Pain with ejaculation

[Pacman27]

I saw new 75-year-old patient. Completely normal with a very healthy sex life

He complains of pain with ejaculation. Not in the penis but in the groin area and into his right lower quad. That is the only time the pain is present

On exam everything was normal
SLR -
Revere SLR -
Sensation normal and no pain to touch on the penis and testicle

MRI findings show some deg changes and mod to severe canal stenosis at the L4/5 level

Any thoughts on treatment

I started him on a low dose of lyrica and he states he has tried some NSAIDs prior to sex with moderate relief

Thanks

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[Ligament]

hmm, any uro workup yet? Sounds muscular. I suspect this is not a typical pain medicine issue...

 

[Pacman27]

Sorry forgot to mention he has had a urological work up does have an enlarged prostate and is being treated. Urologist told him he should see a spine surgeon

 

[epidural man]

Agree with ligament - sound muscle related.

Maybe pelvic floor physical therapy would help.