1.

造成自體神經調控出問題的原因，通常是手術、藥物、脊髓損傷及糖尿病。手術方面，如：脊椎手術[2]、後腹腔手術[3]、根除性睪丸切除術[4]及大腸直腸手術[5]及膀胱施打肉毒桿菌的病人[6]。傷害到支配膀胱頸括約肌的自主神經系統，將造成暫時或永久性的膀胱頸失能和逆行性射精。

2.

藥物方面，用於治療前列腺肥大的藥物，如：甲型交感神經阻斷劑[7]，藉由放鬆膀胱頸括約肌來緩解膀胱出口阻塞的情形。一方面可改善排尿困難的情況，但是，另一方面卻也導致逆行性射精的現象。抗憂鬱劑、抗精神病藥物（Levomepromazne）[8]、抗癲癇藥物（Phenytoin, Valproate）[9]及抗高血壓的藥物，有些也已被證實會引起逆行性射精。

3.

脊髓損傷方面造成射精與括約肌協調不良[10]，因此產生逆行性射精。

4.

糖尿病方面，因為長期的血糖控制不佳，造成末梢神經及血管病變，影響膀胱頸括約肌的調控，導致逆行性射精。

1.

先天的構造異常，通常見於青春期後的男士，發現有逆行性射精的現象，可能是尿道狹窄造成的。

2.

後天的構造異常，通常是手術造成的，如：恥骨後前列腺手術[11]、經尿道前列腺刮除手術[12]、雷射前列腺汽化手術[13]、膀胱頸切開手術、膀胱頸腫瘤切除手術及膀胱外翻手術[14]，都會造成膀胱頸括約肌的構造改變而導致逆行性射精。有一研究報告指出，接受雷射前列腺汽化手術，伴隨31.7%逆行性射精的發生率[13]。

1.

藥物治療
通常用於膀胱頸解剖構造未經手術的病人，主要在射精的時候增加交感神經的作用，促進膀胱頸括約肌的收縮，以避免精液逆流。目前已被證實的藥物包括了甲型交感神經致效劑，如：Phenylpropanolamine（75 mg bid）、Ephedrine （25-50 mg qid）、Pseudoephedrine（60 mg qid）；抗組織胺的藥物，如：Brompheniramine；以及抗憂鬱劑，如：Imipramine（25 mg bid）[16]。

2.

手術治療
早期有學者嘗試對於手術後的膀胱頸進行重建，現今由於藥物及人工受孕技術的進步，目前手術治療已不普遍。

3.

人工受孕
採集射精後的尿液，取得精子，進行人工受孕[17]。

1.

Robin G, Marcelli F, Mitchell V, et al: [Why and how to assess hypospermia?]. Gynecol Obstet Fertil. 2008 Oct;36(10):1035-42. Epub 2008 Sep 17

2.

Lindley EM, McBeth ZL, Henry SE, et al: Retrograde Ejaculation Following Anterior Lumbar Spine Surgery. Spine (Phila Pa 1976). 2012 Apr 2.

3.

Veroux P, D'Arrigo G, Veroux M,: Sexual dysfunction after elective endovascular or hand-assisted laparoscopic abdominal aneurysm repair. Eur J Vasc Endovasc Surg. 2010 Jul;40(1):71-5. Epub 2010 Apr 18

4.

Pettus JA, Carver BS, Masterson T, et al: Preservation of ejaculation in patients undergoing nerve-sparing postchemotherapy retroperitoneal lymph node dissection for metastatic testicular cancer. Urology. 2009 Feb;73(2):328-31; discussion 331-2. Epub 2008 Nov 20

5.

Kuroda T.: [Continuing problems in patients who undergo repair for anorectal malformation]. Nihon Geka Gakkai Zasshi. 2009 Jul;110(4):191-4

6.

Caremel R, Courtois F, Charvier K, et al: Side effects of intradetrusor botulinum toxin injections on ejaculation and fertility in men with spinal cord injury: preliminary findings. BJU Int. 2012 Jun;109(11):1698-702. doi: 10.1111/j.1464-410X.2011.10639.x. Epub 2011 Oct 7

7.

Kaplan SA.: Side Effects of alpha-Blocker Use: Retrograde Ejaculation.
甲、 Rev Urol. 2009 Fall;11(Suppl 1):S14-8

8.

Mizoguchi Y.: Levomepromazine-induced retrograde ejaculation. J Neuropsychiatry Clin Neurosci. 2012 Dec 1;24(1):E32

9.

Elia J, Imbrogno N, Delfino M, et al: Retrograde ejaculation and abnormal hormonal profile in a subject under treatment with valproate and phenytoin. Arch Ital Urol Androl. 2010 Dec;82(4):193-4

10.

Soler JM, Previnaire JG.: Ejaculatory dysfunction in spinal cord injury men is suggestive of dyssynergic ejaculation. Eur J Phys Rehabil Med. 2011 Dec;47(4):677-81

11.

Zhang F, Wu B, Gao S.: [Incidences of erectile dysfunction and retrograde ejaculation after suprapubic prostatectomy and transurethral resection of the prostate in Chinese men: a meta-analysis]. Zhonghua Nan Ke Xue. 2009 Aug;15(8):738-41

12.

Pereira-Correia JA, de Moraes Sousa KD, Santos JB, et al: GreenLight HPS™ 120-W laser vaporization vs transurethral resection of the prostate (<60 mL): a 2-year randomized double-blind prospective urodynamic investigation. BJU Int. 2012 Jan 18. doi: 10.1111/j.1464-410X.2011.10878.x

13.

Erol A, Cam K, Tekin A, et al: High power diode laser vaporization of the prostate: preliminary results for benign prostatic hyperplasia. J Urol. 2009 Sep;182(3):1078-82. Epub 2009 Jul 18.

14.

Salem HK, Eisa M.: Long-term Follow-up (18-35 years) of Male Patients with History of Bladder Exstrophy (BE) Repair in Childhood: Erectile Function and Fertility Potential Outcome. J Sex Med. 2011 Oct 24. doi: 10.1111/j.1743-6109.2011.02536.x

15.

Juárez-Bengoa A, Bagnarello-González F, Rodríguez-Perdomo DF, et al: [Prevalence of retrograde ejaculation in infertility associated to hypospermia]. Ginecol Obstet Mex. 2011 Feb;79(2):61-6.

16.

Kamischke A, Nieschlag E.: Update on medical treatment of ejaculatory disorders. Int J Androl. 2002 Dec;25(6):333-44

17.

Perrin J, Saïas-Magnan J, Lanteaume A,: [Initial results of a novel technique for sperm retrieval in male infertility due to refractory retrograde ejaculation]. Prog Urol. 2011 Feb;21(2):134-8. Epub 2010 Oct 14