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Urology/Exessive precum and ED

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Question
Hi Dr. Leslie,
Many thanks for giving patients the opportunity to discuss their problems with you. I'm 42 with a history of masturbation for years. From 5 years ago I have many precum upon a very little sexual excitement. This discharge made my erections very soft and short. This fluid dose not contain sperm (I examined it under microscope) but I don't know it originate from vesicle seminal or Cowper glands. The urinary infection and prostate inflammation has also been ruled out (normal PSA). I tried Citalopram, Finasteride, various vitamins and minerals, and even Tadalifil, but no one treated my problem. Do you think I have erectile dysfunction? Is there any solution for this condition.
Thank you again and God bless you.

Answer
Nader:

Precum does not make the erections soft or short.  The fluid may contain some sperm so don't assume that it will always be sperm free.  The fluid typically comes from Cowper's glands and from the peri-urethral glands. Usually, finasteride is the best available treatment for excessive pre-cum, but since pre-cum is not abnormal we don't usually treat it.  

If your erections are consistently inadequate for sexual intercourse, then you have ED.  If so, treatments are available.  Talk to your physicians about what to do next.  

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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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