Retrograde ejaculation
| Retrograde ejaculation | |
|---|---|
| Classification and external resources | |
| Specialty | Urology |
| ICD-10 | N53.1 |
| ICD-9-CM | 608.87 |
| DiseasesDB | 11438 |
| MedlinePlus | 001282 |
Retrograde ejaculation occurs when semen, which would, in most cases, be ejaculated via the urethra, is redirected to the urinary bladder. Normally, the sphincter of the bladder contracts before ejaculation forcing the semen to exit via the urethra, the path of least resistance. When the bladder sphincter does not function properly, retrograde ejaculation may occur. It can also be induced deliberately by a male as a primitive form of male birth control (known as coitus saxonicus) or as part of certain alternative medicine practices.
Retrograde ejaculation is sometimes referred to as a "dry orgasm." Retrograde ejaculation is one cause of male infertility. Men often notice during masturbation that they do not have semen release but there is an orgasm. Another underlying cause for this phenomenon may be ejaculatory duct obstruction.
During a male orgasm, sperm are released from the epididymis and travel via small tubes called the vas deferens. The sperm mix with seminal fluid in the seminal vesicles, prostate fluid from the prostate gland, and lubricants from the bulbourethral gland. During climax, muscles at the end of the bladder neck tighten to prevent retrograde flow of semen. In retrograde ejaculation, these bladder neck muscles are either very weak or the nerves controlling the muscles have become damaged.
A malfunctioning bladder sphincter, leading to retrograde ejaculation, may be a result either of:
It can also be caused by a retroperitoneal lymph node dissection for testicular cancer if nerve pathways to the bladder sphincter are damaged, with the resulting retrograde ejaculation being either temporary or permanent. Modern nerve-sparing techniques seek to reduce this risk; however, it may also occur as the result of Green Light Laser prostate surgery. Surgery on the bladder neck accounted for about ten percent of the cases of retrograde ejaculation or anejaculation reported in a literature review.
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