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Cai T, Pisano F, Magri V, Verze P, Mondaini N, D'Elia C, Malossini G, Mazzoli S, Perletti G, Gontero P, Mirone V, Bartoletti R. Chlamydia trachomatis infection is related to premature ejaculation in chronic prostatitis patients: results from a cross-sectional study. J Sex Med 2014; 11:3085-92. [PMID: 25256084 DOI: 10.1111/jsm.12699] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
INTRODUCTION Chronic bacterial prostatitis (CBP) is reported to be a common finding in men with acquired premature ejaculation (PE). The impact of different pathogens on PE development in chronic prostatitis patients is, however, unknown. AIM To assess a possible link between CBP caused by Chlamydia trachomatis (Ct) and PE. METHODS A consecutive series of 317 patients with clinical and instrumental diagnosis of CBP due to Ct was enrolled (group A) and compared with data obtained from a control group of 639 patients with CBP caused by common uropathogen bacteria (group B). Prostatitis symptoms were investigated with the National Institutes of Health-Chronic Prostatitis Symptom Index (NIH-CPSI), while the ejaculatory status of patients was assessed using the PE Diagnostic Tool (PEDT). MAIN OUTCOME MEASURES All participants were asked to complete the NIH-CPSI, the International Index of Erectile Function-15 erectile function domain (IIEF-15-EFD), the PEDT, and the Short Form (SF)-36 questionnaires. RESULTS Patient groups A and B had comparable scores of NIH-CPSI (P = 0.07), IPSS (P = 0.32), and IIEF-15-EFD (P = 0.33) tests. PE was assessed in 118 patients in group A (37.2%) and in 73 subjects in group B (11.5%). The two groups are different in terms of PE prevalence (P < 0.0002). Compared with group B, group A showed significantly higher scores of the PEDT test (11.3 [±2.6] vs. 4.5 [±2.9], P < 0.0001) and lower scores of the SF-36 tool (96.5 [±1.1] vs. 99.7 [±1.3], P < 0.0001). In our multivariate model assessment, being positive for a Ct infection marker was independently associated with the PEDT score even after adjusting for age, smoking habit, body mass index, and education level (adjusted odds ratio = 3.21; 95% confidence interval: 2.02-4.27; P < 0.003). CONCLUSIONS Patients affected by CBP due to Ct infection reported higher prevalence of PE and lower quality of life when compared with patients affected by CBP caused by traditional uropathogenic bacteria.
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Affiliation(s)
- Tommaso Cai
- Department of Urology, Santa Chiara Regional Hospital, Trento, Italy
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Advances in the understanding and behavioural management of sexual dysfunctions. Curr Opin Psychiatry 2014; 27:369-73. [PMID: 25055043 DOI: 10.1097/yco.0000000000000081] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
PURPOSE OF REVIEW Sexual medicine is a branch often neglected by professionals from different specialties associated with it. However, research in this field has picked up in recent years, owing to recently renewed interest in upholding the sexual rights of the population in general and lesbian, gay, bisexual and transgender groups in particular. The recently released Diagnostic and statistical manual of mental disorders, fifth edition, by the American Psychiatric Association in May 2013 has stirred up the supporters and critics (of Diagnostic and statistical manual of mental disorders, fifth edition) alike. RECENT FINDINGS Diagnostic and statistical manual of mental disorders, fifth edition, has updated diagnostic criteria for some of the sexual disorders to improve understanding and diagnostic validity. Certain sexual dysfunctions have been regrouped and sexual response cycle-based classification has been partially withdrawn. Research in the area of behavioral management of sexual dysfunctions has given some novel concepts, particularly for women. SUMMARY Although improvements in behavioral management (of sexual dysfunctions) and classification/diagnostic criteria in Diagnostic and statistical manual of mental disorders, fifth edition, is a step forward in the field of sexual medicine, we need to further improve our understanding in many of the lacunae, still bearing on the field of sexual medicine, lest we may fall at the first hurdle.
