This information will help you understand retrograde ejaculation and how it may affect you.

You are scheduled to have the lymph nodes behind your abdomen removed. This is done for most patients who have testicular cancer. The nerves that control the way sperm leaves the body can be injured during the operation. If this happens, you will have retrograde ejaculation. This means that during ejaculation, your semen will flow back into your bladder. Normally, it goes out through your penis.

Sperm Pathway Before Surgery  Enlarge Image

Sperm leave the testicles and travel up the vas deferens. When the sperm reach the ejaculatory duct, they mix with semen from the seminal vesicles and the prostate. During orgasm, the bladder neck closes. This prevents semen from flowing back and entering the bladder.

Sperm Pathway After Surgery

Nerves are sometimes damaged during the operation to remove lymph nodes behind the abdomen. When this happens, the bladder neck does not close at orgasm. Semen then flows backward into the bladder rather than forward out of the penis. This is not harmful or painful, but it may cause a subtle change in sensation. A dry ejaculate does not affect erection or orgasm. You will still be able to enjoy sexual activity. After sexual activity, your urine may appear cloudy because it has semen.

Sometimes, the nerves that control the bladder neck can be spared. However, it can take a month to several years for them to begin to work again. Your doctor can tell you if nerve-sparing surgery is a possible option for you.

If you plan to have a family after your surgery, tell your doctor you want to bank sperm before surgery. If you have not banked your sperm, when you are ready to have a family, your doctor can tell you about your options and refer you to a specialist.