Retrograde Ejaculation or Shooting Blanks

Most men experience the joy of ejaculation when the semen, sperm mixed with prostatic fluid, travels outside of the body at the time of orgasm. Retrograde ejaculation occurs when semen goes into the bladder instead of leaving the penis during ejaculation. Retrograde ejaculation isn’t harmful but it can impair fertility since it affects the delivery of sperm to the vagina during intercourse.
During normal ejaculation, internal muscles, called sphincters, close off the opening of the bladder to prevent semen from entering as it passes through the urethra. In retrograde ejaculation, the bladder opening doesn’t close properly and some or all of the semen is allowed to enter the bladder instead of being ejected out the tip of the penis. As a result, semen mixes with urine in the bladder and leaves the body during the next urination.
Retrograde ejaculation does not interfere with a man’s ability to have an erection or an orgasm. Men often first become aware that they have retrograde ejaculation when fertility problems arise. The condition also occurs after prostate surgery where the sphincters can be damaged or injured during the surgery. A common sign indicating retrograde ejaculation is if a man’s urine appears cloudy after sexual climax.
Retrograde ejaculation may occur either partially or completely. Men with incomplete retrograde ejaculation may notice a decrease in semen that comes out during ejaculation. Complete retrograde ejaculation can also be called dry orgasm or dry ejaculation since there is orgasm without the discharge of semen.
Since retrograde ejaculation isn’t harmful, it typically doesn’t require treatment unless it interferes with fertility. In such cases, treatment depends on the underlying cause.
If your doctor discovers that a prescribed medication, such as alpha blockers, is the cause, switching to a comparable medication or discontinuation of the drug often restores normal ejaculation.
Unfortunately, if retrograde ejaculation is caused by surgery or diabetes, it is often not correctable. However, some medications have been shown to improve muscle tone of the bladder neck and therefore reduce the loss of semen into the bladder during ejaculation. These medications include: epinephrine sulfate and epinephrine-like drugs (such as pseudoephedrine, imipramine, midodrin, desipramine and brompheniramine maleate).
Alternatively, men are sometimes encouraged to ejaculate when their bladder is full since having a full bladder can increase bladder neck closure.
If the above measures are not options or are not successful and fertility is still a concern, it is also possible for an urologist to retrieve sperm from a man’s urine following an orgasm and use it for artificial insemination.
It is also possible for men, prior to receiving treatments or surgeries that bring the risk of retrograde ejaculation, to have their semen cryopreserved (frozen) for insemination later.

Bottom Line: Retrograde ejaculation or sperm going backward into the bladder is not a very common problem but can be a problem if a man wishes to achieve a pregnancy with his partner. The condition does not need treatment unless a man wishes to achieve a pregnancy.

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