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Question:
I have had the prostate Turp surgery. Of course my ejaculation no longer is emitted through the penis but goes into the bladder and discharged with urine. I am homosexual, and find I do not feel the same satisfaction as I did before with each orgasm. I do climax, but I find myself somewhat frustrated each time. Is there any way to improve this?
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Answer:
by James Achtzehn: ()
For those readers who may not be familiar with
"prostate Turp surgery," it is a surgical procedure to remove a portion of an enlarged prostate gland. The urethra, the tube that carries urine from the bladder to the end of the penis, runs through the prostate. The prostate makes semen, a fluid that is mixed with sperm as they pass through the urethra, providing essential nourishment for the sperm. As men age, the prosta naturally enlarges and may interfere with normal urination, causing a need to urinate frequently, including during the night. The enlargement of the prostate may be caused by
a tumor which is generally not cancerous, but it can be. This is the reason why men over 50 should have a prostate examination as part of their annual physical exam.
In most cases, prostate Turp surgery should not interfere with sexual functioning, but instead of discharging through the penis at climax, the semen ejaculates backward into the bladder (retrograde ejaculation or "dry come") to be
discharged during urination.
To make sure I understood his situation, I asked the respondent a number of questions, and learned the following:
This is a man in his late 60s who is somewhat sexually active. He had the surgery almost 2 years ago and the enlargement was not caused by cancer. The only complication to the surgery was scar tissue that developed about 2 months later, causing some blockage. The scar tissue was removed and the blockage has improved, although he still has periods of more-than-average urination and has had some trouble maintaining an erection. During ejaculation he says that he feels the rush of semen somewhere in the penis-bladder area, but after it is over, he does not have the same feeling of satisfaction as before. He feels this may be because he doesn’t feel it flowing through the urethra nor see it shoot out of the penis. When asked if he has discussed this with his surgeon, he replied that he discussed it with a urologist who did not feel his condition was unusual and said, "You have the same feeling as before!"
Before surgery, I hope your surgeon explained the
consequences of the surgery and the fact that you would no longer be ejaculating through the penis, but that the ejaculate would go back to the bladder to be ejected with urine. While it would not have made a difference in the outcome of the surgery, it is important, emotionally and
psychologically, that the patient be made aware of all aspects, possible complications, et cetera, of the surgery.
Unfortunately, to my knowledge, there is no way to improve your situation physically. However, you might try refocusing your feelings and sensations. Many men who have spinal cord injuries are unable to experience any feeling in the genitals. In order to have an orgasm they learn other techniques. Try focusing on the entire sexual response. There is an increase in the blood flow, causing you to feel warm all over and your penis to become erect. Your heart rate increases, your breathing becomes more rapid, and the muscles in your entire body tense–your shoulders, your abdomen, your feet. You still have feeling in your penis, so the stimulation to it feels good. Try to become aware of the various sensations throughout your body, not just your genitals. Try to pay more attention to all of these sensations through your ejaculation. Try to move from the lack of sensation of semen passing through your penis to the overall excitement and exhilaration of the total sexual experience. This will take time to develop, but in the end, I think it will help. I suspect that, like the urologist, many people will feel this is not an important issue. However, to the individual’s sexual satisfaction, it is extremely important. I would also suggest that it might be helpful for you to seek a sex therapist to help you refocus your feelings and sensations.
Reviewed by: Patricia Fawver Ph.D. in Sexology
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