Can Men with Kidney Stones Still Ejaculate Normally? Understanding the Impact of Urinary Tract Stones on Sexual Function
Do Kidney Stones Affect Ejaculation?
Most men diagnosed with urinary tract stones—including those located in the kidneys, ureters, or bladder—experience no disruption to their ability to ejaculate. This is because these stone locations typically do not interfere with the anatomical pathways involved in ejaculation. The ejaculatory ducts and the prostatic urethra remain fully patent, allowing semen to pass freely during orgasm. As a result, sexual function—including libido, erection, and ejaculation—remains unaffected in the vast majority of cases.
When Urinary Stones Can Impact Ejaculation: The Exception Is Urethral Stones
Why Urethral Stones Are Different
Unlike stones elsewhere in the urinary system, urethral stones pose a unique risk to normal ejaculation. Because the urethra serves as the final conduit for both urine and semen, a stone lodged in this narrow passage can cause partial or complete obstruction. In some cases, chronic irritation or inflammation from the stone may lead to scar tissue formation or adhesions near the openings of the ejaculatory ducts—especially where they empty into the prostatic urethra.
This mechanical interference can result in several ejaculatory disturbances, including:
- Reduced or absent antegrade ejaculation (retrograde ejaculation is rare but possible in severe cases),
- Noticeably lower semen volume during orgasm,
- Painful ejaculation (dysorgasmia), often described as sharp, burning, or cramping discomfort localized to the penis or perineum,
- And in persistent cases, psychological distress or avoidance of sexual activity due to anticipated discomfort.
Diagnosis: What Steps Should Be Taken If Ejaculatory Changes Occur?
If a man with known or suspected urolithiasis begins experiencing new-onset ejaculatory symptoms—particularly pain, diminished volume, or failed emission—it's essential to rule out urethral obstruction. A targeted diagnostic approach is recommended:
1. Flexible or Rigid Urethroscopy
This minimally invasive procedure allows direct visualization of the entire urethral lumen. It's the gold standard for detecting small or impacted stones, identifying strictures, assessing ejaculatory duct orifices, and even enabling immediate stone removal if indicated.
2. Comprehensive Genitourinary Imaging
In addition to urethroscopy, high-resolution renal and bladder ultrasound (with Doppler if needed) helps evaluate stone burden, hydronephrosis, and associated complications. For complex cases—or when CT imaging is clinically justified—low-dose non-contrast CT urography provides unparalleled detail on stone size, location, density, and surrounding anatomy.
Proactive Management Improves Outcomes—and Quality of Life
It's important to emphasize that ejaculatory dysfunction related to urethral stones is almost always reversible once the obstruction is resolved. Early intervention prevents long-term complications such as ejaculatory duct scarring, chronic prostatitis-like symptoms, or secondary sexual anxiety. Urologists increasingly recognize sexual health as a core component of holistic urological care—so discussing changes in ejaculation isn't "off-topic"; it's clinically relevant and deserves compassionate, evidence-based attention.
Key Takeaway for Patients and Providers
While kidney, ureteral, and bladder stones rarely affect ejaculation, urethral stones are the critical exception. Any new ejaculatory symptom in a patient with urolithiasis warrants prompt evaluation—not just for stone clearance, but for preserving sexual wellness and overall quality of life. Don't hesitate to bring up these concerns with your urologist: open communication leads to better diagnosis, more personalized treatment, and improved long-term outcomes.