An Old Urology Joke Teaches Us a Lot About Male Sexuality
This Urology joke known to every urologic resident is funny, but not factual. The difference between impotency, fertility, libido and climax is revealed using humor. And then this…the male’s lack of knowledge in this regard is in part responsible for the problem of delayed diagnosis in prostate cancer.
When a man has a vasectomy or a prostatectomy his sex drive or libido, which is dependent on the male hormone testosterone, does not change. Testosterone is produced by the testicles and released into the blood stream and subsequently not affected, or its blood level diminished, by either procedure.
One of the oldest Urology jokes around involves a man coming to the Urology clinic for a vasectomy all dressed up in a tuxedo. When asked,” Why the formal attire?” he responds,” If I am going to be impotent, I’m going to look impotent.” The problem with this joke, as explained in the bullet above, is that a vasectomy makes you sterile (no sperm), it has no affect on potency. Potency refers to erectile function which is independent of fertility (which is what a vasectomy affects). I mention this because it is misconceptions like these which abound within the male population, and contribute to the “perfect storm” of delayed diagnosis alluded to earlier in this book. It is still a cute joke however.
· The external sphincter, which is anatomically below the prostate, is not disturbed by the prostate’s removal. The contraction of this muscle contributes to the feeling of climax and is usually not affected by a prostatectomy.
At a three month follow up visit, with a patient in whom I had removed his prostate, I asked if he had had sexual activity. He indicated that everything was working well but that his wife would no longer have sex with him. “When I climax now doc, I start to shuttering all over so bad that it scares my wife. She won’t have sex with me now, she’s afraid I’m going to hurt something.”
· After a prostatectomy the male and female anatomy, from a urinary standpoint, becomes very similar, except for the length of the urethra.
So…a vasectomy doesn’t affect potency. It only affects the sperm that is produced by the testicles and gets into the semen by the vas tubes. Potency which is affected by radiation or surgery of the prostate, refers to the male’s ability to achieve an erection. One can be infertile, potent, have a normal climax and yet have either a good or bad libido. Does that clear it up for you?
And now you know the rest of the story.
John C. McHugh M.D.
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