Retrograde Ejaculation

Prevention

There now are innovative, minimally invasive forms of prostate surgery for enlarged prostates (not cancer) that may cause less retrograde ejaculation than the standard procedures. These newer procedures, such as transurethral needle ablation of the prostate (TUNA) and transurethral microwave thermotherapy (TUMT), are among several being evaluated by the U.S. National Institutes of Health for their success rate and side effects. Even if these procedures cause fewer cases of retrograde ejaculation, however, they may not be appropriate for all patients.

Treatment

Most men who have retrograde ejaculation do not need specific treatment. If the condition is a side effect of medication, your doctor may be able to switch you to a different drug that does not cause the problem. In other men, all that is needed is reassurance that retrograde ejaculation is not a serious medical problem and that it is not a sign of a serious condition such as cancer.

In some men, retrograde ejaculation requires treatment because it interferes with fertility. This treatment varies depending on the cause. If your retrograde ejaculation is a side effect of medication, your doctor probably will switch you to a drug that does not affect ejaculation. If your retrograde ejaculation appears to be related to a mild nerve or muscle problem involving the bladder, then your doctor will treat you with a drug - such as pseudoephedrine (sold under many brand names) or imipramine (Tofranil) - that improves muscle tone at the bladder entrance.

If your retrograde ejaculation is the result of severe damage to the nerves or muscles of your bladder, then it may not be possible to restore normal ejaculation. If this is the case, and you are hoping to father a child, a fertility specialist may be able to help. The fertility specialist may collect sperm from your urine and use washed sperm for an assisted-fertilization procedure. In cases of retrograde ejaculation, three of the most commonly used assisted fertilization procedures are:

• Intrauterine insemination (using a small catheter to put washed sperm inside your partner's uterus at the time of ovulation)

• In-vitro fertilization (incubating eggs and sperm together in the laboratory to produce fertilization)

• Intracytoplasmic sperm injection (injecting a single sperm into your partner's egg to cause fertilization)