Retrograde Ejaculation

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

About Retrograde Ejaculation

Retrograde ejaculation occurs when semen flows back into your bladder, instead of out through your penis.

When you’re sexually excited, sperm leave your testicles and travel up the vas deferens to the ejaculatory duct (see Figure 1). When they reach the ejaculatory duct, the sperm mix with semen from the seminal vesicles and the prostate.

Figure 1. Male reproductive system

Usually, the bladder neck closes during orgasm. This prevents semen from flowing back and entering the bladder, and the semen exits the body through the penis. If you have retrograde ejaculation, however, the bladder neck doesn’t close at orgasm. Semen then flows backward into the bladder rather than forward through the penis.

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Causes of Retrograde Ejaculation

You may develop retrograde ejaculation after you have a retroperitoneal lymph node dissection (RPLND). RPLND is surgery to remove some of the lymph nodes in your abdomen. This surgery is a treatment for testicular cancer. During this surgery, the nerves that control your bladder neck may be injured. Sometimes, these nerves 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 an option for you.

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Retrograde ejaculation isn’t harmful or painful, but it may cause a small change in sensation because no semen exits the penis. This is called a dry ejaculate. A dry ejaculate doesn’t 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 in it.

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If you plan to have a family after your surgery, tell your doctor you want to bank your sperm before surgery. If you haven’t banked your sperm before the surgery and want to have a family, your doctor can tell you about your options and refer you to a specialist.

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