Retrograde Ejaculation: Causes, Diagnosis & Treatment!
Retrograde ejaculation is the medical term for a condition in which the man has the sensation of ejaculation, but there`s no sign of fluid.
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What Is Retrograde Ejaculation?
Retrograde ejaculation is a sexual ejaculatory dysfunction and is believed to occur when there`s little or no sperm that comes out through the opening of the penis during orgasm. The diagnosis can be confirmed by the presence of sperm in a urine sample taken after ejaculation.
A total lack of emission (aspermia) is demonstrated by the lack of sperm in post-ejaculatory urine, unless there`s a blockage in the channel and the tests produce spermatozoids.
Total or partial retrograde ejaculation is due to the inability of the bladder neck to close during orgasm.
The condition isn`t painful, so men start to pay attention only after some dry sex parties where orgasm isn`t accompanied by ejaculation.
Any disease of a medical or surgical nature that interferes with the nerves, the anatomy or functioning of the bladder`s neck can lead to retrograde ejaculation. In this case, most of the ejaculation is retrograde and is eliminated by relief, after orgasm.
Retrograde ejaculation can be caused by a lot of factors as well:
- Diabetes – the condition is often a complication of diabetes which affects the bladder neck sphincter.
- Surgeries that affect the bladder neck or nerves which control this muscle.
This medical condition might also be a complication of surgical procedures, like prostatectomy (classic prostate ablation) or transurethral prostatectomy (prostate ablation under endoscopic control).
- Surgical interventions under the endoscopic control of the bladder neck.
- Surgery in the treatment of testicular, colon or rectal cancer.
- Neurological disorders.
- Some drugs may affect the nervous function of the muscles involved in ejaculation: tricyclic antidepressants (amitriptyline, chlorpromazine, thioridazine) and drugs used to treat high blood pressure (guanethidine, reserpine).
- Spinal cord injuries.
In the treatment of prostate conditions, less aggressive forms of surgery (like transurethral electrophoresis) are increasingly preferred to reduce the risk of retrograde ejaculation. Although these medical procedures are responsible for a reduced number of cases of retrograde ejaculation, they aren`t recommended in all patients.
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Also, blood glucose control in diabetics may prevent retrograde ejaculation.
Another cause of retrograde ejaculation might be the consumption of some chemical substances that may cause it chemically.
The diagnosis of retrograde ejaculation is determined by the urologist, based on the medical history of the patient. A complete physical examination, sperm analysis and urine sample are required.
The diagnosis is confirmed by the presence of a large number of spermatozoids in the urine sample.
Although it isn`t dangerous for health, retrograde ejaculation raises 2 problems which justify specialized control:
- The possibility of an illness which caused the problem of ejaculation.
The treatment of retrograde ejaculation is indicated and administered after a diagnosis documented by the urologist.
Retrograde drug ejaculation is easy to tread by replacing the drug. Instead, retrograde ejaculation caused by lesions of the muscles or nerves might be permanent. Only 40% of injuries respond to treatment.
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Most men don`t need treatment. Around 1/3 of patients with this medical condition caused by muscle or nerve damage might experience improvement after drug therapy which strengthens bladder sphincter tonus (pseudoephedrine, phenylephrine, chlorpheniramine or imipramine). However, these medications increase heart rate and blood pressure, not being recommended for patients with heart diseases or HTA.
If retrograde ejaculation is the result of severe nerve or bladder neck injuries, restoring a normal ejaculation is impossible and the patient is sterile.
Treatment of infertility consists in harvesting spermatozoids from urine and then used in assisted reproductive methods, either by in vitro fertilization or intra-cytoplasmic injections or intrauterine insemination.
Men who suffer from total lack of ejaculation and don`t respond to medication can get sperm for artificial insemination by a medical procedure known as electro-ejaculation.
Diabetes & Infertility
Even if its installation is favored by certain health issues, retrograde ejaculation can also cause diseases, which include diabetes. Statistics show that a lot of men who suffer from this condition are diabetic as well. Also, due to the inability to expel sperm, these men cannot become fathers except by artificially inseminating their partners with sperm harvested in the urine.
Infertility caused by this ejaculation disorder is often treatable. Moral support and openness to variants offered by the experts are the starting points of a couple who wants to start a family.