Urological Concerns: Ejaculation, Urination, and More

Q: Urological Concerns: Ejaculation, Urination, and More

LEE： Hello. 1. Premature ejaculation can gradually improve with experience. 2. Most people experience ejaculation as a flow. True ejaculation, where the semen is expelled forcefully, typically occurs only when one is extremely aroused or, like actors in adult

Many issues?

Hello doctor, I started having the habit of masturbation around the fifth grade, and it has been quite frequent.
When I was younger, I didn't understand it; I just felt it was very pleasurable, almost once a day, sometimes even twice.
After high school, I realized that frequent masturbation might have an impact on my body, so I tried to limit it, but I still do it about three times a week.
I am unsure if my long-term frequent masturbation has led to some current issues:
1.
Premature ejaculation: I currently have no real-life experience, and I often finish within a minute during masturbation.
If I just watched an erotic video, I might finish in as little as 30 seconds.
Is it possible for this situation to improve?
2.
Ejaculation: My semen has never "shot" out; it just flows out.
Most of the time, I feel the sensation of ejaculation after climax, but the semen does not fully exit my body; it remains "completely" at the base of the penis.
I have to apply pressure at the base for the semen to flow out of the urethra.
Why does this happen? Is it related to my hypospadias? (I have a history of hypospadias and had surgery as a child; currently, my urethral opening is on the ventral side of the penis, close to the coronal sulcus.) How can this be improved?
3.
Residual urine: I often feel that my bladder is not completely empty.
After urinating, I still have to squeeze the base of my penis to expel residual urine, but it still doesn't feel completely empty, and I sometimes unintentionally leak urine afterward.
Occasionally, there is a larger amount that has an odor.
How can this be improved?
4.
Short and curved penis: This is likely due to my hypospadias, resulting in a short and curved penis.
How can I provide photos for you to assess whether correction is necessary?
Thank you for taking the time to read through my concerns.

lee, 20~29 year old female. Ask Date: 2010/06/03

Dr. Xu Weikai reply Urology

LEE: Hello.
1.
Premature ejaculation can gradually improve with experience.
2.
Most people experience ejaculation as a flow.
True ejaculation, where the semen is expelled forcefully, typically occurs only when one is extremely aroused or, like actors in adult films, has undergone special training or selection to achieve this consistently.
Hypospadias, after surgery, should improve your condition.
The location of your urethral opening near the corona should not affect ejaculation or fertility; however, if you are unsatisfied, you can undergo another surgery to reposition the urethral opening to the normal location at the tip of the penis.
3.
Residual urine is often due to psychological factors or autonomic nervous system issues.
This situation usually occurs after ejaculation.
Try not to focus on it or force out urine repeatedly, as this will gradually improve; constantly squeezing out a few drops can actually harm the bladder.
4.
Concerns about penile size? Accurate measurement is necessary.
If you have questions, you can ask your doctor during the urethroplasty consultation.
If there are any unclear points, feel free to ask again for further discussion and research.
This response is from Dr.
Hsu Wei-Kai, Director of Urology, Taitung Hospital, Department of Health, Executive Yuan.

Reply Date: 2010/06/03

More Info

It sounds like you are experiencing a number of urological concerns that are affecting your quality of life. Let's address each of your issues one by one, providing insights based on medical knowledge.

1. Premature Ejaculation: It's common for individuals to experience premature ejaculation, especially if they have a history of frequent masturbation. The good news is that this condition can often be improved with practice and certain techniques. Behavioral techniques, such as the "stop-start" method or the "squeeze" technique, can help you gain better control over your ejaculation. Additionally, there are topical anesthetics and certain medications that can help delay ejaculation. Consulting with a urologist or a sexual health specialist can provide you with tailored strategies to address this issue.

2. Ejaculation Issues: The sensation of ejaculation without the forceful expulsion of semen can be concerning. This could be related to your history of hypospadias, which can affect the anatomy and function of the urethra. In some cases, individuals with a history of hypospadias may experience altered ejaculation patterns due to the surgical correction or anatomical changes. It’s important to discuss this with a urologist who can assess your specific situation and determine if any interventions are necessary. They may recommend pelvic floor exercises or other treatments to improve your ejaculation.

3. Post-Void Dribbling: The feeling of incomplete bladder emptying and the need to apply pressure to expel residual urine can be frustrating. This can be due to a variety of factors, including pelvic floor muscle dysfunction or anatomical issues related to your previous surgery. Kegel exercises, which strengthen the pelvic floor muscles, may help improve your control over urination. Additionally, ensuring that you are fully relaxed while urinating and taking your time can also help. If these issues persist, a urologist can provide further evaluation and treatment options.

4. Penile Size and Curvature: Concerns about penile size and curvature, especially in the context of a history of hypospadias, are valid. If the curvature is significant or causing discomfort, it may be worth discussing surgical options with a urologist. They can evaluate whether corrective surgery is appropriate for your situation. As for sharing photos, many medical professionals have secure platforms for patients to upload images for evaluation, but this would depend on the specific practice's policies.

In summary, your concerns are valid and can be addressed with the right medical guidance. It is advisable to consult with a urologist who specializes in sexual health and male reproductive issues. They can provide a thorough examination, discuss your symptoms in detail, and recommend appropriate treatments or interventions. Remember, you are not alone in facing these issues, and there are effective solutions available.

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