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Urology  (Expert Forum)
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Re: Pain in rectum after sex
Questions in the Urology forum are answered by Dr. Stephen Liroff, affiliated with the Henry Ford Hospital. Topics covered include benign prostate disease, penis curvature, cystisis, kidney stones, pediatric urology, prostate, sexual dysfunction, urinary tract infections (UTI), and urological cancers.

Re: Pain in rectum after sex

by Doug-Bank, Jan 01, 1995 12:00AM
Posted By Doug Bank on March 19, 1998 at 12:21:39:

In Reply to: Re: Pain in rectum after sex posted by HFHS M.D.-MS on March 07, 1998 at 12:04:00:







: : 40 year old male with a very active sex life up to about 6 months ago when i started experiencing sever pain in the rectum area after ejaculation. At the same time I noticed that my erection would not stay throughout the sex act. I've been seeing a urologist and am taking antibiotics now fro about 1 month. Still no major change in symptoms, although the ability to get and maintain an erection has gotten worse. Doctor suspects a prostate infection. Anyone out there have a similar experience plesae email  me and let me know your results and forms of treatment.
------------------------------------------------------------------------
Dear Sam
Thanks for your questions.
Acute onset of erectile dysfunction is a younger healthy male is  uncommonly caused by systemic diseases like hypertension or diabetes.   Stressors at work or  relationship tensions are the most common causes.  These are usually self limiting and resolve without medical intervention.  Performance anxiety can be a self fulfilling prophecy if you get too worked up about it because erections are closely associated with emotions.   Pain in the rectum included.      
As far as a prostate infection being the sole cause of your acute onset of erectile dysfunction,  the literature does not support this theory.   If this were the case, one would expect the erectile dysfunction would get better on the antibiotic.  Very few if any antibiotics are associated with erectile dysfunction.    Chronic nonbacterial prostatitis has a stronger association with erectile dysfunction.
The objective for your workup should be to determine if there is a treatable cause to your symptoms including the emotional ones.  If the work-up is negative,  I would discuss with your urologist the  treatment options for erectile dysfunction until a treatable cause can be found.
* Keyword:  Nonbacterial prostatitis, erectile dysfunction
Sam stated that he has been on antibiotics for a month with no change in symptoms. That, coupled with the erectile dysfunction and the rectal pain, makes it sound a lot like chronic prostatitis to me. Unfortunately, this prostatitis tends to be chronic because they cannot figure out how to cure it. It may sound silly, but have you tried a sitz bath (just sit in a hot bath every day for 10-15 minutes or more) for a month.
Doug


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