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The neurophysiological control of the erectile process is under the influence of central and peripheral processes. At least three kinds of erection can be distinguished in man: central, reflexogenic, and nocturnal types. Emission, as the first phase of ejaculation, is a sympathetic spinal cord reflex. The spermatozoa undergo final maturation in the epididymis and are stored there prior to ejaculation. The autonomic nervous system plays a key role in the efferent pathway of the ejaculatory reflex. The spinal network plays a significant role in processing and directing afferent and efferent information in the ejaculatory process. The ejaculatory-related cerebral network includes the medial preoptic area (MPOA), the paraventricular nucleus of the hypothalamus (PVN), the nucleus paragigantocellularis (nPGi), the posterodorsal medial amygdaloid nucleus (MeApd), and the parvocellular subparafascicular thalamic nucleus (SPFp). An improved understanding of the complex influences on ejaculation may open new therapeutic strategies for ejaculatory disorders.
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