Prostate removal surgery (prostatectomy) significantly alters the mechanics of ejaculation, though the ability to experience a sexual climax typically remains. Whether a man ejaculates fluid depends entirely on the type of surgery performed, which is determined by the underlying medical condition. For men undergoing removal for prostate cancer, the physical output of fluid is usually eliminated, resulting in a “dry orgasm.” Procedures done to treat a benign enlarged prostate often result in fluid being produced but traveling backward into the bladder.
The Prostate’s Contribution to Ejaculatory Fluid
Normal ejaculation involves the coordinated release of fluids from several glands, primarily the prostate and seminal vesicles. The prostate gland secretes a whitish, slightly acidic fluid that makes up 25% to 30% of the total semen volume. This fluid contains substances like citric acid and zinc, which aid in sperm nourishment and semen liquefaction.
The seminal vesicles, located behind the bladder, contribute the largest portion of the fluid, accounting for 65% to 75% of the ejaculate. Their secretion is a yellowish, viscous fluid rich in fructose, providing the primary energy source for the sperm. These fluids mix with sperm from the testicles to form semen, which is expelled through the urethra during orgasm.
The bladder neck, a ring of muscle at the junction of the bladder and the urethra, also plays a mechanical role. During climax, this muscle contracts tightly, preventing semen from flowing backward into the bladder. This ensures the semen is directed forward and out of the body.
The Outcome of Radical Prostate Removal
A radical prostatectomy, typically performed to treat prostate cancer, involves removing the entire prostate gland and the attached seminal vesicles. Since these organs produce over 95% of the seminal fluid, their removal results in a near-total absence of fluid production. This condition is termed anejaculation, or “dry orgasm,” because there is no fluid expelled.
The procedure requires the surgeon to reattach the urethra directly to the bladder, eliminating the valve-like function of the bladder neck. This surgical alteration compromises the mechanism to prevent backward flow. Consequently, men who undergo this surgery will not see any fluid exit the penis during orgasm.
Sperm is still produced in the testicles but is reabsorbed by the body after this surgery. The complete removal of the primary fluid-producing organs defines the universal outcome of anejaculation following a radical prostatectomy.
Orgasm Sensation Without Ejaculatory Fluid
The physical act of ejaculation and the neurological sensation of orgasm are distinct events. Orgasm is primarily a sensory event involving rhythmic muscular contractions and intense pleasure originating in the brain. Ejaculation is the physical expulsion of fluid that accompanies the climax.
Since the nerves responsible for the sensory experience are often preserved during prostate removal, the ability to reach climax usually remains intact. Men still experience the familiar buildup of tension followed by the release associated with orgasm, described as a “dry orgasm” because the physical fluid is absent.
For some men, the sensation of climax may feel different after surgery, sometimes reported as less intense or shorter. However, many men report that the orgasm remains pleasurable, and the loss of the visible ejaculate is the only significant change.
Ejaculation Changes After Other Prostate Surgeries
Procedures performed to treat benign prostatic hyperplasia (BPH), such as Transurethral Resection of the Prostate (TURP) or simple prostatectomy, differ from radical prostatectomy. These surgeries remove only the excess inner tissue of the prostate, leaving the fluid-producing seminal vesicles intact. Consequently, the body continues to produce seminal fluid.
However, these procedures often damage or alter the internal bladder neck sphincter, which normally closes during ejaculation. When the bladder neck cannot close effectively, the climax pushes the semen backward into the bladder instead of forward. This result is called retrograde ejaculation.
The man still experiences the full sensation of orgasm, but little to no fluid is expelled. The semen mixes with urine and is passed harmlessly during the next urination. Retrograde ejaculation is not harmful to health, but it causes infertility.