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Urology/No precum and watery ejaculation

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Question
Here is some background information. I am a gay male and a few weeks ago I had a rough sexual encounter. During the encounter the guy I was with lost the condom inside me while having sex.  The condom did come out and the guy did not finish inside me.  The sex was pretty rough and I ended up being in pain for a few weeks after. Since that encounter I have not had any precum, even when I'm aroused.  Before this I would precum a lot, but now I can't even get a drop out. Also, my ejaculate is thin and watery, almost like precum but much thinner. At times I still feel pressure on my penis like I'm gripping it tightly in my fist. Also, in the morning I have found a yellow crust on the tip of my penis. I'm a little worried that something is wrong.  Please help!

Answer
Jason, I suspect that you probably suffered some soft tissue trauma to the prostate gland.  This could account for the penile pressure you are experiencing.  Generally this clears on its own in a few weeks. A daily warm bath for 12-20 minutes will help.  Also, during the healing period, I suggest you not ejaculate more than twice a week to let the prostate "rest" a bit.  

However, changes in the precum and semen are probably just normal variations that happen periodically to most men.  It is not due to sexual trauma. A more watery consistency of the semen is a commonly noted observation but is not a sign of prostate or other urologic disease.   If one ejaculates infrequently, this usually leads to excessively thick semen often with the presence of gel like material.  Again, this does not imply disease. Ejaculation less often also tends to increase the amount of precum with sexual excitation.

The yellow crust on the penis may be a different issue.  This suggests a drying discharge.  Discharge from the urethra is a common symptom that is called "urethritis".   If thick and discolored (ie yellow, brown, green, etc.) it
may be due to gonorrhea (GC) or another STD.  A clear or slightly opaque discharge is usually not due to GC or a STD but to non-venereal bacteria (like Staph or Strep) or a parasite called Trichomonas.  These are referred to as  "non-specific urethritis" or NSU.  

In order to determine the cause, it is necessary to see your family physician or a urologist.  The etiology of this type of urethritis can be determined by culturing & microscopically examining the discharge.   If the culture demonstrates a bacterial infection, an appropriate antibiotic is prescribed.   Trichomonas is treated with medication the most common being Flagyl.   

Another  common cause of NSU is fluid seeping out of the prostate gland.  The prostate gland manufactures the major component of your semen in response to sexual stimulation.  When a man becomes sexually aroused (foreplay, dreams, fantasies, etc.) and does not ejaculate, this fluid accumulates in the prostate gland.  In such an instance, stool can push on the congested prostate causing a discharge of its fluid from the urethra (it acts like a massage of the gland).  Likewise, as one urinates, the bladder contracts to expel urine.  As the bladder squeezes out the last few drops, it also compresses the prostate.  If the latter is congested, prostatic fluid will appear at the end of urination.   Prostatic fluid discharge is also often noted just with sexual arousal in men with congested glands.  This type of discharge is not harmful and in itself does not require antibiotic therapy.    However, chronic congestion of the prostate may predispose to inflammation of the prostate gland, so called prostatitis.  Periodic ejaculation in moderation (1-2 times a week) will help to prevent this phenomenon from happening.
The bottom line is that you need to see a physician so that a proper diagnosis can be made.  After this, appropriate treatment can be instituted.  

Good luck.

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Arthur Goldstein, M.D.

Expertise

Problems or questions related to the field of urology; ie urinary stone disease, urinary cancers (kidney, bladder, prostate, testis, etc.), urinary infections, etc. I no longer answer questions related to erection problems or male sexual dysfunction.

Experience

I am retired from the active practice of urology. My 34 years was totally in the clinical field and involved the entire gamut of genitourinary problems, with special interest in endourology.

Organizations
American Medical Association, American Urological Association, American College of Surgeons

Education/Credentials
College degree - BS Medical degree - MD Master of Science - MS

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