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Forum Name: Male Sexual Disorders

Question: Retrograde ejaculation - whom to consult


 variablebuddy - Fri Oct 23, 2009 10:03 am

Hi,
I am suffering from dry oragsm i.e. no semen or very less semen that too sometimes is ejected after masturbation. I am 25 yrs old. I am not very much clear on which doctor to consult for it. After reading certain posts on internet, I found that I should consult a urologist. Is this correct, should i go for urologist.?
Around 8-9 yrs back I had met with an accident, wherein I was hurt in kidney, for 2 days there was red urine until the bladder was cleaned with distilled water.
Since then only I seem to have this problem.
Please advise.
 Dr.M.jagesh kamath - Fri Oct 23, 2009 9:20 pm

User avatar Hello,The first thing here is to rule out a dry orgasm and differentiate it from retrograde ejaculation.If after a maturbation urine is collected and examined,shows sperm cells it is retrograde.If there are none it is dry.There is no problem here for sex but the problem here is for fertility.Dry orgasm needs to be investigated further because there may be problem of production or conduction.Retrograde ejaculation means the sperms are produced and instead of coming out gets diverted to the bladder.Medications,surgeries relating to the genitourinary tract,spine inuries all can cause retrograde problems.The best person to contact is a urologist.Ok?
 variablebuddy - Thu Oct 29, 2009 8:47 am

Thanks Doc, I consulted a urologist and he has suggested certain tests including Urine test( Pre and Post Masturbation), Blood test and Scanning as well. Will get back with results.
 variablebuddy - Tue Dec 01, 2009 9:26 am

Hi Doctor,
I underwent urine test (pre and post masturbation)and USG Abdomen and Pelvis. The results are below:
USG Abdomen and Plevis
1. Mild diffuse vesical thickening seen.
2. Significant Post void residue volume-92cc.
USG TransRectal region
Prostrate:
Size - 4.5X1.7X4.1 cms volume 17cc
Prostatic Urethra - 2.0 cms(length)
Right - 1.3 cms(height)
Left - 1.7 cms(height)
Right lobe appears slightly smaller than left lobe.

Seminal Vesicles:
Normal in size, shape, echopattern
Right -4.9mm
Left - 6.9 mm

Ejaculatory Ducts - Not dilated
No abnormality in pre masturbation urine test.
In Post masturbation test - Numerous Spermatozoa seen/hpf 10% are Sluggish.

The Doctor whom I am consulting has suggested endoscopy of urethra to confirm whether there is any blockage or not. Is the endoscopy test required?.
Is there a possibility of getting back to normal ejaculation?
Please advice.Thanks
 Dr.M.Aroon kamath - Mon Dec 07, 2009 10:33 am

User avatar Hi,

Retrograde ejaculation can be defined as the 'total' or occasionally 'partial' absence of a normal antegrade ejaculation because semen passes backwards through the bladder neck into the bladder.

As your urinalysis (pre and post ejacualation) & history suggests that there is a strong possibility of a partial retrograde ejaculation and the USG has shown a significant residual volume (post-void residue).

Urinary bladder out-flow obstruction is a known cause of retrograde ejaculation.One is led to think of this in the abscence of neurologic causes and pharmacologic causes.

Some of the causes of urethral obstruction are...
- Urethral stricture,
- Urethral obstruction
- Urethral valves or verumontanum hyperplasia and
- Ectopic ureterocele.

your doctor was right in suggesting an endoscopy to exclude/treat one of these causes.
Best wishes!

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