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Retrograde ejaculation

Retrograde ejaculation occurs when semen goes backward into the bladder. Normally, it moves forward and out of the penis through the urethra during ejaculation.

Causes

Retrograde ejaculation is uncommon. It most often occurs when the opening of the bladder (bladder neck) does not close. This causes semen to go backward into the bladder rather than forward out of the penis.

Retrograde ejaculation may be caused by:

  • Diabetes
  • Some medicines, including drugs used to treat high blood pressure and some mood-altering drugs
  • Medicines or surgery to treat prostate or urethra problems

Symptoms

Symptoms include:

  • Cloudy urine after orgasm
  • Little or no semen is released during ejaculation

Exams and Tests

A urinalysis that is taken soon after ejaculation will show a large amount of sperm in the urine.

Treatment

Your health care provider may recommend that you stop taking any medicines that may cause retrograde ejaculation. This can make the problem go away.

Retrograde ejaculation that is caused by diabetes or surgery may be treated with drugs such as pseudoephedrine or imipramine.

Outlook (Prognosis)

If the problem is caused by a medicine, normal ejaculation will often come back after the drug is stopped. Retrograde ejaculation caused by surgery or diabetes often can't be corrected. This is most often not a problem unless you are trying to conceive. Some men do not like how it feels and seek treatment. Otherwise, there is no need for treatment.

Possible Complications

The condition may cause infertility. However, semen can often be removed from the bladder and used during assistive reproductive techniques.

When to Contact a Medical Professional

Call your provider if you are worried about this problem or are having trouble conceiving a child.

Prevention

To avoid this condition:

  • If you have diabetes, maintain good control of your blood sugar.
  • Avoid drugs that can cause this problem.

Alternative Names

Ejaculation retrograde; Dry climax

References

Barak S, Baker HWG. Clinical management of male infertility. In: Jameson JL, De Groot LJ, de Kretser DM, et al, eds. Endocrinology: Adult and Pediatric. 7th ed. Philadelphia, PA: Elsevier Saunders; 2016:chap 141.

McMahon CG. Disorders of male orgasm and ejaculation. In: Wein AJ, Kavoussi LR, Partin AW, Peters CA, eds. Campbell-Walsh Urology. 11th ed. Philadelphia, PA: Elsevier; 2016:chap 29.

Niederberger CS. Male infertility. In: Wein AJ, Kavoussi LR, Partin AW, Peters CA, eds. Campbell-Walsh Urology. 11th ed. Philadelphia, PA: Elsevier; 2016:chap 24.

Review Date 1/30/2017

Updated by: Jennifer Sobol, DO, urologist with the Michigan Institute of Urology, West Bloomfield, MI. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.