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Suggest Treatment For Abdominal Aneurysm

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Posted on Wed, 28 Jan 2015
Question: Hi: I need to know more about what I believe my surgeon who repaired a serious abdominal aneurysm 2 years ago. I was told I may experience -- I think he said- retro ejaculation after the thru the groin surgery. I was ok for about a month or so, but then when I reached a climax during sex or masturbation, there was no ejaculation of any kind, but the sexual sensations and release was the same as before.

Is this common and is there anything that can be done about this condition? Why does this happen?

Thanks, XXXXXXX Burket, Ft Myers, FL
doctor
Answered by Dr. Muhammad Ahmad (1 hour later)
Brief Answer:
Your symptoms are highly suggestive of retrograde ejaculation

Detailed Answer:
Hello

Welcome to Health Care Magic.
My name is Dr Muhammad Ahmad & i will look into your problem.

I have gone through your query and would try to help you in the best possible way.

I understand your concern and will try to explain why this happens and what are the treatment options.

What is retrograde ejaculation:

There are certain parts in our body which work on principle of ,should i say "dual traffic mode", i will give you simple example of our mouth/pharynx you can eat through it and you can breathe through it , food and air are two very different things but there is a special valve system present in throat, called epoglottis when you breathe it opens the door to lungs when you eat , door to stomach opens, so when you are breathing you can't swallow and when you are swallowing you can't breathe.

This same principle works in case of ejaculatory system and urinary system , when you ejaculate your prostate contracts and pushes semen through urethra, this urethra has two opening ,one in the bladder and one on the outside,but bladder closes it's valve/sphincter tightly so semen just finds one way to go , that's to the outside.


Now you can understand the cause of retrograde ejaculation through a simple statement" ANYTHING, whether its a drug , nerve injury, disease, chemical or a surgery which causes bladder sphincter to mal-function, will cause retrograde ejaculation."

IS THIS COMMON?

I will not say it is very common but among the surgical complications,if happen, it is a fairly common one, specially if surgery is done through urethra , around the nerves which control this sphincter or any other surgery which directly or indirectly damages sphincter, this happens more commonly in case of surgeries which are done in lower abdomen, in case of aneurysms (which are emergency indication of surgery), surgeon sometimes has to chose between loss of life and loss of sexual functionality of the patient and indeed loss of life is never a good price to pay.This is most probably what happened in your case, they did a life saving procedure and must have tried to save bladder sphincter as well but somehow it lost it's function later.

CAN ANYTHING BE DONE?

Yes!! why not, UROLOGY is such an advanced field today and there are some safe and effective treatment options.

Treatment is always targeted to TREAT THE CAUSE of the bladder valve/sphincter dysfunction.

For example if nerves are lost (which doesn't seem to be your case, because your urination and balder function is fine and erection and ejaculation is functional too.

In structural problems (which seems to be what happened in your case) mostly surgery is used to repair the valve and make it function, structural changes aren't usually treated well with meds but sometimes meds do aid in improvement of valve function before and after surgery.

SUGGESTIONS:

I would suggest you to visit your UROLOGIST and discuss the problem, and treatment options in your scenario, he might want to do some tests like cystoscopy and sphincter tone etc and then after looking at these tests, plus your history and the procedures done at you, he will be able to suggest treatment options.

Hope I have answered your query. If you have any further questions I will be happy to help if not then don't forget to close the discussion and rate it.
Wishing you good health !!

Above answer was peer-reviewed by : Dr. Vaishalee Punj
doctor
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Follow up: Dr. Muhammad Ahmad (19 hours later)
Doctor Ahmad:

Thank you for a detailed and very helpful reply. I am glad to hear that there may be a way to rectify the situation. I will check with my local Urologist who I will be seeing in March.

Only remaining question is: Is there a downside if nothing can be done with this; is there any medical dangers if I have to live with this forever?

I do not know whether the fact that I have Stage 3 Kidney disease which is under control right now. I also take medication to enable my bladder from needing to void so often. The med is Oxybutynin Chloride 5 mg bid.

My urologist noticed a very slight size increase in my prostate and has me taking one capsule of Tamsulosin HCL .4 mg.

My ejaculation situation started before I was taking either of the above meds, but could the meds exacerbate the ejaculation problem?

