- Email: [email protected]
P-03-058 Dyspareunia
S199
P-03 Cases that Matter Posters
fT3 (3.59 pmol/L); even if both LH and total testosterone levels were still below normal (2.0 U/L and 10.4 nmol/L, respectively), gonadal axis showed initial signs of recovery. Therefore, it was decided to closely monitor laboratory tests, without administering testosterone replacement therapy. Conclusion: With weight gain, LH and testosterone gradually increased up to normalization. 11 months after hospitalization, the patient’s BMI was 21.5 kg/m2 and total testosterone reached optimal levels, more than 3-times higher than the first evaluation (25.3 nmol/L; LH 7.5 U/L). Despite taking psychotropic drugs with potentially negative effects on libido, he reported an improvement of his overall sexual functioning, but had not engaged in sexual activity yet. The case will require further assessment to evaluate other crucial aspects connected with undernutrition and hypogonadism, i.e. changes in bone mass density. Policy of full disclosure: Eating disorders in men are often underdiagnosed and overlooked. In particular, Avoidant/ Restrictive Food Intake Disorder is a common condition with unfavourable endocrine consequences, including hypogonadotropic hypogonadism. Weight restoration and psychiatric recovery can promptly lead to full resolution of gonadal axis dysregulation. There is no financial conflict of interest. P-03-055 POST ORGASMIC ILLNESS Mashal, A.1 1 Beer Sheva, Israel Objective: AS 42 y old man, who had been in stable marriage for more than 15 years and had 5 children. One two days after orgasm, he feels weakness, flu like symptoms, headache, pain in hands and legs last for another 2-3 days after sexual intercourse. The patient reported that these manifestation started two years ago, and abstain from sexual intercourse. He is free of all symptoms after these days and if he did not make sex The patient deny any sexual problem or any conflict with the partner. He is otherwise healthy, on no medication. Results: The patient received strong analgesic TRAMADOL and anti histamine LORASTIN to be taken shortly after intercourse , he reported some benefit. Conclusion: Post orgasmic illness syndrome (POIS) is a condition in which affected men develop flu-like symptoms approximately 30-60 minutes after ejaculation .The associated symptoms typically reach their peak severity on the second day and gradually resolve within a week. Although the exact underlying cause is not well understood, some scientists believe the condition may be due to a semen allergy or chemical imbalances in the brain. Limited information is available on the treatment and management of POIS.[1][2][3] References 1. Farley SJ. Postorgasmic illness syndrome. Nat Rev Urol. March 2011; 8(3):121. 2. Waldinger MD, Meinardi MM, Schweitzer DH. Hyposensitization therapy with autologous semen in two Dutch caucasian males: beneficial effects
J Sex Med 2016;13:S172eS212
in Postorgasmic Illness Syndrome (POIS; Part 2). J Sex Med. April 2011; 8(4):1174-1176. 3. Jiang N, Xi G, Li H, Yin J.. Postorgasmic Illness Syndrome (POIS) in a Chinese Man: No Proof for IgE-Mediated Allergy to Semen. J Sex Med. March 2015; 12(3):840-845. Policy of full disclosure: None. P-03-057 THE IMPACT OF SOCIAL CONTEXT ON THE SEXUAL LIFE OF DEAF ADOLESCENT GIRLS Mehrabi Kolibiki, H.1 1 Villeurbanne, France Objective: The social context is one of the factors that most influences sexuality. Depending on the culture and values of the different countries, sexuality acceptance, the age of first sexual relation, sexual practices and the type of sexual relationship are all different. To understand sexual behavior, we must first study the culture and social context of the country concerned. For the study of sexual problems among the deaf, it is very important to know whether these sexual problems are related to their deafness or to the culture of the society in which they live. In this article I analyzed whether deaf people living in two different countries have the same sexual problems. Methods: In this study, a qualitative and quantitative research method has been used. The data were obtained from semistructured interviews as well as questionnaires submitted to 139 deaf and hearing adolescents aged 16 and 20 years who were selected in France and Iran. Results: According of the results of the MANOVA test, has been found that there is a significant difference between deaf Iranian and deaf French girls on “Sex education needs” (p ¼ 0.001) the “sexual cognitive processes” (p ¼ 0.005), the “sexual well-being” (p ¼ 0.05) and the “sexual health behaviors” (p ¼ 0, 05). However, no significant result was found between the Iranian and the French deaf on “sexual information” and “sexual risk behaviors.” Conclusion: According to these results, we can evaluation that weaknesses information sexual in the Deaf is related to their deafness. Despite the existence formal sex education in France and the lack of sex education in Iran, we see both of two deaf groups have the same sexual knowledge. As a consequence of this weakness information sexual we see there is no difference in the risk sexual behavior between them and we can say deafness affects more than culture on their sexual problems. Policy of full disclosure: None.
