Retrograde ejaculation

Overview

Retrograde ejaculation happens when semen is redirected into the bladder rather than being expelled through the penis during orgasm, often resulting in little to no semen during ejaculation, a condition also known as a dry orgasm. While it doesn’t pose health risks, it can lead to male infertility. Treatment is typically pursued to regain fertility.

Symptoms

Retrograde ejaculation is a condition where semen enters the bladder instead of exiting through the penis during orgasm. This does not impact the ability to achieve an erection or experience an orgasm, but it does affect ejaculation. Here are the key signs and symptoms of retrograde ejaculation:

• Dry orgasms: Little to no semen is ejaculated out of the penis during climax.
• Cloudy urine post-orgasm: The presence of semen in the urine after orgasm makes it appear cloudy.
• Male infertility: Difficulty in conceiving a child due to insufficient semen expulsion.

Retrograde ejaculation is not harmful and generally only needs treatment if you are trying to conceive a child. However, experiencing dry orgasms should prompt a consultation with a doctor to rule out any underlying health issues.

If you and your partner have been trying to conceive through regular, unprotected intercourse for a year or more without success, it is advisable to consult a doctor. Retrograde ejaculation could be a contributing factor to fertility issues.

Causes

In the male reproductive system, during orgasm, the vas deferens carries sperm to the prostate, where they combine with other fluids to form semen (ejaculate). The muscle located at the opening of the bladder, known as the bladder neck muscle, contracts to prevent semen from entering the bladder as it moves from the prostate into the urethra, the tube inside the penis. This muscle serves the same function of holding urine in the bladder until urination occurs.

Retrograde ejaculation occurs when semen travels backward into the bladder rather than exiting the body through the penis. This happens due to the failure of the bladder neck muscle to tighten properly, allowing sperm to enter the bladder instead of being expelled through the penis.

Various conditions can disrupt the function of the muscle responsible for closing the bladder during ejaculation. These conditions include:

• Surgery, such as prostate, retroperitoneal lymph node dissection, or neck surgery for testicular cancer
• Adverse effects of several drugs for depression, enlarged prostate, and high blood pressure
• Nerve damage resulting from a medical condition, such as spinal cord injuries, multiple sclerosis, diabetes, or Parkinson’s disease

The main indicator of retrograde ejaculation is a dry orgasm. However, experiencing a dry orgasm, characterized by the release of minimal or no semen, can also result from other conditions, such as:

• Radiation therapy for pelvic cancer treatment
• Surgical excision of the bladder (cystectomy)
• Surgical excision of the prostate (prostatectomy)

Risk factors

A higher chance of retrograde ejaculation exists if:

• You have diabetes or multiple sclerosis
• You take some medications for high blood pressure or a mood problem
• Your spinal cord was injured.
• You have had surgery on your bladder or prostate