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Retrograde Ejaculation

by Irvin H. Hirsch, MD

Retrograde ejaculation is a condition in which semen is ejaculated backward into the bladder rather than out through the penis.

In retrograde ejaculation, the part of the bladder that normally closes during ejaculation (the bladder neck) remains open, causing the semen to travel backward into the bladder. One of the most common causes is prostate surgery for noncancerous prostate enlargement. Other common causes of retrograde ejaculation include diabetes, spinal cord injuries, certain drugs, and some surgical operations (including major abdominal or pelvic surgery).

Men with retrograde ejaculation can still have orgasms. However, retrograde ejaculation decreases the amount of semen ejaculated out of the penis. Sometimes, no semen comes out. The condition can cause infertility but is otherwise not harmful.

Did You Know...

  • Artificial insemination may be possible if infertility is caused by retrograde ejaculation.

A doctor makes the diagnosis of retrograde ejaculation by finding a large amount of sperm in a urine sample taken shortly after ejaculation. Men usually need no treatment unless infertility is a concern. About one third of men with retrograde ejaculation improve after treatment with drugs that close the bladder neck (such as pseudoephedrine, phenylephrine, chlorpheniramine, brompheniramine, or imipramine). However, most of these drugs can increase heart rate and blood pressure, which can be dangerous in men with high blood pressure or heart disease.

If infertility requires treatment and drugs do not help, doctors can sometimes collect a man’s sperm for insemination (see Treatment).

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Drugs Mentioned In This Article

  • Generic Name
    Select Brand Names
  • AFRINOL, SUDAFED
  • No US brand name
  • CHLOR-TRIMETON
  • TOFRANIL