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Dr. David
Dr. David, MD
Category: Urology
Satisfied Customers: 46309
Experience:  Experienced physican in Urology
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Well, my issue began around last September when I began

Customer Question

Well, my issue began around last September when I began experiencing sharp, sudden pains mid-ejaculation. It became more and more frequent until it was occurring every time I masturbated, so I refrained from masturbation for six months. Walking long distances, too, became the cause of intense pelvic pain, whereas sitting and standing doesn't seem to increase the pain at all.
The pain is predominantly focused in the perineum (particularly in the area between my genitals and my right leg) and the shaft of the penis (right side only). I met with my primary care physician about the issue in October. There were no tests done apart from a physical and a simple urine sample, which came back negative. I have tried combating the issue with all sorts of natural remedies recommended for prostate/urinary illnesses (wanting to avoid antibiotics/invasive exams & procedures at all costs)—none of which seem to offer any significant relief. There are no noticeable changes in bowel habits. I do urinate frequently, but that's nothing new, and it's painless 99% of the time. I only notice that I get severe pain deep in my rectum (what I believe may be the prostate) when holding my urine in for too long (which wasn't the case previously). I also get intense bursts of pain which I can only describe as "lightning" that come and go in that same area deep in my rectum, typically coming and going in only a matter of seconds. These "lightning" pains, however, have been ongoing for years, and aren't too frequent (maybe half a dozen times in a year).
Sexual arousal is almost always accompanied by pain which sets in typically within minutes, and this can all result from simply an erection and doesn't require an orgasm. Again, the pain is focused in the perineum (right side) and shaft of penis (right side), and there is no pain on the left hemisphere. The pain isn't constant and depends entirely upon my activity. There were months of physical inactivity (minimal walking, zero sex/masturbation) when I experienced relief from the pelvic pain (and even believed it was improving, which is why I held off on seeing a specialist, since I believe it only required some time and rest). But the pain has returned and is now at its worst since its onset last autumn, all due to sitting in a position which may have put some stress on that area. I recently attempted to massage the perineal area, but even a quick, gentle massage led to a severe increase in pain and I am too hesitant to give another attempt.
So I really don't know what to think. I first assumed this was some form of prostatitis (assumed to be bacterial in origin, since I was living in a very musty, unhygienic environment when symptoms first appeared), but some of these issues strike me as muscular/neurological in nature. I don't normally hear of any prostatitis suffers as having any problems with walking due to the symptoms. Any insight into my issue is greatly appreciated. Thank you.
Submitted: 1 year ago.
Category: Urology
Expert:  Dr. David replied 1 year ago.

This is Dr. David

I agree with you. I think you could be having sporatic prostatitis prostate infect or inflammation which can be causing your symptoms of pain when you ejaculate.

prostatitis can be viral or bacterial infection of the prostate gland.

some prostatitis can get better on its own sometimes.

sometimes a course of antibiotics is needed to treat bacterial prostatitis

prostatitis would not show up on a urinalysis

blood test can show elevation of your blood PSA levels when you have prostatitis.

I would talk to your doctor about blood testing to check your PSA level

and try a course of antibiotics like ciprofloxicin 500mg twice a day for 7-10 days and see if that helps your symptoms.

let me know if you have questions.

Expert:  Dr. David replied 1 year ago.

do you have other questions?