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Dr. Tharun
Dr. Tharun, Urology Resident
Category: Urology
Satisfied Customers: 3682
Experience:  MBBS, DNB surgery and presently working as Urology resident towards the degree of Urologist.
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My name is***** am a reasonably healthy 58 year

Customer Question

Hello, My name is***** am a reasonably healthy 58 year old male from Ireland, below I set out my symptoms and concerns, perhaps you would be good enough to give me your observations.

Classic urinary problems caused by enlarged prostate.

• A weak or slow urinary stream

• A feeling of incomplete bladder emptying

• Difficulty starting urination

• Frequent urination

• Urgency to urinate

• Getting up frequently at night to urinate

• A urinary stream that starts and stops

• Straining to urinate

• Continued dribbling of urine

• Returning to urinate again minutes after finishing

My situation with regard to the above

• I have a reasonably good stream

• I do get the incomplete bladder emptying feeling, see below

• I don’t really have a problem getting started

• I do not urinate frequently, quite the opposite in fact

• Do not get the urgency to urinate other than when I do

• I never need to urinate during the night unless I had a lot to drink beforehand

• My urinary stream does not start and stop

• I do not strain to urinate

• I do have a problem with dribbling or completely emptying the bladder, I need to press on the prostate area to get the last of the urine to exit.

• I do not heed to return to urinate again minutes after finishing.

The only problem that I have had with my urinary system was many years ago, when at the end of urination I used to pass a sort of white lime like substance, this caused a little discomfort when passing it as it was not completely liquid, this situation may have lasted for a year or more and happened when I was in my early twenties, I think, (I am now 58).

I have the feeling (rightly or wrongly) that my bladder is bigger or has a larger capacity than normal, and that maybe this presses on the prostate.

The problem that I do have concerns ejaculation, I find that the semen does not shoot out as it should, in my case it emerges very slowly and weakly, sometimes it can take a couple of minutes before the seminal fluid emerges at all. I find that when I press on the area behind the scrotum with my fingers, I can get the semen to emerge. This situation has been with me for 10 or more years, but is slowly getting worse.

Submitted: 1 year ago.
Category: Urology
Expert:  Dr. Tharun replied 1 year ago.
HIDo you take any medications for the prostate as such ?Any other medications you take ?'Have you done any scans?Please let me know.Dr.Tharun
Customer: replied 1 year ago.

As I have already pointed out I have not consulted with anyone regarding the problem.

I am not on any medications of any sort

I have not had any scans done.

Trust this is the information you need

John

Expert:  Dr. Tharun replied 1 year ago.
HIThanks for the info.Quantity of the semen decreases as the age advances ; this is universal. If the volume of the semen decreases , naturally the force with which it gets expelled also get slow. Ejaculation is a coordinated process between the urethral musculature and the pelvic musculature which together contract to push out the semen. The muscle tone also decreases with age and we become less agile as we age. So this also contributes to the slow expulsion of the semen.There are hardly any drugs to correct it . You can try exercising which can improve the muscle tone of the body concentrating especially on the pelvic muscles.Eat healthy and drink plenty of water which can improve semen production.If you have any questions, please let me know.Dr.Tharun
Customer: replied 1 year ago.

I am sorry but I did not even mention that quantity of semen has decreased, what I am worried about is that the expulsion of the semen seems to be almost blocked, is this caused by the prostate???.

As I said I have some of the symptoms of an enlarged prostate, but I do not have all of them, could an enlarged bladder have an effect on my condition.

I am quite certain that the musculature that you mention is not the cause, I am quite fit and active.

Can you tell me why I have to press on my prostate area to expel the last drops of urine and also to expel semen.

Please give me your opinion on the condition that I describe

Expert:  Dr. Tharun replied 1 year ago.
Usually prostate gland stops before the opening of the ejaculatory ducts. So prostate enlargement should not block the flow of the semen.Unless the prostate is big enough to go beyond the ejaculatory duct opening it can block the flow of the semen. But in that case urine flow must also be affected equally.Pressing in the perineal region compresses the bulbar urethra and in the process pushes the urine/ semen stored there after urination or ejaculation. It is seen in every man.Dr.Tharun

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