Retrograde ejaculation occurs when semen enters the bladder instead of going out through the urethra during ejaculation.
The main reason for retrograde ejaculation is that the bladder neck does not close. This causes semen to go backwards into the bladder rather than forward out of the penis.
Retrograde ejaculation may also be caused by:
- Some medications, including drugs used to treat high blood pressure ( hypertension) and some mood-altering drugs
- Surgery to the prostate or urethra
The condition is uncommon.
- Cloudy urine after orgasms
- Little or no semen is released during ejaculation
Exams and Tests
A urinalysis that is taken soon after ejaculation will show a large amount of sperm in the urine.
Your health care provider may recommend that you stop taking a drug, if it is causing your retrograde ejaculation. This can make the problem go away.
Retrograde ejaculation that is caused by diabetes or surgery may be treated with medications such as pseudoephedrine or imipramine.
If retrograde ejaculation is caused by medications, stopping the drug will often bring back normal ejaculation. If retrograde ejaculation is caused by surgery or diabetes, it is often not correctable.
The condition may cause infertility. However, semen can often be removed from the bladder and used during assistive reproductive techniques to achieve a pregnancy.
When to Contact a Medical Professional
Call for an appointment with your health care provider if you are having trouble conceiving a child or you are worried about retrograde ejaculation.
Maintaining good blood sugar control may help prevent this condition in men who have diabetes. Avoiding drugs that cause retrograde ejaculation will also prevent this condition.
Lipshultz LI, Thomas AJ, Khera M. Surgical management of male infertility. In: Campbell-Walsh Urology. 9th ed. Philadelphia, Pa: Saunders Elsevier; 2007:chap 20.
Heidelbaugh JJ. Management of erectile dysfunction. Am Fam Physician. 2010;81:305-312.
Bhasin S, Basson R. Sexual dysfunction in men and woman. In: Kronenberg HM, Melmed S, Polonsky KS, Larsen PR, eds. Williams Textbook of Endocrinology. 12th ed. Philadelphia, Pa: Saunders Elsevier; 2011:chap 20.
Linda J. Vorvick, MD, Medical Director, MEDEX Northwest Division of Physician Assistant Studies, University of Washington, School of Medicine; Scott Miller, MD, Urologist in private practice in Atlanta, Georgia. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.
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