Painful ejaculation (dysorgasmia)

Painful ejaculation is called dysorgasmia. Although it can be a symptom of genuine bacterial prostatitis, it is more frequently a component of Urological Chronic Pelvic Pain Syndrome (UCPPS) and has nothing to do with infection. Dysorgasmia can be a sign of pelvic floor dysfunction. Dr. Potts has more aptly termed this phenomenon ejaculatory dyssynergia. 

determining the cause of dysorgasmia

As in most medical conditions, the patient's history is vital to understanding the cause of dysorgasmia. When and how did it begin? Are there other associated symptoms, even if these may not seem to be urological? A thorough physical examination helps to confirm potential sources of the pain. These can include myofascial trigger points, pudendal neuralgia (chronic pelvic pain originating from damage or irritation of the main pelvic nerve), and very rarely, infection (chronic prostatitis).

Because this condition is too often erroneously attributed to prostatitis, it is extremely important to confirm an infectious cause by obtaining localization cultures. If a doctor or nurse practitioner would commit a patient to the standard 4-6 week course of antibiotics, they had better know for certain that the patient truly has an infection and if that organism is resistant to the antibiotic. Far too many men have been prescribed long courses of potentially dangerous antibiotics without any evidence of an infection, much less a disorder of the prostate gland.

vista urology's approach to painful ejaculation

Since there are several causes for the symptoms of dysorgasmia, Dr. Potts has developed an approach that takes into consideration biological, psychological, and social factors. In rare cases, the phenomenon can be caused by blockage of the ejaculatory duct. Dr. Potts rules out this condition through careful, gentle palpation and ultrasound.