title: Radiological findings of sexual intercourse related emergency department admissions: a first overview.
abstract: OBJECTIVE
  Sexuality is an essential aspect of human function, well-being and quality of life. Many people have sex without complications. However, there are some people who need to seek emergency medical help for related health problems. The aim of this study was to present a first overview of patients who received a radiological examination related to sexual intercourse based emergency department admission.
  
  
  METHODS
  Our centralized electronic patient record database was reviewed for patients who had been admitted to our emergency department with an emergency after sexual intercourse between 2000 and 2011. The database was scanned for the standardized key words 'sexual intercourse' or 'coitus' retrospectively. For all patients identified in the electronic patient record database the radiological examinations were searched for manually in our Radiology Information System, and reviewed by three independent radiologists.
  
  
  RESULTS
  One hundred and twenty nine out of 445 (29,0%) patients received a radiological examination after immediate emergency department admission related to sexual intercourse. Fifty two out of 129 (40.3%) patients had positive radiological findings while 77 (59.7%) did not. Eighty point seven percent (n = 42) of the radiological findings were a sexual intercourse-associated pathology and 19.2% (n = 10) were considered to be incidental findings. Age and male sex positively correlated with radiological imaging workup (p<0.001, respectively p<0.037). The most common sexual intercourse-associated pathology was headache attributed to cerebrovascular insult (n = 21, 40.3%) followed by epididymitis (n = 7, 16.6%) and obstructive uropathy (n = 5, 11.6%). Of the patients with headache attributed to non-traumatic intracranial hemorrhage, subarachnoid hemorrhage (n = 14, 66.6%) was the most common, followed by intracerebral bleeding (n = 4, 19.0%) and one subdural hemorrhage.
  
  
  CONCLUSIONS
  Pathological findings are manifold. Cerebral imaging is the most common type of radiological imaging performed. Further prospective and standardized studies should be performed to better evaluate the significance of radiological imaging in this patient collective with the aim to gain better knowledge on what patients profit from what type of radiological imaging when presenting with a sexual intercourse related emergency.
  
  
  CONCLUSIONS
  The present study provides a first overview on radiological findings of sexual intercourse related emergency department admissions.
authors.affiliation: Department of General Anaesthesiology, Intensive Care and Pain Management, Medical University of Vienna, Vienna, Austria; University Department of Emergency Medicine, University Hospital and University of Bern, Bern, Switzerland.
authors.forename: Carmen A
authors.initials: CA
authors.lastname: Pfortmueller
authors.affiliation: University Institute of Diagnostic, Interventional and Pediatric Radiology, University Hospital and University of Bern, Bern, Switzerland.
authors.forename: Adrian C
authors.initials: AC
authors.lastname: Schankath
authors.affiliation: University Institute of Diagnostic and Interventional Neuroradiology, University Hospital and University of Bern, Bern, Switzerland.
authors.forename: Pasquale
authors.initials: P
authors.lastname: Mordasini
authors.affiliation: University Department of Emergency Medicine, University Hospital and University of Bern, Bern, Switzerland.
authors.forename: Jana
authors.initials: J
authors.lastname: Koetter
authors.affiliation: University Institute of Diagnostic and Interventional Neuroradiology, University Hospital and University of Bern, Bern, Switzerland.
authors.forename: Roland
authors.initials: R
authors.lastname: Wiest
authors.affiliation: University Department of Emergency Medicine, University Hospital and University of Bern, Bern, Switzerland.
authors.forename: Aristomenis K
authors.initials: AK
authors.lastname: Exadaktylos
authors.affiliation: University Institute of Diagnostic, Interventional and Pediatric Radiology, University Hospital and University of Bern, Bern, Switzerland.
authors.forename: Stefan
authors.initials: S
authors.lastname: Puig
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D016208:Databases, Factual; D004630:Emergencies; D004636:Emergency Service, Hospital; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010343:Patient Admission; D011859:Radiography / Q000379:methods; D012189:Retrospective Studies; D012725:Sexual Behavior; D055815:Young Adult
references.citation: Headache. 2001 May;41(5):512-4
references.pmid: 11380651
references.citation: J Korean Med Sci. 2006 Dec;21(6):995-9
references.pmid: 17179675
references.citation: Indian J Med Res. 2009 Dec;130(6):681-8
references.pmid: 20090128
references.citation: Ann Intern Med. 2005 Jan 4;142(1):20-7
references.pmid: 15630106
references.citation: Eur J Neurol. 2008 Nov;15(11):e101-2
references.pmid: 18973608
references.citation: Arch Neurol. 2004 Jul;61(7):1114-6
references.pmid: 15262745
references.citation: Emerg Radiol. 2010 Sep;17(5):403-12
references.pmid: 20556627
references.citation: Urol Res. 2006 Jun;34(3):225-6
references.pmid: 16477426
references.citation: J Clin Neurosci. 2010 Oct;17(10):1349-51
references.pmid: 20655230
references.citation: J Sex Med. 2008 Feb;5(2):284-8
references.pmid: 18069993
references.citation: BJU Int. 2002 Feb;89(3):273-7
references.pmid: 11856110
references.citation: J Neurosurg. 2011 Apr;114(4):969-77
references.pmid: 20540599
references.citation: Cochrane Database Syst Rev. 2009 Oct 07;(4):CD007424
references.pmid: 19821415
references.citation: Z Kardiol. 1999 Jan;88(1):44-8
references.pmid: 11021276
references.citation: Emerg Med J. 2013 Oct;30(10):846-50
references.pmid: 23100321
references.citation: Diagn Interv Imaging. 2012 Jun;93(6):509-19
references.pmid: 22541240
references.citation: Urologe A. 2011 Oct;50(10):1248, 1250-2, 1254-6
references.pmid: 21927878
references.citation: Cesk Neurol. 1970 May;33(3):162-7
references.pmid: 5443431
references.citation: J Neurol Neurosurg Psychiatry. 2000 Dec;69(6):768-72
references.pmid: 11080229
references.citation: Stroke. 2012 Aug;43(8):2115-9
references.pmid: 22821609
references.citation: Postgrad Med J. 1996 Nov;72(853):653-6
references.pmid: 8944205
references.citation: J Med Case Rep. 2008 Jan 16;2:6
references.pmid: 18199324
references.citation: Headache. 2004 Mar;44(3):244-8
references.pmid: 15012662
references.citation: J Trauma. 2000 Aug;49(2):351-8
references.pmid: 10963554
references.citation: J Emerg Med. 2011 Sep;41(3):257-60
references.pmid: 18829203
references.citation: World J Urol. 2004 Nov;22(5):392-8
references.pmid: 15290204
references.citation: AJR Am J Roentgenol. 2007 Oct;189(4):913-21
references.pmid: 17885065
references.citation: Lancet. 1953 Oct 17;265(6790):799-801
references.pmid: 13098084
references.citation: Arch Neurol. 1981 Nov;38(11):710-2
references.pmid: 7305700
references.citation: Am J Forensic Med Pathol. 2012 Mar;33(1):90-2
references.pmid: 20562688