Department of Urology, Tulane University School of Medicine, New Orleans, LA, USA.
Johns Hopkins School of Medicine, James Buchanan Brady Urological Institute, Baltimore, MD, USA.
J Sex Med. 2020 Nov;17(11):2229-2235. doi: 10.1016/j.jsxm.2020.08.020. Epub 2020 Sep 30.
Postorgasmic illness syndrome (POIS) is a rare syndrome of unknown etiology where patients experience distressing physical and psychological after ejaculatory sequelae.
To better characterize the epidemiology, symptomatology, disease course, and treatment of POIS, with specific interest placed on examining relationships between disease presentation and measures of disease burden.
A 30-item questionnaire was distributed to an online community of patients with POIS from June 2019 to January 2020. We assessed diagnostic criteria and clusters of symptomatology described in prior studies. Outcome measures include self-reported measures of symptom severity, disease burden, and behavioral changes. Statistical correlations were assessed with Pearson's chi-squared (χ) and ordinal regression analyses.
The main outcome measures of this study are self-reported measures of symptom severity, disease burden, and behavioral changes.
The sample consisted of 302 men (mean age: 32.6 ± 11.4 years, mean age of onset: 19.1 ± 7.8 years) with 89% satisfying ≥3 diagnostic criteria. Common symptoms were difficulty concentrating (254, 84%), extreme fatigue (250, 83%), irritability (225, 74%), and muscle weakness (212, 70%). Common symptom clusters were general (219, 72%), muscle (137, 45%), and head (93, 31%). Common behavioral modifications were avoiding masturbation (215, 71%), schedule changes (213, 71%), and abstinence (186, 62%). Head and throat symptom clusters demonstrated worse disease burden outcomes. Professional medical advice was sought by 51% of participants. Attempted treatments included pharmacotherapy, vitamins, supplements, and herbs with variable efficacy.
This study further characterizes POIS, including how patients respond to the condition, how it is treated in the community, and presentations that may be associated with more severe disease.
STRENGTHS & LIMITATIONS: This is the largest study to date that concerns patients suffering from POIS and includes a diverse, global population. Limitations include that the survey was only administered in English and within 1 online community, that results were self-reported, and that the response rate was low (32%).
Characterizing symptom cluster, but not number of diagnostic criteria, may offer prognostic value, and investigation to elucidate pathophysiology and potential treatments for POIS is necessary. Natale C, Gabrielson A, Tue Nguyen HM, et al. Analysis of the Symptomatology, Disease Course, and Treatment of Postorgasmic Illness Syndrome in a Large Sample. J Sex Med 2020;17:2229-2235.
射精后疾病综合征（POIS）是一种罕见的病因不明的综合征，患者在射精后会出现痛苦的躯体和心理后遗症。
更好地描述 POIS 的流行病学、症状学、病程和治疗情况，特别关注疾病表现与疾病负担衡量指标之间的关系。
我们于 2019 年 6 月至 2020 年 1 月期间，向 POIS 患者在线社区分发了一份 30 项的调查问卷。我们评估了既往研究中描述的诊断标准和症状学聚类。研究结果包括自我报告的症状严重程度、疾病负担和行为改变的衡量指标。采用 Pearson's chi-squared（χ 2 ）和有序回归分析评估统计学相关性。
本研究的主要结果是自我报告的症状严重程度、疾病负担和行为改变的衡量指标。
样本由 302 名男性（平均年龄：32.6±11.4 岁，平均发病年龄：19.1±7.8 岁）组成，其中 89%符合≥3 项诊断标准。常见症状包括难以集中注意力（254 例，84%）、极度疲劳（250 例，83%）、易怒（225 例，74%）和肌肉无力（212 例，70%）。常见的症状聚类包括全身（219 例，72%）、肌肉（137 例，45%）和头部（93 例，31%）。常见的行为改变包括避免自慰（215 例，71%）、调整日程（213 例，71%）和禁欲（186 例，62%）。头部和喉咙症状聚类与更严重的疾病负担结果相关。51%的参与者寻求过专业医疗建议。尝试过的治疗方法包括药物治疗、维生素、补充剂和草药，疗效不一。
本研究进一步描述了 POIS，包括患者对疾病的反应方式、社区内的治疗方式以及可能与更严重疾病相关的表现。
这是迄今为止针对 POIS 患者的最大规模研究，包括了来自不同地区的多样化人群。研究的局限性在于，该调查仅以英文形式在 1 个在线社区进行，结果为自我报告，且应答率较低（32%）。
对症状聚类的描述而非诊断标准的数量可能具有预后价值，有必要对 POIS 的病理生理学和潜在治疗方法进行研究。Natale C, Gabrielson A, Tue Nguyen HM, et al. Analysis of the Symptomatology, Disease Course, and Treatment of Postorgasmic Illness Syndrome in a Large Sample. J Sex Med 2020;17:2229-2235.
