title: Sexual activity-related emergency department admissions: eleven years of experience at a Swiss university hospital.
abstract: BACKGROUND
  Most people enjoy sexual intercourse without complications, but a significant, if small, number need to seek emergency medical help for related health problems. The true incidence of these problems is not known. We therefore assessed all admissions to our emergency department (ED) in direct relation to sexual intercourse.
  
  
  METHODS
  All data were collected prospectively and entered into the ED's centralised electronic patient record database (Qualicare, Switzerland) and retrospectively analysed. The database was scanned for the standardised key words: 'sexual intercourse' (German 'Geschlechtsverkehr') or 'coitus' (German 'Koitus').
  
  
  RESULTS
  A total of 445 patients were available for further evaluation; 308 (69.0%) were male, 137 (31.0%) were female. The median age was 32 years (range 16-71) for male subjects and 30 years (range 16-70) for female subjects. Two men had cardiovascular emergencies. 46 (10.3%) of our patients suffered from trauma. Neurological emergencies occurred in 55 (12.4%) patients: the most frequent were headaches in 27 (49.0%), followed by subarachnoid haemorrhage (12, 22.0%) and transient global amnesia (11, 20.0%). 154 (97.0%) of the patients presenting with presumed infection actually had infections of the urogenital tract. The most common infection was urethritis (64, 41.0%), followed by cystitis (21, 13.0%) and epididymitis (19, 12.0%). A sexually transmitted disease (STD) was diagnosed in 43 (16.0%) of all patients presenting with a presumed infection. 118 (43.0%) of the patients with a possible infection requested testing for an STD because of unsafe sexual activity without underlying symptoms.
  
  
  CONCLUSIONS
  Sexual activity is mechanically dangerous, potentially infectious and stressful for the cardiovascular system. Because information on ED presentation related to sexual intercourse is scarce, more efforts should be undertaken to document all such complications to improve treatment and preventative strategies.
authors.affiliation: University Department of General Internal Medicine, Inselspital Bern, Bern, Switzerland. cpfortmueller@gmail.com
authors.forename: Carmen Andrea
authors.initials: CA
authors.lastname: Pfortmueller
authors.forename: Jana Nimia
authors.initials: JN
authors.lastname: Koetter
authors.forename: Heinz
authors.initials: H
authors.lastname: Zimmermann
authors.forename: Aristomenis Konstantinos
authors.initials: AK
authors.lastname: Exadaktylos
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002318:Cardiovascular Diseases / Q000209:etiology; D003075:Coitus; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data*; D005260:Female; D006261:Headache / Q000209:etiology; D006785:Hospitals, University / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008875:Middle Aged; D009422:Nervous System Diseases / Q000209:etiology; D012189:Retrospective Studies; D017678:Sex Distribution; D013557:Switzerland; D014552:Urinary Tract Infections / Q000209:etiology; D014947:Wounds and Injuries / Q000209:etiology; D055815:Young Adult
keywords: abdomen - uro-genital; neurology