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Question
Dr. Leslie, I am a 59 years old male who had a great sex life up to 3 years ago when I started experiencing weak force ejaculation where I expel couple drops and have to milk the rest out of the urethra by hand. I also have been experiencing pain, upon touch, on the lateral-posterior side of my left testes (possible epidydims) I have a normal solid erection and libido.  When having sex, I feel a strong orgasm is coming to end up with disappointment and just drippage.  I did have chlamydial urithritis 5 years ago but it was cured with minocycline. My testosterone is slightly on the low side for my age.  Twenty years ago I had a rectal surgery but it never caused a sexual problem.  Please help me.

Answer
Mak:

Decreased semen expulsion is often due to retrograde ejaculation and sometimes is due to prostate issues.  It could also be a side effect of some medications, such as finasteride and dutasteride.  If the problem bothers you, contact your local general physician or consult a urologist.

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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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