From the Research
Post-Ejaculatory Leg Pain
- Post-ejaculatory pain syndrome is a rare and distressing sexual disorder in men, characterized by involuntary spasm of certain muscles of the male genitalia, which can be triggered by psychosexual conflicts 1.
- Painful ejaculation has a prevalence of 1-25% and can have a detrimental effect on patients' quality of life, reducing individual self-esteem and associated with sexual dysfunction 2.
- The aetiology of painful ejaculation includes simple infection or inflammation of the urinary tract, benign prostate hyperplasia, ejaculatory duct obstruction, post-radical prostatectomy, and side effects of certain medications 2, 3, 4.
- Post orgasmic illness syndrome (POIS) is a rare condition with symptoms lasting 2-7 days after ejaculation, and is thought to be related to an acute compression proprioceptive axonopathy in the muscle spindle, similar to delayed onset muscle soreness (DOMS) 5.
- The pathomechanism of POIS and DOMS have some similarities, but also differences, particularly in the extent of secondary tissue damage and spermidine depletion 5.
Possible Causes
- Prostatevesicular causes, such as prostatitis, ejaculatory duct obstruction, and benign prostate hyperplasia (BPH) 3, 4.
- Postsurgical causes, such as radical prostatectomy and inguinal hernioplasty 3.
- Pharmacologic causes, such as antidepressants 3.
- Psychogenic causes, such as psychosexual conflicts and sexual abuse 1, 3.
- Rare causes, such as vesicular stone and urethral meatus pain 3.
Prevalence and Impact
- Painful ejaculation has a significant impact on the quality of life of affected men, with approximately 20% of men with lower urinary tract symptoms (LUTS) suggestive of BPH complaining of specific prostatitis-like symptoms of pain/discomfort on ejaculation 4.
- Men with BPH and painful ejaculation have more severe LUTS and reported greater bother, and had a higher prevalence of erectile dysfunction and reduced ejaculation, than men with LUTS only 4.