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Q. I get excruciating pain in prostate after ejaculation. Please help.

Answered by
Dr. Ankush Jairath
and medically reviewed by Dr. Vinodhini. J
This is a premium question & answer published on Apr 28, 2020

Hi doctor,

This is a bit of an awkward question for me as I have never talked about it before, but I have been worrying about the condition of my prostate. If I masturbate, or just ejaculate for that matter, I get a very harsh pain more than once in about 24 hours period which I believe to be in my prostate. It is in the same place every time and it can go on for quite a while, and even come back multiple times throughout the day. I am just turning 20. I am very active and healthy, so something like this has harmed me physically and psychologically. Please help.

#

Hello,

Welcome to icliniq.com.

You need to understand that painful ejaculation both during masturbation or intercourse is mostly due to infection or inflammation of the sexual tract such as seminal vesicle, prostate, urethra or with the use of certain drugs. Sometimes it can be due to psychological causes with the partner. (I do not think you fall under later categories).

Please answer some of my queries. Do you have intercourse before? Any relationship issues? Do you have hematospermia (blood in semen) anytime? Any surgeries in childhood? Any testicular swelling or UTI (urinary tract infection) in the past? Any foul-smelling discharge from urethra? Any other urinary symptoms such as frequency, urgency, poor stream, nocturia, dribbling, burning micturation? Are you a diabetic?

Though I still believe that your symptoms are due to inflammation of sex organs but above questions will help me to reach a proper diagnosis.

Thank you doctor,

I was sexually active three years ago but neither of us has STIs (sexually transmitted infection) that I am aware of. I have never had blood in my semen. I have never had surgery. No UTI's, foul-smelling discharge, and problems with urination. I am not a diabetic. I am not an avid smoker but I smoke on occasion socially.

#

Hi,

Welcome back to icliniq.com.

I made my most probable diagnosis, prostatitis.

Now you need to understand your problem a bit. Prostatic gland is relatively less vascular gland and all the medication when given reach a specific organ via blood. So whatever medication taken has to be continued for slight long period (may be six weeks or so). First I will prescribe medicines and then explain you each and everything.

Take tablet Levofloxacin 500 mg at bed time for two weeks, Septran DS (Trimethoprim) BD for two weeks, Alfuzocin 10 mg once daily for six weeks, Chymoral forte (Trypsin Chymotrypsin) twice daily for two weeks, syrup Citralka 10 ml BD for two weeks (just to decrease the acidity of your urine).

Do a sitz bath twice a day for 15 minutes. Anything in excess is bad may be it masturbation or intercourse. You can do masturbation or intercourse on alternative days. Better to use protection (condoms) while doing intercourse.

Sitz bath with lukewarm water is a very important part of the treatment. Kindly do it with honesty (most tend to forget or ignore this part).

Tests which need to be done:

1. Trans Rectal USG (TRUS).

2. Semen culture (not an emergency but yes required).

Better to quit smoking (even occasionally) altogether.

Do not worry, prostatitis is very common in sexually active men but most of the time we do not discuss these things in detail and ignore them. I have not added any pain killers as you do not need them.

I strongly feel you will be better after two weeks.


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