Pain on ejacualation

For the first time I have experienced a pain/stinging sensation when ejaculating.  What could be the cause? I do have periods when I urinate 3 times during the night and frequently during the day but this seems to come and go. I had a PSA test a year ago and it was low. After digit testing I was told last year that I have a slightly enlarged prostate gland which is normal in men my age (64).  I have arraged for another PSA test. Is there something I should do about this new symptom?

[Kevin Pho, MD]

There would be several possibilities.  The first would be any type of genitourinary infection.  I would suggest a urinalysis and culture as a first step.  Tests for STDs such as gonorrhea and chlamydia should also be done.  

If negative, then tests for the prostate should be considered.  A digital rectal exam to examine for possible infection can be considered.  A scrotal ultrasound to evaluate for epididymitis can also be done.  

If infection is not revealed, then anatomical abnormalities can cause pain.  A cystoscopy to evaluate any urethral strictures or polyps can be considered.  

In any case, I would suggest a urology referral for further evaluation.

Followup with your personal physician is essential.

This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.

Thanks,
Kevin, M.D.