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Male | 47

Why do I experience pelvic pain after ejaculation?

Good evening, male, 47 y/o. For about 30 years I have been suffering from pelvic pain that arises ONLY a few hours after ejaculation. The pain originates precisely at the base of the scrotum and extends over hours to the entire scrotum and sometimes to the shaft of the penis. It arises as an itch, then a pinch, then grows in intensity until it becomes aching with a strong sense of heat accompanied by pronounced relaxation of the scrotum. Ice and (sometimes) supine position are the only things that provide temporary relief. I should add that prolonged abstinence has always given me discomfort and sensation of urinary urgency, which disappears with orgasm. Until two years ago the pain disappeared with sleep at night, so I only had regular sexual activity before going to sleep, and in this way I had a normal sex life and children. Then it began to occur EVEN THE NEXT DAY starting around noon and escalating into the evening, then (usually) disappearing the next morning. Over the years I have consulted several urologists. In 2001 the first transrectal ultrasound (all negative). Recent worsening of symptoms (i.e., their persistence even the next day) prompted me to confront other urologists, who were unable to help me. Prescribed spermioculture and Stamey test (all negative), prostate echo normal (some calcification). For the past two years I have been taking prostate supplements, anti-inflammatories, muscle relaxants, PEA etc without success. I tried acupuncture, ozone therapy, craniosacral osteopathy, TENS, pelvic floor physiotherapy (identified and treated contracted "triggers"), without success. A neurologist hypothesized muscular causes possibly related to a tempomandibular dislocation (hypothesis ruled out by maxillofacial surgeon) and prescribed Mutabon Mite 2 cpp/day which I took for three months, without success. A psychologist specializing in chronic pain has suggested nociplastic (psychogenic) pain and is helping me to manage the distress this problem causes me, but unfortunately not to reduce it as I had hoped. Thanks to her, however, I was able to accurately track the point of origin and course of the pain (so-called "somatic tracking"). On the advice of the GP I went in February to the Niguarda Hospital Pain Therapy where, with hypothesis pudendal neuropathy, I was prescribed pelvic MRI (resulted adductor enthesopathies), lumbosacral MRI (resulted disc dehydration, asymptomatic), pelvic EMG (no abnormalities), physiatric examination (no abnormalities). I have follow-up visit in September to evaluate nerve block, but in light of the negative EMG I don't know what they will say. In the meantime I have been prescribed Pregabalin 25+25 and then 50+50, which makes me sleep very well but has no effect on the disorder, so I will insist a little longer and then I think I will discontinue. I am very frustrated, I am asking if anyone reading me has any idea, if not of a treatment, at least of a diagnosis that I've never been given. Thank you.

1 Answer

Answered on 16th July '24

The pain you experience in your penis and scrotum after ejaculation is understandably uncomfortable. You've consulted many doctors and tried various treatments, but the cause of your pain remains elusive. Your proactive approach to seeking help and trying different therapies is commendable. While doctors are considering possibilities such as pudendal neuropathy, a clear diagnosis has yet to be made. Unfortunately, I cannot provide a definite diagnosis or solution at this moment, but you must continue to follow up with your urologists.

28 people found this helpful

Questions & Answers on "Urology" (936)

Pain while urinating and dark yellow urine

Male | 20

It seems you have some pain during urination and your pee is dark yellow. These things may indicate that you are dehydrated, meaning you need more water in your body. Not taking in enough fluids can make the urine concentrated hence causing irritation to the bladder. Drink plenty of water throughout the day to ease the stinging when passing urine and make it healthier in color.

Answered on 10th June '24

Dr. Neeta Verma

Dr. Neeta Verma

I'm having itchy penis. It started on Saturday.

Male | 32

If you are going through an itchy penis, you should refer a urologist or a dermatologist with a specialization in genital conditions. They will be able to diagnose you properly and suggest the best treatment for you. It is advised to consult a physician instead of self-diagnosing and applying home remedies.

Answered on 23rd May '24

Dr. Neeta Verma

Dr. Neeta Verma

I'm a male 27 years old For more than a month and half i had unsafe sex without penetration and the next day i went to a dr. To prevent stds he gives me a dose of certifaxone and zithromax (azithromycin) A month later i felt uncomfortable because i stopped masturbating, I thought if i masturbated i will feel normal, i made a kind of force masturbating without full erection then my penis got swelling from below part, the day after this symptom left and i started to feel pain in the right testicles. I went to the urologist and i made urine analysis the pus rate was high from 10-15 and RBCs were 70-80 he gave me (qunistarmax - levloxacine) and cystinol, celebrex, Avodart,rowatinex and after 10 days after finishing i made another urine analysis and all rates were good but i still have mild pain in right testicle sometimes and in pubic area from the right side and having a symptom of dropping pee after finishing all pee then i made ultrasound on prostate and was 21gram and testicles with normal epididymis and recently then i reached another urologist and he give me what i am taking now Prostanorm and ciprofloxacin then vibramycin After having half of ciprofloxacin and prostanorm andi found a sign in my underwear like cum or pre cum with no excitement Do I have resistant std bacteria or prostate problem ?

