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Chronic Pain in Penis and Testicles, Especially After Ejaculation

I just turned 40. I have had chronic pain in my penis and testicles for about a year now. It started immediately and intensely one day after I had just gotten a new Cialis prescription. I took one and masturbated, which I hadn't actually done in about a month or two (was completely celibate). I had an intense aching pain in my penis afterwards. The pain has continued for constantly for a year. I also feel like an uncomfortable "pulling" feeling when I get an erection. Note that I haven't had actual sex with anyone in at least 4 years. I saw a urologist initially. He checked for an infection and didn't find one. He did a scope up my penis but didn't see anything but diagnosed me with BPH. He prescribed me antibiotics, which didn't solve anything. He recommended I see a neurologist. I was already seeing a neurologist for pain in my arms and legs. He did EMG for that and found no problems. He prescribed me Gabapentin which seems to help arms and legs but not pelvic pain. I got prescribed Lyrica, but still have pain. I saw another urologist, who diagnosed me with Chronic Pelvic Pain Syndrome.

I recently got an PNI injection to block pain in my ilinoingular nerve. I masturbated to test out the result last night. I have had intense pain all day in my penis as a results of ejaculating. Ejaculating is what triggers the pain more than anything. It is pretty much impossible for me to have sex now and I can't seek a romantic relationship, so this is very problematic for me. The pain management clinic that gave my injection ordered an MRI, but my insurance company denied the MRI because they said they didn't have enough evidence that I tried enough options. I don't know what's wrong with me, and the medical professionals I talk to don't seem to have a clue. My insurance is resisting my efforts to get imaging. Someone please help.
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20620809 tn?1504362969
Wow, a lot going on. Have to say that I'm sorry that you are in this situation.  One thing that I think will help is to speak to a therapist.  I know that sounds crazy but for two reasons, I think it is an important step for you.  First, this is probably a lot emotionally to deal with.  You are probably lonely and feeling like a loss in your life.  Second, you would be amazed at the psychological ramifications that our body undergoes.  That will make anything like this worse.  We hyper focus, stress and worry.  Been there.  So, I'd see what kind of help you can get in this regard to explore how to best handle your emotions surrounding the situation and to see if mental health piece also contributes to it.  

When your insurance company says they want you to explore more options, have you asked what options you need to explore? If they are making that statement, there has to be x number of things you are expected to do first.  I'd ask for them to be specific so you can do those things.  Who knows, perhaps it will uncover the issue when you do those steps. That's the problem though, isn't it?  You don't really know WHAT to do to figure this out.  You've sought the care of doctors.  What is their 'next step'?  

For the mean time, don't ejaculate.  Find other ways to feel fulfilled. I hate to recommend that to you but it's better than pain.  Since chronic pelvic pain syndrome usually comes with inflammation, what about taking an Nsaid?  That may help or should.  Alpha blockers are another mediation given.  https://www.health.harvard.edu/newsletter_article/chronic-nonbacterial-prostatitis-chronic-pelvic-pain-syndrome
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