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Re: Orgasm and Urine Loss From: dahmd@gate.net Sun Nov 3 17:40:30 1996 Messages sorted by: [ date ][ thread ][ subject ][ author ] Next message: Robert J. Woolley: "Re: Orgasm and Urine Loss" Previous message: Betsy Hyde: "ginger root bibliography (no garbage!)" In article wcely@teleport.com (William Cely) writes: >She is a 35 y.o. who had a laparoscopic Burch by me 8 weeks ago and is now >continent but complains that during intercourse she loses urine with orgasm. I have seen 3 such patients in my short career and all were under age 25 and none had had any prior significant gynecologic surgery. I recall that only one of these patients had delivered a child. The history was exactly the same: spurts of urine only during orgasm and not during foreplay or coitus. I believe none reported loss of urine with coughing, laughing, or other activities. Exams were unrewarding for prolapse, urine infection, etc. All responded to voiding before intercourse and the use of oxybutynin (Ditropan) or imipramine (Tofranil). I assume this was detrusor spasm. All assured me it was urine as it smelled and in one case tasted like urine (the very embarrassed patient urinated on her boyfriend during oral sex). I suppose so-called "female ejaculation" is possible but why would present as a new finding in your patient? Furthermore, the reported incidence of de-novo detrusor spasm after a retropubic urethropexy is up to 18%. My work-up would generally include a thorough history and pelvic exam, urinalysis and culture, and either urodynamics or empiric treatment with an anticholinergic medication for bladder spasm. Gook luck! Ashley D. Ashley Hill, M.D. dahmd@gate.net Orlando, FL Next message: Robert J. Woolley: "Re: Orgasm and Urine Loss" Previous message: Betsy Hyde: "ginger root bibliography (no garbage!)"

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