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Andrologia Jul 2020Premature ejaculation is a common male sexual disease in andrology practice. The goal of essay is to investigate the relation of anogenital distance that predicts...
Premature ejaculation is a common male sexual disease in andrology practice. The goal of essay is to investigate the relation of anogenital distance that predicts prenatal testosterone exposure with premature ejaculation. Between January and May 2019, 150 men were participated in the study. The patients were evaluated with anamnesis and physical examination; age, smoking, alcohol consumption, intravaginal ejaculation latency time, body mass index, premature ejaculation diagnostic tool, distance from anal point to scrotum and distance from anal point to penis were recorded. According to premature ejaculation diagnostic tool score, the patients were classified as premature ejaculation group (score ≥11) and control group (score <11). The mean of the male age was 30.73 ± 4.40 years. The mean intravaginal ejaculation latency time score was 3.42 ± 2.71 min. Two groups were compared using the distance from anal point to scrotum distance from anal point to penis. In the premature ejaculation group, the distances were found lower (77.46 ± 2.31 and 54.78 ± 2.56 mm) than the control group (81.32 ± 3.11 and 58.16 ± 3.48 mm). There were statistical differences between two groups (p < .001). It was concluded that it is likely to have a negative relationship between anogenital distance and premature ejaculation diagnostic tool score.
Topics: Adult; Anal Canal; Case-Control Studies; Humans; Male; Organ Size; Penis; Perineum; Premature Ejaculation; Scrotum
PubMed: 32201974
DOI: 10.1111/and.13571 -
Urology Feb 2016To review potential therapeutic targets and future therapeutic molecules in premature ejaculation (PE). PE is the most prevalent sexual dysfunction and affects about 23%... (Review)
Review
OBJECTIVE
To review potential therapeutic targets and future therapeutic molecules in premature ejaculation (PE). PE is the most prevalent sexual dysfunction and affects about 23% of the male population. It is a universal disorder: it is independent of age and social or marital status. Men with PE typically refer associated comorbidities and report a significant impact not only on their quality of life but also on the satisfaction of the partner. Although common and treatable in most cases, the drugs currently available may affect sexual spontaneity and the cost can prove to be a hindrance.
MATERIALS AND METHODS
A comprehensive literature revision was performed using PubMed and Scopus to identify relevant articles published in the fields of PE and its treatment until May 2015.
RESULTS
The main central targets identified include serotonergic, dopaminergic, and oxytocinergic neurotransmitters, opioid receptors, and mechanisms involved in the control of the spinal ejaculatory generator, located at the T12-L1-2 spinal cord level. On the other hand, peripheral interventions at semen's transport may also delay ejaculation by decreasing sequential contractions of the epididymis, vas deferens, seminal vesicles, prostate, and bladder neck.
CONCLUSION
There is a wide range of future options with regard to the treatment of PE. Molecules like DA-8031, Promescent, silodosin, Botulinum toxin-A, and resiniferatoxin may be near future treatments for this disorder.
Topics: Humans; Male; Penis; Premature Ejaculation
PubMed: 26627373
DOI: 10.1016/j.urology.2015.11.003 -
Pharmacological Reviews Jul 2012Male sexual response comprises four phases: excitement, including erection; plateau; ejaculation, usually accompanied by orgasm; and resolution. Ejaculation is a complex... (Review)
Review
Male sexual response comprises four phases: excitement, including erection; plateau; ejaculation, usually accompanied by orgasm; and resolution. Ejaculation is a complex sexual response involving a sequential process consisting of two phases: emission and expulsion. Ejaculation, which is basically a spinal reflex, requires a tight coordination between sympathetic, parasympathetic, and somatic efferent pathways originating from different segments and area in the spinal cord and innervating pelvi-perineal anatomical structures. A major relaying and synchronizing role is played by a group of lumbar neurons described as the spinal generator of ejaculation. Excitatory and inhibitory influences from sensory genital and cerebral stimuli are integrated and processed in the spinal cord. Premature ejaculation (PE) can be defined by ≤1-min ejaculatory latency, an inability to delay ejaculation, and negative personal consequences. Because there is no physiological impairment in PE, any pharmacological agent with central or peripheral mechanism of action that is delaying the ejaculation is a drug candidate for the treatment of PE. Ejaculation is centrally mediated by a variety of neurotransmitter systems, involving especially serotonin and serotonergic pathways but also dopaminergic and oxytocinergic systems. Pharmacological delay of ejaculation can be achieved either by inhibiting excitatory or reinforcing inhibitory pathways from the brain or the periphery to the spinal cord. PE can be treated with long-term use of selective serotonin-reuptake inhibitors (SSRIs) or tricyclic antidepressants. Dapoxetine, a short-acting SSRI, is the first treatment registered for the on-demand treatment of PE. Anesthetics applied on the glans penis have the ability to lengthen the time to ejaculation. Targeting oxytocinergic, neurokinin-1, dopaminergic, and opioid receptors represent future avenues to delaying ejaculation.
