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Retrograde ejaculation

Ejaculation retrograde; Dry climax

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

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Male reproductive system

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:

Symptoms

Symptoms include:

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:

Related Information

Diabetes
High blood pressure - adults
Prostate resection - minimally invasive - discharge
Transurethral resection of the prostate - discharge
Radical prostatectomy - discharge

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.

McMohan CG. Disorders of male orgasm and ejaculation. In: Partin AW, Domochowski RR, Kavoussi LR, Peters CA, eds. Campbell-Walsh-Wein Urology. 12th ed. Philadelphia, PA: Elsevier; 2021:chap 71.

Niederberger CG, Ohlander SJ, Pagani RL. Male infertility. In: Partin AW, Domochowski RR, Kavoussi LR, Peters CA, eds. Campbell-Walsh-Wein Urology. 12th ed. Philadelphia, PA: Elsevier; 2021:chap 66.

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Review Date: 1/10/2021  

Reviewed By: Kelly L. Stratton, MD, FACS, Associate Professor, Department of Urology, University of Oklahoma Health Sciences Center, Oklahoma City, OK. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

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