It can depend on one or more of several causes, including: Anejaculation, especially the orgasmic variant, is usually indistinguishable from retrograde ejaculation.
However, a negative urinalysis measuring no abnormal presence of spermatozoa in the urine will eliminate a retrograde ejaculation diagnosis.
Thus, if the affected person has the sensations and involuntary muscle-contractions of an orgasm but no or very low-volume semen, ejaculatory duct obstruction is another possible underlying pathology of anejaculation.
[citation needed] The first-line method for sperm retrieval in men with spinal cord injury is penile vibratory stimulation (PVS).
In case of failure with PVS, spermatozoa are sometimes collected by electroejaculation, or surgically by percutaneous epididymal sperm aspiration (PESA) or testicular sperm extraction (TESE).