Dear Dr. Motola:
After having very successful Green Light PVP surgery, I do not ejaculate. I was told that about 33% of men can still ejaculate normally after this procedure. Why can 33% still ejaculate and the rest not? (I know that the semen goes backwards in cases like mine).
Approximately 1/3 of patients are able to ejaculate after a Green Light PVP , with the remaining patients demonstrating either retrograde or no ejaculation. The most widely held understanding of this is that the preservation of some of the bladder neck (opening of the bladder between the prostate and the bladder) is preserved during the procedure. During ejaculation the bladder neck is supposed to close down, forcing the ejaculate forward through the penis. If the bladder neck remains open during ejaculation, then the semen will flow "retrograde"" or backwards into the bladder. If the verumontanum (the opening of the ejaculatory duct at the level of the prostate) were lasered, obstruction ...
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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