By Zawn Villines
Reviewed by Daniel Murrell, MD
Normally, semen exits the penis when a man ejaculates. Retrograde ejaculation causes some semen to travel backward into the bladder.
Normal ejaculation forces semen—sometimes called ejaculate—through the man’s urethra and out of the penis. The ejaculate can move out of the penis because a small muscle, called the bladder sphincter, closes the opening to the bladder, preventing the semen from entering the bladder.
- Most men ejaculate more than 1.5 milliliters (ml) of semen.
- Men with retrograde ejaculation may ejaculate nothing at all.
- Retrograde ejaculation is a symptom, not a diagnosis.
- There is no need to treat retrograde ejaculation if a man is not trying to get his partner pregnant.
What is a retrograde ejaculation
Because retrograde ejaculation can affect a man’s experience of sex, some men may opt to treat the condition even if it has no serious underlying cause.
- Testicular sperm aspiration (TESA): This procedure is performed under local anesthesia, and uses a needle to remove sperm from the testicles.
- Percutaneous epididymal sperm aspiration (PESA): This procedure, which uses local anesthesia, relies on a needle to remove sperm from the epididymis—the duct that connects to the testes.
- Testicular sperm extraction (TESE): Like TESA, TESE removes sperm directly from the testicles under sedation. Unlike TESA, TESE requires an incision in the testicle.
- In vitro fertilization (IVF): This procedure involves removing an egg from the woman and then fertilizing it in a petri dish. When an embryo grows, a doctor implants it into the woman’s uterus.
- Intrauterine insemination (IUI): With this procedure, a doctor injects semen directly into a woman’s uterus while she is ovulating.
Treatment for retrograde ejaculation depends on the cause of the problem. When men experience retrograde ejaculation due to medication, changing medications usually resolves the problem. When retrograde ejaculation is due to severe nerve damage, it may not be reversible.
Retrograde ejaculation may be caused by:
- Diabetes: Blood sugar that remains uncontrolled for a long time can damage the organs and nerves, affecting the muscles of the bladder.
- Damage to the nervous system: Injuries and illnesses that damage the nervous system, such as multiple sclerosis and spinal cord injuries, can damage the nerves and muscles of the bladder. Surgery on the lower spine may have a similar effect.
- Surgery: Surgery on the prostate, testicles, colon, rectum, bladder, or the lower spine may cause retrograde ejaculation.
- Medication: Some medications can interfere with ejaculation. Those include drugs for an enlarged prostate, some antidepressants, and some anti-psychotic drugs.
Removal of part of the prostate through surgery is one of the most common causes of retrograde ejaculation. About 10 to 15 percent of people who undergo this surgery can expect to experience retrograde ejaculation because surgery may damage the muscles and nerves of the bladder.
Retrograde ejaculation is neither dangerous nor painful and does not always require treatment. It can, however, be a symptom of another medical condition.
- ejaculate is not present following an orgasm
- there is consistently less ejaculate than usual following an orgasm
- a couple has still not gotten pregnant after a year of trying
- A 2017 study detailed a case in which retrograde ejaculation was the first and only symptom of type 1 diabetes. So men who experience retrograde ejaculation should talk to their doctors.
Retrograde ejaculation is not entirely preventable.
Retrograde ejaculation is not always reversible. However, the infertility it can cause is treatable. Even when a man cannot ejaculate at all, a fertility specialist may be able to help.
SOURCE: MEDICAL NEWS TODAY