Pain, Burning after Ejaculation

Q. Whenever my boyfriend comes, he gets a burning feeling at the head of his penis. It is extremely painful for him. He says it doesn’t go away unless he tries to have a bowel movement, which it makes him feel like he has to do. He says that the pain goes from the head of his penis to his anus. He also says it feels a little better if he put something cold on his penis. Do you know what this might be? I hate to see him in such pain.

A. Pain in the penis after ejaculation usually comes from the prostate; that is why he feels it in the anus. The most common cause is prostatitis. This condition is an inflammation in the prostate gland, usually caused by bacteria. Such infections are easily treated by antibiotics. Another possible cause is a urethral stricture, a narrowing in the urethra that prevents the passage of semen out of the penis.

His doctor can probably diagnose the problem with a good medical history and physical exam. A rectal exam can reveal whether his prostate is swollen and tender. Also, by checking his urine for bacteria or blood, his doctor can identify a urinary tract infection. Checking for a stricture requires either a cystoscopy (in which the doctor looks in the bladder through a tiny scope inserted into the penis) or an X-ray exam called a urethrogram. Both can be done in the doctor’s office and both are painless.