Anonymous on September 1, 2011

How do I have satisfying orgasms after prostate surgery?

Since I had TURP surgery, my ejaculate goes into the bladder and is discharged with urine. I am homosexual, and now I don’t have the same satisfaction from orgasm that I had before. I do climax, but I find myself somewhat frustrated each time. Is there any way to improve this?

answered by David Sobel, MD, JD on September 1, 2011

Thanks for coming to us with your question. I’ll do my best to offer you some helpful information.

TURP surgery (short for “transurethral resection of the prostate”) is often performed to treat an enlarged prostate and the urinary problems it causes. And, as you described, after surgery, semen may no longer come out when you orgasm…or there may be very little semen.

That said, for most men, the sensation of orgasm after a TURP is actually the same as before. But after a lifetime of ejaculating, this may seem strange. Many men aren’t bothered by the change and it doesn’t affect their sexual pleasure…but others find the change significant. So while you’re not alone in your understandable frustration, it’s hopefully just a matter of time until you adjust to the change.

On a physical level, the only change caused by a TURP is that a man can no longer get a woman pregnant. This is something doctors ask about before surgery…but it doesn’t sound like this side-effect is a concern for you.

Other possible reasons for a less intense orgasm are age and hormone levels. As men age, their orgasms often become less intense. And, as you know, since TURPs are also generally done as men enter their 50s, 60s and 70s. The timing of the TURP may just be correlating with the sexual symptoms that occur with aging.  

Additionally, hormone levels can also play a role in less intense orgasms, which is something your doctor can help you with.

Lastly, over time, your prostate tissue will grow back to some degree…and you may find that your ejaculate returns, too. But this is rare, as retrograde ejaculation is usually permanent.

Bottom line, if your hormone levels check out but you continue to have unfulfilling orgasms, you may want to consult a sex therapist in the short-term.

Thanks again for writing, and I wish you good luck resolving this issue to your satisfaction.

Related Info:

David Sobel, MD, JD

Dr. Sobel is a Colorado-based urologist and Director of the Denver Center for Men’s Health. His areas of expertise include men's sexual health and all areas of urology, including urologic oncology, treatment of benign prostatic hypertrophy, stone disease and incontinence. Dr. Sobel was educated at the University of Michigan Law School and the University of Illinois at Chicago College of Medicine, and completed his residency at the Rush University Medical Center in Chicago, IL.

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