Is Rectal Ejaculation Real?

In 2021, doctors from the University of Texas Medical Center in Galveston, Texas published a case study about a case about a patient that passed urine with feces, feces with urine, and semen with feces (1). 

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The Short Answer.

This case study shows that while uncommon, it's possible for urine, feces, and even semen to come out of the wrong holes (1).

  • A 33-year-old male presented with five days of testicular pain and a report of sperm passage from his rectum while ejaculating over the past two years.
  • Imaging of the patient's pelvis revealed evidence of a rectal-prostate fistula. The patient was treated with piperacillin-tazobactam (an antibiotic) and a surgical fistula repair was performed. 
  • Further investigation uncovered that the man had spent nearly three weeks in a medically-induced coma due to a cocaine and phencyclidine overdose two years prior to this incident. 
  • Doctors think that a botched Foley-catheter placement may have been to blame - likely due to a premature balloon dilation in the man's prostatic urethra. Ouch!

What is a rectal-prostate fistula?

A fistula is an abnormal connection between two body parts, such as an organ or blood vessel and another structure. Fistulas are usually the result of an injury or surgery. Infection or inflammation can also cause a fistula to form.

In this case, the patient in question had a fistula that formed between their rectum and their prostate, aptly called a rectal-prostate fistula

How common are rectal-prostatic fistulas?

Rectal-prostatic fistulas have an incidence of about 0.5 cases per 100,000 people each year. 

In adults, these abnormal connections are usually caused by some sort of trauma, surgery, radiation, or an inflammatory condition like Crohn’s disease. 

They can also be caused by prostate cancer or prostate cancer therapy. Symptoms of RUF can be feces in the urine, urine in the feces, urinary tract infections and in this case, semen exiting the rectum.


What caused this man to leak semen from the wrong hole?

For this particular 33-year-old, the problem likely started when he was put into a medically induced coma after a drug overdose. It’s hypothesized that while he was in the coma, a Foley catheter was incorrectly inserted. 

A Foley catheter is a tube that’s inserted into a patient’s urethra to drain the bladder of urine. Catheters are extremely common for hospitalized patients, but as this case shows, anything that’s inserted into the body, must be done so with extreme care to avoid serious complications.

How he knew something was wrong

The patient finally went to the doctor because he was having intense pain in his testicles over the course of 5 days. 

It was at that point that he told the doctors that he’d been passing semen and urine from his anus for two years. He also said that he had experienced feces in his urine as well. 

After performing imaging on the man's pelvis, doctors found a fistula between the patient’s anus and prostate, which was responsible for his bodily fluids exiting from the wrong holes. 

How can I avoid a rectal-prostatic fistula?

While this story probably makes you feel very uncomfortable, the good news is that doctors were able to patch the fistula through surgery. The patient was able to make a full physical recovery with the only side effect being reduced semen volume over several months. 

If he had not sought treatment, it’s likely that this condition would have become life-threatening. The authors of this case study concluded by saying, “This case not only highlights a rare complication of catheter use but also emphasizes the importance of provider mindfulness when utilizing seemingly benign therapies such as Foley catheters.”

If you're experiencing health issues - go to a doctor! As this case illustrates, time is of the essense. Had this man waited any longer to seek treatment, it's entirely possible that this story would be even more grim. 

Conditions like erectile dysfunction, low semen volume, poor sperm quality, bad-tasting cum, or even infertility often make people embarrassed or reluctant to seek medical care. Know this - no matter what your problem is, even if it’s shooting cum out of your ass, medical professionals have probably already seen it. Do not delay in seeking medical help!

✔️ References

1. A Curious Case of Rectal Ejaculation. doi: 10.7759/cureus.17330