Topics: Anesthetics, Local; Antidepressive Agents, Tricyclic; Clinical Trials as Topic; Ejaculation; Humans; Male; Nervous System Physiological Phenomena; Premature Ejaculation; Selective Serotonin Reuptake Inhibitors; Treatment Outcome
PubMed: 22679220
DOI: 10.1124/pr.111.004952 -
Andrologia Jul 2021We aimed to investigate the relationship between premature ejaculation and the age when men had been circumcised before adulthood. A total of 2,768 sexually active male...
We aimed to investigate the relationship between premature ejaculation and the age when men had been circumcised before adulthood. A total of 2,768 sexually active male patients aged between 18 and 65 years were included in this study. A multicentre study was conducted prospectively with the participation of 20 centres. A survey consisting of 12 questions prepared by the researchers, as well as the validated Turkish versions of the five-item Premature Ejaculation Diagnostic Tool, was administered to all participants. The study included 1,603 participants who met the inclusion criteria. There was no significant difference in the Premature Ejaculation Diagnostic Tool and self-reported ejaculation time between the participants who had been circumcised at different ages during childhood. Remembering circumcision experience with fear or anxiety did not increase the risk of sexual dysfunction compared to the participants who described their experience with happiness or with no particular emotion. There was no significant difference in Premature Ejaculation Diagnostic Tool scores or the self-reported ejaculation time of the participants circumcised at different ages. The age of childhood circumcision, having a fearful or anxious circumcision experience, does not affect the risk of premature ejaculation in adult life.
Topics: Adolescent; Adult; Aged; Circumcision, Male; Ejaculation; Humans; Male; Middle Aged; Premature Ejaculation; Self Report; Surveys and Questionnaires; Young Adult
PubMed: 33709439
DOI: 10.1111/and.14048 -
European Urology Apr 2014
Topics: Benzylamines; Humans; Male; Naphthalenes; Premature Ejaculation; Selective Serotonin Reuptake Inhibitors
PubMed: 24091022
DOI: 10.1016/j.eururo.2013.09.027 -
Zhonghua Nan Ke Xue = National Journal... Oct 2018Premature ejaculation is a common disease in adult males, which may severely affect the mental health and distort the spousal relationship of the males. Treatment of... (Review)
Review
Premature ejaculation is a common disease in adult males, which may severely affect the mental health and distort the spousal relationship of the males. Treatment of premature ejaculation aims at increasing the intra-vaginal ejaculation latency time, enhancing the control of ejaculation and improving sexual satisfaction, and comprehensive treatment may help most to achieve these objectives. Though drug therapy remains an important option, there are many other effective strategies for the treatment of premature ejaculation, including psychotherapy, behavioral therapy, traditional Chinese medicine treatment, and surgery. Recently, various studies have demonstrated even better effects of a combination of the above strategies on premature ejaculation.
Topics: Adult; Benzylamines; Ejaculation; Female; Humans; Male; Medicine, Chinese Traditional; Naphthalenes; Premature Ejaculation; Selective Serotonin Reuptake Inhibitors; Treatment Outcome
PubMed: 32212451
DOI: No ID Found -
Progres En Urologie : Journal de... Dec 2023We aimed to determine the effectiveness of penis-root masturbation (PRM), a newly defined behavioral therapy (BT) technique, in patients with unsuccessful medical...
AIM
We aimed to determine the effectiveness of penis-root masturbation (PRM), a newly defined behavioral therapy (BT) technique, in patients with unsuccessful medical treatment due to premature ejaculation (PE).
MATERIAL AND METHODS
The study included 35 patients aged 25-43 years, who were diagnosed with lifelong PE. Patients and their partners were informed about the PRM technique and asked to practice PRM three times a week for three months, with or without sexual intercourse. The patients' Premature Ejaculation Diagnostic Tool (PEDT) scores and intravaginal ejaculatory latency time (IELT) were recorded and compared before PRM training (T0) and at the third (T3) month after the start of PRM training.
RESULTS
The mean±SD PEDT scores were 16.26±1.94 at T0, 10.63±1.14 at T3. When compared to T0, the PEDT values at T3 were significantly lower (P=0.021). In terms of IELT, the mean T3 values (192.43±56.71) were significantly longer (P=0.035) than at T0 (50.43±13.84seconds).
CONCLUSION
PRM BT shows promise for lifelong PE patients who do not benefit from or discontinue to pharmacotherapy. Larger prospective trials are required to confirm these findings.
