Management of Post-Ejaculatory Perineal Pain

Abstract

Note: Postings to Androlog have been lightly edited before publication.

Patients who present with unexplained urologic pain often pose a substantial challenge in regard to both evaluation and treatment. It is safe to say that all clinically active urologists are quite familiar with patients presenting with chronic testicular pain, nonbacterial prostatitis, chronic epidiymitis, and the like. In this edition of Androlog, Dr Jay Sandlow describes a patient who presents with a more unusual complaint: perineal pain that occurs exclusively following ejaculation. The members of Androlog offer a variety of suggestions regarding the management of this condition.

Dr Jay Sandlow describes his patient:

Dr Richard Berger offers advice based upon his own clinical experience with patients such as this:

Dr Woet Gianotten offers his own perspective as a psychotherapist in the management of patients with complaints such as this:

Dr Toeman Kadiogly suggests ejaculatory duct reflux as a possible etiology:

Dr Michael Perelman joins the discussion, suggesting a specific evaluative approach aimed at determining the presence of a muscular component to this patient's pain:

Finally Dr Jorge Hallak suggests that acupuncture might be considered in the management of this patient: