| Table 1. Chronological timeline of clinical events, symptom evolution, and therapeutic interventions | ||||
| Date / Period | Clinical Event | Symptoms | Episode Duration | Therapeutic Intervention |
|---|---|---|---|---|
| 1993 | Vasectomy | No POIS reported | - | - |
| 2014 | First PESA procedure | First appearance of post- ejaculatory symptoms |
2-3 days | No specific treatment |
| 2014 | Three additional PESA procedures | POIS episodes occurring after >90% of ejaculation events |
2-3 days | Symptomatic medications used intermittently |
| 13 Dec 2022 |
Initiation of multimodal therapy | Persistent POIS symptoms | 2-3 days | Escitalopram 10 mg/day Tamsulosin 0.4 mg/day Ebastine 10 mg/day |
| 06 Feb 2023 |
Follow-up evaluation | Partial clinical improvement (~30%); reduced symptom intensity | 2-3 days | Montelukast 10 mg/day added Tamsulosin increased to 0.4 mg twice daily |
| 2023- 2025 |
Long-term follow-up | Sustained remission with no recurrence of symptoms |
No episodes |
Maintenance of escitalopram Tamsulosin Ebastine Montelukast |