This case concerns a 59-year-old male with a past medical history of hypertension, chronic renal insufficiency, and autoimmune pancreatitis secondary to IgG4-related disease, on chronic steroids. The patient experienced acute onset of lightheadedness, a tingling sensation to both hands, and jaw tightness while masturbating. He was found to have a Type A aortic dissection. This is the first case of its kind to document an atypical, painless aortic dissection presentation in a patient with IgG4-related disease. This piece explores how fibroinflammatory sequelae of IgG4-related disease can result in aortic manifestations and discusses the importance of considering a broader differential including aortic syndrome when encountering patients presenting with atypical symptoms.

OBJECTIVE: To identify atypical masturbatory behaviors (AMB) and to reveal their effects on both sexual and masturbational erection hardness in men with erectile dysfunction (ED).
METHODS: Patients with ED and healthy controls were questioned about their masturbation habits. Accordingly, \"rubbing in a prone position,\" \"pressure on penis,\" and \"masturbation through clothes\" were included in the traumatic masturbation syndrome (TMS) group. Erection hardness score (EHS) is used to measure the erectile functions during masturbation (mast), foreplay (presex), and sexual intercourse (sex), separately.
RESULTS: The data of 448 participants, 266 (59%) from the patient group, and 182 (41%) from the control group were analyzed. The mean ages were 30 years in both groups (p = 0.734). The rate of \"rubbing in a prone position\" and \"penile pressure\" while masturbating was higher in patients than the controls (10.2% vs. 6%, p = 0.024 and 8.6% vs. 3.3%, p = 0.0002, respectively). Patients had 2.2-fold (odds ratio, 2.21; 95% confidence interval, 1.40-3.47; p = 0.001) increased risks of having at least one AMB, compared with controls. In the secondary analysis, the patient group was divided into 2 subgroups according to having TMS (ED + TMS) or not (ED). The percentage of patients with EHS≥3 during masturbation was higher than those during sex and presex in the \"ED + TMS\" group (60.2%, 38.8%, and 37.2%, respectively, p = 0.0001; n = 98). Comparing the percentage of patients with EHS≥3 during mast, presex, and, sex was found to be similar in the \"ED\" group (58.9%, 56.5%, and 56%, respectively, p = 0.753; n = 168).
CONCLUSIONS: Atypical masturbatory behaviors are more common in young men presenting with erectile dysfunction. These patients have higher erection hardness scores during masturbation compared to partnered sex.

Penile fracture is a rare urological emergency typically caused by vigorous sexual intercourse, masturbation, and trauma. Only very few cases with a non-coital etiology or trauma have been reported in the literature. While cases of penile fracture resulting from the manipulation of the erect penis during masturbation have been reported in the Middle East, we report here a rare case of a penile fracture as a result of manipulation of the turgid penis during nocturnal penile tumescence. Following penile manipulation during nocturnal penile tumescence, our patient presented with persistent penile pain, progressive penile swelling, and penile deformity. Immediate surgical management was carried out with excellent outcomes. The diagnosis of the case with the specifics of the intraoperative findings and the surgical procedure are presented in this report. Our goal is to emphasize that non-coital-related penile fractures can occur and should be recognised to prompt early diagnosis and prompt treatment to avoid complications.
La fracture du pénis est une urgence urologique rare, typiquement causée par des rapports sexuels vigoureux, la masturbation et les traumatismes. Seuls quelques cas d’étiologie non coïtale ou de traumatisme ont été rapportés dans la littérature. Alors que des cas de fracture du pénis résultant de la manipulation du pénis en érection pendant la masturbation ont été rapportés au Moyen-Orient, nous rapportons ici un cas rare de fracture du pénis résultant de la manipulation du pénis turgescent pendant la tumescence nocturne du pénis. Suite à la manipulation du pénis pendant la tumescence nocturne, nos patient ont présenté une douleur persistante au niveau du pénis, un gonflement progressif du pénis et une déformation du pénis. Une intervention chirurgicale immédiate a été réalisée avec d’excellents résultats. Le diagnostic de ce cas, ainsi que les détails des résultats peropératoires et de la procédure chirurgicale sont présentés dans ce rapport. Notre objectif est de souligner que les fractures du pénis non liées à l’acte sexuel peuvent se produire et doivent être reconnues pour un diagnostic et un traitement précoces afin d’éviter les complications. Mots-clés: Fracture du pénis, Tumescence nocturne du pénis, Manipulation du pénis, Masturbation.

Penile fracture is a rare condition with an incidence of 1 case per 175000 United States male population. It can be caused by vigorous sexual intercourse and masturbation. Patients usually present with pain and swelling of the penis and can be diagnosed clinically. It mostly occur as a result of rupture of tunica albuginea of corpora cavernosa. Ultrasound is the most reliable investigation to detect penile fractures. Patients need prompt treatment with exploration and repair of defects to prevent long-term sequelae. Here we present a case of 44 years male who developed a penile fracture following sexual intercourse and underwent surgical exploration and repair.
UNASSIGNED: masturbation; penis; sexual intercourse.

