This information will help you understand retrograde ejaculation and how it may affect you.
About Retrograde Ejaculation
Ejaculation is when semen comes out of your penis after reaching orgasm (an intense feeling of pleasure). Retrograde ejaculation is 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 (duct that sends sperm from your testicles to your urethra) 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.
During orgasm, your bladder neck closes and semen exits your body through your penis. When your bladder neck closes, it prevents semen from flowing back and going into your bladder. If you have retrograde ejaculation, your bladder neck doesn’t close at orgasm. This means that semen flows backward into your bladder instead of forward through your penis.
Causes of Retrograde Ejaculation
You may get retrograde ejaculation after you have a retroperitoneal lymph node dissection (RPLND). RPLND is surgery to remove some of the lymph nodes in your abdomen (belly). This surgery is a treatment for testicular cancer. During surgery, the nerves that control your bladder neck may be injured. Sometimes, these nerves can be spared, but it can take a month to several years for them to begin to work again. Your doctor can tell you if surgery is an option for you.
You may also get retrograde ejaculation after you have transurethral resection of the prostate (TURP). TURP is a surgery done to treat urinary problems caused by an enlarged prostate. TURP may cause injury to the nerves causing your bladder neck to stay open during orgasm.
Retrograde ejaculation can also be caused by diabetes, multiple sclerosis (MS), certain medications, and spinal cord injury.
Sexuality
Retrograde ejaculation isn’t harmful or painful, but it may cause a small change in sensation during sex because no semen exits the penis. This is called a dry ejaculate. A dry ejaculate doesn’t affect erection (getting hard for sex) or orgasm. You will still be able to enjoy sexual activity. After sexual activity, your urine (pee) may be cloudy because it has semen in it.
Fertility
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 surgery and want to have a family, your doctor can tell you about your options and refer you to a specialist. For more information, read our resource Instructions for Your Retrograde Semen Analysis (www.mskcc.org/pe/retrograde_semen_analysis).