What Is Retrograde Ejaculation?
Retrograde ejaculation is a condition that occurs when the semen goes back into the bladder rather than coming out of the penis through the urethra.
In males, both urine and semen both pass through the urethra (a tube that takes urine from the urinary bladder to the outside). There is a muscle at the neck of the urinary bladder, which helps to hold urine unless one is ready to pass urine. During an orgasm, this particular sphincter or band of muscle contracts to keep the semen from entering the urinary bladder. This helps it to flow through the urethra and out of the penis.
In retrograde ejaculation, this sphincter or muscle fails to contract as it stays relaxed, and the semen ends up in the urinary bladder. This is called dry orgasm. It feels like a normal orgasm despite the ejaculation and does not affect sexual pleasure. It is not a disease or a serious health condition.
What Causes Retrograde Ejaculation?
In males, during an orgasm, a tube takes the sperm to the prostate gland. The sperm then mix with other fluids in the prostate gland to produce semen. The muscle at the bladder neck constricts to prevent the semen from entering the urinary bladder as it goes from the prostate gland into the urethra (the tube inside the penis). This bladder neck muscle holds urine in the bladder until one urinates.
In retrograde ejaculation, the bladder neck muscle does not constrict properly. Due to this, the semen can re-enter the bladder instead of being thrown out of the body through the penis.
There are certain conditions that cause problems with the muscle present at the bladder neck that helps constrict the bladder during the process of ejaculation. These include the following:
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Certain surgeries include retroperitoneal lymph node dissection surgery for testicular cancer, prostate surgery, or bladder neck surgery.
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The side effect of some medicines that are used to treat high blood pressure, depression, and prostate enlargement.
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Certain medical conditions cause nerve damage, such as multiple sclerosis, diabetes, spinal cord injury, or Parkinson's disease.
Dry orgasm can also be caused by other conditions, such as:
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Surgical removal of the prostate gland.
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Surgical removal of the surgical bladder.
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Radiation therapy to treat pelvic cancer.
What Are the Symptoms of Retrograde Ejaculation?
Retrograde ejaculation does not affect the capability to get an erection or have an orgasm. During an orgasm, the semen goes back into the urinary bladder instead of ejaculating out of the penis. The followings are the sign and symptoms of retrograde ejaculation:
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Dry Orgasms - Orgasms in which there is ejaculation of the semen but not out of the penis.
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Cloudy Urine - Urine mixed with semen.
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Male Infertility - Inability to get a woman pregnant.
How Is Retrograde Ejaculation Diagnosed?
If one is having frequent dry orgasms, it is better to consult a doctor. Retrograde ejaculation is not a serious or harmful condition, and other reasons could also cause dry orgasms. It is necessary to address any underlying condition present.
A thorough physical examination is performed to check for any abnormalities, leading to the following:
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A lack of ejaculation during orgasm.
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Cloudy urine.
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The doctor should be informed about the following:
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If one is experiencing dry orgasm symptoms for how long?
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Presence of any injuries or chronic illnesses.
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Medications that one is taking.
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The type of cancer treatment, if any.
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Urine test - In retrograde ejaculation, the urine has a good amount of sperm in it.
How Is Retrograde Ejaculation Treated?
Retrograde ejaculation due to damaged nerves caused by multiple sclerosis, diabetes, certain surgeries, and other conditions can be treated with the help of medications. If retrograde ejaculation is caused due to surgery leading to permanent changes in the anatomy, then medicines might not be helpful, such as bladder neck surgery and transurethral resection of the prostate gland. If certain drugs that one is taking are leading to problems with ejaculation, then one might have to stop taking them for a certain period of time. Medications causing retrograde ejaculation include drugs to treat prostate problems, high blood pressure (alpha-blockers), and depression.
The medications used to treat retrograde ejaculation include the following:
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Imipramine (antidepressant).
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Midodrine (for blood vessel constriction).
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Chlorpheniramine and Brompheniramine (antihistamines to help with allergies).
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Medications to treat the symptoms of cold such as Ephedrine, Pseudoephedrine, and Phenylephrine.
These medicines help constrict the bladder and neck muscles during ejaculation so that the semen does not flow backward. These medications can effectively treat retrograde ejaculation, but they come with their share of side effects or adverse reactions in combination with other medications. Some drugs used to treat retrograde ejaculation might increase the heart rate and blood pressure, which can prove fatal if one suffers from high blood pressure or heart disease.
Infertility Treatment:
Retrograde ejaculation gives rise to male infertility, which needs treatment. In order to get the partner pregnant, one need to ejaculate enough semen into the vagina so that it can reach her uterus for fertilization with the egg. If medications alone do not help with retrograde ejaculation, then one will likely have to undergo an infertility procedure known as assisted reproductive technology to get their female partner pregnant. In certain cases, the sperm can be recovered from the urinary bladder, processed in the laboratory, and can be used to inseminate the female partner clinically (intrauterine insemination). Certain advanced assisted reproductive techniques are sometimes required to treat retrograde ejaculation. Nevertheless, after taking proper treatment, several men with retrograde ejaculation are able to get their female partners pregnant.
What Are the Complications of Retrograde Ejaculation?
Retrograde ejaculation in itself is not a serious or life-threatening condition. However, there are a few complications related to the condition:
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Inability to make the female partner pregnant.
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Decrease in sexual pleasure due to constant worry about ejaculation absence.
Conclusion:
Retrograde ejaculation is a condition in which there is a backward flow of the ejaculated semen into the urinary bladder instead of coming out of the penis. If a medicine causes the condition, normal ejaculation often resumes after the drug is stopped temporarily. Retrograde ejaculation caused by surgery or conditions like diabetes and multiple sclerosis can not be corrected. This is not a problem unless one is trying to conceive. It is not a life-threatening condition, and there is no need for treatment.
