In a normal situation, the semen ejects out of the urethra and penis when a man has an orgasm. But when the semen travels backward into the bladder instead of flowing out of the urethral opening, the condition is known as retrograde ejaculation.
The tiny sphincter muscle that lies at the bladder entrance closes the opening to prevent flow of semen back at the time of ejaculation. However, in retrograde cases, this muscle does not function normally, and as a result, part of the semen flows backward into the bladder and less semen leaves the penis.
Retrograde Ejaculation Causes
- Any damage to the bladder muscles from surgery or injury can cause ejaculation problems.
- Any problem with the nerves that control bladder muscles can cause the semen to flow backward into the bladder. The muscle and nerve damage can be a complication of surgical procedures, including
- Prostate surgery poses a greater risk of retrograde ejaculation. As a result of the surgery, which involves removal of prostate tissue through urethra, there is a 10-15 % chance of retrograde ejaculation.
- Prostatectomy or surgery that involves removal of the prostate gland can cause semen to flow backward after the procedure.
- Extensive pelvic surgery to treat prostate, colon, testicles, or rectum cancer can cause semen to return to the bladder.
- Staging surgery, which involves removal of lymph nodes in penis and lower abdomen to determine the extent to which cancerous cells have spread in the body, is also responsible for this type of ejaculation.
- Any chronic medical illness that causes nerve damage, such as diabetes, multiple sclerosis, can interfere with a man’s ability to have a normal ejaculation.
- Certain medications, including anti-depressants, mood altering drugs, or medications used to treat hypertension, prostate enlargement, or psychosis, may cause retrograde ejaculation.
The condition may occur partially or fully. The backward flow of semen into the bladder doesn’t cause any harm, as it mixes with the urine and is eliminated with normal urination.
Retrograde ejaculation isn’t directly related to impotence, but it can still cause infertility, as the condition interferes with a man’s ability to have normal ejaculation. As a result, the sperm does not reach the woman’s uterus, thus preventing pregnancy.
- Cloudy urine after intercourse
- Possible infertility
- Discharge of little or no semen from the urethra during ejaculation
Diagnosis and Treatment
Ideally the best way to diagnose the problem is a urine test obtained shortly after ejaculation. If the urine analysis finds large amount of sperm in the urine, then the problem is diagnosed as retrograde ejaculation.
If the condition is a side effect of certain drugs you are taking, then it is best advised to discontinue the use of that specific medication after consulting your doctor. For people with diabetes experiencing retrograde ejaculation, it will help to talk to your doctor. Often epinephrine-like drugs are prescribed to treat the condition caused by diabetes or genitourinary tract surgery.