Differential Diagnosis for Painful Ejaculation

• Single most likely diagnosis
  • Prostatitis: This is a common condition that can cause painful ejaculation due to inflammation of the prostate gland. The pain is often described as a sharp or burning sensation and can be accompanied by other symptoms such as frequent urination, pain in the groin or pelvic area, and discharge.
• Other Likely diagnoses
  • Epididymitis: Inflammation of the epididymis, a tube at the back of the testicle that stores and carries sperm, can cause painful ejaculation. This condition is often caused by a bacterial infection and can be accompanied by symptoms such as swelling, redness, and pain in the testicle.
  • Seminal vesiculitis: Inflammation of the seminal vesicles, which are glands that produce a significant portion of the fluid in semen, can cause painful ejaculation. This condition can be caused by a bacterial infection and can be accompanied by symptoms such as pain in the pelvic area and frequent urination.
  • Urethritis: Inflammation of the urethra, the tube that carries urine and semen out of the body, can cause painful ejaculation. This condition is often caused by a bacterial infection and can be accompanied by symptoms such as burning during urination and discharge.
• Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
  • Testicular cancer: Although rare, testicular cancer can cause painful ejaculation and should not be missed. It is essential to perform a thorough physical examination and consider imaging studies if necessary.
  • Prostate cancer: Prostate cancer can also cause painful ejaculation, and it is crucial to rule out this condition, especially in older men.
• Rare diagnoses
  • Orchitis: Inflammation of one or both testicles, usually caused by a viral or bacterial infection, can cause painful ejaculation.
  • Interstitial cystitis: A chronic condition that causes bladder pressure, bladder pain, and sometimes pelvic pain, can cause painful ejaculation in some cases.
  • Spondyloarthritis: A type of arthritis that can cause inflammation in the spine, joints, and other parts of the body, can cause painful ejaculation in some cases.
  • Neurological disorders: Certain neurological disorders, such as multiple sclerosis or peripheral neuropathy, can cause painful ejaculation due to nerve damage.