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Consistency of ejaculate

For some time now, I have noticed a change in the consistency or fluidity of my ejaculate from smooth to somewhat lumpy, as though composed in part of tapioca.  The little gelatinous blobs tend to clump and, if I wait too long to ejaculate, can cause the orgasm to be mildly uncomfortable, though not painful.  It's as though they create somewhat of a damming effect, allowing me to feel their passage through the penis during orgasm.

The gelatinous pieces tend to be dryer than surrounding ejaculate insomuch as I can easily separate them from the fluid and break them down if rolled between my thumb and forefinger.  (It may sound strange to do something like that; but when confronted with such an oddity, I wanted to be able to explain as much about it as I could.)

I'm 34, very healthy, and get annual bloodwork to verify as much, as well as two annual FAA physicals.  I eat healthy and exercise, am about 18% bodyfat, and have no symptoms that would suggest infection of any kind.  Although I know prostatic infections can be hard to diagnose and treat.

It so happens that my FAA medical examiner is a urologist, and he looked at me as though I were crazy when I tried to explain this to him.  He suggested a digital exam, whereby he could "milk out" some of the fluid by pressing on the prostate.

For this same condition, I went to another urologist--so as to avoid mentioning the condition to the FAA, which believes that human frailty is verboten in aviation--about two years ago.  He gave me a digital prostate exam, and I thought I was going to go through the roof when he hit the prostate.  It felt tender, and the event made me sick to my stomach for hours.  Now the thought of another similar exam can easily reproduce that sick feeling.

HELP.  I don't know how to proceed.

Thank you.

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Certainly any infection of the prostate can cause a change in the consistency in the ejaculate.  I would send off a urine test for culture and possible prostatic fluid to ensure this isn't the case.  If there is evidence of infection, appropriate antibiotics should be considered.  

You can also send off the semen for analysis if there continues to be symptoms despite negative tests.  Another consideration would be a transrectal ultrasound to image the prostate - there are cases of prostatic abscesses that may not be appropriately treated with antibiotics.

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.

Kevin, M.D.
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