P-03-058 DYSPAREUNIA Melnykov, S.1 1 Institute of Urology, Sexology and Andrology, Kyiv, Ukraine Objective: Patient S.P., 37 years old, has come with complaints about dyspareunia, pain feelings during coitus with irradiation
S200
into clitoris and small vulvar lips. Sick nurse. She has been married for 23 years, fiduciary relationships in family, loves her husband. Methods: Menstruations’ debut at the age of 12, regular, painless. Sexual debut at the age of 23, single sexual partner. One childbirth through natural birth passages. Contraception e interrupted sexual intercourse, condom. During sexual intimacy she achieved orgasm more than in half of cases. Frequency of sexual intercourse was 2-3 times per week. One year ago due to undesirable pregnancy the artificial interruption in the period of 7-8 weeks was carried out, complicated with placental polyp and repeated curettage of uterine cavity. When resuming sexual relationships in one month after treatment pain feelings appeared. During gynecological examination of the woman a chronic inflammatory disease of organs of small pelvis was revealed. During sexological examination by ultrasonography method with the use of Doppler method of organs of small pelvis in the first phase of menstrual cycle signs of violation of blood flow in genitals were revealed: increase of index of resistance (IR) to 0.69 and reduction of voluminous blood flow (Vvol) to 3.31 ml/min. Results: Individual psychotherapy and psychotherapy of a couple. Complex anti-inflammatory therapy. Physical therapy. Electric sleep. In 3 months after treatment the harmony of sexual relationships of spouses was achieved. When using Doppler method of organs of small pelvis Doppler indicators normalized: index of resistance (IR) has normalized to 0.57, and voluminous speed of blood flow (Vvol) has normalized to 3.46 ml/min. To prevent unplanned pregnancy we recommended using vaginal ring NovaRing. Conclusion: Optimal choice of method of contraception promotes preservation of reproductive and sexual health of a couple and prevention of possible sexual dysfunctions during unplanned pregnancy. Policy of full disclosure: None. P-03-059 TREATING THE PATIENT AND NOT LAB FINDINGS: A 35-YEAR OLD MAN WITH INCREASED PROLACTIN LEVELS AND OSTEOPOROSIS Mintziori, G.1 1 Ippokrateio General Hospital, Department of Endocrinology, Thessaloniki, Greece Objective: Sexual health is a state of physical, emotional, mental and social well-being in relation to sexuality; it is not merely the absence of disease, dysfunction or infirmity. When a disease or dysfunction is detected however, physicians often try to address them, regardless of the presence of respective symptoms. Methods: A 35-year-old married man was assessed at the outpatient clinic of the Department of Endocrinology, Ippokratio
P-03 Cases that Matter Posters
Hospital of Thessaloniki, Greece after having visited several physicians in a small town of Northern Greece. His initial symptom was lumbar pain but his radiology findings were suggestive of osteoporosis and he was further referred to orthopedics and endocrinologists. After complete hormonal work-up and dual-energy x-ray absorptiometry (DXA), the patient was diagnosed with hyperprolactinemia and osteoporosis. He had been treated with carbegoline for hyperprolactinemia and was referred to our center for secondary osteoporosis. History taking revealed an undisturbed sexual life with normal libido and absence of galactorrhea. Results: Carbegoline was stopped and consequent hormonal and biochemistry wok up demonstrated normal findings. Secondary causes of osteoporosis were not found and DXA was not repeated. Conclusion: In the respective case careful history taking that reveals a healthy sexual life with normal libido excludes true hyperprolactinemia. The patient’s decreased bone mass density (BMD) is most probably due to idiopathic decreased peak BMD. Conclusion. The patient in our case is a (sexually and overall) healthy young that was over treated due to abnormal lab findings in absence of symptoms. Carefull history taking can save our patients from getting over treated. Policy of full disclosure: None. P-03-060 HIGH FLOW PRIAPISM - A CASE REPORT Ofer, Y.1 