Brief Answer:
Seems to be a case of reverse ejaculation. Please see details and follow!!!

Detailed Answer:
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I have completely reviewed your health query, and well realize all those concerns. Being your physician, I will take care all of them today and will extend my expertise to solve the problems.


This is usually called dry orgasm. It is mostly considered as to be the first sign of a medical illness named 'RETROGRADE EJACULATION'. In this disease there is no ejection of the sperms from urethra, rather they go back into the urinary bladder.


Cause of the issue:-
There is a muscle at the neck of the bladder that holds the urine until you actually go to urinate in the restroom. This is the same muscle which contracts and holds tight the neck of bladder at the time of orgasm so that seminal fluid (sperms and secretions) are not entered the bladder. In this way semen comes out from the tip of penis normally.
If this bladder neck muscle is damaged somehow, there is no semen at climax. Rather semen goes into the bladder.

Why does all of this happens in some:-
Multiple sclerosis disease, spinal cord injury and surgery, High blood pressure and diabetes mellitus causes it. Nerves supplying this muscle are damaged actually.
Blood pressure medication (Losartan causes very rarely this problem though).
Bladder surgery; Prostate surgery.
Cancer of the pelvic areas and radiotherapy treatment received for the same.

Diagnosis is based on history, thorough physical examination and Urinalysis for presence of sperms after getting masturbated in doctor office and collecting the sample of urine thereafter.

Treatment may include:-
I usually diagnose such cases while screening and doing a workup for infertility in my patients. And I usually treat Dry Orgasm by using drugs like Imipramine, chlorpheniramine, Ephedrine, Phenylephrine. (don't try any drugs without asking your Physician.

Final suggestion:-
This was just a roadmap to solve your issue. Please spare some time and make an appointment with a Urologist for thorough evaluation and treatment accordingly.

Hope I answered all of your queries. Let me know if you have further clinical concerns or doubts. I will be more than happy to get back to you. Please don't forget to give 'Five star rating' (if agreed) to help me assist patients in a better way; and, please don't forget to click on 'Close This Discussion'.
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Regards!
DR. HANIF
USA

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