Complex sexual dysfunctions by voluminous non-reducible, incarcerated, inguinoscrotal, monoblock fixed epiplocele – DOI: 10.37072/JCS.2022.01.01

I.Vasile NIȚESCU1, II.Mircea BEURAN2, Sebastian VÂLCEA2, Bogdan DIMITRIU2, III. Andy PETROIANU3, Bogdan MARINESCU4, Valentin NIȚESCU5

1.Medical Centre for Obstetrics-Gynaecology and Sexology; 2. Surgery Department of the Emergency Clinical Hospital “Floreasca”; 3. Department of Surgery, Faculty of Medicine, Federal University of Minas Gerais, Brazil; 4. Department of Infertility, Clinical Hospital of Obstetrics- Gynecology “Prof. Dr. Panait Sîrbu”,Giulești Maternity Hospital; 5. Hôpital Universitaire “Pitié-Salpêtrière”, Service de Chirurgie Générale, Viscérale et Endocrinienne, Faculté de Médecine, Sorbonne Université (Paris)

Abstract
Sexual activity is conditioned by the morphophysiology of the brain and the integrity of the genitals that become essential to the reproductive period in both women and men.
In the present case, the existence of a surgical pathology, due to the diversity of sexual dys- functions, also determined sterility, directly affecting the perpetuation of the human species. The compression on the neurovascular elements in the right inguinal canal (Fig.1a,b,c), respectively on the pedicle and the right testicle, the blood vessels and the left testicle by the epiplocele became bulky and irreducible, determined the appearance and accentuation of sexual dysfunctions, these becoming complex.
The occurence of strong local pain in the scrotum generated reflex pain in the epigastrium and lumbar spine, which appeared during physical exertion by the patient. The pain symptoms were present daily, during the work process, imposing rest in a supine position. Peno-vaginal sexual intercourse and, less frequently, fellatio became rare, and sexual dysfunction became complex, namely libido, erection, copulation and orgasm, leading to infertility.
In this context, the sexual intercourse was more and more difficult, it did not lasted more than 4-5 minutes, the patient had a reduced intensity orgasm and the volume of the eliminated sperm fluid was between 2.5-3 ml per sexual intercourse (3 ml, after several rest days), which determined the patient to see a sexologist.
Keywords:
Incarcerated epiplocele, necrosis, sterility, sexual dysfunction

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