Dr. Luc Valiquette explains: Retrograde ejaculation is the passage of semen backwards into the bladder rather than out of the body through the urethra and penis, possibly due to damage to the urinary sphincter that keeps the opening to the bladder tightly closed. When this happens, less or no semen comes out the tip of the penis, but men can still experience orgasm (this is called a dry climax).
While some types of prostate surgery (e.g. TURP) can cause this phenomenon, there is no retrograde ejaculation after prostate cancer surgery (radical prostatectomy), because there is no sperm left to expel. The surgery removes both the prostate and the seminal vesicles (two small structures at the base of the bladder) — together, these organs provide semen that carries the sperm through the urethra and out the penis during ejaculation. The vas deferens (the main duct through which sperm is carried from the testicles to the ejaculatory duct) is cut at the prostate level. A man will continue to have a sensation of ejaculation as the bulbocavernous muscles (muscles of the perineum involved in erection, ejaculation and feelings of orgasm) contract rhythmically during orgasm.
There is no harm associated with this absence of sperm other than infertility, but there is no way to correct it. Since most prostate cancer patients are aged 50 or over, this condition is rarely a concern. Younger men who want to remain fertile can preserve their sperm at a sperm bank for future use — obviously, this has to be done before surgery.
