In normal ejaculation, several events must take place. Sperm, which are made in the testicles, travel to the epididymis, a “greenhouse,” in which they mature. During orgasm, sperm are rocketed from the epididymis through the vas deferens during a series of powerful muscle contractions. They shoot through the ejaculatory ducts and mix with fluid produced by the prostate and the seminal vesicles. Simultaneously, a muscular valve in the bladder neck slams shut, forcing this fluid out the only possible exit—through the urethra and penis to the outside world, rather than backward into the bladder.

In most men who have undergone a TUR procedure for BPH, this valve is damaged; and therefore, because there’s no barrier to keep sperm from going back into the bladder, it isn’t forced out the urethra (this is called “dry,” or retrograde ejaculation).

After radical prostatectomy, there is usually no emission of fluid because the prostate and seminal vesicles, which produce the vast majority of this fluid, are gone and the vas deferens has been shut off. (A few men, however, do continue to produce a small amount of ejaculate. This fluid comes from the nearby Cowper’s glands; like the prostate and seminal vesicles, these are known as “sex accessory” tissues.)

After radiation therapy, many men also have a loss of ejaculate fluid because the glands responsible for making this fluid are “dried up.” In any event—no matter what causes “dry” ejaculation—the lack of fluid should not interfere with orgasm. The reason is that orgasm doesn’t really have much to do with the prostate. Think about it—women don’t have prostates, yet they do have orgasms. Why? Because . . .

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