Archive for the ‘Retrograde ejaculation’ Category

New Help For the Enlarged Prostate Gland-The Uro-Lift

January 21, 2015

The enlarged prostate is a medical condition in which the prostate gland that surrounds the male urethra (tube in the penis that transports urine and semen located in the penis) becomes enlarged with advancing age and begins to obstruct the urinary system. The condition is common, affecting approximately 37 million men in the United States alone. BPH symptoms include sleepless nights as men are awakened to empty their bladder and urinary problems such as dribbling after urination, frequency of urination, and urgency of urination. This condition can cause loss of productivity, depression and decreased quality of life. About one in four men experience these urinary symptoms by age 55 and by age 70, over 80 percent of men suffer from BPH.

Treatment options
Medication is often the first-line therapy for enlarged prostate, but relief can be inadequate and temporary. Side effects of treatment can include sexual dysfunction, dizziness and headaches, prompting many patients to quit using the drugs. For these patients, the classic alternative is surgery that cuts or ablates prostate tissue to open the blocked urethra. While current surgical options, such as transurethral resection of the prostate (TURP or “roto rooter”), can be very effective in relieving symptoms, it can also leave patients with permanent side effects such as urinary incontinence, erectile dysfunction and retrograde ejaculation (dry orgasm).

A new study in published in Urology Practice, an official journal of the American Urological Association, concluded that the UroLift System preserves sexual function and provides rapid improvement in symptoms, flow and quality of life that are sustained to two years.

UroLift, which provides rapid relief of enlarged prostate symptoms with minimal side effects, are durable for at least two years after treatment, with less than one in ten patients requiring an additional procedure for symptom relief. At two years only 7.5% of patients required an additional procedure for lower urinary tract symptoms. Adverse events were typically early, mild and transient. There was no occurrence of de novo sustained ejaculatory or erectile dysfunction\impotence.

Bottom Line: Millions of American men suffer from the enlarged prostate gland. Help is available often starting with medication. Another option is Uro-Lift which can be done in the ambulatory treatment center and has immediate results.

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Retrograde Ejaculation or Shooting Blanks

October 26, 2011

Most men experience the joy of ejaculation when the semen, sperm mixed with prostatic fluid, travels outside of the body at the time of orgasm. Retrograde ejaculation occurs when semen goes into the bladder instead of leaving the penis during ejaculation. Retrograde ejaculation isn’t harmful but it can impair fertility since it affects the delivery of sperm to the vagina during intercourse.
During normal ejaculation, internal muscles, called sphincters, close off the opening of the bladder to prevent semen from entering as it passes through the urethra. In retrograde ejaculation, the bladder opening doesn’t close properly and some or all of the semen is allowed to enter the bladder instead of being ejected out the tip of the penis. As a result, semen mixes with urine in the bladder and leaves the body during the next urination.
Retrograde ejaculation does not interfere with a man’s ability to have an erection or an orgasm. Men often first become aware that they have retrograde ejaculation when fertility problems arise. The condition also occurs after prostate surgery where the sphincters can be damaged or injured during the surgery. A common sign indicating retrograde ejaculation is if a man’s urine appears cloudy after sexual climax.
Retrograde ejaculation may occur either partially or completely. Men with incomplete retrograde ejaculation may notice a decrease in semen that comes out during ejaculation. Complete retrograde ejaculation can also be called dry orgasm or dry ejaculation since there is orgasm without the discharge of semen.
Since retrograde ejaculation isn’t harmful, it typically doesn’t require treatment unless it interferes with fertility. In such cases, treatment depends on the underlying cause.
If your doctor discovers that a prescribed medication, such as alpha blockers, is the cause, switching to a comparable medication or discontinuation of the drug often restores normal ejaculation.
Unfortunately, if retrograde ejaculation is caused by surgery or diabetes, it is often not correctable. However, some medications have been shown to improve muscle tone of the bladder neck and therefore reduce the loss of semen into the bladder during ejaculation. These medications include: epinephrine sulfate and epinephrine-like drugs (such as pseudoephedrine, imipramine, midodrin, desipramine and brompheniramine maleate).
Alternatively, men are sometimes encouraged to ejaculate when their bladder is full since having a full bladder can increase bladder neck closure.
If the above measures are not options or are not successful and fertility is still a concern, it is also possible for an urologist to retrieve sperm from a man’s urine following an orgasm and use it for artificial insemination.
It is also possible for men, prior to receiving treatments or surgeries that bring the risk of retrograde ejaculation, to have their semen cryopreserved (frozen) for insemination later.