Male | 27

Answered on 23rd May '24

Dr. Neeta Verma

Dr. Neeta Verma

I’m not sure if it’s. A symptom of sti but I get like a sharp pressure pain and very light stinging when I wee and when holding in a wee. but in the mornings or when I have a full hydrated bladder it doesn’t hurt at all

Male | 25

The symptoms you're describing may indicate UTI or STI.... It's important to see a doctor for proper diagnosis and treatment. Drink plenty of WATER and avoid holding in your urine.... Practice safe sex to prevent STIs. ....

Answered on 23rd May '24

Dr. Neeta Verma

Dr. Neeta Verma

Good evening, male, 47 y/o. For about 30 years I have been suffering from pelvic pain that arises ONLY a few hours after ejaculation. The pain originates precisely at the base of the scrotum and extends over hours to the entire scrotum and sometimes to the shaft of the penis. It arises as an itch, then a pinch, then grows in intensity until it becomes aching with a strong sense of heat accompanied by pronounced relaxation of the scrotum. Ice and (sometimes) supine position are the only things that provide temporary relief. I should add that prolonged abstinence has always given me discomfort and sensation of urinary urgency, which disappears with orgasm. Until two years ago the pain disappeared with sleep at night, so I only had regular sexual activity before going to sleep, and in this way I had a normal sex life and children. Then it began to occur EVEN THE NEXT DAY starting around noon and escalating into the evening, then (usually) disappearing the next morning. Over the years I have consulted several urologists. In 2001 the first transrectal ultrasound (all negative). Recent worsening of symptoms (i.e., their persistence even the next day) prompted me to confront other urologists, who were unable to help me. Prescribed spermioculture and Stamey test (all negative), prostate echo normal (some calcification). For the past two years I have been taking prostate supplements, anti-inflammatories, muscle relaxants, PEA etc without success. I tried acupuncture, ozone therapy, craniosacral osteopathy, TENS, pelvic floor physiotherapy (identified and treated contracted "triggers"), without success. A neurologist hypothesized muscular causes possibly related to a tempomandibular dislocation (hypothesis ruled out by maxillofacial surgeon) and prescribed Mutabon Mite 2 cpp/day which I took for three months, without success. A psychologist specializing in chronic pain has suggested nociplastic (psychogenic) pain and is helping me to manage the distress this problem causes me, but unfortunately not to reduce it as I had hoped. Thanks to her, however, I was able to accurately track the point of origin and course of the pain (so-called "somatic tracking"). On the advice of the GP I went in February to the Niguarda Hospital Pain Therapy where, with hypothesis pudendal neuropathy, I was prescribed pelvic MRI (resulted adductor enthesopathies), lumbosacral MRI (resulted disc dehydration, asymptomatic), pelvic EMG (no abnormalities), physiatric examination (no abnormalities). I have follow-up visit in September to evaluate nerve block, but in light of the negative EMG I don't know what they will say. In the meantime I have been prescribed Pregabalin 25+25 and then 50+50, which makes me sleep very well but has no effect on the disorder, so I will insist a little longer and then I think I will discontinue. I am very frustrated, I am asking if anyone reading me has any idea, if not of a treatment, at least of a diagnosis that I've never been given. Thank you.

Male | 47

Answered on 16th July '24

Dr. Neeta Verma

Dr. Neeta Verma

pulled testicle down while washing Now it’s hanging wont go up

Male | 23

You might have encountered testicular torsion, a condition of the testicle that twists and cuts off blood supply. This is an acute medical case and you should immediately see a urologist. 

Answered on 23rd May '24

Dr. Neeta Verma

Dr. Neeta Verma

Hi, I am worried about erectile dysfunction. I'm going through puberty but don't seem to get random erections anymore and only ones caused by stimulation. Is there something wrong?

Male | 14

During puberty it's normal for the frequency and spontaneity of erections to change. Hormonal shifts affect sexual development differently for everyone. While early puberty often involves more frequent and spontaneous erections, this can change as puberty progresses. There's nothing wrong it's natural.

Answered on 23rd May '24

Dr. Neeta Verma

Dr. Neeta Verma

Have spot or wart on my penis

Male | 43

it is advised that you see a urologist for a complete assessment and diagnosis. Human papillomavirus (HPV) strains may be responsible for the development of warts on the male genitals and the treatment options include medical assistance. 

Answered on 23rd May '24

Dr. Neeta Verma

Dr. Neeta Verma

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