Painful ejaculation.
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 alpha-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.
Ilie
Cristian P
CP
Department of Urology, Central Clinical Emergency Military Hospital, Bucharest, Romania. cristi2575@yahoo.com
Mischianu
Dan L
DL
Pemberton
Richard J
RJ
D004542:Ejaculation / Q000502:physiology*; D006801:Humans; D008297:Male; D009948:Orgasm / Q000502:physiology*; D010146:Pain / Q000209:etiology* / Q000503:physiopathology; D059408:Pain Management; D010147:Pain Measurement; D011468:Prostatectomy / Q000009:adverse effects; D011469:Prostatic Diseases / Q000150:complications* / Q000503:physiopathology / Q000601:surgery; D020018:Sexual Dysfunctions, Psychological / Q000150:complications* / Q000503:physiopathology; D013449:Sulfonamides / Q000627:therapeutic use; D000077409:Tamsulosin
D013449:Sulfonamides; D000077409:Tamsulosin