According to renowned urologist Paul Perito MD, retrograde ejaculation is a condition that causes semen to spew into the bladder instead of dispelling it from the body. The condition can preclude ejaculation completely or allow only small amounts to pass through the anterior urethra. Retrograde ejaculation will often present alongside infertility or azospermia although, according to Paul Perito MD, the condition accounts for fewer than 2% of infertility cases. It is, however, more frequent in cases of the latter, having about a 20% correlation rate.
Paul Perito MD explains that in order for antegrade ejaculation to happen, the seminal vessels, vas deferens, bladder neck, external sphincter, the prostate and the perennial musculature must all be functional and anatomically correct. There is a specific series of events which push semen through the urethral tube, says Paul Perito MD, and even if one of these functions presents a defect there can be problems with the ejaculatory process.
Patients suffering from retrograde ejaculation, notes Paul Perito MD, may still have an orgasm but it will not present itself with seminal fluid. Paul Perito MD notes that a thorough history as well as a physical exam will confirm a diagnosis of retrograde ejaculation. The patient will be requested to file a history report including any medical conditions, current medications or previous surgical procedures, and history of aspermia (the total lack of seminal fluid). A urine sample will be collected, post ejaculation, to check for the presence of sperm, says Paul Perito MD.
Retrograde ejaculation is reported as having three primary causes: anatomic, neurogenic, and pharmacologic. According to Paul Perito MD, anatomic retrograde ejaculation may occur as the result of medical procedure, such as those involving the neck of the bladder. Certain treatments for benign prostatic hyperplasia may result in RE in approximately three quarters of the treated patients. Additionally, reports Paul Perito MD, other possible etiologies include transurethral incision of the prostate, open prostatectomy, and urethral trauma. Congenital defects, such as an ectopic ejaculatory duct and utricle cysts are also known causes anatomic retrograde ejaculation, says Paul Perito MD. Neurogenic defects as a result of testicular tumor treatments may also play a role in retrograde ejaculation. According to Paul Perito MD, some medications may interfere with the body’s ability to properly release semen. Finally, when there is no evidence of a pharmacological, anatomical, or neurological defect, retrograde ejaculation may be considered a psychogenic condition. Fortunately, says Paul Perito MD, idiopathic cases have a high success rate, with around 80% of patients responding well to treatment.
Treatment of RE may focus on semen’s restoration into an antegrade ejaculatory state. According to Paul Perito MD, retrograde ejaculation does not necessarily have to be treated unless the end goal is to restore fertility or for certain health issues. The choice to seek treatment for retrograde ejaculation is a personal one, but should be discussed openly with the patient’s physician as well as a sexual partner. Paul Perito MD maintains that open communication with both parties will lead to less frustration and less anxiety.
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Urological surgeon Paul Perito MD has devoted his entire professional career to treating men suffering from Erectile Dysfunction. He is the founder and namesake of Miami’s Perito Urology, where he conceived and initiated the world’s first minimally invasive approach to penile implantation. Paul Perito MD has performed over 3000 of these procedures on men across the globe that enjoy a shorter recovery time and less scarring than traditional implantation methods. Since 1995, Paul Perito MD and Perito Urology have become synonymous with effective erectile dysfunction treatment and world-class service unparalleled anywhere in the nation. He is a graduate of the University of Maryland Medical School as well as a frequent contributor to text published by medical journals nationwide.
Paul Perito MD provides the information contained in this article for educational purposes only. It is not intended to treat or diagnose any condition.
