Retrograde ejaculation occurs when the semen, which will, in most cases, ejaculate through the urethra, is transferred to the bladder. Usually, the sphincter from the bladder contracts before ejaculation forces the semen out through the urethra, the least resistant pathway. When the bladder sphincter is not functioning properly, retrograde ejaculation may occur. It can also be caused by males as a primitive form of male birth control (known as coitus saxonicus ) or as part of certain alternative treatment practices.
Video Retrograde ejaculation
Signs and symptoms
Retrograde ejaculation is sometimes referred to as "dry orgasm." Retrograde ejaculation is one of the causes of male infertility. Men often pay attention during masturbation that they have no release of semen but there is an orgasm. Another underlying cause for this phenomenon may be duct obstruction of ejaculation.
During a male orgasm, the sperm is released from the epididymis and runs through a small tube called the vas deferens. The sperm mixture with seminal fluid in the seminal vesicles, prostate fluid from the prostate gland, and the lubricant of the bulbourethral gland. During the climax, the muscles at the tip of the bladder neck tighten to prevent retrograde flow of semen. In retrograde ejaculation, the muscles of the bladder neck are very weak or the nerves that control the muscle have been damaged.
Maps Retrograde ejaculation
Cause
A malfunctioning bladder sphincter, leading to retrograde ejaculation, may result:
- Dysfunction of the autonomic nervous system. (Dysautonomia)
- Surgery on the prostate. This is a common complication of transurethral resection of the prostate, a procedure in which the prostate tissue is removed, sliced ​​by a wedge, through a resectoscope passed through the urethra.
It can also be caused by retroperitoneal lymph node dissection for testicular cancer if the neural pathway to the bladder sphincter is damaged, with retrograde ejaculation produced either temporarily or permanently. Modern neural frugal techniques seek to reduce this risk; However, it can also occur as a result of the Green Light Laser prostate surgery. Surgery on the bladder neck accounts for about ten percent of cases of retrograde or anejaculation ejaculation reported in the literature review.
Retrograde ejaculation is a common side effect of drugs, such as tamsulosin, which is used to relax the muscles of the urinary tract, treating conditions such as benign prostatic hyperplasia. By relaxing the muscles of the bladder sphincter, the chances of retrograde ejaculation increase.
Drugs that mostly cause it are antidepressants and antipsychotics, and NRIs such as atomoxetine; patients who experience this phenomenon tend to stop using drugs.
Retrograde ejaculation can also be a complication of diabetes, especially in the case of diabetics with poor long-term blood sugar control. This is because of neuropathy in the bladder sphincter. Post-puberty men (aged 17 to 20 years) who experience recurrent episodes of retrograde ejaculation are often diagnosed with urethral stricture disease as soon as the initial complaints arise. It is not currently known whether congenital malformation from the urethral stem is responsible, or if the pressure applied to the base of the penis or perineum immediately before inevitable ejaculation may inadvertently damage the urethra. This damage is most often seen within 0.5 cm of the ejaculatory duct (usually distal ductus).
Retrograde ejaculation can also result from pinching the opening of the urethra opening, to avoid creating chaos in ejaculation (known as Hughes' technique).
Conditions that can affect bladder neck muscles
Drugs for treating high blood pressure, benign prostate hyperplasia, mood disorders, surgery on the prostate and nerve injury (which can occur in multiple sclerosis, spinal cord injury or diabetes).
Diagnosis
The diagnosis is usually by way of urinalysis done on a urine specimen obtained immediately after ejaculation. In the case of retrograde ejaculation, the specimen will contain an abnormal level of sperm.
Especially in the case of angiaculation orgasm, anejaculation can often be confused with retrograde ejaculation, and they share some of the fundamental aspects of the cause. Urinalysis is used to distinguish both.
Testing
A genital examination of the genitals is applied to ensure that there is no anatomical problem. Urine will be checked for the presence of semen. If there is no sperm in the urine, it may be due to damage to the prostate as a result of previous surgery or radiation therapy.
Treatment
Treatment depends on the cause. Drugs can work for retrograde ejaculation but only in some cases. Surgery is rarely the first choice for retrograde ejaculation and the results have proved inconsistent. Drugs do not help to decrease ejaculation if there is permanent damage to the prostate or testes from radiation. Drugs also do not help if prostate surgery has resulted in damage to the muscles or nerves. Drugs only work if there is mild nerve damage caused by diabetes, multiple sclerosis or minor spinal cord injuries.
Drugs
- Tricyclic antidepressants such as imipramine.
- Antihistamines like chlorphenamine.
- Decongestants such as ephedrine and phenylephrine.
These drugs tighten the muscles of the bladder neck and prevent semen from entering the bladder. However, drugs do have many side effects and they should be taken at least 1-2 hours before intercourse. In many cases, drugs fail to work at the right time because most men can not predict when they will have an orgasm.
Infertility treatments
If couples experience infertility due to retrograde ejaculation and unhelpful drugs, male ejaculation may be centrifuged from lost urine immediately after coitus, and isolated sperm are directly injected into women through the use of intrauterine insemination. In more severe cases, in vitro fertilization with intracytoplasmic sperm injection may be used.
Accidental induction
Taoism
The Daoists and some alternative medicine fields recommend and teach deliberate retrograde ejaculation as a way of "saving body energy". One way to achieve this is to apply pressure to the perineum during orgasm. It is believed that doing this causes the sperm to walk to the head and nourish the brain, or it is preserved physically by keeping the sperm (and thus, the "intelligence" that creates it) in the body. This approach has since been discredited by modern medicine, because retrograde sperm-ejaculation actually enters the bladder and is only lost in the next urination. However, there is another Taoist perspective on the general problem of ejaculation and techniques that do not involve retrograde ejaculation (see Tao sexual practices).
Contraception
In certain cultures, deliberately inducing retrograde ejaculation by pressing the urethra at the base or applying pressure to the perineum is performed as a form of primitive male birth control ( coitus saxonicus ). An example is the Oneida Community practice. However, it is not considered a reliable method when compared to the most modern types of birth control. In addition to the general risk of pregnancy from pre-ejaculation and lack of protection from PMS, the technique itself can be difficult to do properly during coitus action, especially if men do not fully understand the anatomy involved.
Many doctors also do not recommend coitus saxonicus because of the risk of pressure on the pudendal nerve, which can cause numbness to the penis.
See also
- Aspermia
- ejaculatory channel obstruction
- Hypospermia
- Spermaturia
Note
External links
- https://web.archive.org/web/20040602100023/http://www2.rz.hu-berlin.de/sexology/ECE1/retrograde.html
- Sexual Medicine Society of North America Sites: SexHealthMatters.org
Source of the article : Wikipedia
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