For most people in the world, a really satisfactory bowel movement feels...good. The relief, the relaxation, we've all been there. But apparently, for the patient in this case study, defecation felt more than good, it felt GREAT.
But is it possible for a crap to feel TOO great? Apparently so. After all, the man actually complained. On the other hand, he only complained after he'd been suffering this problem for 10 years...
Van Der Schoot and Ypma. "Seminal vesiculectomy to resolve defecation-induced orgasm." British Journal of Urology International, 2002, 90, 761-762.
(This is another article courtesy of the bibliography of "Bonk: The Curious Coupling of Science and Sex". Where would this blog be without Mary Roach, I ask you.)
Sci is often surprised and somewhat heartened by the number of things that can get the human species off. It ensures our continued existence, if nothing else (at least, for as long as the planet holds out). But this is the first time I had ever heard of defecation-induced orgasm. I mean, sure, taking a sh** feels good, but not THAT good. And it's certainly not the same kind of good, if you know what I mean here.
But apparently, defecation-induced orgasm does exist. Not only does it exist, it can actually NEGATIVELY impact your quality of life. A 70-year-old man came in complaining of fatigue. It turned out that after each defecation he felt the sense of orgasm, though he never actually ejaculated. He also noticed a rise in pulse rate and "a sense of relaxation, which changed to fatigue". Haven't we all been there. The feeling he got after taking a crap was the same he felt during sex. He could also get the same effect whenever he went to the bathroom after needing to pee REALLY badly. Interestingly, he had no sexual or urinary problems at all.
For the first ten years of this, he apparently didn't tell anyone and lived a happy life where I would assume he was VERY regular for a man of his age, and had some incredible moments in the restroom. But once he reached 70, his daily (or every-other-day, or whenever) defecation began to induce too much fatigue. He just couldn't take it anymore. And so he went to his general practitioner, who referred him to a urologist, who referred him to a neurologist, who referred him to a psychiatrist, who referred him to an acupuncturist (I guess they must have thought it was all psychological). Even the acupuncturist (acupuncture THERE?!) threw up his hands in defeat. Finally, he came back to DIFFERENT group of urologists, and they were the ones who solved the problem, and then presumably were so passionate about their tasks that they wrote this entire case study with perfectly straight faces.
I can only imagine what it must have been like for the poor guy, you know? Going around to each of these different doctors, and having to explain to each of these different people "yeah, so when I take a crap it feels REALLY good..." Embarrassing doesn't seem to cover it. I'm sure all of them were polite enough not to laugh, but I wonder how many of them said "and this is a problem...why?" And I'm sure if he was married, his wife wasn't complaining.
So what was wrong? Well, it turns out that six years before, he had had his prostate removed (in what is called a retropubic prostatectomy, which doesn't bring up half the things on Google you thought it would), due to the benign prostate enlargement that often happens to older men. Benign prostate enlargement isn't cancer or anything, but can cause urination problems because it surrounds the vas deferens (the tube going out). Enlargement can thus squeeze you shut. Usually you can medicate to reduce it, or have surgery if the medication isn't working. But of course, prostates don't swell up overnight, it had been in the process of enlarging for several years previously. And it was the enlargement that presumably produced the opportunity for this symptom to arise.
When the doctors performed a cytoscopy, they found that one of his ejaculatory ducts (men have two of them, one from each seminal vesicle, which secrete fluid that becomes semen) was extremely large. The ejaculatory ducts empty into the vas deferens when it heads through the prostate. Apparently in the course of the man's prostate enlargement, this duct had also been stretched, and it now had a problem with reflux, which is when something moves backward and it shouldn't. In this case, they think that urine was actually moving backward into the duct. They aren't sure whether this caused his symptoms (probably not). Just to be sure, they removed BOTH seminal vesicles. The guy retained his sexual function, and didn't get tired at inconvenient times anymore.
So what do they think happened? The hypothesis they came up with is that, because the ejaculatory duct was so enlarged, it because oversensitive. Thus, excessive neuronal stimulation in the region (due to defecation or urination with force) could stimulate it. But if this was the case, wouldn't there be fluid coming out of the penis? The seminal vesicle produces fluids involved in semen, there might not be the usual amount of fluid, but you would there would be some, right? I don't really know.
So if this ever happens to you, you can count yourself very lucky, for a while. For some, the fatigue may be worth it. And do you REALLY want to go around to six different doctors telling them exactly what happens until it finally gets fixed? It might end up being better to "suffer" in silence.
DKE Van Der Schoot and AFGVM Ypma (2002). Seminal vesiculectomy to resolve defecation-induced orgasm British Journal of Urology International, 90, 761-762 DOI: 10.1046/j.1464-410X.2002.03046.x