Ejaculatory Dysfunction Associated With Chronic Prostatitis
Chronic prostatitis is associated with sexual dysfunction. Now comes a new study documenting exacly which type of dysfunction and how severely.
The study from Turkey involved 43 chronic prostatitis sufferers and 20 asymptomatic healthy volunteers with average age approximating 33 years; the patients had suffered a mean period of approximately 38 months and had a mean Chronic Prostatitis Symptom Index (CPSI) score of 26. The findings were that:
- Mild- moderate erectile dysfunction was reported in 23.2% of the patients and 10% of the controls (p = 0.19).
- Severe erectile dysfunction was not found in either group.
- Premature ejaculation was found in 67.4% of the patients and 40% of the controls.
- Pain on ejaculation was reported in 37.2% of the patients; none of the controls had it.
- 42% of the patients had more than one dysfunction; none of the controls have more than one.
The differences between the patients and controls reached statistical significance with regards to ejaculation disorders and having more than one sexual dysfunction. The prevalence of erectile dysfunction was not statistically significantly different between patients and controls. The following were not statistically significantly associated with any of the observed dysfunctions: age, disease duration, and symptom scores.
The study suffers from data censoring in that 30 patients who were evaluated for inclusion had no regular sexual activity. One might hypothesize that one reason this subgroup of patients has no regular sexual activity is that it is highly symptomatic. If this is true, then had this subgroup been included, then the prostatitis patients would have almost surely looked even worse in comparison to the healthy control group. In other words, the study may have seriously underestimated the severity of symptoms in the patients with chronic prostatitis.
So what is the source of the ejaculatory pain: Urethra, prostate, seminal vesicles, bladder? The only real clue comes from some of the post-op patients in the surgical trial — which is accruing patients who on average are older and who have substantially greater symptom severity than reported here — who report that after removal of their prostate and seminal vesicles they no longer have pain on orgasm (post-op patients do not ejaculate the same volume as they do before surgery); informal allusions to this can be heard in the videos posted on the home page of the Prostatitis Surgery web site. The implication that the ejaculatory pain associated with chronic prostatitis has origins in and/or is somehow mediated by the prostate and/or seminal vesicles.