1 Rambam Health Care Campus, Urology, Haifa, Israel Objective: Priapism is a persisting and abnormal penile erection without any sexual stimulation. There are two types of priapism: Ischaemic priapism: The most common type of priapism, (8090% of priapism cases) characterized by little or low blood flow and cavernosal hypoxia. Non-ischaemic priapism (high flow) is a persistent erection caused by dysregulation of the cavernosal blood flow. High-flow priapism results from unregulated, continuous arterial inflow into the lacunar spaces (an arterial-lacunar fistula). High-flow priapism is usually secondary to blunt trauma. This form of priapism should not be considered as a medical emergency. The initial management of arterial priapism is conservative, consisting of local maneuvers (e.g.: local compression) and observation. Spontaneous resolution occurs in 62% of cases. Selective embolisation is recommended in carefully selected cases, considering risks and benefits. Absorbable material (clot, gel-foam, etc.) is preferred for fistula embolization. The odds of spontaneous resolution, the risks of complications after treatment and possibly the lack of adverse consequences in case of delayed intervention must be explained to the patient. Surgical management of arterial priapism includes closing the fistula by suture, and requires the use of intraoperative ultrasonography. It is rarely needed and should be considered only as the very last resort. Methods: A 20 years old generally healthy male was referred to us because of erectile dysfunction (ED) and persistent
J Sex Med 2016;13:S172eS212
P-03 Cases that Matter Posters
fT3 (3.59 pmol/L); even if both LH and total testosterone levels were still below normal (2.0 U/L and 10.4 nmol/L, respectively), gonadal axis showed initial signs of recovery. Therefore, it was decided to closely monitor laboratory tests, without administering testosterone replacement therapy. Conclusion: With weight gain, LH and testosterone gradually increased up to normalization. 11 months after hospitalization, the patient’s BMI was 21.5 kg/m2 and total testosterone reached optimal levels, more than 3-times higher than the first evaluation (25.3 nmol/L; LH 7.5 U/L). Despite taking psychotropic drugs with potentially negative effects on libido, he reported an improvement of his overall sexual functioning, but had not engaged in sexual activity yet. The case will require further assessment to evaluate other crucial aspects connected with undernutrition and hypogonadism, i.e. changes in bone mass density. Policy of full disclosure: Eating disorders in men are often underdiagnosed and overlooked. In particular, Avoidant/ Restrictive Food Intake Disorder is a common condition with unfavourable endocrine consequences, including hypogonadotropic hypogonadism. Weight restoration and psychiatric recovery can promptly lead to full resolution of gonadal axis dysregulation. There is no financial conflict of interest. P-03-055 POST ORGASMIC ILLNESS Mashal, A.1 1 Beer Sheva, Israel Objective: AS 42 y old man, who had been in stable marriage for more than 15 years and had 5 children. One two days after orgasm, he feels weakness, flu like symptoms, headache, pain in hands and legs last for another 2-3 days after sexual intercourse. The patient reported that these manifestation started two years ago, and abstain from sexual intercourse. He is free of all symptoms after these days and if he did not make sex The patient deny any sexual problem or any conflict with the partner. He is otherwise healthy, on no medication. Results: The patient received strong analgesic TRAMADOL and anti histamine LORASTIN to be taken shortly after intercourse , he reported some benefit. Conclusion: Post orgasmic illness syndrome (POIS) is a condition in which affected men develop flu-like symptoms approximately 30-60 minutes after ejaculation .The associated symptoms typically reach their peak severity on the second day and gradually resolve within a week. Although the exact underlying cause is not well understood, some scientists believe the condition may be due to a semen allergy or chemical imbalances in the brain. Limited information is available on the treatment and management of POIS.[1][2][3] References 1. Farley SJ. Postorgasmic illness syndrome. Nat Rev Urol. March 2011; 8(3):121. 2. Waldinger MD, Meinardi MM, Schweitzer DH. Hyposensitization therapy with autologous semen in two Dutch caucasian males: beneficial effects
