Replies of a specialist

I’m 19 years old and have urine problems – I urinate a lot during the day. Could this be related to a sexually-transmitted disease?

Are you also experiencing excessive thirst, which would be a natural response to excessive urination? It could point to diabetes, so you should consider consulting your doctor. Excessive urination is not a typical sign of sexually-transmitted infections. It could be a sign of urinary tract inflammation or renal inflammation, though this does not commonly occur in men.

I have a burning sensation at the tip of my penis. What does that mean?

The medical term for this condition is dysuria, which is primarily caused by urinary tract infections. Please visit your doctor to get proper treatment.

I’m a healthy male, aged 37. I’m worried about the small volume of my seminal ejaculate and weak orgasms. I know this could be related to my age, but the problem has never before been this serious. Is there any food, food supplements or medicines I could buy to increase the volume of my ejaculate and increase the intensity and length of my orgasm? Thank you for your reply.

I am not aware of any product that could help you with this. Erection problems can be medicated. Perhaps it would be best to consult your doctor and see whether you can start taking sildenafil, tadalafil or vardenafil. Most of the products you can buy online are not proven as effective.

I’m 36. Around one year ago I suddenly noticed that my sexual drive as well as power had been reduced. It has become very difficult for me to get aroused, even when I watched erotic movies. My partner and I see each other once a month; it’s like this at the moment. When I come over, our desire and need is much bigger because of that, we become more active, but here lies my problem – I start to experience erection problems. Sometimes I get no erection at all and sometimes it’s weak. When I try to penetrate her, my penis becomes flaccid and it’s impossible to keep the intercourse going. I simply cannot maintain an erection. I’ve tried pills which raise the nitrogen blood level. It helped, but I’m afraid to take them again. I don’t know how safe they are, whether or not they present health hazard, even though they are supposedly 100% herbal.

Please visit a general practitioner. Prescription-free pills that are not bought in a pharmacy are not reliable and can be dangerous.

I have regular sexual relations with my partner. Sometimes during intercourse my penis becomes flaccid and then later becomes erect again. Is this a physical thing?

I believe that there is nothing wrong with you. If you can get to the end of the intercourse, that is not a problem.

I’m 70. My seminal discharge is very small in terms of volume, I’d say just a few drops. Is this because of the aging process or can there be other reasons for it? Is the sexual drive also reduced because of that? Can this condition be improved?

The volume of the seminal fluid depends on the frequency of discharge, patency of the duct and gland function. In any case I would recommend a complete prostate test (which you should undertake once a year anyway), and if you want you can also have your testosterone levels measured.

Two weeks ago I started taking a medicine to reduce gastric acid. A week later I discover that my penis was considerably softer during erection. In the patient information leaflet I then read that in very rare cases adverse effects can include erection problems. Four days after I stopped taking the medicine things are still the same. Will this condition improve or will I face long-term consequences?

Wait a few days so that the effect of the medicine stops completely. In the event that problems persist please note that they were not caused by the medicine but occurred at the same time by chance.

Five or six years ago I was diagnosed with carcinoma of the right testicle. The testicle was removed, my condition is now stable but I’m experiencing sexual problems. For the past two years I’ve been having erection problems that have been getting worse and I’ve also experienced loss of libido. I’d like to know if there’s any correlation between my current problems and having a testicle removed. Do you recommend I get some tests done or go on a treatment? I’m 32.

After one of the testicles has been removed, the other takes over its hormonal and reproductive role, so this is not the cause of your problems. I would advise you to see a urologist.

I’m 17 and have a problem. During erection I cannot get the foreskin over the head, and also cannot put on a condom, because it hurts to do so. When the penis is in a flaccid state, I don’t have these problems, the foreskin comes over the head easily, but not during the erection. What do you recommend? Should I try pulling down the foreskin even though it hurts?

Based on the type of difficulty you describe I would recommend circumcision.

Is it true that varicocele causes infertility in men and should be operated on as soon as possible? I have it on my left side and have no problems. My wife uses no protection and hasn’t yet become pregnant. My doctor suggested surgery.

Varicocele (abnormal dilation of the veins of the spermatic cord) can be a cause of infertility, because the pooling of venous blood above the testicle increases its temperature, causing abnormal development of the sperm cells. Prior to having the surgery you need to have your semen checked (spermiogram). Your wife also needs to be tested, since the cause of her not conceiving may not only lie with you.

I have premature ejaculation so I have decided to put an end to my problem. I’d like to see a urologist but don’t know how to get to one. Do I have to see my doctor first and get a referral letter or can I see a urologist straight away? I’d also like to know whether I have to pay for this medical treatment myself or not. Thank you for your reply.

For a check-up with a urologist in a public health care institution or a urologist holding a concession (in this case the check-up is free of charge) you need a referral letter from your doctor. If you would like to have a check-up without the referral letter, you can make an appointment at a self-payment outpatient clinic and pay for the service.

As a grown man I have to urinate three to four times a night – what does that mean? I have no other difficulties except for the slightly burning sensation prior to urinating.

Frequent urination has several causes, e.g. infection (particularly when you experience a burning sensation during urination) or enlarged prostate. I would advise you to see your doctor and have your urine checked; if necessary, you will be referred to a urologist.