Expert: Arthur Goldstein, M.D. - 10/17/2006

Question
 Male 24 years old.  Recently Ive noticed unexpected prostate fluid being released through my penis at random times, about a litte more than a teaspoon.  This is the second time its happened in two days.  A couple of days before, I had some testicular pain for two evenings.  Is this something I should be worried about?

Answer
Kevin, this is a very common condition with the medical name congestive?prostatitis. During sexual arousal the prostate gland manufactures fluid that accounts for about 2/3 of the volume of ejaculate.  The seminal vesicles are paired structures located behind the prostate gland that also manufacture fluid.  Sperm from the testicles (which account for only 1-2% of the semen) travel up a series of tubes (epididymis and vas deferens) on each side to join the seminal vesicles forming the paired ejaculatory ducts.  These structures empty into the prostatic portion of the urethra.  At the time of ejaculation, prostatic fluid is discharged into the urethra (urinary canal) where it mixes with discharge from the ejaculatory ducts forming the semen.  The semen volume is in the 2-6 cc range.   Arousal without ejaculation causes the prostate to swell with fluid producing tension on the prostate’s capsule. ?Stool passing through the rectum actually pushes on the distended prostate producing the penile discharge.  Prolonged sitting (you sit on the prostate) can cause the discharge to be noted before voiding.  At the end of urination, as the bladder is emptying out the last few drops of urine, it actually squeezes the?prostate.  If the prostate is congested, you will then note this fluid at?the end of urination.  With congestive prostatitis discomfort is often referred
to the testicle(s), groin, low back or rectal area.  This pain in the testicles is denoted by the slang terms: “blue balls” or “lover’s nuts”.    Irritating urinary symptoms may also occur.  In some patients, only the discharge is noted.  The discharge is generally immediately relieved by ejaculation and prevented by  avoiding sexual arousal without ejaculation.  Sitting in a warm bathtub?for 10-15 minutes daily will also provide some relief.  If no better, consult with a urologist.  Good luck.