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Retrograde ejaculation

Retrograde ejaculation occurs when semen enters the bladder instead of emerging through the penis during orgasm. Although you still reach sexual climax, you may ejaculate very little or no semen. This is sometimes called a dry orgasm. Retrograde ejaculation isn't harmful, but it can cause male infertility. Treatment for retrograde ejaculation is generally only needed to restore fertility.

Symptoms Causes Risk factors Complications Prevention

Retrograde ejaculation doesn't affect your ability to get an erection or have an orgasm — but when you climax, semen goes into your bladder instead of coming out of your penis. Retrograde ejaculation signs and symptoms include:

  • Dry orgasms, orgasms in which you ejaculate very little or no semen out of your penis
  • Urine that is cloudy after orgasm (because it contains semen)
  • Inability to get a woman pregnant (male infertility)

When to see a doctor

Retrograde ejaculation isn't harmful and requires treatment only if you're attempting to father a child. However, if you have dry orgasms, see your doctor to be sure your condition isn't caused by an underlying problem that needs attention.

If you and your partner have had regular, unprotected intercourse for a year or longer and have been unable to conceive, see your doctor. Retrograde ejaculation may be the cause of your problem if you ejaculate very little or no semen.

During a male orgasm, a tube called the vas deferens transports sperm to the prostate, where they mix with other fluids to produce liquid semen (ejaculate). The muscle at the opening of the bladder (bladder neck muscle) tightens to prevent ejaculate from entering the bladder as it passes from the prostate into the tube inside the penis (urethra). This is the same muscle that holds urine in your bladder until you urinate. With retrograde ejaculation, the bladder neck muscle doesn't tighten properly. As a result, sperm can enter the bladder instead of being ejected out of your body through the penis.

Several conditions can cause problems with the muscle that closes the bladder during ejaculation. These include:

  • Surgery, such as bladder neck surgery or prostate surgery
  • Side effect of certain medications used to treat high blood pressure, prostate enlargement and mood disorders
  • Nerve damage caused by a medical condition, such as diabetes, multiple sclerosis or a spinal cord injury

A dry orgasm is the primary sign of retrograde ejaculation. But dry orgasm — the ejaculation of little or no semen — can also be caused by other conditions, including:

  • Surgical removal of the prostate (prostatectomy)
  • Surgical removal of the bladder (cystectomy)
  • Radiation therapy to treat cancer in the pelvic area

You're at increased risk of retrograde ejaculation if:

  • You have diabetes or multiple sclerosis
  • You've had prostate or bladder surgery
  • You take certain drugs for high blood pressure or a mood disorder
  • You had a spinal cord injury

Retrograde ejaculation isn't harmful. However, potential complications include:

  • Inability to get a woman pregnant (male infertility)
  • Less pleasurable orgasm due to worries about absent ejaculate

If you take medications or have health problems that put you at risk of retrograde ejaculation, ask your doctor what you can do to lower your risk.

If you need to have surgery that may affect the bladder neck muscle, such as prostate or bladder surgery, ask about the risk of retrograde ejaculation. If you plan to have children in the future, talk with your doctor about options for preserving semen before the surgery.

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