Retrograde ejaculation occurs when semen flows backward into the bladder rather than being expelled through the urethra during orgasm. This condition can significantly impair fertility and sexual satisfaction.
The underlying mechanism involves failure of bladder neck closure during ejaculation. Causes include diabetes-induced neuropathy, pelvic surgery, spinal cord injury, and certain medications such as alpha-blockers.
Patients may report reduced semen volume or “dry orgasm.” Diagnosis is confirmed by detecting sperm in post-ejaculatory urine samples.
Treatment depends on etiology. Sympathomimetic medications may improve bladder neck tone in selected cases. For fertility purposes, sperm retrieval from urine for assisted reproductive techniques may be considered.
Timely diagnosis ensures appropriate counseling and erotic therapeutic planning.
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