Topics: Male; Humans; Premature Ejaculation; Masturbation; Prospective Studies; Ejaculation; Behavior Therapy
PubMed: 37758608
DOI: 10.1016/j.purol.2023.09.010 -
Clinical Anatomy (New York, N.Y.) Jan 2016Human semen contains spermatozoa secreted by the testes and a mixture of components produced by the bulbo-urethral and Littre (paraurethral) glands, prostate, seminal... (Review)
Review
Human semen contains spermatozoa secreted by the testes and a mixture of components produced by the bulbo-urethral and Littre (paraurethral) glands, prostate, seminal vesicles, ampulla, and epididymis. Ejaculation is used as a synonym for the external ejection of semen, but it comprises two phases: emission and expulsion. As semen collects in the prostatic urethra, the rapid preorgasmic distension of the urethral bulb is pathognomonic of impeding orgasm, and the man experiences a sensation that ejaculation is inevitable (in women, emission is the only phase of orgasm). The semen is propelled along the penile urethra mainly by the bulbocavernosus muscle. With Kegel exercises, it is possible to train the perineal muscles. Immediately after the expulsion phase the male enters a refractory period, a recovery time during which further orgasm or ejaculation is physiologically impossible. Age affects the recovery time: as a man grows older, the refractory period increases. Sexual medicine experts consider premature ejaculation only in the case of vaginal intercourse, but vaginal orgasm has no scientific basis, so the duration of intercourse is not important for a woman's orgasm. The key to female orgasm are the female erectile organs; vaginal orgasm, G-spot, G-spot amplification, clitoral bulbs, clitoris-urethra-vaginal complex, internal clitoris and female ejaculation are terms without scientific basis. Female sexual dysfunctions are popular because they are based on something that does not exist, i.e. the vaginal orgasm. The physiology of ejaculation and orgasm is not impaired in premature ejaculation: it is not a disease, and non-coital sexual acts after male ejaculation can be used to produce orgasm in women. Teenagers and men can understand their sexual responses by masturbation and learn ejaculatory control with the stop-start method and the squeeze technique. Premature ejaculation must not be classified as a male sexual dysfunction. It has become the center of a multimillion dollar business: is premature ejaculation-and female sexual dysfunction-an illness constructed by sexual medicine experts under the influence of drug companies?
Topics: Ejaculation; Humans; Male; Penis; Premature Ejaculation
PubMed: 26457680
DOI: 10.1002/ca.22655 -
The Journal of Sexual Medicine Dec 2015The specific determinants and underlying factors linking erectile dysfunction (ED) and premature ejaculation (PE) have yet to be clearly identified. (Meta-Analysis)
Meta-Analysis Review
INTRODUCTION
The specific determinants and underlying factors linking erectile dysfunction (ED) and premature ejaculation (PE) have yet to be clearly identified.
AIM
The aim of this study was to review and meta-analyze all available data regarding the link between ED and PE.
METHODS
An extensive Medline Embase and Cochrane search was performed including the following words: "premature ejaculation" and "erectile dysfunction".
MAIN OUTCOME MEASURES
All observational trials comparing the risk of ED in relation to PE were included. Data extraction was performed independently by two of the authors (G.R, G.C.), and conflicts resolved by the third investigator (M.M.).
RESULTS
Out of 474 retrieved articles, 18 were included in the study for a total of 57,229 patients, of which 12,144 (21.2%) had PE. The presence of PE, however defined, was associated with a significant increase in ED risk (odds ratio: 3.68[2.61;5.18]; P < 0.0001). Meta-regression analysis showed that the risk of ED in PE subjects was higher in older individuals as well as in those with a lower level of education and in those who reported a stable relationship less frequently. In addition, subjects with PE and ED more often reported anxiety and depressive symptoms and a lower prevalence of organic associated morbidities, including diabetes mellitus, hypertension and dyslipidemia. All the latter associations were confirmed even after adjustment for age. Finally the risk of PE-related ED increased with the increased proportion of acquired ejaculatory problems (adj r = 0.414; P < 0.0001 after the adjustment for age).
CONCLUSIONS
In conclusion, the present data showed that ED and PE are not distinctly separate entities, but should be considered from a dimensional point of view. Understanding this dimensional perspective might help sexual health care professionals in providing the most appropriate therapeutic approach to realistically increase patient related outcomes in sexual medicine.
Topics: Adult; Aged; Anxiety; Depression; Ejaculation; Erectile Dysfunction; Humans; Male; Middle Aged; Odds Ratio; Premature Ejaculation; Prevalence; Sexual Behavior; Surveys and Questionnaires
PubMed: 26552599
DOI: 10.1111/jsm.13041 -
Zhonghua Nan Ke Xue = National Journal... Feb 2019Premature ejaculation is a common male sexual dysfunction disorder, and there are many controversies over its definition. With deeper insights into the etiology and... (Review)
Review
Premature ejaculation is a common male sexual dysfunction disorder, and there are many controversies over its definition. With deeper insights into the etiology and pathogenesis of premature ejaculation, more and more auxiliary examinations are used in its diagnosis, prognostic evaluation and treatment, such as transrectal ultrasonography of seminal vesicles, determination of serum 5-hydroxytryptamine (5-HT) concentration, serum hormone levels, penile sensitivity detection, brain function tests, and genetic sequencing. This review outlines the latest advances in the auxiliary examination of premature ejaculation and provides clinicians with some diagnostic indexes or methods of premature ejaculation for reference.
Topics: Humans; Male; Penis; Premature Ejaculation; Seminal Vesicles; Ultrasonography
PubMed: 32216205
DOI: No ID Found