Retrograde Ejaculation: Causes, Symptoms, Treatment and Cost

Retrograde ejaculation is the medical term for when semen travels backwards into your bladder, instead of forward and out of the penis during orgasm. It occurs when semen does not travel through the urethra.

There are several types of retrograde ejaculation:-

• Acquired Retrograde Ejaculation: This type of retrograde ejaculation typically happens as a result of surgery or medications taken to treat certain medical conditions. Common causes include prostate removal, prostatectomy (surgery to remove part or all of the prostate), diabetes and medications used in anesthesia.
• Spontaneous Retrograde Ejaculation: This type is rare and may be caused by an abnormality in the genito-urinary tract such as a stricture or low cervical mucus pH levels; often seen in men who have had multiple bouts with sexually transmitted diseases (STDs).
• Congenital Retrograde Ejaculation: As its name implies, this form is congenital and present from birth due to a defect in the development of certain muscles, nerves and other structures in the urinary tract that control ejaculation

• It can be caused by damage to nerves or hormones connected to the bladder and ejaculatory ducts, as a result of certain medical conditions and treatments, such as diabetes or nerve damage following prostate surgery.
• Other causes may include certain medications such as certain antidepressants and alpha-blockers, as well as spinal cord injuries or multiple sclerosis.

• Difficulty or inability to release semen during ejaculation.
• Dry orgasms, whereby little to no semen is released.
• Pain in the abdomen, lower back, or groin upon ejaculation.
• Urine that appears cloudy after ejaculation.
• Lower volume of ejaculate or reduced force of stream during urination.

• Practice pelvic floor exercises: Exercising the muscles that control urination helps strengthen them and can help prevent retrograde ejaculation.
• Quit smoking: Smoking can weaken the pelvic muscles, leading to increased chances of retrograde ejaculation, so quitting smoking may help.
• Limit alcohol intake: Heavy drinking can reduce muscle tone in the bladder sphincter and contribute to retrograde ejaculation. Limiting alcohol intake may be beneficial to overall sexual health.
• Discuss medications you are taking with your doctor: If a man is taking medications such as certain antidepressants or alpha blockers that could be causing retrograde ejaculation, his doctor may advise changing or lowering the dose of medication.
• Use a condom during intercourse: A condom reduces direct stimulation of the penis and prostate gland and prevents any semen from entering the bladder—which in turn can reduce chances of backward ejaculation for some people with mild conditions.

• Physical Examination:A physical examination may be performed to look for abnormalities of the urethra, prostate and surrounding area.
• Urine Analysis:A urine sample is collected and examined for the presence of sperm cells. This is done to determine if retrograde ejaculation is the cause of infertility in a man.
• Ultrasound:An ultrasound scan can be used to assess the anatomy of the bladder, prostate and seminal vesicles. This helps diagnose retrograde ejaculation.
• Cystoscopy:It is an endoscopic procedure which involves passing a small camera into the bladder via the urethra to view the bladder neck muscles and structures that control ejaculation.
• Post-ejaculatory urine analysis:In this test, a man collects his urine after an orgasm and examines it under a microscope for sperm cells. If present, then it indicates retrograde ejaculation has occurred.

• Urinary tract infections:When the prostate and the surrounding area become infected, this can lead to painful urination, cloudy urine, and a burning sensation.
• Difficulty conceiving:If a man is unable to ejaculate semen normally, he may be unable to conceive naturally with a partner.
• Dry orgasm experience:Retrograde ejaculation can lead to a dry orgasm experience or no orgasm at all for the man or his partner.
• Bladder stones:Without regular emptying of semen during ejaculation, crystals form in urine that can contribute to bladder stones.
• Reduced sexual pleasure:Because of the lack of semen expulsion during intercourse, there may be reduced sexual pleasure as this may interfere with lubrication and arousal in both partners.

• Practicing yoga, such as yoga asanas, pranayama and meditation to reduce stress and improve overall health.
• Massaging the pelvic area using herbal oil, such as sesame oil or ashwagandha oil.
• Drinking herbal teas, like ashwagandha tea or shatavari tea to calm the nervous system and improve bladder function.
• Consuming supplements like Vitamin B complex, Vitamin C, Zinc, Maca root extract and Tribulus terrestris can also be beneficial in treating retrograde ejaculation naturally.

• Foods that contain zinc, such as oysters, beef, and lamb can help improve hormone balance and semen entry into the bladder.
• Additionally, foods high in antioxidants like berries can help protect urinary tract health and improve chances of success with medical treatments.
• Fruits such as bananas, cherries, apples and pomegranates are great sources of vitamins and minerals that are essential for male reproductive health.
• Also foods rich in omega-3 fatty acids like salmon forms a good source of essential nutrients to support sperm production and quality.
• Other beneficial foods include dark green leafy vegetables like spinach which contain large amounts of folate which can improve sperm motility by improving mitochondrial energy production in the cells responsible for sperm movement.
• Eating plenty of whole grains helps provide the body with much-needed dietary fiber which helps to regulate hormonal balance and digestion which can reduce any harmful effects from toxins or medications used to treat retrograde ejaculation.

