Ability to orgasm but cannot ejaculate...

[trs550]

I am a 41 year old gay male in a monogamous relationship.  Approximately 2 weeks ago after having anal sex, a very large hemorrhoid appeared.  This has never happened to me before but I attributed it to a rather intense session with my partner.  Since then, my erections have minimized substantially and after a very long time masturbating, typically 2 to 4 hours, I feel an orgasm and some seminal fluid discharges but I cannot ejaculate.  I typically have very powerful ejaculations so I'm worried that something else may be occurring.  The hemorrhoid has since decreased but now I am having painful bowel movements and blood in the stool.  I am going to my physician tomorrow but was wondering if anybody could shed any light on my experience.  Thanks.

[Vanessa Lacuesta]

Hi,

At this point, what is needed is an objective evaluation of your case. We can not tell what causes the discharge to thicken . What I am considering is still an infection. Since, the discharge is not purulent (yellowish, greenish), a viral infection may be a differential. With a significant sexual history ,then an infection may still be a primary thing to consider.

A prostate secretion culture ,semen culture and urethral swab culture may help.

[trs550]

Thank you so much for your response.  I have a thorough examination scheduled this coming Monday.  Since my post, my partner was tested positive for syphilis and this may be directly related to my issues.  I received a penicilin injection today and waiting to see if this helps other issues by Monday.  In any event, my doctor is not ruling out anything.

To confirm, no problems urinating although the urgency has been more frequent lately.  And, aside from taking so long to achieve orgasm, no pain.  I tried again last night.  It took nearly 3 hours to "get there" and all I had was a little bit of clear sticky fluid but a very intense orgasm.  Another new issue that presented today is a white mucousy/thick discharge from my rectum.  Could this be the semen I am not ejaculating? If so, how could it get to my rectum?  Needless to say, I am worried but trying to remain calm until I know exactly what I'm dealing with here.

[Vanessa Lacuesta]

Hi,

Problems with ejaculation may be due to structural and psychological factors and both need to be  evaluated and assessed along this line. Prostate disorders may cause pain or difficulties with ejaculation. Strictures along the urethra may also cause some degree of ejaculatory problems.

At this point I can not say if there is an association between the hemorrhoids and the ejaculation issues. Firstly, this has to be ascertained that what you have are hemorrhoids although based on your post this is likely to be so.

Do seek consult with your physician. A complete physical examination may readily aid in arriving at the diagnosis. An ultrasound of the prostate or a digital rectal examination will be able to help .

Are there any problems with urination?

Any pain with ejaculation?