Poor ejaculation

[User-CPPS]

This user's main thread is here: https://ucpps.men/viewtopic.php?t=6726

Hi there,

As a teenager many years ago in the 1990s I had 2 cystoscopies. One in 1996 with 14 after having first symptoms of UCPPS and my urologist having no clue what my problem was. After that I had mental issues because I was sure that the procedure had hurt me from inside. I think it was a rigid device and I did not have full narcosis. I thought that I had bladder problems and pain after urinating. Some months after that procedure I managed to "learn" how to masturbate and I don't have a comparison to people who did not have a procedure like mine. I felt that my ejaculation did not come all at once. At least half of it stayed in the urethra and came out with time.

This thought did not leave so I researched a good professor of urology and went there with my parents in 1998 at the age of 16. I told him that I felt broken and needed to make sure I am ok. So he performed the same procedure, but this time with full narcosis. When I woke up I had a little blood in my urine but I recovered. He told me I am ok.

Still, after all this years I was wondering if something got broken. I have a nervous bladder at times and there were some occasions where I peed myself, I think 4-5 times in my life. Other than that, some wet shorts or pants. In good times, just a nervous bladder and in good times a normal bladder.

Also, in this life span I watched porn. So masturbating to is is sometimes a matter of seconds, which is bad for my mental health, since those porn stars have sex for at least 30 minutes. If I have sex myself, it is very strange. Sometimes, I as soon as I put on speed I cannot hold it. Sometimes, it is, like a switch, I think I can hold it very long.

But the most important thing that bothers me is that my ejaculation is poor. When I come, just one part shoots outside, the rest is staying and comes out within some minutes. I wish I could shoot everything out as in the movies. Is it like this because I am broken because of the cystoscopies?

Am I allowed to do some exercises?

[User-CPPS]

PS:
Sometimes after ejaculating I have bladder problems and have to run to the toilet.

[webslave]

If any ducts in the prostate are inflamed, or the tissues around the ducts are inflamed, the ducts become partially occluded (think of a garden hose being pinched). So after ejaculation, the fluids will leak for a while. This is nothing to be alarmed about, it is simply a by-product of common inflammation. This scenario is not connected to cystoscopy.

However, cystoscopy can cause a stenosis or narrowing of the urethra, called a 'stricture', which could also cause post-ejaculation leakage. It is rare, happening in about 2% of patients. But if you had that, you'd also have other symptoms like straining to urinate, pain during urination, and urinary tract infections.

If you suspect a stricture, see the urologist and he will order up a retrograde urethrogram (X-ray procedure).

Exercises are fine. Avoid squats.

[User-CPPS]

Thank you.

So you cannot differentiate the fluids that may come after ejaculation from the ejaculation itself?

Before alpha blockers or tadalafil I had pain during ejaculation, but no straining, just sometime poor streams and nervous bladder. I never had Urinary tract infection, only once a real prostatitis with several different bacteria over the course of 2-3 months, but this was 14 years after my last cystoscopy. So maybe I was lucky and did not have a stricture?

I am sorry, I was not clear what I meant with exercise. I meant Kegel and pelvic muscle exercises.

I can avoid squats, as long as other exercises are ok. Are all leg exercises with weight bad?

Admin comment: No, you cannot differentiate. Avoid kegels (search this site for the reason). Exercises that tense the pelvis are counterproductive.

[User-CPPS]

Dear webslave and all,

I know that only a retrograde urethrogram would make things clear but still it is another invasive method and I would rather go without X-rays in that area if the body (though I had at least one in 1996-1998).

My last cystoscopy was in 1998. They told me I was ok. Still, this second cystoscope could have injured me again? Also after it I had some painful smear tests when I had my prostatitis in 2012.

It is hard to differentiate from CPPS. The following years I was fine with just a nervous bladder, in 2004 CPPS returned. After taking Prozac in. 2007 I even not looked back to these traumas of the past.

Today tadalafil (Cialis) daily manages 75% of my symptoms alone. I don’t have post urinary pain or after ejaculation.

Still, I have

• Sometimes poor, slow stream
• Frequently going to pee
• Sometimes dual stream
• Wetting my shorts with some urine because I did not wait enough after urinating,
• Wetting my shorts because I could not go fast enough to the toilet
• Still sperm in the penis after ejaculating because contractions not strong enough

As mentioned before I never had a urinary tract infection besides in 2012 having a real bacterial Prostatitis for three months.
I don’t strain to go to the bathroom, sometimes when I feel that my pelvic muscles are strained I need to go the toilet and in these ocassaions I have really poor stream and I press to urinate. But this happens seldom, normally after ejaculating.

