The patient walked into the consultation room and without hesitation proceeded to hug me. It is unusual for a patient to hug his doctor so I got confused, not sure if the gentleman was a long-time friend or a patient. The problem of meeting many people is that sometimes one is unable to recognise faces.
DISTRESS
“So, how have you been all these years?” He asked with genuine enthusiasm, “I have not stopped reading your articles in the Saturday Nation from the time you first treated me,” he said with excitement. “That’s good to know,” I said. “The joy of a writer is to know that someone reads your work.” And with that I asked for his official name to enable me retrieve his records. “Erick. I am the one who had only one testis, you remember, the one whose wife dragged into your clinic because she was convinced that a man ought to have two balls?” He burst out laughing. I traced his records and for sure it had been a long time. It had been 10 years since we first met. I had diagnosed him with one undescended testis and had him undergo an operation.
Ideally, a man has to have two testes hanging outside his body. Nature made it that way because the temperatures inside the body are too high for the testes to function normally. In fact if testes remain inside the body without hanging out, a man can become impotent and worse still he can develop cancer of the testis. A common abnormality is for one testis to hang out and one to remain stuck in the pelvis. If noted at birth, an operation can be done to make both testes hang outside the body. If noted later in life, however, the undescended testis is removed because it has a high risk of becoming cancerous in future.
“My problem now is that I ejaculate too fast and my wife has given me the last warning to style up or face unspecified consequences,” Erick said staring into the horizon. I could see a man in distress. After years of attending to patients with sex problems, I am able to quickly pick those who have gone into psychological distress with a fair amount of accuracy.
“I see this new issue is really stressing you,” I interjected.
SATISFACTION
“It is unfair to be called names and treated badly for problems that are not of your own making; she even hurls insults at me in front of my friends,” he said, his eyes welling up with tears.
Incidentally, going deeper into the history of his sexual function, I discovered that Erick actually had premature ejaculation from the start of his marriage. He always ejaculated within a minute of penetrative sex. He had what is classified as primary premature ejaculation, a type of premature ejaculation that begins from the time one starts to have sex. This is as opposed to secondary premature ejaculation, which can come later in life.
“But what I don’t understand is why it should be such a big deal now, 10 years after we had our wedding,” Erick interrupted, “I would expect that if she coped with it all these years she should be used to it now and should not mistreat me for it.”
Well, unfortunately, the distress caused by premature ejaculation worsens with age. In the early years of a man, he is able to have sex more frequently, and he gets erections much sooner after a round of sex. As such, he is able to satisfy his partner who may have been left hanging after the first or even second round. As age catches up, however, a man needs more time to recover from the experience of ejaculation. This means that his wife may not get the satisfaction she previously got when sex was more frequent.
SELF-CONFIDENCE
The problem of premature ejaculation is a physical one in most cases, that is, it is the physical inability to delay ejaculation.
If not managed well, it becomes a psychological problem. The worst scenario is where your partner makes you feel inadequate such that you lose your self-confidence. Lack of self-confidence further worsens sexual performance. All these sexual dynamics happen in the context of a relationship that may be facing other challenges like poor communication, power fights, stress of parenting or money problems, which all add to the stress. The result is that intimacy wanes and this only works to worsen premature ejaculation. Overall, therefore, older men tend to ejaculate faster and suffer severe psychological and relationship consequences such as divorce.
“In fact I feel that the unspecified consequences that my wife talks about could be divorce, I don’t want to lose my family, especially my two children,” Erick said as tears rolled down his cheeks.
The good thing is that premature ejaculation is easy to treat. I put Erick on medication and counselling. Three weeks after his visit to the clinic, I received a card from him with this message: “Your friend with a single ball is now doing wonders and his wife is pleading that he should not venture out because other women can take him away! Asante sana.”