Bottom Line: Retrograde ejaculation or sperm going backward into the bladder is not a very common problem but can be a problem if a man wishes to achieve a pregnancy with his partner. The condition does not need treatment unless a man wishes to achieve a pregnancy.

Treatment of the Enlarged Prostate Gland With Laser Therapy

April 25, 2010

The prostate gland is a walnut sized organ below the bladder, which surrounds the urethra.  For reasons not completely understood, the prostate gland begins to grow around age 50 and causes symptoms affecting urination.  The enlarged prostate gland is a non-cancerous condition that affects nearly 14 million men over age 50.

The symptoms of the enlarged prostate include frequency of urination, getting up at night to urinate, urgency to urinate, decrease in the force and caliber of the urine stream and feeling that the bladder is not emptying.

The treatment for enlarged prostate includes medication to shrink the prostate gland or to relax the muscles in the prostate to relieve the obstruction.  Surgical therapy includes transurethral resection of the prostate (TURP) or open surgery for very large prostate glands. Recently laser therapy has become available for treating the enlarged prostate gland and is considered minimally invasive therapy.

Laser therapy is a procedure performed with a small fiber that is inserted into the urethra, the tube in the penis that allows urine to go from the bladder to the outside of the body.  The fiber delivers high-powered laser energy, which quickly heats the prostate tissue, which causes the tissue to dissolve or vaporize.  This process is continued until all of the enlarged prostate tissue has been removed. The end result is a wide-open channel for urine to pass through the urethra.

Laser therapy can be performed in a hospital outpatient center or an ambulatory treatment center.  Usually no overnight stay is required.  However, in some cases when a patient comes from a great distance, has associated medical problems such as heart disease, diabetes, or severe hypertension, or is in frail condition, an overnight stay may be recommended.

After the procedure

Most men will go home within a few hours after treatment. If a tube or catheter was inserted after the procedure, it will usually be removed the next day after the procedure.

Most patients experience marked improvement in their urinary symptoms immediately after the procedure.  This improvement typically occurs within the first 24 hours after the procedure.  However, the past medical history, health condition and other factors can influence treatment recovery.

Some men may experience mild discomfort such as slight burring during urination and small amounts of blood in the urine for a week or two.  Also, depending upon the condition of a man’s bladder, he may experience greater frequency and urge to urinate.  This will resolve over time as the bladder adjusts now that the obstruction has been removed.

There is no change in a man’s sexual function after the procedure.  His ability to engage in sexual intimacy after the procedure is unchanged.  Most men can begin sexual activity two weeks after the procedure.  Approximately 25% of men will have a decreased or absence of ejaculation at the time of orgasm.  The fluid is still there but goes backwards into the bladder and passes in the urine the next time the man urinates.

What are the risks of the laser procedure?

Every medical treatment may have side effects.  The same is true for the laser treatment.  The most common side effects include:  blood in the urine, bladder spasms, and urgency of urination.  These symptoms are usually temporary and will subside in a few days or weeks.

Bottom Line: Enlarged prostate gland is a common condition that affects most men after age 50.  Treatment options include medications, surgery and minimally invasive treatment using lasers.  The laser treatment produces a rapid improvement in urine flow, a quick return to normal activities, short or no hospitalization.

EjD, Ejaculatory Dysfunction-The New Sexual Dysfunction

April 11, 2010

Millions of men suffer from EjD or ejaculatory dysfunction.  The most common variety is premature ejaculation followed by retarded ejaculation or not being able to achieve an orgasm.  Another less common EjD is retrograde ejaculation or seminal fluid going back into the bladder instead of exiting the penis at the time of orgasm.  This article will discuss the three common EjD conditions and what can be done to resolve them.

It is estimated that one-third of American men suffer from premature ejaculation or ejaculation within seconds of vaginal penetration.  This is of great concern and embarrassment to those who experience this malady.

One folk remedy that is available to all men is self-stimulation or masturbation. Having repeated orgasms will bring on delayed ejaculation in nearly every man. The best premature ejaculation tip is to double the number of orgasms a man has per week. And if that doesn’t work, double it again.  Now isn’t that a great assignment?

Another method that requires cooperation with the partner or significant other is the “pull out technique.” This consists of having sex for a few minutes then pulling out and stopping for a few minutes to postpone orgasm.

