Retrograde ejaculation is the entry of semen into the bladder instead of going out through the penis during male sexual climax. This condition is relatively uncommon and may occur either partially or completely. Symptoms include little or no semen discharged during sexual climax, cloudy urination after sexual intercourse, and possible infertility. The presence of semen in the bladder is relatively harmless. It mixes with the urine leaving the body with normal urination. However, if this condition is left untreated it can lead to permanent infertility.
Under normal circumstances, ejaculation propels semen forward through the tip of the penis, rather than backwards into the bladder. This is because the sphincter muscle located at the entrance of the bladder closes the opening to the bladder and prevents semen from entering. In retrograde ejaculation, the sphincter does not function properly, allowing all or part of the semen to travel into the bladder at the time of the retrograde ejaculation.
Retrograde ejaculation can result from a variety of causes. Such as, a prior prostatectomy (removal of the prostate gland), urethral surgery, extensive pelvic surgery, certain types of surgery of the lower spine, surgery on the bladder neck, and diabetes. Men with diabetes should maintain good blood sugar levels, which may be helpful in preventing the development of retrograde ejaculation. This condition is also common in men with multiple sclerosis. If there is extensive nerve or muscle damage, the condition may be permanent. Fortunately, if retrograde ejaculation is treated with medication (to improve muscle tone at the bladder neck) there is a 40% chance that a man will return to normal ejaculation. In cases where men do not respond to medication, fatherhood may still be possible through assisted-fertilization techniques.
Also, certain medications - especially psychiatric medications - may interfere with the function of the nerves that control the muscles involved in ejaculation. Such medications can include, amitriptyline, amoxepine, chlorpromazine, and thioridazine. So if possible it is best to stay away from these drugs. Also, certain drugs to treat high blood pressure like guanethidine and reserpine can cause this retrograde ejaculation. If drugs are the cause of the problem, removal of the specific drug may resolve the condition.
If you suspect that you may have retrograde ejaculation, it is recommended that you schedule an appointment with your health care provider, since this condition could be an indication of an underlying health problem. Typically, the diagnosis will be made by a urologist (a doctor that specializes in urinary-tract problems and reproductive disorders). Your doctor may begin by asking you questions about your medical and sexual history. These questions will be followed by a thorough physical examination. Then a urinalysis will be performed: A specimen of your urine will be obtained shortly after ejaculation and will be tested for large amounts of semen.
© - Reproduced with permission of SexInfo, University of California at Santa Barbara, 2007.