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Dr. Y.
Dr. Y., Urologist
Category: Urology
Satisfied Customers: 20393
Experience:  Specializing in general urology and reconstructive urology.
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I am 71 year old male who underwent an open Trasvenial Prostatectomy

Resolved Question:

I am 71 year old male who underwent an open Trasvenial Prostatectomy operation seven years ago. I have an active sex life with a 48 year old partner who has been on the pill for the past four years. She now wishes to come off the pill for health reasons. What are the chances of my fathering a child if we engage in unprotected intercourse afterwards?
Submitted: 2 years ago.
Category: Urology
Expert:  Dr. Y. replied 2 years ago.
Hello and thanks for trusting me to help you today. I look forward to working with you.
Was your prostatectomy done for cancerous reasons?
Have you had a semen analysis done?
Customer: replied 2 years ago.

Not done for cancerous reasons.

No I haven't had a semen analysis.

Expert:  Dr. Y. replied 2 years ago.
Can you actually ejaculate with any semen coming out of the end of the penis?
Customer: replied 2 years ago.

The short answer is 'no': I experience a feeling of orgasm, but without any ejaculate. There can be a few drops of pre-ejaculate during foreplay.

If I understood correctly the explanation I was given by the consultant at the time of the operation was that the semen is 're-routed' into the urinary tract and could be 'retrieved' by 'washing it out' of the urine if required for insemination. I seem to recall the consultant saying it was unlikely there would be any semen ejaculated during intercourse, but that this couldn't be 100% guaranteed.

Expert:  Dr. Y. replied 2 years ago.
Yes, you are correct. After the surgery that you had, your semen goes backwards into your bladder. This is called retrograde ejaculation. The only way you will be able to father a child with your sperm is to see and infertility specialist to do a washing of your urine after you ejaculate. They can take this sperm and use it for artificial insemination into your spouses eggs. Hope this helps and let me know if you have questions.
Customer: replied 2 years ago.

What risk am I running of a pregnancy arising from having unprotected sex with my partner after she comes off the pill in a few months time? What steps would you advise to ensure we avoid pregnancy?

(My query arose from the need to ensure that I would not bring on an unwanted pregnancy, rather than to use sperm retrieved from urine for purposes of insemination.)

Expert:  Dr. Y. replied 2 years ago.
If any amount of semen comes out, there is a possible risk of pregnancy, but it would be low. The only way to ensure not getting pregnant is to use contraception or get a vasectomy.
If your partner is in menopause, then you would not have to worry about getting her pregnant. In this case, you would not need contraception. Hope this helps.
Customer: replied 2 years ago.

One further query: If "the only way you will be able to father a child with your sperm is...to do a washing of your urine after you ejaculate", how is it possible for "any amount of semen - however minute - to come out" during intercourse? I assume that the only way this would be possible would be through what I referred to as 'pre-ejaculate' - meaning a drop or two of clear mucous substance of egg-white consistency that is occasionally is evident during sexual arousal. Are you saying there is a risk of this having sperm content? How can this substance contain sperm if all the sperm has been 're-routed' to the bladder to be passed out in my urine?

Expert:  Dr. Y. replied 2 years ago.
Yes. Your pre ejaculate can contain very small amounts of sperm. All it takes is one sperm to fertilize an egg. If you can't afford to father a child at this point, I would not leave anything up to chance
Dr. Y. and other Urology Specialists are ready to help you
Customer: replied 2 years ago.

I found the exchanges to the point, clear, sympathetic in manner. Thank you very much.