Overview

Retrograde ejaculation occurs when semen enters the bladder instead of emerging through the penis during orgasm. Although you still reach sexual climax, you might 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.

Source: http://www.mayoclinic.com

Symptoms

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:

• Orgasms in which you ejaculate very little or no semen out of your penis (dry orgasms)
• 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 female partner have had regular, unprotected intercourse for a year or longer and have been unable to conceive, see your doctor. Retrograde ejaculation might be the cause of your problem if you ejaculate very little or no semen.

Source: http://www.mayoclinic.com

Causes

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, retroperitoneal lymph node dissection surgery for testicular cancer or prostate surgery
• Side effect of certain medications used to treat high blood pressure, prostate enlargement and depression
• Nerve damage caused by a medical condition, such as diabetes, multiple sclerosis, Parkinson's disease 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

Source: http://www.mayoclinic.com

Diagnosis

Your doctor will:

• Ask questions about your symptoms and how long you've had them. Your doctor might also ask about any health problems, surgeries or cancers you've had and what medications you take.
• Do a physical exam, which will likely include an exam of your penis, testicles and rectum.
• Examine your urine for the presence of semen after you have an orgasm. This procedure is usually done at the doctor's office. Your doctor will ask you to empty your bladder, masturbate to climax and then provide a urine sample for laboratory analysis. If a high volume of sperm is found in your urine, you have retrograde ejaculation.

If you have dry orgasms, but your doctor doesn't find semen in your bladder, you might have a problem with semen production. This can be caused by damage to the prostate or semen-producing glands as a result of surgery or radiation treatment for cancer in the pelvic area.

If your doctor suspects your dry orgasm is something other than retrograde ejaculation, you might need further tests or a referral to a specialist to find the cause.

Source: http://www.mayoclinic.com

Complications

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

Source: http://www.mayoclinic.com

Prevention

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 might 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.

Coping and support

Alterations in orgasm are linked with lower emotional and physical satisfaction, which might lead to stress for you and your partner. Retrograde ejaculation can be especially challenging if you and your partner want to conceive a child.

While most men can get their female partners pregnant with infertility treatment, it can be costly and require stressful medical procedures for both you and your partner. Talking with a counselor might help.

Understanding all of your options and communicating with your doctor and partner can help.

• Know what it will cost. Your insurance may or may not cover the costs necessary for sperm retrieval and artificial insemination of your partner.
• Talk to your doctor. Ask about all your options. You'll need to meet with a urologist who specializes in male infertility.
• Communicate with your partner. Make sure you and your partner both understand your options and the potential risks of fertility procedures. You should both attend every consultation appointment.

Source: http://www.mayoclinic.com

Risk factors

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

Source: http://www.mayoclinic.com