Thanks again for your speedy and thorough reply to my original questions.
I will look forward to hearing your opinion on these new questions.

Regards and Happy Healthy New Year.
XXXXXXX
doctor
Answered by Dr. Muhammad Ahmad (1 hour later)
Brief Answer:
There should not be any problem medically, if this persists.

Detailed Answer:
Hi,

Thanks for writing back,

Here I will want to clear one thing, what ever I say about prognosis and causes is mostly according to your history, description, and most common scenarios which I can expect happening in your situation, problem in reality might be different completely or slightly. I am trying to make you understand how this happened and what can be the options, what exactly you need can only be told by a doctor who examines you, get you tested and reads and knows about the previous procedure details done on you. I hope that at the end of this discussion you will end up understanding your condition, possibilities and treatment options in a better way.

So here I will answer the questions you just asked,

WHAT IF NOTHING GETS DONE:

There SHOULD NOT be any medical complication if nothing gets done because semen goes to bladder and bladder gets empty when you urinate.

Only long term effect is loss of ejaculation in other words not being able to impregnate. In these cases in vitro fertilization technique is used.

I am glad that your kidney problem is under control, Kidney issue has very little to no role to play in ejaculation issue.

Can Oxybutynin and Tamsulosin HCL exacerbate the problem?

It pleases me that you are so well aware and ready to learn more, about your medical conditions and Meds you are taking. This depends upon the cause of problem, if your problem is because of dysfunction of bladder sphincter these meds are expected to exacerbate the situation but if the cause has nothing to do with bladder and sphincter tone then it may have little or no considerable effect. But in my opinion and the idea I could make out of your history, I think these drugs could have been having an effect.

Considerable or not, that your urologist will be able to say for sure, after determining the cause, and severity.

In my opinion you don't have to worry about the situation, this doesn't seem to be a dangerous one and it is not expected to cause you any medical issues except the one I mentioned above.

Hope I have answered your query. If you have any further questions I will be happy to help if not then don't forget to close the discussion and rate it.
Wishing you good health and a great new year!!
Above answer was peer-reviewed by : Dr. Ashwin Bhandari
doctor
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Follow up: Dr. Muhammad Ahmad (21 hours later)
Hi again Doctor:
You mentioned my overall awareness of my medical situation. Evidently I never mentioned that I had a single right lung Xplant at the Mayo Clinic over 5 years ago, and have had 5 surgeries since - not related to my transplant:

I have had two Kyphoplasties to repair spinal compression fractures, a lapindectomy for spinal stenosis, a double umbilical hernia repaired, an abdominal aneurysm repaired with a stent done via groin arteries, dozens of broncoscopies, literally hundreds of Xrays, and many CT's and MRI's. and a multitude of other tests. and minor non-invasive procedures.

In "self-defense" I had to do a lot of detailed research, consulting doctors and other medical experts at the Mayo and locally and at the VA.

Jokingly, my friends and even a couple of nurses tell me that I should be able to pass the medical boards by now. True that I have learned more about the medical profession, medications, procedures etc. etc, but I do not consider myself a "doctor" although now my friends and neighbors come to me for all kinds of advice. I help them where I can if it is only to refer them to a doctor I have used and trust.

In addition to the above, I suffered a TIA - no damage. Then later after my lung surgery, I suffered a very very mild heart attack - again no damage and only a tiny scar on the tip of one chamber.

My 3 attending doctors at the Mayo keep marveling at my continued progress. I am truly blessed, but a lot of my success has been strictly following Dr. orders, exercising regularly and taking my meds. faithfully.

I am now in a "Pay Back/Forward" mode. I participate in a child's literacy program locally and conduct The Better Breathers of Cape Coral -- a COPD support group. I will never be able to ever return all the blessings I have had bestowed on me, but I do what I can.

Sorry to go on, but I feel good that you are even more informed than when we started.

Thank you again for all the excellent info you gave me -- much more than any commercial medical websites. Thanks for "listening."

Have a great year. When this session is completely over, I hope I can find you to provide update on my problem. I do not see my urologist until March, and cannot get an earlier date.

Regards and Blessings,
XXXXXXX
doctor
Answered by Dr. Muhammad Ahmad (3 hours later)
Brief Answer:
It's a pleasure to know all you shared.

