Retrograde Ejaculation

What is Retrograde Ejaculation?

Retrograde ejaculation is the reverse entry of semen into the bladder instead of being expelled through the penis during male sexual climax and ejaculation. This condition is relatively uncommon and may occur either partially or completely, which means that a male might reach sexual climax but may ejaculate very little or no semen (this is sometimes called a “dry orgasm”). Symptoms include little or no semen discharged during sexual climax, cloudy urination after sexual intercourse, and possible infertility. The presence of semen in the bladder is relatively harmless. It mixes with the urine leaving the body during normal urination. If this condition is left untreated, it can lead to permanent infertility.

Typically during ejaculation, the ejaculate is propelled forward in the urethra and out of the body through the head of the penis. This is because the sphincter muscle located at the entrance of the bladder closes the opening to the bladder and prevents semen from entering. During retrograde ejaculation, the sphincter does not function properly and allows all or some of the ejaculate to travel into the bladder at the time of the retrograde ejaculation.

 

 

Causes and Treatments

Retrograde ejaculation can result from a variety of causes, such as a prostatectomy (removal of the prostate gland), urethral surgery, extensive pelvic surgery, certain types of surgery of the lower spine, surgery on the bladder neck (the portion of the urinary bladder adjacent to the prostate gland in males) and diabetes. Males with diabetes should maintain normal blood sugar levels, which may be helpful in preventing the development of retrograde ejaculation. This condition is also common for males with multiple sclerosis. If there is extensive nerve or muscle damage, the condition may be permanent. Fortunately, if retrograde ejaculation is treated with medication (to improve muscle tone at the bladder neck), there is a 40 percent chance that a male will be able to experience normal ejaculation. In cases where males do not respond to medication, fatherhood may still be possible through assisted-fertilization techniques.

Certain medications (especially psychiatric medications) may interfere with the functioning of the nerves that control the muscles involved in ejaculation. Such medications can include amitriptyline, amoxepine, chlorpromazine, and thioridazine. It is best to stay away from these drugs, if possible. Certain drugs that treat high blood pressure, like guanethidine and reserpine, can cause retrograde ejaculation. If a prescription drug is at the root of the problem, removal of that specific drug may resolve the condition.  

If you suspect that you may have retrograde ejaculation, it is recommended that you schedule an appointment with your healthcare provider, since this condition could be an indication of an underlying health problem. Typically, the diagnosis will be made by a urologist (a doctor that specializes in urinary-tract problems and reproductive disorders). Your doctor may begin by asking you questions about your medical and sexual history and then perform a thorough physical examination. A urinalysis will be performed, during which a sample of your urine will be obtained shortly after ejaculation and tested for large amounts of semen. 

References

1. LeVay, Simon, Janice I. Baldwin, and John D. Baldwin. Discovering Human Sexuality. Sunderland, MA: Sinauer Associates, 2009. Print

Last Updated: 15 April 2014.

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