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Retrograde Ejaculation

  • Male genitourinary system

Definition

Retrograde ejaculation is a condition in which semen travels back into the bladder instead of forward through the urethra.

What is going on in the body?

Normally, the bladder neck closes tightly during orgasm. This prevents semen from travelling back into the bladder. The semen has nowhere to go but out of the urethra and the tip of the penis. Damage to the bladder neck or neurologic disorders may prevent it from closing properly.

Risks

What are the causes and risks of the condition?

The most common cause of retrograde ejaculation is transurethral resection of the prostate. This is surgical removal of prostate tissue through the urethra. Other causes include:
  • operations involving the abdomen, pelvis, or genitals
  • diabetes
  • multiple sclerosis, a progressive neurological disorder that can disrupt nerve pathways to the bladder neck
  • some medications used to treat heart disease, high blood pressure, and benign prostatic hyperplasia, or enlarged prostate, which can relax the bladder neck

Diagnosed

How is the condition diagnosed?

A urine specimen is taken right after the man has an orgasm. If many sperm are found in the urine under the microscope, the diagnosis is made.

Long Term Effects

What are the long-term effects of the condition?

Retrograde ejaculation can cause male infertility, a condition in which a man is unable to impregnate a woman.

Other Risks

What are the risks to others?

Retrograde ejaculation is not contagious, so there are no risks to others.

Treatments

What are the treatments for the condition?

Many men can be treated with medications that tighten up the bladder neck, such as ephedrine. Men with neurologic disease can have vibratory or electrical stimulation to assist with appropriate ejaculation. For men with infertility, sperm can be recovered from the bladder following orgasm for artificial insemination or for in vitro fertilization. The bladder may need to be rinsed out before and after orgasm to recover good sperm.

Side Effects

What are the side effects of the treatments?

Some of the medications used to tighten up the bladder neck can cause arrhythmias, or irregular heartbeats.

After Treatment

What happens after treatment for the condition?

No subsequent treatment or long term monitoring is necessary.

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