Semen not being propelled forward, leaking backward, or a weakened sensation during ejaculation is a common but rarely discussed issue in hypospadias. The cause is usually mechanical.
Ejaculation happens when semen is pushed forward along the channel. When the opening is set further back, the channel does not have the length needed for that forward push; semen cannot be expelled with enough force and partly leaks out.
Once the channel is completed all the way to the tip, ejaculatory dynamics improve noticeably in most cases. If a diverticulum is present it is narrowed, and if a stricture is present it is cleared, as part of the same plan.
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