No Semen During Orgasm?

Dear Dr. Motola,

I have been diagnosed with an enlarged prostate. Recently my wife and I noticed that there was no semen coming from the penis during climax-nothing at the time of ejaculation. Can you tell me what could be the problem, and what treatment options might be available to me?

The lack of semen coming from the penis (anejaculation) can occur as a result of a various number of entities. This may occur on a psychological basis, however if this were so, orgasm would not be associated with it.

Many different conditions can result in the lack of ejaculation including prostatic hypertrophy, urinary tract obstruction, prostatitis, and assorted neurologic conditions. Diabetes is one of the diseases that is most often associated with the lack of ejaculation. In this condition, retrograde ejaculation (passage of ejaculatory fluid into the bladder at the time of orgasm) may commonly occur. A thorough evaluation by a urologist should sort out the cause of the lack of ejaculation.