Painful orgasm after radical prostatectomy could be related to the bilateral sparing of the seminal vesicles during the procedure, European researchers suggest.
Prostatectomy, or surgical removal of the prostate, is a common treatment for prostate cancer. It may be done in an open procedure or with the assistance of a robot that performs the surgery laparoscopically.
Many men have problems with orgasm after radical prostatectomy, including pain and urine loss. Some men are no longer able to reach orgasm.
But orgasm is considered an important part of the sexual experience. Men who have orgasmic difficulties are often less satisfied – emotionally and physically – with their sexual relationships and might start to avoid sex. The situation may lead to strain in their relationships.
Because the prevalence and risk factors for painful orgasm have not been widely studied, a team of scientists from Sweden, Greece, and Italy decided to investigate.
A group of 1,288 men who had had either open or robot-assisted laparoscopic prostatectomy participated in the study. The men completed a study-specific questionnaire about their quality of life, particularly sexual life. A control group of 442 men also answered the questionnaire.
Overall, 11% of the participants had painful orgasms. For men who had had their prostate removed, the rate was 18%. Painful orgasms were much less common in the control group; only 6% of the men who had not had prostate surgery had painful orgasms.
Two factors seemed to be most associated with painful orgasm: the degree of sparing of the seminal vesicles and the patient’s age.
Located near the pelvic nerve, the seminal vesicles are a pair of male genital organs that produce and release semen. Many surgeons preserve the tips of the seminal vesicles when performing a prostatectomy because complete removal may lead to urinary incontinence and erectile dysfunction.
The researchers suggested that what remains of the seminal vesicles after surgery could still contract and emit fluid, causing painful orgasm.
In this study, men under age 60 tended to have more painful orgasms than older men. This may be because younger men are more likely to have their seminal vesicles spared to help preserve erectile function.
The authors recommend alerting patients about the possibility of painful orgasm after radical prostatectomy.
The study was published online in February in the Journal of Sexual Medicine.
Resources
The Journal of Sexual Medicine
Mogorovich, Andrea, MD, et al.
“Radical Prostatectomy, Sparing of the Seminal Vesicles, and Painful Orgasm”
(Full-text. First published online: February 19, 2013)
http://onlinelibrary.wiley.com/doi/10.1111/jsm.12086/abstract
Medscape Reference
Brzezinski, David W., MD
“Seminal Vesicle Anatomy”
(Updated: July 5, 2011)
http://emedicine.medscape.com/article/1949303-overview