Question: 44 male. Good health. good diet. maybe 10 pounds overweight at most. BP normal to low. Vasectomy 4 years ago. Had prostatitis a year ago, tip of penis hurt like hell for a while. Visited Urologist, diagnosed with enlarged prostate and prostatitis (prostatitis was cleared with diet alteration and antibiotics, not sure which did what). Still have enlarged prostate. Urethra scoped and fine. Otherwise no major health problems other than Ankylosing Spondylitis which affects my hips but is not currently problematic. Celebrex as needed, havent had any in a month.
About 6 months ago during sex and masturbation i began noticing a pre release of what i'd describe as semen light. thicker than urine but very runny, clear with a hint of semen in it. no real smell to it. similar to drops of pre cum but maybe a little thinner. Not pleasurable but not too uncomfortable when it happens, just embarrassing. Always happens involuntarily when i am getting close to ejaculation. Lately its gotten a bit worse during sex and i feel like i might have to pee a little then the runny clear pre ejaculate comes out. I dont think its urine, but i'm not sure. an empty bladder does not seem to prevent this from happening.

I have no problem at all getting and staying erect. When it happens, It does not end my erection and i can almost always still finish and ejaculate completely normally though its sometimes much more difficult to get there if this pre ejaculate happens. I still ejaculate normally when i do. I'd say about as much pre ejaculate comes out when this happens as normal ejaculate does when i finish. Makes sex really damn messy when it happens and my wife thinks i've cum when i havent, and receiving oral sex is dangerous because i cannot sometimes predict when this stuff will come out, there are no physical cues sometimes so i give no verbal or physical cues to her and it can be enough overwhelm her if she's not expecting it. Usually it more runs out than propels out. and of course i dont want urine in my wifes mouth. Sorry to be graphic doc :-) Trying to give you all the info.
Occasionally it will end my erection but i think that's more from embarrassment than an inability to keep going. I can sometimes feel it coming on and can push it back and stop it from happening, but thats kind of a buzz kill to do as well, and i often cant stop it or dont know its about to happen.
I used to be a rockstar in bed, this has really changed everything and is plaguing me and ruining my sex life with my wife. Do you have any insights? suggestions? diagnoses? Need further info?
I dont think i have any semen in my urine. No blood in either. I seem to be otherwise fine. Of course with the enlarged prostate, peeing is often a bit drippy and slow and more frequent, but if my bladder is full i have no problem taking a nice long regular pee. :-)
Please help.
Thanks! XXXXXXX

Thank you Dr. XXXXXXX
I'm going to schedule a Dr's appt now, but i have a few follow up questions..

I am allergic to penicillin, might there be any worries with Cefixime ?

And the anti inflammatory, did you mean diclofenac? Is there any worry / interaction taking that along side Celebrex?

And at what dosages would you recommend Cefixime and diclofenac and for how long?
Do you think this is curable or is this a long term problem i might always have to deal with?
Thanks XXXXXXX

Last question, thanks for the previous answers.

I am also taking 200mg/day Doxycycline Hyclate to clear a staff infection on my skin (mostly on my neck and chin but a little bit on legs / arms / back)

Also taking Simvastatin to lower cholesterol as a precautionary (i had open heart surgery 7 years ago, my cholesterol is at 195 and dropping)

Any conflicts with those drugs? Thank you for all of your help, i truly appreciate it

Are you saying that the Doxycycline should treat this so i don't need the Cefixime? Or are you saying there is a drug conflict between the two drugs and i should not take both together?

Is there an OTC anti inflammatory that will help me until i can get the prescription Diclofenac? My wife has 800mg ibuprofen that i take sometimes when my Ankylosing Spondilitis is flaring up. Or i can just take 800mg of Advil :-) Will that help until i can get the stronger Diclofenac?

Thanks Doc!