retrograde ejaculation

Etiology

• benign prostatic hypertrophy
• surgical procedures
  • transurethral prostatectomy
  • lumbar sympathectomy
  • retroperitoneal lymph node dissection
• peripheral neuropathy
  • diabetic neuropathy
  • spinal cord lesions
• pharmaceutical agents
  • alpha-adrenergic receptor antagonists (alpha-blockers)
    • selective alpha-1 blockers (tamsulosin, silodosin) implicated more than less selective agents
  • antipsychotic agents

Pathology

• relaxing the bladder can cause semen to go backwards to the bladder during ejaculation

Clinical manifestations

• absent or intermittent emission of semen, often as a part of an infertility evaluation

Laboratory

• analysis of postmasturbation specimen for spermatozoa

Management

• pharmaceutical agents with modest benefit
  • ephedrine
  • phenylpropanolamine
  • imipramine

More general terms

• ejaculatory dysfunction