Painful ejaculation

• Published in: BJU international 2007-06, Vol.99 (6), p.1335-1339
• Main Authors: Ilie, Cristian P., Mischianu, Dan L., Pemberton, Richard J.
• Format: Article
• Language: English
• Subjects: Biological and medical sciences; dysorgasmia; Ejaculation - physiology; ejaculatory pain; Humans; Male; man; Medical sciences; Nephrology. Urinary tract diseases; Orgasm - physiology; Pain - etiology; Pain - physiopathology; Pain Management; Pain Measurement; post‐orgasmic pain; Prostatectomy - adverse effects; Prostatic Diseases - complications; Prostatic Diseases - physiopathology; Prostatic Diseases - surgery; sexual dysfunction; Sexual Dysfunctions, Psychological - complications; Sexual Dysfunctions, Psychological - physiopathology; Sulfonamides - therapeutic use
• ISSN: 1464-4096; 1464-410X
• DOI: 10.1111/j.1464-410X.2007.06664.x

The first mini‐review in this section is a systematic literature review on postorgasmic pain in the male. The authors found a significant incidence of this problem and have suggested that studies are required into aetiology and treatment. The issue of saturation biopsy of the prostate is discussed in the second article, followed by papers on basal cell carcinoma of the prostate, and finally, a discussion of screening for prostate cancer, and particularly new efforts at targeting special groups. We reviewed previous publications on post‐orgasmic pain with reference to prevalence, epidemiology and treatment options, using the Ovid and PubMed (updated May 2006) databases to comprehensively search MEDLINE for reports on post‐orgasmic pain that included peer‐reviewed English‐language articles. Official proceedings of internationally known scientific societies were also assessed. Because of the heterogeneity of the studies we did not apply meta‐ analytic techniques to the data. The incidence of post‐orgasmic pain is 1–9.7%. The ejaculatory pain is associated with prostatitis, chronic pelvic pain syndrome, benign prostatic hyperplasia, and ejaculatory duct obstruction; it is also described in patients after procedures like radical prostatectomy. Aetiopathogenic theories include those referring to bladder neck closure and pudendal neuropathy. The treatment options vary from self‐care, a ‘perineal hyperprotection programme’ to medication with the α‐blocker, topiramate, and even surgical procedures like removing a section of the sacrotuberous ligament, neurolysis of the pudendal nerve or removing a section of the sacrospinous ligament. This is the first update of the subject, with reference to prevalence, epidemiology and treatment options. There is a need for adequately powered, prospective randomized trials on aetiology and treatment options.