Retrograde ejaculation

  • Definition
    • Retrograde ejaculation occurs when semen enters the bladder instead of going out through the urethra during ejaculation.

  • Alternative Names
    • Ejaculation retrograde; Dry climax

  • Causes
    • Retrograde ejaculation is uncommon. It most often occurs when the opening of the bladder (bladder neck) does not close. This causes semen to go backwards into the bladder rather than forwards out of the penis.

      Retrograde ejaculation may be caused by:

      • Diabetes
      • Some medicines including, drugs used to treat high blood pressure and some mood-altering drugs
      • Medicines or surgery to treat prostate or urethra problems
  • Symptoms
    • Symptoms include:

      • Cloudy urine after orgasms
      • Little or no semen is released during ejaculation
  • Exams and Tests
    • A urinalysis that is taken soon after ejaculation will show a large amount of sperm in the urine.

  • Treatment
    • Your health care provider may recommend that you stop taking any medicines that may cause retrograde ejaculation. This can make the problem go away.

      Retrograde ejaculation that is caused by diabetes or surgery may be treated with drugs such as pseudoephedrine or imipramine.

  • Outlook (Prognosis)
    • If the problem is caused by a medication, normal ejaculation will often come back after the drug is stopped. Retrograde ejaculation caused by surgery or diabetes often cannot be corrected.

  • Possible Complications
    • The condition may cause infertility. However, semen can often be removed from the bladder and used during assistive reproductive techniques.

  • When to Contact a Medical Professional
    • Call your health care provider if you are worried about this problem or are having troubles conceiving a child.

  • Prevention
    • To avoid this condition:

      • If you have diabetes, maintain good control of your blood sugar.
      • Avoid drugs that can cause this problem.
  • References
    • Bhasin S, Basson R. Sexual dysfunction in men and women. In: Kronenberg HM, Melmed S, Polonsky KS, Larsen PR, eds. Williams Textbook of Endocrinology. 12th ed. Philadelphia, PA: Elsevier Saunders; 2011:chap 20.

      Goldstein M. Surgical management of male infertility. In: Wein AJ, ed. Campbell-Walsh Urology. 10th ed. Philadelphia, PA: Elsevier Saunders; 2011:chap 22.

      Heidelbaugh JJ. Management of erectile dysfunction. Am Fam Physician. 2010;81:305-312.