Retrograde Ejaculation

In retrograde ejaculation, semen travels backward into the bladder, rather than forward out of the penis.

Retrograde ejaculation occurs because the urinary sphincter (the band of muscle around the opening between the bladder and urethra) does not contract and close as it normally does during ejaculation. Thus, semen can travel into the bladder. Common causes include diabetes, spinal cord injuries, certain drugs (especially some used to treat high blood pressure), and some surgical procedures (such as major abdominal or pelvic surgery, particularly transurethral resection of the prostate gland, or TURP).

Symptoms and Diagnosis

The amount of fluid ejaculated from the penis is decreased. Sometimes no fluid comes out. These changes may puzzle or worry some men. Nonetheless, many men with retrograde ejaculation have orgasms and enjoy sexual activity.

Retrograde ejaculation is diagnosed when a large number of sperm is found in a urine sample.

Treatment and Outlook

Most men need no treatment. However, if the disorder is worrisome, it can be treated. Treatment is often effective.

Treatment involves taking drugs that cause the urinary sphincter to contract and close, such as pseudoephedrine, phenylephrine, chlorpheniramine, brompheniramine, or imipramine. However, most of these drugs can increase heart rate and blood pressure. These effects can be dangerous in men with high blood pressure or coronary artery disease.

Retrograde ejaculation is not harmful. About one third of men who are treated improve.