Differential Diagnosis for Sudden Watery Semen

• Single most likely diagnosis
  • Retrograde ejaculation: This condition occurs when semen enters the bladder instead of the urethra during ejaculation, resulting in a sudden change to watery semen. It is often associated with diabetes, surgery, or certain medications.
• Other Likely diagnoses
  • Low sperm count (Oligospermia): A decrease in sperm concentration can lead to watery semen.
  • Hypogonadism: A condition where the testes do not produce enough testosterone, potentially affecting semen quality.
  • Infections (e.g., prostatitis, epididymitis): Inflammation of the prostate or epididymis can alter semen consistency.
  • Medications (e.g., alpha-blockers, antidepressants): Certain medications can affect ejaculation and semen quality.
• Do Not Miss
  • Testicular cancer: Although rare, testicular cancer can cause changes in semen consistency. It is crucial to rule out this potentially life-threatening condition.
  • Neurological disorders (e.g., multiple sclerosis, spinal cord injuries): Conditions affecting the nervous system can disrupt normal ejaculation and semen quality.
• Rare diagnoses
  • Ejaculatory duct obstruction: A blockage in the ejaculatory ducts can prevent semen from mixing with other fluids, resulting in watery semen.
  • Seminal vesicle dysfunction: Problems with the seminal vesicles, which produce a significant portion of the fluid in semen, can lead to changes in semen consistency.
  • Hormonal imbalances (e.g., hyperthyroidism, hypothyroidism): Certain hormonal disorders can affect semen quality and consistency.