If it's not retrograde...what is it?

[q's]

I am happy to see posts regarding the issue of retrograde ejaculation. My husband and I were advised by his urologist to start taking sudafed 30 mg 2-4 hours before intercourse for 3-6 months. After 6 months of trying unsuccesfully, we are seeking the help of a fertility clinic. When getting his semen analysis done (twice) we were informed that it actually isn't retrograde ejaculation after all, but what it is, is still unknown to us. We are now being referred to another urologist to investigate this problem.

When his semen analysis was taken, the technician told us that his urine was clear and there was NO sign of semen/or sperm. Therefore, his ejaculation was not going into his bladder afterall, but where then? Has anyone else experienced this or any other form? Are there any males who can neither ejaculate normally, or through retrograde? She thinks maybe there is a blockage of some kind that is impairing the ejaculate to come out normally, or through his bladder. At this point we are frustrated and sad with the news.

The fertility clinic said that a testicular biopsy might help? Anyone had that done with success and what does it involve? My husband isn't thrilled with the idea of it, but if it helps, we will try anything.

Any advice, suggestions would be so helpful! Thanks so much!

[Martin]

I remember my surgeon telling me at my last post-op meeting that, should the ejaculation not come back, they would (or could) evaluate what is causing it - all sounded pretty much like what you describing.

The semen may go into the bladder, but it's possible that the body is even incapable of doing that and so the semen is not transported out of the testicle at all.

Worst case scenario, I think, is to extract the sperm right from the testicle. Apparently, they have quite a good success rate with that.
Sounds like your doctors still haven't ruled out any other possibilities yet, though, so I'd take it one step at a time and not expect the worst just yet.

I take you he didn't bank any sperm?
(not being thrilled about the idea of a testicle biospy is quite the understatement!!! just the idea makes me cringe ...)

- M

[Scott]

This has been discussed before on the TC-NET mailing list, where it was explained that RPLND can also "interfere with the nerves that control emission (the mixing of sperm with semen). Closing the bladder sphincter won't help with the latter."

[wolken]

well , after RPLND i had no sperm in my urine either ...but this was tested only twice ( due to high acidity in my urine i had no semen , second sample just did no have any semen in it ) ...
After my urologist suggested tofranil ( anis-depressant ) that helps close the bladder neck I’m ejaculating normally . ask your doc about tofranil , maybe it can help you too ...
btw , my wife is now 5 months pregnant ....she got pregnant one month after i started taking tofranil ...
good luck !

[q's]

I had not heard about this medication until now, but it gives me great hope. Did you have any side effects from it? Congrats on your pregnancy! It's always nice to hear the success stories along with the great support!

[wolken]

no side effects at all ! well , i usually take one pill ( 50 mg) which can last up to 3 days ( in my case ) ...so far i havent taken that many pills and cant tell u for sure if there are any side effects !
but check it out with the doc , and i hope that it will work for u too !

[q's]

If you don't mind me asking, how long before you started ejaculating normally? Once it started working, did it continue without the pill or do you need to take it every time? We have an appointment this week and I am definetly going to inquire about Tofranil. Again, thanks so much for the suggestion!

[wolken]

it started working just after taking couple of pills..the pill kicks in after 3-4 hours.unfortunately I'm not back to normal , i have to take a pill every time....
the best way is to take it every 3 days ....
i wish u good luck with ur doc ..and i hope u will be proud parents soon ....