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Retrograde ejaculation

Retrograde ejaculation occurs when semen enters the bladder instead of going out through the urethra during ejaculation.

Alternative Names

Ejaculation retrograde

Causes

Retrograde ejaculation is uncommon. The main reason it occurs 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
  • Medications or surgery¬†to treat prostate or urethra problems

Symptoms

  • 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.

Treatment

Your health care provider may recommend that you stop taking any medicines that may cause 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.

Outlook (Prognosis)

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.

Possible Complications

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.

Prevention

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.

References

Goldstein M. Surgical management of male infertility. In: Wein AJ, ed. Campbell-Walsh Urology. 10th ed. Philadelphia, Pa:Saunders Elsevier; 2011:chap 22. 

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.

Updated: 10/9/2012

Linda J. Vorvick, MD, Medical Director and Director of Didactic Curriculum, MEDEX Northwest Division of Physician Assistant Studies, Department of Family Medicine, UW Medicine, School of Medicine, University of Washington. Louis S. Liou, MD, PhD, Chief of Urology, Cambridge Health Alliance, Visiting Assistant Professor of Surgery, Harvard Medical School. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M. Health Solutions, Ebix, Inc.


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