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Dear Dr. Leslie,
I am an individual who suffers from 4 very serious psychiatric disorders in the same family of disorders: obsessive compulsive disorder, body dysmorphic disorder, hypochondriasis (constant terrifying fear that every small symptom means I have a horrible disease), and somatization disorder (a disorder in which my mind actually creates physical symptoms for which there is no physical cause.

Since the age of 15 I started taking an SSRI at the maximal dose, which has prevented me from getting wet dreams. However, I recently came off the SSRI because it was affecting my erectile function (despite being in serious psychological dire straits) and last night had my first wet dream ever.

However, 2 months ago, I also developed a post-void dribble, immediately in the middle of one day, after having sex with a prostitute. I have tested for every STD, taken antibiotics, and done SEVERAL urine flow tests, post void residual tests, prostate ultrasounds and DRE's, bladder ultrasounds, two lumbar/sacral MRIs and a pelvic CT scan. Everything has come out normal. As a result, my doctors have concluded, as have my psychiatrist and psychotherapist, that my urine dribble is psychosomatic.

My question is as follows: while I certainly did have a wet dream (my penis was wet with some semen and a lot of prostatic fluid when i woke up), I am wondering if I released some urine also.

There was a great deal of fluid because I had not masturbated for a week so before. But not enough fluid to be a full on urination. When I woke up, the fluid was absorbed into my underwear, and partially absorbed into the bed sheets, but still wet. This is because part of it got onto the penis-hole in my boxers and the rest of it shot up unto the sheets--it is not as if the fluid penetrated the underwear through to the sheets.

The consistency of the fluid when i touched my boxers was slightly sticky and when i squeezed against my boxers it would turn white on my fingers and bubble up a little bit. The fluid was cold, but my room was very cold. Finally when it dried it was firmer than I would assume urine would be (certainly firmer than if water had dried). It smelled like semen/pre-cum but I cannot tell if there was the smell of urine also.

FInally, there were not globs of semen everywhere, except for on the head and shaft of my penis when I woke up, where there was clearly semen and prostatic fluid. The rest of it was pretty well absorbed into my underwear.

I know how stupid a question this is, but would it be okay, considering the fact that all the urine-related tests I have run have turned out normal, to just call this a wet dream and celebrate it? Is it even possible to orgasm and urinate at the same time?

Thanks so much.

Answer
Alex:

While it is possible some urine was released at the time of the "wet dream", it is unlikely.  It is not possible to be sure from here.

It is possible to have an orgasm and urinate at the same time, but it is exceedingly unlikely in someone who has not had prostate or other pelvic surgery.  The normal anatomy and physiological processes specifically shut off the entry to the bladder during sexual arousal to prevent urine loss during ejaculation and so the semen goes where it is supposed to and not backwards into the bladder.

Look at it another way.  It's unlikely any urine was lost and if you lost a little urine, so what?

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Stephen W. Leslie, MD

Expertise

Questions concerning erectile dysfunction, kidney stones and prostate disorders including prostate cancer. I have a special interest in kidney stone disease prevention.

Experience

Full time practicing urologist with 30 years experience. Associate Professor of Surgery and Chief of Urology at Creighton University Medical Center. Editor in Chief of eMedicine Urology internet textbook. Author of only NIH approved book written for patients by a urologist on the subject of kidney stones "The Kidney Stones Handbook". Inventor of the "Parachute" and "Escape" kidney stone baskets and the "Calculus" stone prevention analysis computer program.

Organizations
American Urological Association, Ohio State Medical Association, Sexual Medicine Society

Publications
Men's Health, Journal of Urology, Urology, Healthwatch Magazine, Emergency Medicine Monthly, eMedicine, "The Kidney Stones Handbook", and numerous articles in various newspapers. He is also the editor of the Urology Board Review by McGraw-Hill used by urologists to study for their Board Certification Examinations.

Education/Credentials
Graduate of New York Medical College with residencies completed at Metropolitan Hospital New York, Albany Medical Center and University of Wisconsin-Madison.

Awards and Honors
Thirlby Award of the American Urological Association. Rated as one the country's Best Urologists by the Independent Consumer's Research Institute

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