What causes post-ejaculatory pain (dysorgasmia)?

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Differential Diagnosis for Pain after Ejaculating

Single Most Likely Diagnosis

  • Prostatitis: This is an inflammation of the prostate gland, which can cause pain after ejaculating, along with other symptoms such as painful urination, frequent urination, and pelvic pain. The proximity of the prostate to the urethra and its involvement in the ejaculatory process make it a common cause of post-ejaculatory pain.

Other Likely Diagnoses

  • Epididymitis: Inflammation of the epididymis, a tube at the back of the testicle that stores and carries sperm, can cause pain after ejaculating. This condition often results from bacterial infections and can be accompanied by symptoms like testicular pain and swelling.
  • Urethritis: Inflammation of the urethra, often due to infection, can lead to pain during or after ejaculation, among other symptoms like burning during urination and discharge.
  • Seminal Vesiculitis: Inflammation of the seminal vesicles, which are involved in the production of semen, can cause pain after ejaculation, along with other symptoms like pelvic pain and difficulty urinating.

Do Not Miss Diagnoses

  • Testicular Torsion: Although less common, testicular torsion is a medical emergency that can cause severe pain, including pain after ejaculation, and requires immediate attention to save the affected testicle.
  • Prostate Cancer: While less likely to present primarily with post-ejaculatory pain, advanced prostate cancer can cause a variety of symptoms including pain. Given the potential severity of this condition, it should not be overlooked.
  • Urethral Stricture: A narrowing of the urethra can cause obstructive symptoms and pain during or after ejaculation. This condition can lead to serious complications if not addressed.

Rare Diagnoses

  • Orchitis: Inflammation of one or both testicles, usually caused by bacterial or viral infections, can lead to pain after ejaculation, though it's more commonly associated with testicular pain and swelling.
  • Interstitial Cystitis: A condition causing bladder pressure, bladder pain, and sometimes pelvic pain, which might be exacerbated by ejaculation in some cases, though it's more commonly associated with urinary frequency and urgency.
  • Pudendal Neuralgia: A condition characterized by pain in the distribution of the pudendal nerve, which could potentially cause pain after ejaculation, though it's a less common cause of this specific symptom.

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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