Definition

Retrograde ejaculation occurs when semen enters the bladder instead of emerging through the penis during orgasm. Although you still reach sexual climax, you may ejaculate very little or no semen. This is sometimes called a dry orgasm. Retrograde ejaculation isn't harmful, but it can cause male infertility. Treatment for retrograde ejaculation is generally only needed to restore fertility.

Signs and symptoms

  • Dry orgasms, orgasms in which you ejaculate very little or no semen out of your penis
  • Urine that is cloudy after orgasm (because it contains semen)
  • Inability to get a woman pregnant (male infertility)
Cause

During a male orgasm, a tube called the vas deferens transports sperm to the prostate, where they mix with other fluids to produce liquid semen (ejaculate). The muscle at the opening of the bladder (bladder neck muscle) tightens to prevent ejaculate from entering the bladder as it passes from the prostate into the tube inside the penis (urethra). This is the same muscle that holds urine in your bladder until you urinate. With retrograde ejaculation, the bladder neck muscle doesn't tighten properly. As a result, sperm can enter the bladder instead of being ejected out of your body through the penis.

Several conditions can cause problems with the muscle that closes the bladder during ejaculation. These include:
  • Surgery, such as bladder neck surgery or prostate surgery (transurethral resection of the prostate)
  • Side effect of certain medications used to treat high blood pressure, benign prostatic hyperplasia and mood disorders
  • Nerve damage caused by a medical condition, such as diabetes, multiple sclerosis or a spinal cord injury
  • Retroperitoneal lymph node dissection for testicular cancer
A dry orgasm is the primary sign of retrograde ejaculation. But dry orgasm — the ejaculation of little or no semen — can also be caused by other conditions, including:
  • Surgical removal of the prostate (prostatectomy)
  • Surgical removal of the bladder (cystectomy)
  • Radiation therapy to treat cancer in the pelvic area

The presence of semen in the bladder is harmless. It mixes with the urine and leaves the body with normal urination.