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   DIVISION OF MALE REPRODUCTIVE MEDICINE AND SURGERY                   
I had surgery 5 yrs. ago for BPH. It left me with retrograde ejaculation. I have been to several Urologists, Some that have been very rude and dismissive of the problem. I have COPD along with Major Depression. I have tried higher dosages, but I get a bad reaction from my other meds. I take 600mg of Bupropion a day along with Advair, alprolozam 1mg 3/day, Zolpidem Tartrate 10mg, Levothyroxine 25mg and sudaphed 1 3x day. Along with vitamins, and selenium, anti-oxidant, E & B complex, niacin and D. It has gotten to where I can't feel an orgasm, but have semen in my urine. I am getting desperate and further depressed. Is there treatment, if so how do I find a urologist that can help? I have been to 4 that were dismissive and 1 very rude.

RE is common after BPH surgery, as you must know. Unfortunately, orgasm and sensation issues alone are often rooted in non-urological origins (it is often said that orgasm happens in the brain). Indeed, depression, chronic disease, and medications listed above are all risk factors. Urologists might check for major hormonal issues that can sometimes affect orgasm, but might not be able to treat many of the non-urological root causes. The brain and nerves are very complex, and unfortunately this means that solutions are not simple. For some patients, modifying/eliminating risk factors might be a good place to start.