The aim of my presentation is to discuss case study of a man who visited my practice and claimed problems in the relationship with his wife. He discovered her contacts with other men on her PC. He kept referring particularly to her infidelity and consequently felt very hurt. Up to that point he was convinced that there were no problems either in their relationship or sex life. Only during the third visit he admitted that he has suffered from EP since the very beginning of his active sex life. Material and methods: A forty two years old men come for a first visit in January 2007, apparently full of tension and depression. Following twenty years lasting relationship which he evaluated as ”nice“, last week he discovered that his wife was chatting with other men on line, she developed an emotional relationship with one of them and was sending around her pornographic images. He claimed that there were no problems in their sex life and that he was always the one who initiated it. In October ’06 she had moved to her own bedroom supposedly due to her back pain. Retrospectively he saw as the main problem in the relationship the lack of communication. During his next visit he rather dealt with the questions of the future of the relationship and asked if he should be giving her one more chance. It was suggested that his wife shall visit the practice too. During the third visit he gradually came to the conclusion that there must be something wrong with him for he ejaculates too early, sometimes already before he enters the vagina, sometimes a few seconds after the beginning of copulation. Along with a continual psychotherapy the treatment by sertralin was applied. Conclusions: With these kind of patients what is most important is exploration and of course a complex examination. This particular patient claimed his merital problems as the first point. Late treatment of his EP may not safe the marriage but certainly can contribute to better communication of the couple. In order to sucessfully resolve this case a cooperation of his wife would be desireable.

GONA Sexuological centre Prague

2. český a mezinárodní andrologický kongres, Štiřín, 3.-5.5.2007