L’eiaculazione retrograda è una condizione in cui durante l’orgasmo maschile manca la fuoriuscita di sperma o è in quantità minime. Il liquido spermatico è presente, ma invece di risalire lungo il pene, dalla prostata fa un percorso inverso e va a depositarsi nella vescica (diverso da aneiaculazione in cui non vi è questa azione). Non eiaculare non è pericoloso per la salute, ma può avere complicanze sulla sfera sessuale ed emotiva oltre che sulla ferilità. Che fare? Quali cure in questo caso? E come si fa la diagnosi?
Complicazioni
L’eiaculazione retrograda può comportare infertilità maschile ed un disagio sessuale dovuto alla mancanza di eiaculato. Può altresì provocare qualche deficit funzionale e nel piacere laddove la preoccupazione per l’assenza di eiaculato sia particolarmente importante, sia cioè vissuta con forte imbarazzo.
Come si fa la diagnosi?
Altre condizioni di salute possono provocare un orgasmo senza fuoriuscita di liquido spermatico (si parla anche di “orgasmo a secco” o “asciutto”), come anche l’aneiaculazione. Per questo è importante una diagnosi precisa, anche nell’ottica di stabilire una cura efficace, specie se si vogliono avere dei figli. Cosa fare? Il primo step è sicuramente il consulto di uno specialista in andrologia/urologia che possa prescrivere i giusti esami. Sarà utile indicare quando il problema si è posto la prima volta (o se c’è sempre stato), se vi sono altri sintomi correlati, se si soffre di altre patologie, se si assumono farmaci i si sono subiti interventi chirurgici ivi localizzati per tumore o meno. probabilmente sarà necessario anche un esame fisico del pene, dei testicoli, della prostata e del retto.
La raccolta delle urine post -orgasmo servirà poi a stabilire se vi è presenza di sperma. In genere questo test si esegue in un ambulatorio medico dove, è necessaria la masturbazione. Se il risultato sarà positivo si potrà parlare di eiaculazione retrograda, se negativo, ci si indirizzerà verso altro e più precisamente verso una diagnosi di aneiaculazione e dunque un problema con la produzione di sperma. Tale condizione può essere provocata da un danno o anomalia alla prostata o alle ghiandole seminali, dovuto ad un problema fisiologico presente sin dalla nascita, ad un cancro nella zona pelvica o a chirurgia o radioterapia nella stessa area. In tutti i casi sarà necessario stabilire bene le cause determinanti di un orgasmo a secco.
Quali cure?
L’eiaculazione retrograda in genere non richiede alcuna cura specifica a meno che non interferisca con la fertilità e si desiderino dei figli. Il tali casi la cura ovviamente non può prescindere dalla causa scatenante, sottostante al problema. Alcuni farmaci ad esempio sono efficaci in caso di eiaculazione retrograda dovuta ad un danno ai nervi del muscolo della vescica provocati da diabete, sclerosi multipla o alcuni interventi chirurgici: non funzioneranno invece in caso di operazioni che alterano l’anatomia di alcune parti importanti come nel caso della chirurgia del collo vescicale e la resezione transuretrale della prostata.
Se a stimolare l’eiaculazione retrograda sono invece alcuni farmaci che si stanno assumendo (ad esempio quelli per i disturbi dell’umore, gli alfa-bloccanti – che servono per la pressiona alta o altri per la prostata ingrossata) a seconda dei casi potrà essere avviata una modifica terapeutica per questa condizione, con altri medicinali, aggiustamenti nei dosaggi o sospensione laddove possibile. E’ sempre opportuno evitare il fai da te: sospendere di proprio arbitrio un medicinale per l’ipertensione ad esempio, può essere molto pericoloso.
Va detto inoltre che non esistono farmaci specifici per il trattamento dell’eiaculazione retrograda: si utilizzano medicinali che hanno altre indicazioni principali, come i seguenti:
- Imipramina (Tofranil)
- Clorfeniramina e brompheniramine
- L’efedrina, pseudoefedrina e fenilefrina
Questi medicinali sostanzialmente aiutano a mantenere il muscolo del collo vescicale chiuso durante l’eiaculazione (quando è aperto favorisce il reflusso del liquido spermatico all’interno della vescica, dando luogo alla condizione). Chiaramente, pur essendo efficaci allo scopo hanno effetti collaterali, alcuni lievi altri pericolosi, da soli o in combinazione con altri prncipi attivi, come i seguenti:
- Effetti negativi con interazione di altri farmaci
- Aumentano la pressione sanguigna e la frequenza cardiaca (il che non è positivo per chi soffre di ipertensione o malattie cardiovascolari di altro genere)
Per il resto, in caso di profondo disagio nell’atto sessuale a causa dell’orgasmo asciutto può essere utile un trattamento psicoterapico che aiuti ad accettare e a superare il problema.
Infertilità
Un discorso a se stante va fatto in caso di infertilità: se si vuole un figlio e le terapie sopra elencate non producono risultati ottimali in tal senso può essere necessario ricorrere a tecniche di fecondazione assistita.
Il più delle volte gli spermatozoi necessari allo scopo possono essere raccolti nella vescica, mentre in pochi altri casi possono essere necessarie metodiche leggermente più complesse, ma poiché il problema non è nella qualità dello sperma e dunque degli spermatozoi, in genere la fecondazione assitita ha esito positivo molto facilmente.
Leggi anche:
-
Mancata eiaculazione nonostante orgasmo, quali cause ? L’andrologo risponde
-
Eiaculazione precoce rimedi, cure, consigli
-
Aneiaculazione, cause e rimedi
Fonte: Mayo Clinic
Foto: Thinkstock
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