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February 27, 1967


JAMA. 1967;199(9):661-662. doi:10.1001/jama.1967.03120090103024

In the past, retrograde ejaculation of seminal fluid into the urinary bladder was a secret known to a few contraceptively motivated members of the oldest profession, who were able to bring it about in their patrons by a skilled rectal maneuver. Without the benefit of this assistance, retrograde flow of semen is now known to occur under a variety of circumstances. It has been observed after transurethral prostatectomy, bilateral surgical sympathectomy for hypertension, and administration of sympatholytic drugs. It has also been reported recently in cases of diabetes complicated by neuropathy.

The mechanism of retrograde ejaculation, when surgical excision of bladder neck muscles (as in transurethral resection) is not involved, is neurogenic. The normal process of ejaculation, which follows emission of semen from internal genital organs into the posterior urethra, begins with reflex closure of the internal vesical sphincter. This closure prevents seminal fluid from entering the bladder and permits