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Urinary Disorders

Pain during erection and after ejaculation

02/23/2006

Question:

I had a successful and uneventful vasectomy almost 2 years ago. Last year while running a long run, I noticed a pain that had developed, emanating from my upper pubic region (left-side, about 1" above and to the left of the base of the penis) downward, right next to my penis. My thought was that I had pulled some type of groin muscle due to overuse. The pain basically went away after that. Now, however, it seems that this pain returns during erection and post-ejaculation. The pain during erection occurs in the same location (pubic region), but also now extends down into my left testicle (I have isolated the discomfort to my left vas deferens, noticing 1-2 soft bumps on that tube). Seems the pain increases during the cremasteric reflex (I have done some research), when the testicle is pulled up toward the body. The post-ejaculation pain then occurs about 2-4 inches below my navel, in my lower abdomen (left side), and is not really a sharp pain but an unmistakable pain that flares up about 10 seconds post-ejaculation and then subsides completely. I`ve seen a urologist about this and was put on medication for an infection, which didn`t help things at all. I`ve researched inguinal hernias (he checked me and apparently didn`t find anything) and now the cremaster muscle since the pain really seems to begin when the reflex occurs, but sometimes, as I`m sitting, I do feel a pain in the pubic area to the upper left of the base of my penis. Not sure what the heck this is, but it`s really a bother.

Answer:

Though it is difficult to say without examining you I believe this represents an injured ligament or muscle in the inguinal or pelvic area.  Anti-inflammatories are often helpful such as Motrin or Advil and I would suggest a 2-3 week course of 400mg three or four times a day.  I also suggest you have a full physical examination and laboratory studies as deemed appropriate by your physician.

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Response by:

Martin I Resnick, MD Martin I Resnick, MD
Formerly, Professor of Urology
School of Medicine
Case Western Reserve University