Very worried.

Since last July I have been experiencing several uncomfortable symptoms: burning along the urethra, burning and redness at the tip of the penis, a burning sensation in the perineum and the need to urinate frequently.  Because of this my urologist performed several exams: a DRE, he felt my prostate was fine. He then performed a testicular and pelvic ultrasound and found everything normal except for a 27% post mictional residue. He suspected stenosis, so I went to a clinic and a micturitional retrograde uretrhocystography was performed. The results were inconclusive.  He then performed a cystoscopy and found an inflamed veru montanum and urethritis.  He prescribed doxycicline and Flomax for 8 weeks.  That was 3 days ago.I filled the the prescription right away. Now here comes the big problem. Since yesterday when I have sex or when I masturbate there is little or no ejaculate. I am very worried because this has never happened to me before.  Here come the questions:
1. Is lack of ejaculate a side effect of Flomax?
2. If not, what can be causing this problem. I dont have burning or pain during ejaculation, simply there is little or nothing coming out.
3. Could this be a smyptom of what the urologist found in the cystoscopy?
4. Is there a test to determine what is causing this condition?
Even though Im trough with tests I need to know what is going on.

[Kevin Pho, MD]

To answer your questions:
1) It is possible that retrograde ejaculation is occuring as a side effect of the Flomax.  Try stopping it and see if the condition improves.

2) Again, you may want to consider the possibility of retrograde ejaculation.  This occurs when the ejaculate goes into the bladder instead of through the urethra.  This normally occurs due to diabetes or via surgery.

3) It is possible that it may caused by the procedure, but I would discuss this with your urologist.

4) To diagnose this, a urine specimen is taken right after the man has an orgasm. If many sperm are found in the urine under the microscope, the diagnosis is made.

Followup with your personal physician is essential.

This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.

Thanks,
Kevin, M.D.