Retrograde Ejaculation, A Simple Guide To The Condition, Diagnosis, Treatment And Related Conditions

Retrograde ejaculation is a medical disorder when semen enters the bladder instead of going out through the urethra during ejaculation.
Retrograde ejaculation (RE) occurs when the semen passes into the bladder rather than along the urethra.
Retrograde ejaculation is uncommon.
RE is a common type of ejaculatory dysfunction, but accounts for 0.3%-2% of infertility of males.
This condition is marked by significant retrograde propulsion of seminal fluid into the bladder
The bladder neck in the normal physiological condition closes with high pressure during ejaculation, forcing semen deposited into the posterior part of the urethra to flow forward through the urethra and out the urethral meatus
It most often occurs when the bladder neck opening does not close.
This causes semen to go backwards into the bladder rather than forwards out of the penis.
Retrograde ejaculation may be caused by:
1. Diabetes
2. Some medicines including, drugs used to treat high blood pressure and some mood-altering drugs
3. Medicines or surgery to treat prostate or urethra problems
With impaired or absent bladder neck closure, semen in the early part of the urethra may be propelled along the path of least resistance into the bladder
Symptoms are:
1. Cloudy urine after orgasms
2. Little or no semen is released during ejaculation
A urinalysis that is taken soon following ejaculation will show a large number of sperm in the urine.
Treatment
1. The doctor may recommend that the man stop taking any medicines that may potentially induce retrograde ejaculation.
2. Neurological causes of RE, such as spinal cord injury, are not responsive to medical treatment
However, in some patients with partial neurological injuries (i.e. in the early stages of progressive spinal cord trauma) medical treatment of the nerve helps.
Retrograde ejaculation that is caused by diabetes or surgery may be treated with medicines such as imipramine or pseudo-ephedrine.
These agents facilitate forward propulsion of semen by raising bladder neck tone
a. Imipramine
b. Several alpha adrenergic agonists have also been widely prescribed to treat both RE
These drugs (sympathomimetics) are ephedrine, pseudo-ephedrine, and midodrine are alternative pharmacological choices to imipramine
c. Midodrine is an alpha adrenergic receptor agonist mainly used to cure orthostatic hypotension.
It has also been demonstrated to activate the sympathetically innervated structures, such as the prostate, vas deferentia, and seminal vesicles, and to provide the rhythmic muscle contraction required during ejaculation
Electro-ejaculation is primarily used to achieve forward ejaculation in non-ejaculatory men after retroperitoneal lymph node dissection (RPLND) or spinal cord injury.

TABLE OF CONTENT
Introduction
Chapter 1 Retrograde Ejaculation
Chapter 2 Causes
Chapter 3 Symptoms
Chapter 4 Diagnosis
Chapter 5 Treatment
Chapter 6 Prognosis
Chapter 7 Male Orgasm
Chapter 8 Premature Ejaculation
Epilogue