• Foods high in sugar:Eating too much sugar can lead to higher levels of insulin which can interfere with the proper functioning of the hormones involved in ejaculation.
• Processed foods:Processed foods such as white bread, chips and fast food should be avoided as these contain unhealthy fats that can increase inflammation and disrupt the hormone balance involved in ejaculation.
• Caffeine:Too much caffeine has been linked to difficulty achieving orgasms and reduced sperm production, which may contribute to retrograde ejaculation.
• Alcohol:Heavy drinking is associated with inhibited testosterone production and swelling of tissues which can make it difficult for semen to travel correctly through the urethra during ejaculation.
• Smoking:Smoking cigarettes can impair capillary function, obstructing delivery of oxygen-rich blood to reproductive organs, thus leading to retrograde ejaculation or other sexual dysfunction issues.

• Transurethral Resection of the Ejaculatory Ducts (TURED):This is a procedure where the obstructed portions of the ejaculatory ducts are removed, allowing semen to enter the bladder instead of exiting through the urethra.
• Artificial Urinary Sphincter (AUS):An artificial urinary sphincter is placed over the bladder neck to close off urine from entering the urethra during ejaculation, allowing semen to be expelled from the body in a normal fashion.
• Overflow Incontinence:This is when medication such as ephedrine or pseudoephedrine can be taken to reduce pressure in the bladder and allow for normal ejaculation.
• Vibratory Stimulation:Vibration applied to areas around or near the prostate or base of penis can result in ejaculation into the urethra and out of the body.

In order to diagnose and treat this condition, it is best to consult with a urologist, who specializes in conditions involving the urinary and reproductive tract.

They can perform tests to determine the cause of retrograde ejaculation and provide treatment options such as medications or surgical intervention.

• Urethral suppositories:These are small medications placed directly into the urethra to help relax the pelvic muscles in order to control retrograde ejaculation.
• Muscarinic receptor agonists:Muscarinic agonists stimulate nerves in the bladder neck and enable better function of bladder muscles, reducing retrograde ejaculation symptoms.
• Alpha-blockers:These drugs relax the smooth muscles within the bladder and prostate, allowing for easier ejaculation. Examples include tamsulosin (Flomax) and alfuzosin (Uroxatral).
• Phosphodiesterase Inhibitors:These drugs work by relaxing the muscle in the bladder and prostate, allowing for increased ejaculate volume. Examples include sildenafil (Viagra), vardenafil (Levitra), and tadalafil (Cialis).
• Antidepressants:These medications can help reduce anxiety, which can trigger retrograde ejaculation in some people. Examples include selective serotonin reuptake inhibitors like sertraline (Zoloft) or fluoxetine (Prozac).
• Flutamide:This non-hormonal drug works by decreasing testosterone levels that may be contributing to retrograde ejaculation.
• Hormone Therapy:Testosterone replacement may help increase a man’s ability to ejaculate normally if his low testosterone is causing his condition. For example, topical cream or injectable testosterone is available for men who want to take advantage of this option.

Generally, if the underlying cause is managed successfully, then most men can resume normal ejaculatory function within a few weeks to months.

No, the results of treatment for retrograde ejaculation are not necessarily permanent.

Depending on the cause of the condition, some treatments may provide only temporary relief from symptoms.

• Avoid putting pressure on the bladder and prostate during activities such as lifting and strenuous exercise.
• Avoid sexual activity that may put pressure on the bladder or prostate, such as prolonged thrusting or anal sex.
• Drink plenty of fluids throughout the day to stay hydrated and reduce the risk of urinary tract infections (UTIs).
• Monitor urine output to ensure that it is adequate to keep the bladder healthy and reduce the risk of UTIs.
• Take medications as prescribed to help with ejaculation, if needed.
• Ask your doctor about any dietary changes or supplements that may help improve ejaculation control and quality of life.

Generally, the cost ranges from around Rs 6,000 to Rs 10,000 for medical medications, Rs 8,000 to Rs 15,000 for surgeries such as transurethral resection of ejaculatory ducts (TURED) and around Rs 3,000 to Rs 5,000 for spermatic aspiration.

• Abdominal cramping
• Urinary tract infections
• Loss of semen during ejaculation.
• Bladder spasms, which can cause pain or discomfort.
• Loss of sexual pleasure and sensation.
• Difficulty achieving orgasm and ejaculation.
• Increased risk of developing urinary incontinence.

If you are suffering from any complications relating to Acute Renal Failure then you should consult a doctor nearby as they can have complications like 'infertility, Dry orgasm experience, bladder stone etc' in which treatment course can range from a few months to years depending on the severity of the situation.