I made a “flow” test 10 years ago after drinking a bottle of water at my urologist and the test was ok because of the big amount of drinking I had good pressure.

As mentioned in my main thread I try to rule out why my wife and me can’t get a child and I test my sperm. I struggle to get the normal amount in the cup because the whole amount does not shoot out but when orgasmic contractions stop there is still some sperm left that flows outside either with time or with some pressure on the penis.

Before medications (alpha blockers and now tadalafil this residue of urine or sperm after urinating or ejaculating was the biggest part of my pain symptoms that I learned to connect to UCPPS.

Because of the wish to have a child stopped with SSRI (Prozac/Zoloft) and I am struggling with withdrawal. So I think about those traumas (cystoscopies and all urological treatments) again which I learned to forget.

So, bottom line, how likely is it that I have strictures after all this years that lead to difficulties emptying my penis from urine or sperm?

I could live with the symptoms but if that means I am not fertile because not enough sperm is going out where it should belong then I would feel awful.

In all these years, nothing was constant. I also have good days with normal toilet situations and I also had some strong ejaculations. I have to do a semen test I two days and I had to ejaculate on Friday and be abstinent before the test. I also tried to ejaculate in a cup just to see how much I produce. If my worries weren’t enough something bad Happened, which was not typical: after orgasm almost no sperm came out and what came out just flowed sadly. I only know this when I am sick or when I had an ejaculation just before. So I am not just worried that I can’t get everything out but I worried to get something out at all.

Can my weakened psyche be so strong that my body reacts that way? I did not drink much that days and I had a Doxycycline, Diclofenac and Pantoprazole treatment from the fertility clinic to fight the Inflammations in my sperm. I was hoping that things would get better.

Is there any advice for me?

[webslave]

Given that you are a UCPPS patient, the chances are much higher that this is just your anxiety talking than any physical problem. That's our starting point. Secondly, strictures have very defined symptoms. I have an appointment now so I cannot expand on this, but Google 'urethral stricture symptoms' and read several websites to see if you have the symptoms. You need to have a bunch of the symptoms, not just one or two. Back later ...

[User-CPPS]

I am looking forward to you to be back. I am hopeless and anxious. Also, I connected these symptoms to UCPPS before and not to physical injuries.

1. "Reduced urine flow is the usual first symptom. Straining to pass urine is common but a complete blockage of urine flow is rare." Reduced flow, but no straining. Some times I need to press to finish what’s left inside so i don’t wet my pants.
2. "Spraying of urine or a double stream may occur. double stream may happen. Dribbling of urine for a while after going to the toilet to pass urine." Yes , if I don’t take time I wet my shorts
3. "Frequency sometimes occurs (needing to pass urine more often than normal)." Yes but given my nervous bladder it can be because of this
4. "Urine infections." Big no, just once bacterial Prostatitis in 2012
5. "You may have a reduced force of ejaculation." At the moment yes. Not always weak, but always the feeling of residual that flows outside later or with next urine
6. "Sometimes, mild pain on passing urine since medication no." Just when having daily ejaculation and irritated pelvic muscles and then I strain to pee and thus may hurt.

If I did not know about the power of pelvic muscles I would go all in with the stricture thesis

[webslave]

1. Sit to pee and take your time. This will eliminate straining completely. or should.
2. Again, sit to pee, and at the end put you hand up behind your testicles and "milk" forward to force any trapped urine out to the front of the penis. Dab with a little toilet paper.
3. Common to both disorders
4. Good, that's a strike against stricture
5. If the ejaculation is occasionally strong and forceful, shooting some way from the penis, that suggests there is no stricture. With UCPPS it is very typical to have weak and strong ejaculations at different times, randomly.

Ultimately, the best tests for a stricture, which can very rarely occur due to instrumentation (eg after cystoscopy) are flexible cystoscopy and retrograde urethrography (RUG), also voiding cystourethrography (VCUG) dynamic contrast imaging. Speak to uro.

[User-CPPS]

Dear webslave, thank you very much, I think positive now. I will talk to Uro.