retrograde ejaculation

Retrograde ejaculation is a condition in which semen is ejaculated into the bladder instead of exiting the body through the penis. Anatomically, the spermatic duct joins the path of the urethra for semen to exit the body. Caused by a malfunction in the valves that control the flow of urine versus semen through the urethra, this rare condition is sometimes the result of diabetes or the removal of the prostate gland. Normally, the valve between the bladder and the urethra constricts during ejaculation or conversely, the valve between the vas deferens and the urethra closes during urination. For men diagnosed with retrograde ejaculation, sperm may be retrieved from collected urine processed by the andrology laboratory. Because the acidity of urine can be detrimental to sperm, a man may take sodium bicarbonate to neutralize the acidity of the urine to allow collection of more viable sperm. Alternatively, a man can empty his bladder and have a catheter inserted to fill the bladder with laboratory solution. After ejaculation, the fluid is collected, the liquid removed and the sperm harvested.

symptoms

No ejaculate indicates retrograde ejaculation.

cause

The most common reason for retrograde ejaculation is previous prostate surgery. Other possible causes are cancer, diabetes, multiple sclerosis and surgeries involving the abdomen, pelvic or genital areas. Also, certain medications used to treat heart disease and high blood pressure can cause the bladder neck to relax. In some cases, the exact source of the problem is unknown.

treatment

Healthcare providers commonly approach this condition in one of two ways -- through the use of drugs or assisted reproductive technologies.

Antihistamine drugs are used to tighten the bladder opening in an attempt to prevent the sperm from flowing backwards. Various assisted reproductive procedures can bypass the normal way sperm is deposited into the vagina, such as intracytoplasmic sperm injection (ICSI), in vitro fertilization (IVF) and zygote intrafallopian transfer (ZIFT).