Post-Shockwave Lithotripsy: Why Am I Unable to Ejaculate?

Inability to ejaculate after shockwave lithotripsy?

After undergoing an examination at the hospital for ureteral stones, I had shock wave lithotripsy.
I noticed blood clots in my urine, but I haven't seen any stones.
Additionally, I can engage in sexual activity, but I experience orgasm without ejaculation (it's been four days since the procedure).

Niming, 30~39 year old female. Ask Date: 2015/12/12

Dr. Fu Shizhang reply Urology

The absence of semen during ejaculation may be a side effect of medication (retrograde ejaculation) and is unrelated to shock wave lithotripsy.
Discontinuing the medication should allow for recovery, and there is no need for excessive concern.
Postoperative hematuria is also a normal phenomenon; it is advisable to drink plenty of water.
As for whether the stones have been expelled, a follow-up visit to the clinic is necessary for assessment.
Online responses are for reference only, and if needed, it is still recommended to seek medical attention at a healthcare facility.

Reply Date: 2015/12/12

More Info

After undergoing shockwave lithotripsy (SWL) for ureteral stones, experiencing changes in ejaculation can be concerning and may stem from several factors related to the procedure and the body's healing process. Here’s a comprehensive overview of why you might be unable to ejaculate after the treatment and what you should consider moving forward.

Understanding Shockwave Lithotripsy
Shockwave lithotripsy is a non-invasive procedure that uses sound waves to break kidney stones or ureteral stones into smaller pieces, allowing them to pass more easily through the urinary tract. While this procedure is generally safe and effective, it can lead to temporary side effects, including discomfort, bleeding, and changes in urinary function.

Possible Reasons for Inability to Ejaculate
1. Physical Trauma: The shockwaves used in lithotripsy can cause minor trauma to the surrounding tissues, including the reproductive organs. This trauma may lead to temporary swelling or inflammation, which can affect the normal function of the reproductive system, including ejaculation.

2. Nerve Irritation: The procedure may irritate or affect the nerves that control ejaculation. The pelvic region is densely packed with nerves, and any disruption can lead to altered sensations or difficulties in achieving ejaculation.

3. Psychological Factors: Anxiety or stress related to the procedure or the underlying condition (like the presence of stones) can also impact sexual function. The psychological aspect of recovery should not be underestimated, as it can play a significant role in sexual health.

4. Medication Effects: If you were prescribed medications for pain management or to help with recovery post-procedure, some of these medications can have side effects that impact sexual function, including ejaculation.

5. Healing Process: After any medical procedure, the body goes through a healing phase. During this time, various functions may be temporarily altered. It is possible that your body is still adjusting after the lithotripsy, and normal function will return as healing progresses.

What to Do Next
1. Monitor Symptoms: Keep track of any other symptoms you may be experiencing, such as pain, changes in urination, or any unusual sensations. This information can be helpful for your healthcare provider.

2. Consult Your Doctor: It is essential to follow up with your urologist or healthcare provider regarding your inability to ejaculate. They can perform a thorough evaluation to rule out any complications or underlying issues that may need to be addressed.

3. Discuss Sexual Health: Be open about your concerns regarding sexual function. Your doctor can provide guidance and may refer you to a specialist in sexual health if necessary.

4. Patience and Time: Recovery from procedures like SWL can take time. Many patients find that their sexual function returns to normal as they heal. However, if the issue persists beyond a few weeks, it is crucial to seek medical advice.

5. Consider Psychological Support: If anxiety or stress is a concern, consider speaking with a mental health professional who specializes in sexual health. They can provide strategies to help manage any psychological barriers you may be facing.

Conclusion
In summary, the inability to ejaculate after shockwave lithotripsy can result from a combination of physical, psychological, and procedural factors. While it can be distressing, many patients experience a return to normal function as they heal. It is essential to maintain open communication with your healthcare provider to ensure that any underlying issues are addressed and to receive appropriate support during your recovery.

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