Semen In Urine: Causes and Treatment

Semen is a whitish fluid that contains seminal fluid and sperm, while urine is a liquid waste material that is often yellow or clear and produced in and excreted by the body. 

However, there can be a mix-up with semen in urine since the male urethra is a shared passage of urine and semen. 

Overall the function of the male urethra is to allow the passage of urine and semen. 

This conduit connects to the urinary system’s distal portions, including the urinary bladder, and links it to the external environment, permitting urine excretion from the body.

In the male reproductive system, when ejaculation occurs, sperm is forcefully expelled from the tail of the epididymis. 

It then enters a series of tubes, of which the first is the deferent duct. Next, sperm travels up to the spermatic cord into the pelvic cavity. 

The next tube is the part of the urethra connected to the prostate behind the bladder. This location is where ejaculate fluid from the seminal vesicle flows to form semen. 

Typically, urine is cleared before ejaculation by pre-ejaculate fluid or Cowper’s fluid produced by a special gland. 

Women use their urethra only for urinating, while men use their urethra for both urination and ejaculation.                                                                                                                                                                    

How can you tell if sperm is in your urine?

Semen is generally released from the penis when a man ejaculates, and it is possible to experience semen leakage at other times, such as urinating or sleeping. 

So, it is possible to detect semen in urine since both fluids share a common conduit or exit. Hence, it is not uncommon for sperm to be present in urine, especially if a man has recently ejaculated. 

There are a few ways to tell if sperm is in your urine: 

  • To check if there is sperm in your urine, you can try a pH test of the urine. If the results of the pH test are more alkaline, it indicates that there’s sperm since urine on its own is more acidic.
  • Look for any cloudy or semen-like discharge in the urine since sperm leakage after urination may cause the urine to appear cloudy. If you notice that, then presumably, sperm is present. But not all white substances in a man’s urine are inevitably semen; urine can be affected by regular diet, exercise, and kidney function.
  • Look for any sperm in a urine sample under a microscope; you might be able to detect some. 

Pre-cum vs urine and sperm

Note that pre-ejaculate or pre-cum differs from both urine and semen. Precum is often a clear, colorless, and viscous fluid that also passes from the urethra of the penis during sexual arousal. 

Although it is similar in composition to semen, it has different chemical properties. Pre-ejaculate mainly functions as a lubricant and an acid neutralizer, so the presence of sperm in the fluid is variable from low to absent. 

Can urine and sperm come out together? 

Often, semen can only flow out when the penis is stiff and almost at the climax. However, when a penis is erect, urine doesn’t usually pass through the urethra. 

So although sperm and urine both pass through the urethra, they are unlikely to be released together. 

What does sperm in urine indicate? 

It might mean a leak of some semen can remain in the urethra after ejaculation. However, semen leakage after ejaculation is not a cause for concern, and not all discharge from the penis is semen.    

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What causes semen in urine?

The most common cause of semen leaking into the urine is urinating after masturbation or sexual intercourse. So it is not a shock to find semen or seminal fluid mixed with urine, especially during urination after intercourse or masturbation. 

A urinalysis can discover if there is seminal fluid leakage or some ejaculate in urine. 

Another probable cause is retrograde ejaculation. A sphincter or muscle around the neck of the bladder contracts during orgasm to keep semen from entering the bladder and helps prevent urination until the appropriate time. 

If the bladder neck muscle has a dysfunction, retrograde ejaculation occurs, causing semen to go to the bladder rather than exiting through the urethra. Then, semen is combined with urine. 

Retrograde ejaculation can be due to injury to the nervous system and chronic conditions like diabetes. 

However, scientists have shown that health conditions or background factors can contribute to sperm leakage. The study contents reveal the following causative factors: 

Prostate cancer

Uncontrolled development of cells in the body can affect the prostate gland, mainly since prostate cancer affects 1 in 9 males at some point in their lives. 

It causes prostate problems such as changes in semen and ejaculation, difficulty urinating, pelvic discomfort, and erectile dysfunction.

Urinary incontinence

Seminal fluid leakage after urination may be due to urinary incontinence, which occurs when you urinate involuntarily. 

Urinary incontinence usually happens when you lose control over your urinary sphincter, thus allowing semen and urine to mix up. 

Side effects of medication

It can also be due to an adverse effect of certain prescribed medicines such as alpha-blockers, mood stabilizers, or antidepressants.

