Causative and risk factors
Normally during ejaculation, the bladder outlet is tightly closed by a sphincter to prevent entry of sperm into it. But when the sphincter is not tightly closed, sperms may enter into the bladder during ejaculation, leading to low semen quantity or none at all. This is also called as dry orgasm (person experiences orgasm but semen ejaculated is little or none).
The causes that affect the closing of the bladder sphincter include prostate or bladder neck surgery, diabetes mellitus, multiple sclerosis and spinal cord injury.
Side effects of medicines used to treat hypertension, mood disorders, and prostate enlargement can also cause retrograde ejaculation.
Clinical presentation
Men with retrograde ejaculation usually have clouding of urine. Very little or no semen is ejaculated during orgasm (dry orgasm). They are usually unable to get their partners pregnant.
Investigations
Based upon your symptoms, your doctor will perform physical examination to rule any abnormality with the penis and testicle. He/she will order urine analysis on a specimen that is obtained after ejaculation to check for presence of sperms. If no sperms are found, your doctor may recommend further testing to find out the cause for low semen quantity on ejaculation.
Treatment
Treatment for retrograde ejaculation is needed only if you are attempting to father a child. Certain medicines can be used to treat retrograde ejaculation. Medicines only work in cases where the cause is mild nerve damage. It does not work in cases where the cause is severe damage to prostate or testes.
Men with infertility and not responding to medicines will require assisted reproductive procedures like intrauterine insemination, in-vitro fertilization in order to get their partner pregnant.
The outcome depends upon the severity of the condition. Most men are able to get their partner pregnant once they seek treatment. Infertility is the biggest complication of retrograde ejaculation.
