Need guidelines about this case.
However before labelling the patient, it is wise to exclude organic problems
In view of the possibility of HIV, You need to rule it out also.The investigations ordered by you are not enough. He also needs a semen culture/expressed prostatic secretion culture and sensitivity aa well.
The treatment has to strictly according to the sensitivity report.
If there is infection in the EPS he may need cyclical antibiotics for an extended period of time. He should also use a condom in this period His partner also should be evaluated for 1. Urinary and 2. STDs and treated accordingly.
i need to know his urine reports and VDRL reports. Also let me know if he is an alcoholic and i would also request for his Tuberculosis test profile
Loss of libido premature ejaculatation may be symptom of ED but its management will be definitely diffrent or must be refer to psychologist and may requires psychiatric.
Greetings and sharing with Good Question and very common problem in Young and Adolescents in day to day Practice.
My opinion is please check the levels of Testosterone Hormone, counselling and treat with Mild Anti-Psychotics along with Nutritional Supplements would help the patient. At the same time advice to role out Investigation Pathology like Urine and Semen analysis.
Go for Aids serology test.