Sexual Urological Emergencies.

Introduction: Sexual intercourse is often a reason for an emergency room visit because of urinary tract traumas.

Aim: To present an organized description of the most common urological emergencies during sexual intercourse and its management in emergency settings.

Methods: We reviewed the most common urological emergencies that occurred related to sexual intercourse. Our literature search was conducted in Medline, Embase, and Cochrane databases in October 2014 to identify the different sexual urological emergencies needing immediate care: type, etiology, presentation, radiologic and/or surgical intervention, and outcomes.

Main Outcome Measure: We identified original articles, review articles, and editorials addressing the subject, restricting the search to the last 14 years (2000-2014), also including additional papers, outside this time frame, that we believed to be relevant.

Results: Men of younger age were the most affected. Trauma to the genitourinary organs resulted primarily from autoeroticism and hetero and homosexual relations. The major pathologies we came to identify in this setting were: penile fractures, false penile fractures, penile strangulation, penile necrosis, and urethrovesical foreign bodies resulting from autoeroticism practices. We reviewed each one separately according the articles selected previously.

Conclusions: Sexual activity is mechanically dangerous, and it is not that uncommon for injuries to occur with patients referring to the emergency department for help. Young men are the most common group affected, with penile fracture being consistently the most common urological emergency concerning coitus. Some injuries concerning the low urinary tract or genitalia can usually be treated directly in the emergency department, whereas penile fracture or penile strangulation might need surgical intervention. Urethrovesical foreign bodies result mainly from sexual or autoeroticism practices and need individualized management. Emergency department personnel need to be trained in order to promptly recognize and manage these kinds of injuries. Rigorous data collection would surely improve treatment success and preventive strategies. Gaspar SS, Dias JS, Martins F, and Lopes TM. Sexual urological emergencies. Sex Med Rev 2015;3:93-100.