J Sex Med 2016;13:S172eS212
in Postorgasmic Illness Syndrome (POIS; Part 2). J Sex Med. April 2011; 8(4):1174-1176. 3. Jiang N, Xi G, Li H, Yin J.. Postorgasmic Illness Syndrome (POIS) in a Chinese Man: No Proof for IgE-Mediated Allergy to Semen. J Sex Med. March 2015; 12(3):840-845. Policy of full disclosure: None. P-03-057 THE IMPACT OF SOCIAL CONTEXT ON THE SEXUAL LIFE OF DEAF ADOLESCENT GIRLS Mehrabi Kolibiki, H.1 1 Villeurbanne, France Objective: The social context is one of the factors that most influences sexuality. Depending on the culture and values of the different countries, sexuality acceptance, the age of first sexual relation, sexual practices and the type of sexual relationship are all different. To understand sexual behavior, we must first study the culture and social context of the country concerned. For the study of sexual problems among the deaf, it is very important to know whether these sexual problems are related to their deafness or to the culture of the society in which they live. In this article I analyzed whether deaf people living in two different countries have the same sexual problems. Methods: In this study, a qualitative and quantitative research method has been used. The data were obtained from semistructured interviews as well as questionnaires submitted to 139 deaf and hearing adolescents aged 16 and 20 years who were selected in France and Iran. Results: According of the results of the MANOVA test, has been found that there is a significant difference between deaf Iranian and deaf French girls on “Sex education needs” (p ¼ 0.001) the “sexual cognitive processes” (p ¼ 0.005), the “sexual well-being” (p ¼ 0.05) and the “sexual health behaviors” (p ¼ 0, 05). However, no significant result was found between the Iranian and the French deaf on “sexual information” and “sexual risk behaviors.” Conclusion: According to these results, we can evaluation that weaknesses information sexual in the Deaf is related to their deafness. Despite the existence formal sex education in France and the lack of sex education in Iran, we see both of two deaf groups have the same sexual knowledge. As a consequence of this weakness information sexual we see there is no difference in the risk sexual behavior between them and we can say deafness affects more than culture on their sexual problems. Policy of full disclosure: None.
P-03-058 DYSPAREUNIA Melnykov, S.1 1 Institute of Urology, Sexology and Andrology, Kyiv, Ukraine Objective: Patient S.P., 37 years old, has come with complaints about dyspareunia, pain feelings during coitus with irradiation
S200
into clitoris and small vulvar lips. Sick nurse. She has been married for 23 years, fiduciary relationships in family, loves her husband. Methods: Menstruations’ debut at the age of 12, regular, painless. Sexual debut at the age of 23, single sexual partner. One childbirth through natural birth passages. Contraception e interrupted sexual intercourse, condom. During sexual intimacy she achieved orgasm more than in half of cases. Frequency of sexual intercourse was 2-3 times per week. One year ago due to undesirable pregnancy the artificial interruption in the period of 7-8 weeks was carried out, complicated with placental polyp and repeated curettage of uterine cavity. When resuming sexual relationships in one month after treatment pain feelings appeared. During gynecological examination of the woman a chronic inflammatory disease of organs of small pelvis was revealed. During sexological examination by ultrasonography method with the use of Doppler method of organs of small pelvis in the first phase of menstrual cycle signs of violation of blood flow in genitals were revealed: increase of index of resistance (IR) to 0.69 and reduction of voluminous blood flow (Vvol) to 3.31 ml/min. Results: Individual psychotherapy and psychotherapy of a couple. Complex anti-inflammatory therapy. Physical therapy. Electric sleep. In 3 months after treatment the harmony