Detailed Answer:
Hi,
Thanks for writing back,
It's a pleasure to read how you fought with your conditions and living a healthy life, in fact helping and guiding others to achieve health.

I indeed couldn't even guess that you have gone through so many medical situations and procedures and still you are doing great. We don't really see many patients who have gone through so much and in age of 74 the question asked by them is related to their sex life.

I have to congratulate you on what ever you have achieved so far, its always a doctor's dream to come across such patient who wants to learn , understand, and fight his condition by his will power and following doctors advice strictly.

I indeed would like you to guide people about health issues, what doctor should they see how exercise helps how will power help,why follow drz instructions, you have so much to give , and i know you will keep giving.

Thank you so much for your trust and discussion with me , I am pleased that you understand our limitations on internet based medicine we do not have access to you and your labs so we try our best to give you closest diagnosis and description of possible problem. It is a great way to create a better understanding of disease and possible prognosis.

YES YOU CAN CONTACT me at http://doctor.healthcaremagic.com/doctors/dr-muhammad-ahmad/69304 and ask a direct question to me and i will be answering you directly.

Have a great year :)

Note: Consult a Urologist online for consultation about prostate and bladder problems, sexual dysfunction, kidney stones, prostate enlargement, urinary incontinence, impotence and erectile dysfunction - Click here.

Above answer was peer-reviewed by : Dr. Bhagyalaxmi Nalaparaju
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Answered by
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Dr. Muhammad Ahmad

General & Family Physician

Practicing since :2012

Answered : 1308 Questions

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Suggest Treatment For Abdominal Aneurysm

Brief Answer: Your symptoms are highly suggestive of retrograde ejaculation Detailed Answer: Hello Welcome to Health Care Magic. My name is Dr Muhammad Ahmad & i will look into your problem. I have gone through your query and would try to help you in the best possible way. I understand your concern and will try to explain why this happens and what are the treatment options. What is retrograde ejaculation: There are certain parts in our body which work on principle of ,should i say "dual traffic mode", i will give you simple example of our mouth/pharynx you can eat through it and you can breathe through it , food and air are two very different things but there is a special valve system present in throat, called epoglottis when you breathe it opens the door to lungs when you eat , door to stomach opens, so when you are breathing you can't swallow and when you are swallowing you can't breathe. This same principle works in case of ejaculatory system and urinary system , when you ejaculate your prostate contracts and pushes semen through urethra, this urethra has two opening ,one in the bladder and one on the outside,but bladder closes it's valve/sphincter tightly so semen just finds one way to go , that's to the outside. Now you can understand the cause of retrograde ejaculation through a simple statement" ANYTHING, whether its a drug , nerve injury, disease, chemical or a surgery which causes bladder sphincter to mal-function, will cause retrograde ejaculation." IS THIS COMMON? I will not say it is very common but among the surgical complications,if happen, it is a fairly common one, specially if surgery is done through urethra , around the nerves which control this sphincter or any other surgery which directly or indirectly damages sphincter, this happens more commonly in case of surgeries which are done in lower abdomen, in case of aneurysms (which are emergency indication of surgery), surgeon sometimes has to chose between loss of life and loss of sexual functionality of the patient and indeed loss of life is never a good price to pay.This is most probably what happened in your case, they did a life saving procedure and must have tried to save bladder sphincter as well but somehow it lost it's function later. CAN ANYTHING BE DONE? Yes!! why not, UROLOGY is such an advanced field today and there are some safe and effective treatment options. Treatment is always targeted to TREAT THE CAUSE of the bladder valve/sphincter dysfunction. For example if nerves are lost (which doesn't seem to be your case, because your urination and balder function is fine and erection and ejaculation is functional too. In structural problems (which seems to be what happened in your case) mostly surgery is used to repair the valve and make it function, structural changes aren't usually treated well with meds but sometimes meds do aid in improvement of valve function before and after surgery. SUGGESTIONS: I would suggest you to visit your UROLOGIST and discuss the problem, and treatment options in your scenario, he might want to do some tests like cystoscopy and sphincter tone etc and then after looking at these tests, plus your history and the procedures done at you, he will be able to suggest treatment options. Hope I have answered your query. If you have any further questions I will be happy to help if not then don't forget to close the discussion and rate it. Wishing you good health !!