title: [Painful ejaculation].
abstract: OBJECTIVE
  To clarify definition, epidemiology, diagnosis, evaluation, etiologies and treatment of painful ejaculation (PE).
  
  
  METHODS
  Review of the literature performed by searching the Medline database using keywords ejaculation, orgasm, pain, pelvic pain, sexual behavior.
  
  
  RESULTS
  PE is a pelviperineal pain caused by ejaculation or orgasm. Its prevalence rate is between 1 and 4% amongst the general population. Mainly located in the penis, pain usually lasts less than 5 minutes. Assessment is clinical and there is no level of evidence about the strategy of complementary investigations. Benign prostatic hyperplasia, chronic pelvic pain syndrome, radical prostatectomy, prostate brachytherapy and some antidepressant medications are the best estimated etiologies found in the literature. A link between urogenital infections and PE is likely but not clearly established. Alpha-blockers had good therapeutic results in few low level of evidence studies.
  
  
  CONCLUSIONS
  The assessment of PE is not clearly defined. Some etiologies are known but PE may be a functionnal pain. Only high level of evidence studies would validate the use of the alpha-blockers as an efficient therapeutic option.
authors.affiliation: Service urologie-andrologie, CHR La Source, BP 86709, 45067 Orléans cedex 2, France. Electronic address: ddelavierre@orange.fr.
authors.forename: D
authors.initials: D
authors.lastname: Delavierre
authors.affiliation: Service d'urologie, CHU de Rouen, 76031 Rouen, France; EA 4308, université de Rouen, 76821 Rouen, France.
authors.forename: L
authors.initials: L
authors.lastname: Sibert
authors.affiliation: Clinique urologique, CHU de Nantes, 44093 Nantes, France; Centre fédératif de pelvi-périnéologie, CHU de Nantes, 44093 Nantes, France.
authors.forename: J
authors.initials: J
authors.lastname: Rigaud
authors.affiliation: Clinique urologique, CHU de Nantes, 44093 Nantes, France; Centre fédératif de pelvi-périnéologie, CHU de Nantes, 44093 Nantes, France.
authors.forename: J-J
authors.initials: JJ
authors.lastname: Labat
mesh_terms: D000317:Adrenergic alpha-Antagonists / Q000627:therapeutic use; D000928:Antidepressive Agents / Q000009:adverse effects; D001918:Brachytherapy / Q000009:adverse effects; D004542:Ejaculation / Q000502:physiology*; D007172:Erectile Dysfunction / Q000209:etiology; D006801:Humans; D015994:Incidence; D008297:Male; D010146:Pain / Q000209:etiology* / Q000503:physiopathology* / Q000517:prevention & control; D015995:Prevalence; D011468:Prostatectomy / Q000009:adverse effects; D011470:Prostatic Hyperplasia / Q000150:complications; D011472:Prostatitis / Q000150:complications; D011795:Surveys and Questionnaires
chemical_list: D000317:Adrenergic alpha-Antagonists; D000928:Antidepressive Agents
keywords: Comportement sexuel; Douleur; Douleur pelvienne; Orgasm; Orgasme; Pain; Pelvic pain; Sexual behavior; Éjaculation