Patient's question:
A year ago, I had a prostate cyst resection. After the surgery, I found that there was no semen discharge during intercourse or masturbation, and I felt left lower abdominal distension and pain. When I urinated, I noticed white cloudy liquid being excreted with the urine, and the abdominal distension and pain also subsided immediately! When I visited the doctor after a year of marriage without conception, I was diagnosed with retrograde ejaculation!Doctor's answer:
Retrograde ejaculation refers to a condition where a man has normal penile erection, normal sexual intercourse, reaches sexual climax, and has the action and sensation of ejaculation, but no semen is expelled from the urethra, instead it is retrogressively injected into the bladder. There are two main causes of retrograde ejaculation: one is the paralysis or weakness of the bladder neck, and the other is increased resistance in the membranous part of the urethra, such as severe traumatic urethral stricture or inflammatory urethral stricture. Retrograde ejaculation primarily occurs due to various reasons leading to dysfunction of the bladder neck sphincter, where the urethral orifice fails to close during ejaculation, causing semen to retrogress from the posterior urethra into the bladder. Common causes include:① Prostate surgery or transurethral resection of the bladder neck obstruction that damages the muscles and elastic fibers of the bladder neck, leading to relaxation of the bladder neck and causing retrograde ejaculation. Additionally, sympathectomy of the thoracolumbar region, pelvic surgery, and spinal cord injury can also result in loss of bladder neck function, causing retrograde ejaculation.
② Diabetes-related sympathetic nerve lesions, severe urethral stricture, bladder stones, cystitis, urethritis, and other conditions can also lead to retrograde ejaculation.
③ Long-term use of drugs that block sympathetic nerve function, such as guanethidine, reserpine, methyldopa hydrochloride, bencyclan, and phenformin, can cause retrograde ejaculation.
④ In rare cases, congenital anomalies such as spina bifida, congenital urethral valves, bladder diverticula, and bladder neck contracture can also result in retrograde ejaculation.