FROM OUR EXPERTS
Dear Dr. Motola,
Over a period of a year my amount of fluid ejaculated has dropped to almost zero. Do you have any thoughts on what might be contributing to this? Is this a common problem? The normal aging process is associated with a gradual decrease in ejaculatory volume. Patients who have had previous surgery on their prostate or on the bladder neck may experience decreased ejaculatory volumes. Medications such as alpha-blockers ( Flomax , Hytrin , Uroxatrol ) can be associated with decreased or absent ejaculatory volumes. Medical conditions such as diabetes and low levels of androgens can also be associated with this. An evaluation with a urologist will help lead to a better understanding of what the cause of the low ejaculate is.
NBP; Prostatodynia; Pelvic pain syndrome; CPPS; Chronic nonbacterial prostatitis; Chronic genitourinary pain
Blood in the semen
Blood in the urine
Pain that is located:
Above the pubic bone (suprapubic) Between the genitals and anus (perineal) Low back Scrotum Tip of penis Urethra
Problems with urinating
Decreased urinary stream
Frequent urination Pain or burning with urination Incomplete emptying of your bladder Weak urine stream
Pain with bowel movements
Pain with ejaculation
Signs and tests
A physical examination usually will not show anything unusual. However, the prostate may be swollen, soft or firm, warm, and tender.
Urine tests may show white or red blood cells in the urine. A semen culture may show increased white blood cells and low sperm count with poor movement (motility).
Urine culture or culture from the prostate does not show bacteria.
I was recently contacted by another urologist who asked me a very interesting question - Are you aware of using a radical prostatectomy to treat prostatitis ? Prostatitis is an infection or inflammation of the prostate gland. There are different grades of prostatitis. Acute bacterial prostatitis develops when a bacteria grows inside the cells of the prostate causing fevers and severe burning when urinating. Chronic bacterial prostatitis develops when the bacteria returns to the prostate cells but the symptoms are not as severe. The man may have a low grade temperature, some discomfort when he urinates, and aches of the genitalia. These are very curable with antibiotics. Chronic non-bacterial prostatitis occurs when inflammatory cells are present in the prostate cells, not bacteria. This can occur in men after trauma, prolonged sitting, recent viral syndrome and previous bouts of bacterial prostatitis. This is the most common type of prostatitis that I see in private practice. Men gen...
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