From the Guidelines
Seminal discharge after urination is most commonly indicative of retrograde ejaculation, prostatitis, or benign prostatic hyperplasia (BPH), and requires medical attention to determine the underlying cause and appropriate treatment. The symptom of seminal discharge after urination can be associated with various conditions, including:
- Retrograde ejaculation, where semen enters the bladder during orgasm instead of exiting through the urethra 1
- Prostatitis, which is inflammation of the prostate gland, and may be accompanied by pain, urinary frequency, and sometimes fever
- Benign prostatic hyperplasia (BPH), which typically presents with difficulty starting urination, weak stream, and incomplete bladder emptying Other potential causes include urethritis, sexually transmitted infections, or pelvic floor dysfunction. According to the AUA/ASRM guideline (2024), a low volume, acidic pH, azoospermic ejaculate is typically indicative of distal obstruction in the genital tract, such as congenital bilateral absence of the vas deferens (CBAVD) or ejaculatory duct obstruction (EDO) 1. Treatment depends on the underlying cause, and may involve antibiotics, alpha-blockers, or specific interventions for retrograde ejaculation. The NCCN guidelines (2024) also suggest that problems with ejaculation, including climacturia, can be managed with SSRIs, clomipramine, pelvic physical therapy, or testosterone therapy 1. Medical evaluation is essential to determine the underlying cause and appropriate treatment, especially if accompanied by pain, burning during urination, blood in urine or semen, or fever.
From the Research
Indications for Seminal Discharge after Urination
The indications for seminal discharge after urination can be related to various conditions, including:
- Infections of the urogenital tract, such as acute bacterial prostatitis 2 or Chlamydia trachomatis 3
- Inflammatory pathologies, which can cause hematospermia 4
- Obstruction of the seminal tract, which can be caused by infectious processes 5
- Other conditions, such as chronic prostatitis 3 or seminal vesicle dysfunction 6
Possible Causes
Some possible causes of seminal discharge after urination include:
- Bacterial or viral infections, which can lead to deterioration of spermatogenesis, impairment of sperm function, and/or obstruction of the seminal tract 5
- Inflammatory processes in the reproductive tract, which can cause hypofunction of the seminal vesicles and poor sperm motility 6
- Chlamydia trachomatis infection, which can cause chronic prostatitis and other conditions 3
Diagnostic Considerations
Diagnosis of the underlying condition causing seminal discharge after urination may involve:
- Urinalysis and urine cultures to determine the responsible bacteria and its antibiotic sensitivity pattern 2
- Laboratory blood, urine, and semen tests to identify pathological factors 4
- Transrectal ultrasonography, magnetic resonance imaging, urethrocystoscopy, and histological confirmation by biopsy to exclude urogenital malignant disorders 4
- Assessment of the secretory activity of the seminal vesicles and its relationship to sperm motility 6