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Suggest Treatment For Night Falls

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Posted on Tue, 24 Jun 2014
Question: I do experience nightfalls every other week. Also when having bowel movements, I do see semen oozing from my penis. I rarely enjoy sex as sometimes I don't get strong erections and if I do I still ejaculate after some seconds. What could be the problem. I have had this problem for the last 10 years. Am 41 years old now.
doctor
Answered by Dr. T Chandrakant (59 minutes later)
Brief Answer:
investigations to go to the root cause.

Detailed Answer:
Hi.
Thanks for your query and history you have provided , sufficient enough to decipher something.

Few Suggestions to start with::
Please understand and keep fixed in mind that nightfall is absolutely a natural and normal phenomenon. It is like overflow of a tank. The discharge is necessarily a prostatic fluid and get overflown the moment the prostate is full with its own secretions. A normal person can get nightfall ranging from 2 to 4 times in a week in a very young age to few times in a month as the age advances.

This may be another added reason that you see semen oozing from penis at the time of bowel movement.

You say: you enjoy sex rarely as you do not get full erections sometimes and there is an early ejaculation. This itself indicates there is tremendous stress and tensions due to this or other reasons.
The anxiety of performance adds to the pre-existing problems.
This is a psychological part of the problem.

Let us talk of the Organic/ bodily problem::
I think you have an additional problem with the prostate.
I would suggest to get yourself examined by an Urologist / General Surgeon. The examination is not complete unless the pre-rectal palpation of the prostate is done. This direct examination has no alternative as it gives the information no other test can give. We can know the size, consistency , smoothness , nodularity, feeling of a cyst or a mass, tenderness ( pain on palpation/ pressure).
By doing the prostatic massage we can get a sample of the prostate fluid for analysis.
Additional information can be sought by ::
Ultrasonography of abdomen for whole and genito-urinary system.
Per-rectal ultrasonography to get a clearer picture of the prostate, seminal vesicles.
Blood investigations including that for sugar.
Urine - Routine, microscopy, culture and sensitivity.
Semen: analysis, gram staining and staining for AFB ( since the problem is long standing).
X-ray of the Chest.
Intravenous pyelography (IVP) only if indicated.
All these investigation will lead to a proper diagnosis and a proper treatment.

Do not take symptomatic treatment at the moment , as you must have been given so many times. Do not take cialis.

Above answer was peer-reviewed by : Dr. Vaishalee Punj
doctor
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Follow up: Dr. T Chandrakant (1 hour later)
Thank you for the detailed answer. Last year, December to be precise, my doctor recommended that I do a scan of the abdomen. According to the results, my prostrate was normal in size. May be I didn't mention this before, I do experience urgent need to urinate and also a burning sensation. My bladder is never full but I do feel as though it is.

Lastly, my erections are weak even during nightfalls.
doctor
Answered by Dr. T Chandrakant (1 hour later)
Brief Answer:
Please go for systematic investigations

Detailed Answer:
Most welcome.

Was it ultrasound scan or CT scan ?

I would request you to follow the investigations as mentioned to get a proper diagnosis. You need to be examined by a Doctor - Urologist preferably to get a clinical / physical examination of the prostate.

Prostatitis is not easy to diagnose. It can cause urgency to urinate, gives burning sensation and feeling of a fullness in the bladder.

Once you are diagnosed well and treated properly, sexual function will automatically improve.





Above answer was peer-reviewed by : Dr. Yogesh D
doctor
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Follow up: Dr. T Chandrakant (21 hours later)
Thanks Doctor. It was both CT and ultrasound. However, the results showed normal prostrate size. The doctor prescribed two types of medicens which helped me for a while (I could hold my urine for a longer period and the burning sensation was reduced). But my PE didn't improve. Also, how come when i use Cialis i get headache and my body becomes irritable and sensitive? Could it be that i react to it? thanks
doctor
Answered by Dr. T Chandrakant (2 hours later)
Brief Answer:
Cialis works by dilatation of arteries.

Detailed Answer:
Prostatitis does not always be accompanied by prostate enlargement.
So one can have a normal size prostate and still be suffering from a mild form of prostatitis. You would have continued the previous tablets which your Doctor prescribed.

Cialis ( tadalafil ) acts by increase in blood blow by dilatation of the arteries particularly in the penis but it work s on the other blood vessels of the body too. This is why everyone gets that typical problem in the head and body. Anyone who has taken it for the first time without knowing this can be afraid to take it again.
I do not think you reacted to it.

You can always start from the lower dose of half of 25 mg tablet and increase till the body is accustomed to it.
Note: For more detailed guidance, please consult an Internal Medicine Specialist, with your latest reports. Click here..

Above answer was peer-reviewed by : Dr. Yogesh D
doctor
Answered by
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Dr. T Chandrakant

General Surgeon

Practicing since :1984

Answered : 19779 Questions

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Suggest Treatment For Night Falls

Brief Answer: investigations to go to the root cause. Detailed Answer: Hi. Thanks for your query and history you have provided , sufficient enough to decipher something. Few Suggestions to start with:: Please understand and keep fixed in mind that nightfall is absolutely a natural and normal phenomenon. It is like overflow of a tank. The discharge is necessarily a prostatic fluid and get overflown the moment the prostate is full with its own secretions. A normal person can get nightfall ranging from 2 to 4 times in a week in a very young age to few times in a month as the age advances. This may be another added reason that you see semen oozing from penis at the time of bowel movement. You say: you enjoy sex rarely as you do not get full erections sometimes and there is an early ejaculation. This itself indicates there is tremendous stress and tensions due to this or other reasons. The anxiety of performance adds to the pre-existing problems. This is a psychological part of the problem. Let us talk of the Organic/ bodily problem:: I think you have an additional problem with the prostate. I would suggest to get yourself examined by an Urologist / General Surgeon. The examination is not complete unless the pre-rectal palpation of the prostate is done. This direct examination has no alternative as it gives the information no other test can give. We can know the size, consistency , smoothness , nodularity, feeling of a cyst or a mass, tenderness ( pain on palpation/ pressure). By doing the prostatic massage we can get a sample of the prostate fluid for analysis. Additional information can be sought by :: Ultrasonography of abdomen for whole and genito-urinary system. Per-rectal ultrasonography to get a clearer picture of the prostate, seminal vesicles. Blood investigations including that for sugar. Urine - Routine, microscopy, culture and sensitivity. Semen: analysis, gram staining and staining for AFB ( since the problem is long standing). X-ray of the Chest. Intravenous pyelography (IVP) only if indicated. All these investigation will lead to a proper diagnosis and a proper treatment. Do not take symptomatic treatment at the moment , as you must have been given so many times. Do not take cialis.