Retrograde Ejaculation Possible Complication of Diabetes, Certain Medications, Surgical Procedures

Retrograde Ejaculation Possible Complication of Diabetes, Certain Medications, Surgical ProceduresRetrograde ejaculation occurs when semen enters the bladder, rather than exiting the body via the urethra during ejaculation.  Retrograde ejaculation can be caused by a number of medical conditions, drugs, and even certain types of medical procedures, including spine surgeries that involve the use of bone growth proteins.

Retrograde Ejaculation Symptoms
Under normal circumstances, the sphincter of the bladder contracts before ejaculation, forcing the semen to exit via the urethra.  But when the bladder sphincter does not function properly, retrograde ejaculation – also known as “dry orgasm” – can occur. The primary symptoms of retrograde ejaculation include:

  • Little or no semen discharged from the urethra in conjunction ejaculation
  • Possible infertility
  • Cloudy urine after sexual climax


Risk Factors for Retrograde Ejaculation
Risk factors for retrograde ejaculation include:

  • Diabetes
  • Certain drugs, including those used to treat high blood pressure and some antidepressants
  •  Surgery to the prostate or urethra
  • Spinal fusion surgery

Treatment and Diagnosis of Retrograde Ejaculation
Retrograde ejaculation is generally diagnosed via a urinalysis taken shortly after ejaculation that shows a large amount of sperm in the urine. Retrograde ejaculation generally does not need to be treated, unless a man is trying to father a child.  In most cases, a doctor will advise that a patient discontinue taking certain medications if a drug is suspected of causing retrograde ejaculation.  In cases where diabetes or surgical procedures are the culprits, medications such as pseudoephedrine or imipramine may be helpful.  However, retrograde ejaculation associated with these causes is often not correctable.

Medtronic Infuse Bone Growth Protein and Retrograde Ejaculation
For men, a possible side-effect of spinal fusion surgery is retrograde ejaculation.   Recently, research has linked Medtronic Inc’s Infuse Bone Graft product, a bone protein used in spinal fusion surgery, with this often-devastating complication. Last May, a team of researchers from Stanford University reported that recombinant human bone morphogenetic protein-2, or BMP-2 (the bone growth protein contained in Infuse) was associated was a measurable rate of retrograde ejaculation. Their study, published in the Spine Journal, looked at 243 of the researchers’ own patients who had undergone spinal fusion surgery between 2002 and 2004 after Infuse was approved.  They found that retrograde ejaculation occurred in more than 7 percent of the male patients treated with BMP-2, compared with less than 1% of those who received a standard bone graft.

Medtronic has faced charges that it downplayed the rate of some serious side effects, including retrograde ejaculation, in some of its sponsored research for Infuse.  For example, the complication rate reported by the Stanford researchers was similar to the rate found in the unpublished clinical trial data Medtronic submitted to federal regulators to obtain approval for Infuse.  But retrograde ejaculation was never listed as a possible side effect in at least four published papers authored by BMP-2 investigators who had financial ties to Medtronic, according to an investigative report published jointly last year by the Milwaukee Journal Sentinel and MedPage Today. In two of the four papers the retrograde ejaculation was mentioned but was attributed to surgical technique.

Dr. Ken Burkus, a Columbus, Ga. surgeon who co-authored four of the papers, maintained that the link between BMP-2 and the complication was not mentioned in the papers because it was not deemed to be “statistically significant,” according to the Journal Sentinel/MedPage report.  However, the investigation cast doubt on his explanation, with the Journal Sentinel and MedPage reporting that the original data provided to the U.S. Food & Drug Administration stated that retrograde ejaculation rates were at least five times greater in the BMP-2 patients.

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