Hiếm muộn nam do chậm xuất tinh

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Tác giả: Đình Hiếu Lê, Thanh Quang Nguyễn, Nhật Thăng Trần

Ngôn ngữ: vie

Ký hiệu phân loại:

Thông tin xuất bản: Tạp chí Y Dược học Phạm Ngọc Thạch, 2023

Mô tả vật lý: tr.208

Bộ sưu tập: Metadata

ID: 339356

Thêm vào giỏ Liên kết toàn văn

- Đặt vấn đề: Chậm và không xuất tinh (XT) là rối loạn tình dục ít gặp (1 - 4% nam giới), tác động tiêu cực trên đời sống tinh thần và tình dục của cả nam lẫn nữ, và có thể gây hiếm muộn. Chúng tôi trình bày 1 trường hợp hiếm muộn do không XT và tổng quan y văn về hiếm muộn nam liên quan đến chậm và không XT.- Bệnh án lâm sàng: BN nam sinh năm 1991, lập gia đình 12/2018, không thể XT và đạt đỉnh khoái cảm khi quan hệ tình dục (2 - 3 lần/tuần) dù có thể duy trì cương kéo dài. BN thủ dâm gần như mỗi ngày khi độc thân và 3 - 4 lần/tuần từ khi lập gia đình, theo cách đặc thù của mình. XT và đạt đỉnh khoái cảm khi thủ dâm với dương vật vẫn mềm. Tinh dịch đồ và nội tiết tố sinh dục nam huyết thanh trong giới hạn bình thường. Dù dương vật bị cong về mặt bụng khoảng 30o, BN không bị trở ngại khi quan hệ ngã âm đạo. - Kết luận: Không XT khi quan hệ liên quan đến tâm lý và hành vi thủ dâm từ lúc dậy thì, dẫn đến hiếm muộn khi lập gia đình là tình huống bất thường, hiếm gặp. Giải thích nguyên nhân và tư vấn tâm lý tình dục cho BN để thay đổi thói quen tình dục là cần thiết, tuy nhiên, hiệu quả cần thời gian lâu dài, sự hợp tác của BN và cả người vợ, và có thể khó đánh giá. Giải pháp trước mắt là áp dụng các kỹ thuật hỗ trợ sinh sản để giải quyết nhu cầu có con của cặp vợ chồng này. Abstract- Introduction: Delayed ejaculation and anejaculation are rare male sexual dysfunctions (1 - 4%), which has negative impact on both male and female sexual life and could lead to infertility. We presented a male infertility due to anejaculation and reviewed the medical literature regarding this problem. - Study patients: A 29 - years - old man, who got married in Dec 2018, complained of anaejaculation and lack of orgasm in sexual intercourses (2 - 3 times/week) even though he could maintain a prolonged erection. This man masturbated in his own way nearly everyday when he was a bachelor and 3 - 4 times/week since marriage. He could achieve orgasm and ejaculation under masturbation with little penile erection. His semen analysis and sexual hormone profile were within the normal physiological range. Although his penis is curved ventrally up to 30o, he had no problem via vaginal coitus. - Conclusions: Anejaculation during sexual intercourse which might be related to idiosyncratic and frequent masturbation behavior since puberty and during marital life is rare and abnormal cause ofinfertility in this young couple. Medical investigation and sexual consultation seem necessary to modify patient’s sexual attitude and habit, however, its effectiveness takes time and needs a close cooperation of this man and his wife. Short - term medical interventions should be assisted reproductive techniques to meet urgent desire of this couple. DOI: 10.59715/pntjmp.1.3.26

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