Painful Ejaculation: a Contemporary Review

Painful ejaculation is a distressing condition to nearly all affected men. Despite a prevalence of up to 9.7% in the general population and up to 58% among men with chronic prostatitis, it remains poorly understood. There is a wide variety of genitourinary pathology associated with painful ejaculation: benign prostatic hyperplasia, chronic prostatitis, definitive prostate cancer treatment, ejaculatory duct and seminal vesicle abnormalities, medication, and post-procedural sequelae. Effective management requires an understanding of these associations and individualization of workup and treatment. Uroselective alpha blockers are the most studied intervention and appear to have efficacy in several clinical scenarios. Rigorous contemporary data are sparse, and further study is warranted.