Intermittent Pain After Ejaculation: Causes and Concerns - Urology

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Intermittent pain after ejaculation can be a concerning symptom, and it's important to understand the potential causes and when to seek medical attention. Based on your description, the pain you are experiencing near the perineum could be attributed to several factors, including but not limited to, testicular torsion, pelvic congestion, or varicocele.

Testicular Torsion: This is a serious condition where the spermatic cord becomes twisted, cutting off the blood supply to the testicle. It typically presents with sudden, severe pain in the scrotum, and it is considered a medical emergency. However, the pain you describe as intermittent and not consistently severe may suggest that this is not the case, especially if you have previously been evaluated by a physician who found no significant issues.

Pelvic Congestion: After ejaculation, there can be increased blood flow to the pelvic region, which may lead to a sensation of fullness or discomfort. This is often temporary and resolves on its own. If you have a history of similar symptoms that have been evaluated without significant findings, it may be related to this phenomenon.

Varicocele: This condition involves the enlargement of veins within the scrotum, similar to varicose veins in the legs. Varicoceles can cause a dull ache or discomfort, especially after prolonged standing or physical activity. They can also lead to a feeling of heaviness or aching in the scrotal area. If your physician previously diagnosed you with a varicocele, it could indeed be contributing to the symptoms you are experiencing.

Other Considerations: Other potential causes of pain in the perineal area after ejaculation could include prostatitis (inflammation of the prostate), pelvic floor muscle tension, or nerve irritation. Prostatitis can cause pain during or after ejaculation, and it may be accompanied by other symptoms such as urinary frequency or discomfort.

When to Seek Medical Attention: While intermittent pain may not always indicate a serious issue, you should seek medical attention if you experience any of the following:
- Severe or worsening pain
- Swelling in the scrotum
- Changes in urination (e.g., difficulty urinating, blood in urine)
- Fever or chills
- Pain that persists or recurs frequently
In conclusion, while your symptoms may be related to benign conditions such as pelvic congestion or varicocele, it is essential to monitor the situation closely. If the pain persists or worsens, or if you develop new symptoms, it would be prudent to consult a healthcare provider for a thorough evaluation. They may recommend imaging studies, such as an ultrasound, to assess for any underlying issues. Always prioritize your health and well-being by seeking professional advice when in doubt.