Department of Psychiatry and Neurosexology, HagaHospital, The Hague, The Netherlands.
J Sex Med. 2011 Apr;8(4):1171-6. doi: 10.1111/j.1743-6109.2010.02167.x. Epub 2011 Jan 17.
Postorgasmic illness syndrome (POIS) is a post-ejaculatory complex of local and/or systemic symptoms that nearly always occurs within seconds, minutes, or hours post-masturbation, coitus, or spontaneous ejaculation. Recent data suggest an autoimmunogenic/allergic underlying mechanism.
To treat males with POIS by hyposensitization with their own semen (autologous semen).
Two males suffering from POIS, of which one male with coincidental lifelong premature ejaculation (PE) were investigated. Based on their local and systemic symptoms including a positive dermatologic reaction after skin-prick testing with autologous semen, auto-allergy to semen was likely an underlying mechanism. A hyposensitization program was initiated, including multiple subcutaneous (SC) injections with autologous semen, initially at 2 weeks intervals in the first year and gradually at 4 weeks intervals in the second and third year. From initial semen dilutions of 1 on 40,000 and 1 on 20,000, the titers were gradually increased to 1 on 20 and 1 to 280, respectively.
Evaluation with a dedicated questionnaire about severity of POIS symptoms and specialized interviews on self-perceived intravaginal ejaculation latency times (IELT) before and during the desensitization program.
POIS was confirmed in both subjects, PE was confirmed in one male, and skin-prick tests with autologous semen in both subjects were positive. During the program, gradual reduction of complaints resulted in 60% and 90% amelioration of POIS complaints at 31 and 15 months, respectively, which coincided in one male with a delay of the IELT from 20 seconds at baseline to 10 minutes after 3 years of treatment. The cause of this association with IELT is unknown and remains to be elucidated.
Two males with POIS were successfully treated by hyposensitization with autologous semen, which supports an immunogenic/allergic etiology and underscores the clinical implication for immunological sexual medicine.
射精后疾病综合征（POIS）是一种在自慰、性交或自发性射精后数秒、数分钟或数小时内出现的局部和/或全身症状的综合征。最近的数据表明，其潜在机制可能与自身免疫/过敏有关。
通过对自身精液（自体精液）进行低敏化治疗来治疗 POIS 男性患者。
对两名患有 POIS 的男性患者进行了研究，其中一名男性还伴有终生早泄（PE）。根据他们的局部和全身症状，包括自体精液皮试后的阳性皮肤反应，推测精液自身过敏可能是其潜在机制。启动了低敏化方案，包括多次自体精液皮下（SC）注射，最初在第一年每 2 周一次，然后在第二年和第三年逐渐每 4 周一次。初始精液稀释度分别为 1:40,000 和 1:20,000，滴度逐渐增加至 1:20 和 1:280。
使用专门的问卷评估 POIS 症状的严重程度，并在脱敏治疗前后对自我感知的阴道内射精潜伏期时间（IELT）进行专门访谈。
两名患者均确诊为 POIS，一名患者确诊为 PE，两名患者的自体精液皮试均为阳性。在治疗过程中，随着时间的推移，症状逐渐减轻，31 个月和 15 个月时 POIS 症状分别改善了 60%和 90%，其中一名患者的 IELT 也从基线时的 20 秒延迟至 3 年后的 10 分钟。这种与 IELT 的关联的原因尚不清楚，仍需进一步阐明。
两名 POIS 男性患者通过自体精液低敏化治疗取得了成功，这支持了免疫原性/过敏病因，并突出了免疫性性医学的临床意义。
