LISWT report, ejaculation and testosterone q

[StLouisGuy]

2 and 3/4 years ago I did one shot lupron, then external beam, then brachy. I was 60 yrs old with localized cancer with 6,6 ,3-4, 3-4, 4-3 Gleasons and a PSA 8.58, and a large large prostate (37), BMI:37.8 . PSA dropped below 1 and has stayed there. Testosterone returned to a range of 429 to 512. lasting side effects were loss of penile girth, lower libido, ED, and ejaculatory and orgasm issues.

7 months ago I went through a six treatment regimen of LISWT, with very good results, significantly resolving the ED issues. However the ejaculation issues remain. If I am more passive, as in a sensual massage, I suffer extreme premature ejac., , before erect and in minutes, with ejac but no real orgasm behind that. When more active engaged, I become erect, and engage until I get to the point of ejac/orgasm, but then get a sensation of blockage, no ejaculation, and the feelings pass and I lose my erection. I've seen 4 urologists and none have experience w this condition or any thoughts. Any suggestions as to what to do ext? Also, if i want to explore a testosterone increase regimen, with care taken to .minimize estrogen, what type of doc do I consult? All thoughts welcome and appreciated

#testosterone #liswt #ejaculation

[Hidden]

What is LISWT

[BruceSF in reply to Hidden]

low-intensity shockwave treatment

See pubmed.ncbi.nlm.nih.gov/349... for a pilot study that showed improvement in patient self-reports (but not in measurable blood flow improvement)

[Tall_Allen]

I suspect I have blockage of my seminal vesicle ducts. I'm having an MRI in a couple of weeks to investigate. There is a procedure called "transurethral seminal vesiculoscopy" that I'm hoping my urologist can do, but the experts only seem to be in Hong Kong. Or, the following procedure may be more widespread. It is used for infertile men, but the essence is getting rid of an obstruction, which I think is scar tissue in my case.

hopkinsmedicine.org/health/...