Infections

Sexually transmitted diseases can cause penile discharge and seminal fluid leakage. Some leaked fluids can be cloudy or opaque and contain blood or pus. 

Urinary tract infections (UTIs) can also cause seminal fluid leakage. A burning sensation or pain usually accompanies these symptoms during urination.

Nervous system injury

Damage to the nervous system can cause semen leakage and changes in normal ejaculation. 

Degenerative conditions, such as multiple sclerosis, Parkinson’s disease, and spinal cord injury, can lead to such a condition. 

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When to see a doctor

It is always a good idea to consult with your local healthcare team if you sense any kind of problems with your health. You will be reassured and get the proper support. For example, men leak semen during certain activities. 

However, if you notice the following, then it might be more urgent you seek medical attention and advice so doctors can perform further investigations: 

  • Changes in ejaculation
  • Sexual dysfunction 
  • Blood in semen 
  • Smelly urine or semen
  • Semen or urine with an unusual appearance

Treatment

Semen leakage after urination happens rarely, and if it is due to sexual arousal, it usually requires no treatment. 

However, if it is an ongoing issue, you need to get medical treatment, depending on the cause of retrograde ejaculation or any fertility problem, especially for people who want to conceive. So doctors should tailor treatment for each individual. 

The following solutions might help solve the issue:

  • One common medication for retrograde ejaculation is chlorpheniramine. 
  • If the cause is prostate cancer, the treatment will depend on the person’s general health and prostate health. Treatment may include surgery, chemotherapy, radiation therapy, or hormone treatment. 
  • If the cause was a type of medication, your doctor could prescribe an alternative without the side effect. 
  • Behavioral change can help if the cause is psychological urinary incontinence. 
  • The healthcare team must treat underlying problems such as Infections, spinal cord injuries, and other causes of urinary incontinence. 

How to stop sperm leakage in urine

If you are concerned about sperm leakage in urine, there are a few things you can do by yourself to help prevent it:

  • Ensure you pee immediately after ejaculating, which will help rinse the urethra and ensure that sperm doesn’t flow backward. 
  • Tight-fitting clothing can entangle sperm near the urethra, so avoid them.
  • Semen can leak out if you sit long after ejaculating, so keep active.
  • Physical therapy and exercise will always help with most help conditions but focus on practicing Kegels, which can help you gain more control and help delay ejaculation when necessary.
  • Talk to your doctor about alternatives if the medication affects your fertility. For example, if you have premature ejaculation, topicals such as a desensitizing cream can help reduce stimulation and delay orgasm.

Conclusion

Any issue with sexual health can cause considerable psychological strain on individuals and relationships. Having semen in urine or retrograde ejaculation is no different. 

However, although it can be uncomfortable, sperm discharge after urination is not so unusual. Nevertheless, it can be a problem, especially if you are trying to bear kids.  

It can be due to medication like alpha-blocker use and medical conditions such as prostate cancer, urinary incontinence, sexually transmitted diseases, urinary tract infections, and nervous system injury. 

If you’ve noticed any changes in your urine or semen, speak to your doctor about any concerns.  Getting an explanation and understanding of the nature of the condition is imperative to treatment and overall well-being.

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Sources

  1. Ariagno, J. I., Mendeluk, G. R., Pugliese, M. N., Sardi, S. L., Acuña, C., Repetto, H. E., & Curi, S. M. (2005). The only presence of sperm in urine does not imply retrograde ejaculation. Archives of andrology, 51(6), 431–436. 
  2. Tomita, M., Kikuchi, E., Maeda, T., Kabeya, Y., Katsuki, T., Oikawa, Y., Kato, K., Ohashi, M., Nakamura, S., Oya, M., & Shimada, A. (2015). Clinical Background of Patients with Sperm in Their Urinary Sediment. PloS one, 10(9), e0136844. 
  3. Fedder, J., Kaspersen, M. D., Brandslund, I., & Højgaard, A. (2013). Retrograde ejaculation and sexual dysfunction in men with diabetes mellitus: a prospective, controlled study. Andrology, 1(4), 602–606. 
  4. Jefferys, A., Siassakos, D., & Wardle, P. (2012). The management of retrograde ejaculation: a systematic review and update. Fertility and sterility, 97(2), 306–312. 

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