Retrograde ejaculation
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[edit] Retrograde ejaculation in males
In males, retrograde ejaculation occurs when the fluid to be ejaculated, which would normally exit via the urethra, is redirected towards the urinary bladder. Normally the sphincter of the bladder contracts and the sperm goes to the urethra towards the area of least pressure. In retrograde ejaculation this sphincter does not function properly. Causes may be in the autonomic nervous system or the operation of the prostate. Retrograde ejaculation is a common complication of trans-urethral resection of the prostate, a procedure in which diseased tissue is removed, slice by slice, through a resectoscope passed along the urethra.
Retrograde ejaculation is a common side effect of medications such as Tamsulosin that are used to relax the muscles of the urinary tract for various purposes. These medications may cause the bladder sphincter to relax as well and fail to contract fully.
Retrograde ejaculation can also be a complication of Diabetes especially in cases of diabetics with long term poor blood sugar control. This is due to neuropathy of the bladder sphincter.
Diagnosis is usually by way of a urinalysis performed on a urine specimen that is obtained shortly after ejaculation which will have an abnormal level of sperm within it.
Retrograde ejaculation is considered harmless as the only negative effect is the loss or reduction in fertility.
[edit] Potential treatments
Retrograde ejaculation may cause a couple to experience problems such as infertility, as most sperm do not get to the vagina and the rest of the female reproductive system. As a method to induce pregnancy, the retrograde ejaculator's urine is centrifuged and the isolated sperm is then injected into the woman.
In the past, in couples where the male has had retrograde ejaculation, the man has urinated into the female's vagina in an attempt to conceive.
Around 40% of sufferers from retrograde ejaculation have found that use of pseudoephedrine (brands names include Sudafed) noticeably improves the quantity of ejaculate. The tricyclic antidepressant imipramine has also been used as an effective treatment for retrograde ejaculation. It must be noted that both medications have links to erectile dysfunction, pseudoephedrine being the frontline treatment for priapism. People with erectile dysfunction and retrograde ejaculation (not uncommon in those with diabetes) are strongly advised to seek medical advice about the best 'dual' treatment methods available to them, i.e. combining pseudoephedrine or an alternative with an erectile dysfunction treatments such as sildenafil.
In most cases those suffering from retrograde ejaculation are advised that a normal sex life is to be expected, however a significant number of those patients who do have it have reported reduced sensation during orgasm.
[edit] Retrograde ejaculation and alternative medicine
Some fields of alternative medicine actually recommend and teach retrograde ejaculation as a way of "conserving the body's energy" or "conserving sperm". However, there is no scientific basis for this, as the retrograde-ejaculated sperm are simply lost at the next urination. Many doctors do not recommend learning how to perform retrograde ejaculation, as once learnt, the habit may be hard to "unlearn" [citation needed].
One manner of achieving male retrograde ejaculation is by applying pressure to the perineum during orgasm.