Central neuropathic pain: an unusual case of painful ejaculation responding to topiramate.
BACKGROUND
Painful ejaculation (PE) is an uncommon condition and it is usually associated with prostatitis, chronic pelvic pain syndrome, benign prostatic hyperplasia, ejaculatory duct obstruction, radical prostatectomy, and prostate radiation. Topiramate (TPM) is a new antiepileptic drug with recognized efficacy in neuropathic pain.


OBJECTIVE
The study is aimed to evaluate TPM efficacy in ejaculation pain.


METHODS
Following a spinal cord injury, a 53-year-old man was referred to our institute for persistent PE. Neurological examination showed mild hypoesthesia of the genital area. Urogenital examination, neurophysiological tools, and computed tomography of the dorso-lumbar spine were normal.


METHODS
The main outcome measure was the visual analogue scale.


RESULTS
Since pain was refractory to conventional neuropathic pharmacological therapies, TPM was introduced up to 150 mg daily with a dramatic improvement of PE.


CONCLUSIONS
TPM may be considered as a valid therapeutic option for the treatment of PE.
Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Centro Neurolesi Bonino-Pulejo, Messina, Italy. roccos.calabro@centroneurolesi.it
Rocco Salvatore
RS
Calabrò
Angela
A
Marra
Fabrizio
F
Quattrini
Giuseppe
G
Gervasi
Antonino
A
Levita
Placido
P
Bramanti
D000927:Anticonvulsants / Q000627:therapeutic use*; D004542:Ejaculation / Q000502:physiology*; D005632:Fructose / Q000031:analogs & derivatives* / Q000627:therapeutic use; D006801:Humans; D008297:Male; D008875:Middle Aged; D009437:Neuralgia / Q000188:drug therapy* / Q000503:physiopathology*; D013119:Spinal Cord Injuries / Q000503:physiopathology / Q000601:surgery; D000077236:Topiramate
D000927:Anticonvulsants; D000077236:Topiramate; D005632:Fructose