Aspermie avec spermatozoïdes dans les urines post-orgasmiques sous rispéridone : à propos d’un cas à Fada N’Gourma (Burkina Faso)

Introduction :Aspermia is the apparent absence of ejaculate. It may result from anejaculation, retrograde ejaculation, an emission disorder, or obstruction of the seminal tract. Atypical antipsychotics are among the medications associated with sexual and ejaculatory dysfunction.Case presentation :We report the case of a patient with primary infertility and aspermia while receiving risperidone. The evaluation included a clinical examination, hormonal assessment, testicular ultrasonography, and a search for spermatozoa in post-orgasmic urine. Rare spermatozoa, some of which were motile, were identified in the post-orgasmic urine pellet. This finding was compatible with, but did not conclusively establish, retrograde ejaculation. Bilateral testicular atrophy, low total testosterone, and elevated prolactin were also observed.Limitations :The sexual, reproductive, and treatment history was incomplete; hormone assays were not repeated, and LH, FSH, SHBG, and TSH were not measured; transrectal imaging was not performed ; and the patient was lost to follow-up. These limitations reduced diagnostic certainty and precluded a firm assessment of risperidone causality.Conclusion :In this case, rare spermatozoa in post-orgasmic urine were compatible with retrograde ejaculation, but a causal relationship with risperidone was not formally established. Multidisciplinary management involving psychiatry, urology-andrology, endocrinology, and reproductive biology was indicated.