Why doesn't sperm leak out?

If there is something wrong with sperm, it cannot be ignored. After all, it determines whether the male's sexual function is normal and whether the reproductive organs are healthy. If there is something wrong with sperm, it can be caused by many reasons. Especially if you feel that the sperm cannot flow out after ejaculation, you should pay attention to it. It may be caused by congenital defects of the reproductive organs, which will make the treatment complicated.

1. Anatomical abnormalities

1. Congenital defect of the vas deferens

Among male infertility patients, 1% have unilateral or bilateral vas deferens defect. Vas deferens defect is usually a congenital abnormality and is often accompanied by unilateral renal dysplasia. This malformation often coexists with undetected cystic fibrosis, so it is very important to conduct genetic analysis before artificial insemination with epididymal sperm retrieval.

2. Vascular occlusion

Patients with ejaculation disorders caused by typical vas occlusion often present with low semen volume (<1.0mL) as their main complaint. Although there is no abnormality in the testicles and endocrine system of such patients, urine tests after induced ejaculation show no sperm. Patients with incomplete vas occlusion may have low semen volume or oligostenospermia. This lesion may also be secondary to congenital cystic prostate (prostateutricle), or acquired prostatitis and mechanical damage to the prostatic urethra. Transrectal ultrasound examination and vasography can help with diagnosis.

3. Urinary abnormalities

Congenital or acquired urethral abnormalities can cause ejaculation disorders. For example, severe hypospadias, epispadias, and bladder exstrophy can cause ejaculatory duct deformity or retrograde ejaculation, or both. Y-U urethroplasty, transurethral prostate or bladder tumor resection can cause retrograde ejaculation, or urethral damage and stenosis, and cause ejaculation disorders or ejaculation pain.

2. Neurological Causes

Wide-range retroperitoneal lymph node dissection (RLND) for testicular tumors or rectal resection for malignant tumors can damage the celiac nerve and cause ejaculatory disorders. Recently, due to improved surgical methods, 80% of patients who undergo RLND can preserve their sexual function.

2. Spinal cord injury

Although the extent of spinal cord injury varies depending on the site of injury, 80% to 97% of patients lose erectile function and ejaculation ability. Among patients with incomplete spinal cord injury, about 50% retain sexual function.

3. Diabetes and other nervous system diseases

Diabetic neuropathy includes somatic, peripheral and autonomic neuropathy. Among diabetic patients, the incidence of erectile dysfunction is 50%, and the incidence of spermatorrhea or ejaculation disorders is 32%. The frequency of retrograde ejaculation is also high. Systemic neuropathy such as Parkinson's disease and multiple sclerosis can also cause ejaculation disorders, and are often accompanied by erectile dysfunction.