Preejaculatory Illness Syndrome: Two Cases of a Rare Psychosomatic Disorder

Human ejaculation happens in the orgasmic phase of the human sexual response cycle. Among psychosomatic ejaculatory disorders that may happen before ejaculation, we present two cases of preejaculatory illness syndrome. The two cases shared common symptoms of sympathetic over activity, the sensation of impending death, and muscle atonia with subsequent failure to ejaculate. Depression, anxiety disorders, and family histories of psychiatric problems were noticed as risk factors. Medical conditions that may lead to panic attack type symptoms were eliminated before the final diagnosis. After the failure of empirical medications, symptoms became controlled with fluoxetine. Patients reported a recurrence of the symptoms on trying to stop the prescribed medication. On the last follow-up, they still take fluoxetine on a regular base with satisfactory sexual life.

...Human ejaculation is the emission of semen to the exterior. It is a coordinated mechanism of male sexual organs: Prostate, seminal vesicles, urethra, and pelvic floor muscle.[1] It happens in the orgasmic phase of the human sexual response cycle.

Although organic ejaculatory problems such as premature ejaculation, inhibited ejaculation, anejaculation, retrograde ejaculation, and anorgasmia were reported,[2] we have not found reported cases of preejaculatory illness syndrome (PEIS).

Psychosomatic ejaculatory disorders may happen before, during, or after ejaculation. Postorgasmic illness syndrome (POIS) has been reported as patients may have severe fatigue, intense warmth, and a flulike state, with generalized myalgia.[3]

To describe one of the psychosomatic abnormalities that may happen before or during ejaculation disorders, we present two cases of PEIS...

Full article at: http://goo.gl/9hWewS

By:  Adel Mohsen, Mohamed Mohamed Elawdy,1 and Antoine Faix2

Department of Psychiatry, Ibri Regional Hospital, Ministry of Health, Sultanate of Oman

¹Department of Urology, Ibri Regional Hospital, Ministry of Health, Sultanate of Oman

²Department of Sexual Medicine, Clinique Beau Soleil à Montpellier, France

Address for correspondence: Dr. Mohamed Mohamed Elawdy, Department of Urology, Ibri Regional Hospital, Ibri P. O. Box 618, Sultanate of Oman. E-mail: moc.liamg@ydwalemm

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Impact of Prostate Cancer Treatment on the Sexual Quality of Life for Men Who Have Sex with Men

With earlier prostate cancer (PCa) diagnosis and an increased focus on survivorship, post-treatment sexual quality of life (QoL) has become increasingly important. Research and validated instruments for sexual QoL assessment based on heterosexual samples have limited applicability for men-who-have-sex-with-men (MSM).

We aimed to create a validated instrument for assessing sexual needs and concerns of MSM post-PCa treatment. Here we explore post-PCa treatment sexual concerns for a sample of MSM, as the first part of this multi-phase project.

Individual semi-structured interviews were conducted with 16 MSM face-to-face or via Internet-based video conferencing. Participants were asked open-ended questions about their experiences of sexual QoL following PCa. Interviews were recorded, transcribed verbatim, uploaded to NVivo 8^TM , and analyzed using qualitative methodology.

We have conducted semi-structure qualitative interviews on 16 MSM who were treated for PCa. Focus was on post-treatment sexual concerns.

The following themes were inductively derived: (i) erectile, urinary, ejaculation, and orgasmic dysfunctions; (ii) challenges to intimate relationships; and (iii) lack of MSM-specific oncological and psychosocial support for PCa survivorship. Sexual practices pre-treatment ranked in order of frequency were masturbation, oral sex, and anal sex, an ordering that prevailed post-treatment. Sexual QoL decreased with erectile, urinary, and ejaculation dysfunctions. Post-treatment orgasms were compromised. Some single men and men in non-monogamous relationships reported a loss of confidence or difficulty meeting other men post-treatment. Limited access to targeted oncological and psychosocial supports posed difficulties in coping with PCa for MSM.

The negative impact on sexual QoL can be severe for MSM and requires targeted attention. Penile-vaginal intercourse and erectile function have been the primary focus of sexual research and rehabilitation for men with PCa, and do not adequately reflect the sexual practices of MSM. Our findings suggest that future research dedicated to MSM with PCa is needed to incorporate their sexual practices and preferences specifically into treatment decisions, and that targeted oncological and psychosocial support services are also warranted. Lee TK, Handy AB, Kwan W, Oliffe JL, Brotto LA, Wassersug RJ, and Dowsett GW. The impact of prostate cancer treatment on the sexual quality of life for men-who-have-sex-with-men.

Purchase full article at:   http://goo.gl/IefZQt

By:  Lee TK1, Handy AB2, Kwan W1, Oliffe JL3, Brotto LA2, Wassersug RJ4, Dowsett GW5.

• 1British Columbia Cancer Agency, Fraser Valley Cancer Centre, Surrey, BC, Canada.
• 2Department of Obstetrics and Gynaecology, Diamond Health Care Centre, University of British Columbia, Vancouver, BC, Canada.
• 3Faculty of Applied Science, School of Nursing, University of British Columbia, Vancouver, BC, Canada.
• 4Department of Urologic Sciences, Gordon and Leslie Diamond Health Care Centre, University of British Columbia, Vancouver, BC, Canada.
• 5Australian Research Centre in Sex, Health and Society, La Trobe University, Melbourne, VIC, Australia. 

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