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Retrograde ejaculation is the process whereby the semen is passed in a retrograde fashion into the bladder as opposed to out the urethra. There are 3 potential causes of this problem: anatomic (following bladder neck surgery or from a congenital process), neurologic (due to disorders that interfere with the ability of the bladder neck to close during emission, such as Diabetes mellitus or retroperitoneal surgery) and pharmacologic (due to paralysis of the bladder neck by certain medications). This process is diagnosed by the finding of seminal fluid and/or sperm within a urine specimen obtained immediately after orgasm. The treatment of retrograde ejaculation depends to some extent on the cause. Anatomic causes are rarely curable, and sperm harvesting from the bladder is required for those patients wishing to initiate a pregnancy. Pharmacologic causes are generally reversible by withdrawal of the offending medication. Neurologic causes are difficult to treat if there is complete nerve damage such as may occur in spinal cord injured patients. In those patients with a partial neural injury (diabetes), the use of certain medications (pseudoepohedrine for example) may convert the patient to an antegrade ejaculator.

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10y ago

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