What is aspermia?

Aspermia is the lack of semen, not to be confused with azoospermia, which is the lack of reproductive sperm in the semen. It is one of the causes of male infertility. Aspermia has two main causes: retrograde ejaculation and ejaculatory duct obstruction. Men with aspermia experience the sensation of ejaculation, but no semen leaves the body.

Retrograde ejaculation is a condition in which semen flows into the bladder instead of leaving the body through the urethra. In normal ejaculation, the sphincter at the entrance to the bladder contracts, forcing semen out of the bladder and out the urethra. Therefore, retrograde ejaculation is caused by a malfunction of the bladder sphincter, caused by weak muscles or defects in the nerves that supply the muscles.

Aspermia due to retrograde ejaculation can be caused by complications from surgery to treat prostate or testicular cancer, or from nerve damage caused by disease. Some associated conditions are diabetes, multiple sclerosis, and spinal cord injury. Retrograde ejaculation can also be caused by medications including tamsulosin, used to treat benign prostate tumors, antihypertensives used to treat high blood pressure, and antidepressants and antipsychotics used to treat mood disorders. Sometimes changing medications can reverse the condition. Retrograde ejaculation is not dangerous or life-threatening, although it does cause infertility and can also decrease sexual sensation.

Ejaculation duct obstruction, the other possible cause of aspermia, can be due to congenital cysts in the ejaculatory ducts, or from inflammation caused by inflammation or tuberculosis of the prostate. Chlamydial sexually transmitted infection is another possible cause. In addition to aspermia, ejaculatory duct obstruction can also cause pelvic pain, especially after ejaculation. Blockage of the ejaculatory duct can also cause oligospermia, in which some semen is ejaculated, but less than normal. This condition can be treated surgically through transurethral resection of the ejaculatory ducts (TURED) or by balloon catheterization of the urethra or rectum.

Men with aspermia often have normal numbers of sperm cells and are able to father a child, although the sperm must be harvested and injected into the woman. In retrograde ejaculation, sperm can be collected by passing the patient's urine through a centrifuge to separate the semen, while in men with ejaculatory duct obstruction, sperm must be collected directly from the testicles.

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