of sexual relationships of spouses was achieved. When using Doppler method of organs of small pelvis Doppler indicators normalized: index of resistance (IR) has normalized to 0.57, and voluminous speed of blood flow (Vvol) has normalized to 3.46 ml/min. To prevent unplanned pregnancy we recommended using vaginal ring NovaRing. Conclusion: Optimal choice of method of contraception promotes preservation of reproductive and sexual health of a couple and prevention of possible sexual dysfunctions during unplanned pregnancy. Policy of full disclosure: None. P-03-059 TREATING THE PATIENT AND NOT LAB FINDINGS: A 35-YEAR OLD MAN WITH INCREASED PROLACTIN LEVELS AND OSTEOPOROSIS Mintziori, G.1 1 Ippokrateio General Hospital, Department of Endocrinology, Thessaloniki, Greece Objective: Sexual health is a state of physical, emotional, mental and social well-being in relation to sexuality; it is not merely the absence of disease, dysfunction or infirmity. When a disease or dysfunction is detected however, physicians often try to address them, regardless of the presence of respective symptoms. Methods: A 35-year-old married man was assessed at the outpatient clinic of the Department of Endocrinology, Ippokratio
P-03 Cases that Matter Posters
Hospital of Thessaloniki, Greece after having visited several physicians in a small town of Northern Greece. His initial symptom was lumbar pain but his radiology findings were suggestive of osteoporosis and he was further referred to orthopedics and endocrinologists. After complete hormonal work-up and dual-energy x-ray absorptiometry (DXA), the patient was diagnosed with hyperprolactinemia and osteoporosis. He had been treated with carbegoline for hyperprolactinemia and was referred to our center for secondary osteoporosis. History taking revealed an undisturbed sexual life with normal libido and absence of galactorrhea. Results: Carbegoline was stopped and consequent hormonal and biochemistry wok up demonstrated normal findings. Secondary causes of osteoporosis were not found and DXA was not repeated. Conclusion: In the respective case careful history taking that reveals a healthy sexual life with normal libido excludes true hyperprolactinemia. The patient’s decreased bone mass density (BMD) is most probably due to idiopathic decreased peak BMD. Conclusion. The patient in our case is a (sexually and overall) healthy young that was over treated due to abnormal lab findings in absence of symptoms. Carefull history taking can save our patients from getting over treated. Policy of full disclosure: None. P-03-060 HIGH FLOW PRIAPISM - A CASE REPORT Ofer, Y.1 1 Rambam Health Care Campus, Urology, Haifa, Israel Objective: Priapism is a persisting and abnormal penile erection without any sexual stimulation. There are two types of priapism: Ischaemic priapism: The most common type of priapism, (8090% of priapism cases) characterized by little or low blood flow and cavernosal hypoxia. Non-ischaemic priapism (high flow) is a persistent erection caused by dysregulation of the cavernosal blood flow. High-flow priapism results from unregulated, continuous arterial inflow into the lacunar spaces (an arterial-lacunar fistula). High-flow priapism is usually secondary to blunt trauma. This form of priapism should not be considered as a medical emergency. The initial management of arterial priapism is conservative, consisting of local maneuvers (e.g.: local compression) and observation. Spontaneous resolution occurs in 62% of cases. Selective embolisation is recommended in carefully selected cases, considering risks and benefits. Absorbable material (clot, gel-foam, etc.) is preferred for fistula embolization. The odds of spontaneous resolution, the risks of complications after treatment and possibly the lack of adverse consequences in case of delayed intervention must be explained to the patient. Surgical management of arterial priapism includes closing the fistula by suture, and requires the use of intraoperative ultrasonography. It is rarely needed and should be considered only as the very last resort. Methods: A 20 years old generally healthy male was referred to us because of erectile dysfunction (ED) and persistent
J Sex Med 2016;13:S172eS212