Ejaculation retrograde

Alternative names
Retrograde ejaculation

Definition
Retrograde ejaculation refers to the entry of semen into the bladder instead of going out through the urethra during ejaculation.

Causes, incidence, and risk factors

Retrograde ejaculation may be caused by prior prostate or urethral surgery, diabetes, some medications, including some drugs used to treat hypertension and some mood altering drugs.

The condition is relatively uncommon and may occur either partially or completely. The presence of semen into the bladder is harmless. It mixes into the urine and leaves the body with normal urination. Men with diabetes and those who have had genitourinary tract surgery are at increased risk of developing the condition.

Symptoms

     
  • Little or no semen discharged from the urethra in conjunction with the male sexual climax (during ejaculation)  
  • Possible infertility  
  • Cloudy urine after sexual climax

Signs and tests
A urinalysis performed on a urine specimen that is obtained shortly after ejaculation will reveal a large amount of sperm in the urine.

Treatment
If retrograde ejaculation is caused by drugs, removal of the specific drug may resolve the condition. Retrograde ejaculation caused by diabetes or following genitourinary tract surgery may be responsive to the use of epinephrine-like drugs (such as pseudoephedrine or imipramine).

Expectations (prognosis)

If retrograde ejaculation is caused by medications, discontinuation of the medication often restores normal ejaculation. If retrograde ejaculation is caused by surgery or diabetes, it is often not correctable.

Complications
The condition may cause infertility.

Calling your health care provider
Call for an appointment with your health care provider if you are having difficulty conceiving a child or you are concerned about retrograde ejaculation.

Prevention
Maintaining good blood sugar control in diabetic men may be helpful in preventing the development of this condition. Avoiding drugs that cause retrograde ejaculation will prevent the condition developing as a result of their use.

Johns Hopkins patient information

Last revised: December 6, 2012
by Dave R. Roger, M.D.

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