Another method is to decrease the stimulation of the penis using desensitizing cream such as topical xylocaine.  Also, using one or more condoms can decrease the sensation and can prolong ejaculation.

When these non-pharmacologic techniques are ineffective there are medications that can help prolong the time from penetration to ejaculation. Selective serotonin reuptake inhibitors, or SSRIs — are known to cause delayed ejaculation.  Using an SSRI four to six hours before intercourse, men prone to premature ejaculation can last longer.

Delayed ejaculation (or retarded ejaculation) affects a much smaller number of men.  With this problem, men cannot reach orgasm at all, at least not with a partner.  It is most common associated with aging where more stimulatin is required for a man to reach an orgasm with advancing years because the nerve endings in the penis become less sensitive.  Delayed ejaculation may be caused by medicines – like antidepressants– are common culprits.

Retrograde ejaculation is the least common of the ejaculation problems. Retrograde ejaculation can be caused by diabetes, nerve damage, and various medications such as alpha-blockers like Flomax, which are used to treat enlargement of the prostate gland. Retrograde ejaculation is harmless and won’t interfere with the feeling of orgasm. (It can also make for an easy post-sex clean-up.) But since it does affect fertility, some men may need treatment if their partners are trying to get pregnant.

Bottom Line

EjD is a common medical condition that can be overcome.  Be open and communicate with doctor and share your concern with your partner.  Don’t suffer in silence and let the tension mount up and compounding the problem.  Most men with some advice and perhaps some medication from their doctor can overcome this problem.  This translates to less worry and more sex.  Who could ask for anything more?

Ejaculatory Dysfunction-The New Sexual Dysfunction

February 22, 2010

Millions of men suffer from EjD or ejaculatory dysfunction.  The most common variety is premature ejaculation followed by retarded ejaculation or not being able to achieve an orgasm.  Another less common EjD is retrograde ejaculation or seminal fluid going back into the bladder instead of exiting the penis at the time of orgasm.  This article will discuss the three common EjD conditions and what can be done to resolve them.

It is estimated that one-third of American men suffer from premature ejaculation or ejaculation within seconds of vaginal penetration.  This is of great concern and embarrassment to those who experience this malady.

One folk remedy that is available to all men is self-stimulation or masturbation. Having repeated orgasms will bring on delayed ejaculation in nearly every man. The best premature ejaculation tip is to double the number of orgasms a man has per week. And if that doesn’t work, double it again.  Now isn’t that a great assignment?

Another method that requires cooperation with the partner or significant other is the “pull out technique.” This consists of having sex for a few minutes then pulling out and stopping for a few minutes to postpone orgasm.

Another method is to decrease the stimulation of the penis using desensitizing cream such as topical xylocaine.  Also, using one or more condoms can decrease the sensation and can prolong ejaculation.

When these non-pharmacologic techniques are ineffective there are medications that can help prolong the time from penetration to ejaculation. Selective serotonin reuptake inhibitors, or SSRIs — are known to cause delayed ejaculation.  Using an SSRI four to six hours before intercourse, men prone to premature ejaculation can last longer.

Delayed ejaculation (or retarded ejaculation) affects a much smaller number of men.  With this problem, men cannot reach orgasm at all, at least not with a partner.  It is most common associated with aging where more stimulatin is required for a man to reach an orgasm with advancing years because the nerve endings in the penis become less sensitive.  Delayed ejaculation may be caused by medicines – like antidepressants– are common culprits.

Retrograde ejaculation is the least common of the ejaculation problems. Retrograde ejaculation can be caused by diabetes, nerve damage, and various medications such as alpha-blockers like Flomax, which are used to treat enlargement of the prostate gland. Retrograde ejaculation is harmless and won’t interfere with the feeling of orgasm. (It can also make for an easy post-sex clean-up.) But since it does affect fertility, some men may need treatment if their partners are trying to get pregnant.

Bottom Line

EjD is a common medical condition that can be overcome.  Be open and communicate with doctor and share your concern with your partner.  Don’t suffer in silence and let the tension mount up and compounding the problem.  Most men with some advice and perhaps some medication form their doctor can over come this problem.  This translates to less worry and more sex.  Who could ask for anything more?

Dr. Neil Baum is a urologist in New Orleans, Louisiana and can be reached via his website, www.neilbaum.com or (504) 891-8454