leads to fatigue of the ejaculatory center, and the threshold is raised); (3) the degree of stimulation of penis is not sufficient to induce ejaculation (the stimulation of the vagina is not as strong as that of masturbation). 3, the current treatment? The current treatment of functional ejaculation is mainly oriented to two purposes. (1) to be able to ejaculate in the vagina; (2) to have children. Different orientations have different treatment focuses. For the purpose of intravaginal ejaculation, the treatments reported in the literature include: (1) Western medications such as ephedrine, levodopa + bromocriptine, PDE5i + levodopa, yohimbine, midodrine hydrochloride, clomiphene, etc.; (2) Traditional Chinese Medicine (TCM) herbal tonics, proprietary Chinese medicines, acupuncture, acupuncture, knife, massage, etc.; (3) Sexual behavioral training; and (4) Penile Vibrator Stimulation to induce ejaculation therapy (PVS). For treatments aimed at fertility: enter assisted reproduction after ineffective treatment. Or directly into assisted reproduction.