Retrograde Ejaculation & Prostate Cancer
A few weeks ago, I was talking with the director of ProstateCancer.net and he sent me a question from a community member about male orgasm after prostate cancer (PC) surgery and treatments. The question was different because it was related to painful orgasms and “retrograde orgasms.”
After a bit of research, I discovered a trend in the information related to prostate cancer and Retrograde Ejaculation (RE). Depending on what treatments the men had, they reported less semen during their orgasms. Then, once you learn that RE is related to one, single muscle in the prostate gland, I’m surprised it doesn't appear more often. Let's get into it.
What is retrograde ejaculation?
During male orgasm and ejaculation, tubes called the vas deferens transports the sperm to the prostate gland, where additional fluids are added. A small muscle at the neck of the bladder contracts (called a urinary sphincter muscle) to keep the ejaculate from entering the bladder as the semen passes through the prostate. Keep in mind this is the same muscle that works to keep urine in the bladder until you use the bathroom.
When you experience retrograde ejaculation, the ‘bladder muscle’ does not close the way it should. Because of this, semen now can flow backward and enter the bladder instead of leaving your body as it would during ejaculation.
What causes it?
There are many conditions that can cause a man to experience retrograde ejaculation. The ‘bladder muscle’ can be affected by:
Especially having surgery on your bladder, lymph node surgery for testicular cancer or surgery on the prostate (i.e. Transurethral resection of the prostate). It is possible the surgeon may accidentally damage the bladder muscle. If the muscle is damaged, it may not close as tightly as it used to, leaving the semen to take the path of least resistance into the bladder.1
Some of the side effects of medications used to treat high blood pressure, prostate enlargement and depression could cause retrograde ejaculation.
To continue, a “dry orgasm” is the main sign of a retrograde ejaculation. Be mindful that a “dry orgasm” – the ejaculation of little to no semen – can also appear due to other conditions, like:
- Surgical removal of the prostate
- Surgical removal of the bladder
- Radiation therapy to treat cancer in the pelvic area2.
What can you do?
Most men who are experiencing retrograde ejaculation do not need a specific treatment. For example, if RE is caused by a medication, ask your doctor to move you to a different medication. Experiencing RE can be a shock to the system. Keep in mind that it is not a serious medical condition. It can be momentarily painful when it happens, feeling like a sharp stabbing pain, but only lasts a second.
Most men do not experience pain with RE. Repeated retrograde ejaculation, however, can lead to a bladder infection, which itself can be painful. Retrograde ejaculation can interfere with a man's fertility. In this case, I highly recommend having a conversation with your doctor regarding RE, infertility and the possible solutions to this issue.
If the muscles or nerves of the bladder are damaged due to surgery or another issue, unfortunately, it may never be possible to have normal ejaculations. With the assistance of a fertility specialist, you may be able to father a child. The fertility specialist may be able to collect sperm from your urine and use the ‘washed sperm’ in an assisted-fertilization procedure.3
Talk to a specialist for more guidance
As I bring this article to a close, I’d like to restate that retrograde ejaculation can be caused by many issues and for the most part, it is not a serious problem except for causing some discomfort. At the same time, if you are interested in becoming a father who is experiencing RE, all is not lost. Speaking to the right specialist can put you on your way to becoming a father. With all of that said, if you suspect you are dealing with RE, please contact your doctor and let him/her know what you are experiencing.
Which prostate cancer treatment did you first receive?