Retrograde Ejaculation

Retrograde ejaculation is a condition in which semen is ejaculated into the bladder instead of exiting the body through the penis. Anatomically, the spermatic duct joins the path of the urethra for semen to exit the body. Normally, the valve between the bladder and the urethra constricts during ejaculation or conversely, the valve between the vas deferens and the urethra closes during urination. With retrograde ejaculation, there is a malfunction in the valves that control the flow of urine versus semen through the urethra.

Symptoms

No ejaculate or sperm in the urine after ejaculation is highly suggestive of retrograde ejaculation.

Cause

A common reason for retrograde ejaculation is previous prostate surgery. Other possible causes are radiation to treat cancer, diabetes, multiple sclerosis, certain medications and surgeries involving the abdomen, pelvic or genital areas. In some cases, the exact source of the problem is unknown.

Treatment

Healthcare providers commonly approach this condition in one of two ways – through the use of drugs to help control the valves or assisted reproductive technologies if the couple wishes to achieve pregnancy.

A physician may prescribe medications, depending on the underlying cause of the problem. If the man wishes to inseminate his partner, various assisted reproductive procedures can bypass the normal way sperm is deposited into the vagina, such as intracytoplasmic sperm injection (ICSI), in vitro fertilization (IVF) and zygote intrafallopian transfer (ZIFT).

For men diagnosed with retrograde ejaculation, sperm may be retrieved from collected urine processed by the laboratory. Alternatively, a man can empty his bladder and have a catheter inserted to fill the bladder with laboratory solution. After ejaculation, the fluid is collected, the liquid removed and the sperm harvested.