Merck Manual

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Retrograde Ejaculation

By

Irvin H. Hirsch

, MD, Sidney Kimmel Medical College of Thomas Jefferson University

Reviewed/Revised Mar 2022 | Modified Sep 2022
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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 Diabetes Mellitus (DM) Diabetes mellitus is a disorder in which the body does not produce enough or respond normally to insulin, causing blood sugar (glucose) levels to be abnormally high. Urination and thirst are... read more , spinal cord injuries Overview of Spinal Cord Disorders Spinal cord disorders can cause permanent severe problems, such as paralysis or impaired bladder and bowel control ( urinary incontinence and fecal incontinence). Sometimes these problems can... read more , 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.

A doctor makes the diagnosis of retrograde ejaculation by finding a large amount of sperm in a urine sample taken shortly after orgasm.

Treatment of Retrograde Ejaculation

  • Drugs

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 or imipramine). However, men who use these drugs should be alert and periodically checked by their doctor for increases in heart rate and blood pressure. Use of these drugs is limited to men seeking fertility.

Did You Know...

  • Artificial insemination may be possible if infertility is caused by retrograde ejaculation or inability to ejaculate.

Drugs Mentioned In This Article

Generic Name Select Brand Names
Contac Cold 12 Hour, Dimetapp Decongestant, Drixoral, ElixSure Cold, ElixSure Congestion, Entex, Genaphed , KidKare , Myfedrine, NASAL Decongestant, Nasofed, Nexafed, PediaCare Infants' Decongestant, Pseudo-Time, Silfedrine, Sudafed, Sudafed 12 Hour, Sudafed 24 Hour, Sudafed Children's Nasal Decongestant, Sudafed Congestion, Sudafed Sinus Congestion, Sudogest, Sudogest 12 Hour, Sudogest Children's , Tylenol Children's Simply Stuffy, Zephrex-D
Tofranil, Tofranil-PM
NOTE: This is the Consumer Version. DOCTORS: VIEW PROFESSIONAL VERSION
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