What condition is associated with the appearance of spermatozoa in urine?

The presence of spermatozoa in urine is primarily associated with retrograde ejaculation. This condition occurs when sperm is not ejected through the penis during ejaculation but instead travels backward into the bladder. As a result, when the individual subsequently urinates, the urine may contain viable sperm cells.

In retrograde ejaculation, the normal mechanism that propels sperm out of the urethra is disrupted, typically due to factors such as nerve damage, certain medications, or surgery. Therefore, the identification of spermatozoa in urine is a critical indicator of this reproductive issue.

Other conditions listed, such as diabetes mellitus, chronic kidney disease, and acute urinary tract infection, do not directly lead to the presence of sperm in the urine. Diabetes mellitus can affect overall kidney function and urinary health, chronic kidney disease can lead to changes in urine composition but is unrelated to sperm presence, and acute urinary tract infections typically do not involve any reproductive elements. Thus, the best choice in this context is clearly retrograde ejaculation.