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Retrograde Ejaculation

Retrograde ejaculation can be a significant side effect

Because of the large proportion of the male population that is affected by an enlarged prostate, many men will have to undergo some form of surgery or an alternative procedure to address urinary symptoms. One of the most common and inevitable outcomes of most of these procedures is permanent dry ejaculation, also known as retrograde ejaculation. Unfortunately, most of the official publications regarding prostate surgeries do not highlight retrograde ejaculation as a significant side effect because it is not harmful to the patient. Nevertheless, many men find it undesirable for a variety of physical or psychological reasons.

What is normal ejaculation?

Normal ejaculation is a complex process. In the first part, all of the organs that contribute to ejaculate will release their contents into the urethra. First, the neck of the bladder closes, and fluid from the prostate and sperm from the vas deferens starts filling the urethra. The vas deferens is a long tube that hold and transports sperm from the testicle to the urethra. Next, the seminal vesicles release fluid into the ejaculatory duct and the urethra.

In a normal setting, all of these contents will mix within the urethra and will be released during an orgasm. Following prostatectomy or one of the types of transurethral resections of the prostate, the normal anatomy of the bladder neck is knowingly altered to improve the flow of urine out of the bladder. The consequence of this is that ejaculate will flow backwards into the bladder, as that is now the path of least resistance. While there is technically nothing dangerous about this, it does have some consequences.

What is retrograde ejaculation?

First, retrograde ejaculation is a serious issue for men who still want to preserve fertility. While they still produce sperm, advanced techniques by a fertility specialist will be needed to harvest sperm. In these instances, selecting a treatment for enlarged prostate symptoms that does not cause retrograde ejaculation is important. Next, there are published papers and anecdotal accounts that men who suffer from retrograde ejaculation may derive less pleasure than they would have otherwise from an orgasm. The studies cite that more fluid distension of the urethra during ejaculation correlates with more pleasure.

In summary, many men are unaware or feel misled about this side effect of most prostate surgeries. If you are considering a treatment that has almost no risk of causing retrograde ejaculation, such as prostate artery embolization (PAE), please reach out to us today to schedule a consultation.

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