Retrograde Ejaculation
Advice: A common problem after some urological operations, and certain medical treatments. It results in infertility, which can be managed. RE itself is difficult to treat, but can be distressing; please refer if your patient is troubled.
Refer To: Urologist.
Definition:
Retrograde ejaculation is common after bladder neck surgery, which includes TURP, and other BPH procedures. It also occurs with alpha-blocker treatment, but should resolve some time after cessation of treatment. Occasionally, retroperitoneal or pelvic surgery will result in irreversible RE.
Diagnosis:
As mentioned, RE results in infertility, which can be addressed by a reproductive specialist. However, before treatment is started, documentation of the diagnosis is required with a post-‘ejaculation’ urine sample for microscopy to look for sperm.
Treatment of retrograde ejaculation:
Alpha-blockers can be stopped, but other treatment may need to be commenced for lower urinary tract symptoms.
Alpha-agonists have been used in some patients, but great care is required.
Referral:
- Urologist for consideration of treatments
- Reproductive specialist for fertility issues