We present a case of a 32-years-old female patient diagnosed with paranoid schizophrenia for many years who has developed neuroleptic malignant syndrome (NMS) as a result of long-acting antipsychotic\'s injection. Since the initial ineffectiveness of benzodiazepines, the course of electroconvulsive therapy (ECT) has been carried out. In spite of the initial promising response to ECT 3 weeks after the admission her somatic and mental state deteriorated greatly, that was hardly explicable solely by the potential loss of effectiveness of ECT or laboratory tests. Diagnostics extended with imaging tests and gynecological examination revealed the connective tissue-covered cap of a popular multivitamin supplement in patient\'s vagina. During the following deepened interview, she admitted that in fact 6 months ago a piece had gotten stuck while masturbating. However due to the sense of shame and subjective lack of disturbing symptoms she had left it unsaid. One month after the evacuation of the foreign body she has been discharged from the hospital remaining the full remission. The presented case shows that inflammation in the body can complicate catatonia and NMS, causing a non-specific course and difficulties in diagnosis and treatment. In some patients, the inflammatory process may be caused by a foreign body located in various natural orifices in the body. It appears significant in the group of psychiatric patients. Once again it highlights the tremendous role of meticulously conducted interview including the patient\'s autoerotic life.

暂无摘要。

BACKGROUND: Penile ring entrapment during self-sexual satisfaction is one of the rare cases in general and urologic surgery. When the penile shaft is entrapped in a metal ring, one risks possible complete loss of distal penis to strangulation and gangrene. We present management of a case of entrapped penile ring with penile strangulation in resource limited set up amidst absence of management guidelines. The case has been reported in line with SCARE criteria (1).
METHODS: A 43-year-old male presented after 72 h of pilot ball bearing ring penile insertion for sustainability of an erection, with 24 -h history of painful penile swelling and acute urine retention. The patient had history of using recreational drugs and erectile dysfunction with evidence of high-grade penile injuries at presentation. The ring was cut using electrically powered angled grinder, with full penile recovery on conservative management in eight months of follow up.
CONCLUSIONS: Entrapped penile ring is clinically diagnosed but establishing incentive of insertion is difficult just like identifying a correct technique to remove it. Entrapped ring obstructs blood and lymphatic flow leading to oedema and ischaemia with associated penile tissue injuries. High grade penile injuries or penile amputation are sequels of delayed ring removal and good outcomes are tangible through timely multidisciplinary approach.
CONCLUSIONS: Eroticism and erectile dysfunctions are known incentive to using penile rings to sustain erection. Delayed ring removal results in its entrapment and penile strangulation and related complications. Timely removal of ring requires multidisciplinary approach and local management protocols.

Penile fracture is a well-recognized but uncommon urological emergency. It is a tear in the tunica albuginea with rupture of corpus cavernosum. It may be associated with injury to corpus spongiosum and urethra. Diagnosis is usually clinical and Urethral injury should be suspected in penile fracture, especially in those cases with urethral bleeding and bilateral cavernosal rupture. Penile fracture is most commonly caused by injury during sexual intercourse. It has also been described with masturbation, rolling over or falling onto the erect penis, and other scenarios. A cracking or popping sound followed by pain, rapid detumescence, discoloration and swelling of penile shaft and urethral bleeding are common presenting symptoms. Prompt surgical intervention with closure of tunica albuginea is the treatment of choice with satisfactory cosmetic and functional results. We report a case of fracture penis in a 25-year-old male who came to emergency department of our hospital.

Cybersex addiction is a sexual addiction characterized by virtual Internet sexual activity that causes serious negative consequences to one\'s physical, mental, social, and/or financial well-being. Previous studies have mostly addressed cybersex addiction in heterosexual males.
To describe a case report of a 26-year-old gay man suffering from a cybersex addiction.
We use Griffiths\' model of the common components of addictions.
We reveal this case report of cybersex addiction possesses all of six components universal for addictions.
In light of the increasing prevalence of various behavioral addictions (especially, Internet addictions), clinical psychiatrists should be aware of the cybersex addiction phenomenon.

Autoerotic deaths refer to fatalities occurring during individual, solitary sexual activity, in which some device, situation, or act is used to gain or boost the sexual arousal of the subject. Anorectal autoeroticism is an autoerotic paraphilic activity that pertains to the self-insertion of various objects into the anal canal and rectal cavity to gain or heighten the subject\'s sexual drive. Although most foreign bodies inserted into the rectum do not cause significant injury, the introduction of some objects into the rectum might have unpredictable and even fatal effects. In this paper, we describe an intriguing autoerotic case of a 35-year-old male who sustained an explosive rectal trauma as a result of the unanticipated bursting of an expandable rubber pipe stopper that he inserted into his rectum and hyperinflated via an air blow gun connected through a pressure pipe to a centralized air-distribution system. The man sustained a circular abruption of the rectum with partial avulsion of the abdominal wall, associated with bleeding into the abdominal cavity and chest wall, and died before admission to the hospital. A police investigation revealed that the victim was a regular contributor to several web forums dedicated to unusual sexual activities. This case raises awareness of the broadening spectrum of methods and experiments associated with autoerotic behavior. We also reviewed the literature pertaining to this topic and outlined some of the characteristics of atypical autoerotic deaths. Although certain autoerotic methods are relatively common, other unusual autoerotic techniques may present novel challenges within the medicolegal field.