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Men’s Health Clinic – Clinical Notes
Patient: David Oliver
Age: 49 years
Clinician: Dr. Curry
Date of Visit: December 22,2025.
Reason for Visit: Evaluation of sleep- and bladder-related erections, daytime arousal, and orgasm patterns.
Subjective (S)
David presents to the clinic to discuss recent observations regarding erections. He reports:
Morning/Nap Erections: Not frequent, but recently occurred on two consecutive days following short naps. No perceived changes in frequency or rigidity over time. Erections are often noticed upon waking, and he feels fully rested during these events.
Bladder/Pee Erections: Rare in recent years. Previously more frequent, but currently less common. When they occur, he experiences a sense of urgency and often sits on the toilet to urinate while erect, which helps resolve the erection.
Daytime Arousal: Recalling morning or nap erections frequently triggers conscious sexual arousal, memory-based rather than fantasy-driven.
Orgasm Without Full Erection: Occurs often. He notes that orgasm may happen quickly, sometimes without a full erection. Occasionally, achieving orgasm takes longer, but he generally ejaculates without difficulty.
Other Factors: No medications, health conditions, or lifestyle factors affecting erections reported. No sleep disturbances noted.
Objective (O)
Patient alert, oriented, and in no acute distress.
No genitourinary pain or lesions reported.
Describes erections during sleep and following bladder fullness; no abnormal findings noted on history.
Cognitive recollection of erections results in arousal, consistent with normal neurological and psychological patterns.
Assessment (A)
Morning/Nap Erections: Consistent with normal REM-related nocturnal penile tumescence (NPT). Healthy autonomic and neurovascular function indicated.
Bladder-Related Erections: Reflexive, sacral-mediated, age-appropriate decline noted. Presence of urgency with resolution via urination is physiologically normal.
Daytime Memory-Induced Arousal: Normal cognitive-arousal response; does not indicate pathology.
Orgasm Without Full Erection: Occurs via spinal reflex pathways and direct nerve stimulation; normal in middle-aged men.
Overall, erectile physiology is healthy, with all reported variations within expected ranges for age. No indication of organic dysfunction or pathological erectile disorder.
Plan (P)
Reassurance: Educated patient on the physiological basis of sleep-, bladder-, and memory-related erections. Normal variations with age explained.
Behavioral Advice: Continue normal sleep and urination patterns. Using the toilet to relieve bladder-related erections is appropriate.
Monitoring: Advised patient to track any significant changes in erection frequency, rigidity, or function.
Follow-Up: Routine men’s health follow-up in 12 months or sooner if any new symptoms develop.
Clinician Signature: ___________________
Date: ___________________