The prostate gland is a small, walnut-sized organ located beneath the bladder in the male reproductive system. When this gland is removed, typically through a procedure known as a radical prostatectomy, it raises questions about the ability to have children afterward. While the surgical removal of the prostate fundamentally alters the process of reproduction, it does not necessarily end the possibility of biological fatherhood. Understanding the specific changes to the body’s reproductive functions is important for making informed decisions about future family planning.
The Prostate’s Function in Reproduction
The prostate’s primary role in reproduction is to produce a significant portion of the seminal fluid. This fluid makes up approximately twenty to thirty percent of the total volume of semen expelled during ejaculation. The remaining fluid is mostly contributed by the seminal vesicles, two small glands situated just behind the bladder. Together, these fluids create the optimal environment for sperm, providing nourishment and a protective, alkaline buffer against the acidic environment of the vagina. The prostate surrounds the urethra, the tube that carries both urine and semen out of the body. During ejaculation, muscles within the prostate contract to help push the fluid mixture into the urethra.
How Prostate Removal Affects Ejaculation
The removal of the prostate and seminal vesicles has a direct impact on the physical act of ejaculation. A radical prostatectomy surgically disconnects the pathway that allows semen to travel from the reproductive ducts to the urethra. Because the primary fluid-producing glands are removed, the patient will no longer expel any fluid during climax. This condition is referred to as anejaculation, resulting in a “dry orgasm.” The physical sensation of orgasm remains, as it is generated by muscular contractions and nerve signals distinct from the fluid expulsion mechanism.
Sperm Production and Fertility After Surgery
The core biological function of producing reproductive cells remains intact after a prostatectomy. Sperm are created in the testicles, which are not removed during the procedure. This means that sperm production continues in the body, ensuring the man is not completely sterile in the biological sense. However, the lack of a transport mechanism makes natural conception impossible. The surgical removal of the prostate disrupts the vas deferens path, preventing sperm from mixing with seminal fluid and traveling out of the body. The sperm produced by the testes are instead reabsorbed by the body. Consequently, while the man still produces sperm, he cannot naturally impregnate a partner through sexual intercourse.
Options for Conception After Prostatectomy
For men who wish to father children after a prostatectomy, several medical options exist to bypass the anatomical blockage. The most effective strategy involves proactively banking sperm before the surgery occurs. Sperm banking, or cryopreservation, involves freezing and storing sperm samples for future use in assisted reproductive technologies (ART). This is the recommended fertility preservation measure.
If sperm banking was not performed before the procedure, fatherhood can still be achieved through surgical sperm retrieval combined with ART. Fertility specialists can retrieve sperm directly from the testes or the epididymis, the coiled tube behind the testicles where sperm mature. Methods such as Testicular Sperm Extraction (TESE) or Percutaneous Epididymal Sperm Aspiration (PESA) involve a minor procedure to harvest viable sperm cells.
Once retrieved, these sperm are used in advanced techniques like In Vitro Fertilization (IVF) or Intracytoplasmic Sperm Injection (ICSI). ICSI is effective because it requires only a single sperm cell to be directly injected into an egg, overcoming issues related to low sperm count or motility. The successful use of these combined technologies has made biological parenthood a realistic possibility for many men who have undergone prostate removal.