Retrograde Ejaculation Treatment in Singapore

Retrograde ejaculation can be a distressing condition that affects both fertility and sexual satisfaction. If you’re experiencing dry orgasms or reduced ejaculate volume, you’re not alone. Our MOH-accredited urology specialist in Singapore understands the sensitive nature of this condition and provides discreet, comprehensive care. With various treatment options available, from medications to specialised procedures, we can help you address this condition effectively and restore your confidence.

Causes

The primary cause of retrograde ejaculation is dysfunction of the bladder neck muscles. During normal ejaculation, these muscles close to prevent semen from entering the bladder. When this mechanism fails, semen takes the path of least resistance into the bladder. Common underlying causes include:

• Nerve damage from diabetes or multiple sclerosis
• Surgical complications from prostate or bladder procedures
• Spinal cord injuries affecting nerve function
• Congenital abnormalities of the urinary system

Risk Factors

Several factors increase your likelihood of developing retrograde ejaculation:

• Diabetes mellitus (particularly with poor blood sugar control)
• Previous prostate surgery (TURP, prostatectomy)
• Taking alpha-blocker medications for prostate enlargement
• History of bladder neck surgery
• Spinal cord injuries or disorders
• Age (muscle tone naturally decreases)
• Certain antidepressants and antipsychotic medications

Primary Symptoms

• Little to no semen during ejaculation
• Cloudy urine after sexual activity (contains semen)
• Normal orgasm sensation without fluid release
• Inability to impregnate partner despite regular intercourse

Associated Symptoms

• Reduced intensity of orgasm in some cases
• Psychological distress or relationship concerns
• Fertility issues when trying to conceive

When Symptoms Occur

• Consistently during every ejaculation
• May worsen with certain positions or activities
• Often noticed first when trying to conceive

Retrograde ejaculation symptoms typically develop gradually, especially when caused by diabetes or medications. Men often notice the condition when attempting to father children or when partners express concern about the absence of ejaculate.

Experiencing these symptoms? Don’t wait for them to worsen.
Schedule a consultation with our MOH-accredited urologist for an accurate diagnosis and personalised treatment plan.

You should consult a urologist if you experience dry orgasms consistently or notice a significant reduction in ejaculate volume. Immediate medical attention is particularly important if you’re trying to conceive, as retrograde ejaculation is a treatable cause of male infertility. Red flag symptoms requiring prompt evaluation include blood in urine after intercourse, painful orgasms, or sudden onset of symptoms following new medications.

During your first consultation, expect a thorough medical history review and physical examination. Our urologist will discuss your symptoms sensitively and may recommend specific tests. Early intervention often leads to more successful treatment outcomes, particularly for medication-induced cases where simple adjustments can restore normal function.

Accurate diagnosis begins with a detailed medical history focusing on the onset and progression of symptoms. Our urologist will review your medications, surgical history, and any underlying health conditions. A physical examination includes assessment of the genital area and neurological function.

The definitive diagnostic test is a post-ejaculatory urinalysis. You’ll be asked to provide a urine sample immediately after orgasm. The presence of sperm in the urine confirms retrograde ejaculation. Additional tests may include fructose testing (seminal fluid contains fructose), ultrasound imaging to check for anatomical abnormalities, and specialised urodynamic studies to assess bladder neck function. Results are typically available within 24-48 hours for basic tests.

Medications

For retrograde ejaculation caused by nerve damage or mild bladder neck dysfunction, medications can help restore normal ejaculation. Sympathomimetic drugs like pseudoephedrine or imipramine work by tightening the bladder neck muscles during orgasm. These medications are taken before sexual activity and can be effective in 30-40% of cases. Treatment duration varies but typically involves a trial period of 2-4 weeks to assess effectiveness.

Medication Adjustment

When retrograde ejaculation results from current medications, particularly alpha-blockers for prostate enlargement, our urologist may recommend switching to alternative drugs. Tamsulosin, commonly prescribed for BPH, frequently causes retrograde ejaculation. Switching to medications like tadalafil or adjusting dosages can restore normal function while maintaining prostate symptom control. This approach requires careful monitoring over 4-6 weeks.

Sperm Retrieval Techniques

For couples trying to conceive, specialised sperm retrieval methods can overcome fertility challenges from retrograde ejaculation. Post-ejaculatory urine is collected and processed in a laboratory to extract viable sperm. The retrieved sperm can be used for intrauterine insemination (IUI) or in-vitro fertilisation (IVF). Success rates depend on sperm quality and female partner factors.

Vibrator Therapy

Penile vibratory stimulation uses specialised medical vibrators to trigger ejaculation through enhanced nerve stimulation. This technique is particularly useful for men with spinal cord injuries or neurological conditions. The intense stimulation can sometimes overcome the faulty bladder neck closure. Sessions are conducted in clinical settings initially, with home devices available for successful responders.

Bladder Neck Reconstruction

In rare cases where anatomical defects cause retrograde ejaculation, surgical reconstruction of the bladder neck may be considered. This procedure is typically reserved for congenital abnormalities or severe post-surgical complications. The surgery aims to restore the natural closing mechanism of the bladder neck during ejaculation.

Every patient’s condition is unique. Our MOH-accredited urologist will assess your specific situation and recommend the most suitable treatment approach for you.

While retrograde ejaculation itself doesn’t pose direct health risks, leaving it untreated can lead to significant quality of life issues. The primary complication is male infertility, which becomes permanent without intervention. Couples may face years of unsuccessful conception attempts, leading to relationship stress and financial burden from unnecessary fertility treatments.

Psychological complications often develop over time. Men may experience reduced sexual satisfaction, performance anxiety, and relationship difficulties. Some avoid intimate relationships due to embarrassment. The constant worry about the condition can lead to depression and decreased self-esteem. Partners may also experience distress, wondering if they’re the cause of the problem.