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Amano T. Editorial Comment from Dr Amano to Relationship between plasma melatonin levels and the efficacy of selective serotonin reuptake inhibitors treatment on premature ejaculation. Int J Urol 2014; 21:921. [DOI: 10.1111/iju.12474] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Toshiyasu Amano
- Department of Urology; Nagano Red Cross Hospital; Nagano Nagano Japan
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Delay of ejaculation induced by Bersama engleriana in nicotinamide/streptozotocin-induced type 2 diabetic rats. ASIAN PAC J TROP MED 2014; 7S1:S603-9. [DOI: 10.1016/s1995-7645(14)60296-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2013] [Revised: 02/12/2014] [Accepted: 05/27/2014] [Indexed: 11/22/2022] Open
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Olayo-Lortia J, Ferreira-Nuño A, Velázquez-Moctezuma J, Morales-Otal A. Further definition on the multiple partner choice arena: a potential animal model for the study of premature ejaculation. J Sex Med 2014; 11:2428-38. [PMID: 25052779 DOI: 10.1111/jsm.12637] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
INTRODUCTION The multiple partner choice arena (MPCA) is an experimental setup in which male rats display a significant shortening of ejaculation latency, which is the main characteristic of premature ejaculation (PE) in men. Thus, the MPCA is a potential animal model for PE. AIM In this study, we further analyze whether the features of the MPCA satisfy the validity criteria for it to be considered an animal model as well as the possible participation of the serotoninergic system in the faster ejaculation exhibited by male rats in the MPCA. METHODS In Experiment 1, male rats were tested in a standard arena to assess their sexual behavior, then were assessed 1 week later in the MPCA. Another group was first tested in the MPCA, then in a standard arena. In Experiment 2, male rats divided into two groups were treated daily with WAY-100635 (5-HT(1A) antagonist) or vehicle for 15 days. In each group, half of the subjects were tested in a standard arena and half were tested in the MPCA on days 1, 8, and 15 of treatment. MAIN OUTCOME MEASURES Number of intromissions and intromission and ejaculation latencies were the main outcome measures. RESULTS In Experiment 1, males tested in the MPCA ejaculated significantly faster, regardless of the order in which they were evaluated in both arenas. In Experiment 2, the administration of WAY-100635 increased intromission and ejaculation latencies, and the number of intromissions in the MPCA. CONCLUSIONS The results obtained in the MPCA support its use as an animal model for PE evaluation.
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Affiliation(s)
- Jesús Olayo-Lortia
- Programa de Doctorado en Ciencias Biológicas y de la Salud de la Universidad Autónoma Metropolitana, Mexico City, Mexico; Área de Neurociencias, Departamento de Biología de la Reproducción, Universidad Autónoma Metropolitana-Iztapalapa, Mexico City, Mexico
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Dincer M, Serefoglu EC. Re: associations between premature ejaculation, lower urinary tract symptoms, and erectile dysfunction in middle-aged Korean policemen. J Sex Med 2014; 11:2125. [PMID: 24889075 DOI: 10.1111/jsm.12604] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- Murat Dincer
- Department of Urology, Bagcilar Training and Research Hospital, Istanbul, Turkey
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Jern P. Evaluation of a behavioral treatment intervention for premature ejaculation using a handheld stimulating device. JOURNAL OF SEX & MARITAL THERAPY 2014; 40:358-66. [PMID: 24405007 DOI: 10.1080/0092623x.2013.857376] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/06/2023]
Abstract
Premature ejaculation is usually considered to be the most common male sexual complaint. Psychosocial treatment interventions have been recommended by clinicians since the 1950s, but concerns have been raised regarding their efficacy, especially so since the introduction of pharmaceutical treatment interventions. However, as noted in reviews and meta-analyses, one reason for these concerns is the lack of methodologically robust studies that have attempted to evaluate the efficacy of psychosocial treatment interventions. The present study aimed to replicate a recent study showing promising results for a behavioral treatment intervention using a handheld, vibrating stimulation device in a variation of the classical stop-start technique first introduced by Semans in 1956. The present study enrolled 11 men and used a randomized wait list-controlled design. Results provide further support for the efficacy of this novel treatment intervention and suggest that effects are stable or improved further 6 months after completing treatment. The present study contributes to the growing number of studies that suggest that psychosocial treatment interventions are promising alternatives to pharmacological treatment.
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Affiliation(s)
- Patrick Jern
- a Genetic Epidemiology Laboratory , QIMR Berghofer Medical Research Institute , Herston , Australia
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Yang DY, Ko K, Lee WK, Park HJ, Lee SW, Moon KH, Kim SW, Kim SW, Cho KS, Moon DG, Min K, Yang SK, Son H, Park K. Urologist's Practice Patterns Including Surgical Treatment in the Management of Premature Ejaculation: A Korean Nationwide Survey. World J Mens Health 2013; 31:226-31. [PMID: 24459656 PMCID: PMC3888892 DOI: 10.5534/wjmh.2013.31.3.226] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2013] [Revised: 11/12/2013] [Accepted: 11/13/2013] [Indexed: 12/31/2022] Open
Abstract
Purpose According to previous studies, the prevalence of premature ejaculation (PE) in Korea ranges from 11.3% to 33%. However, the actual practice patterns in managing patients with PE is not well known. In this study, we have endeavored to determine how contemporary urologists in Korea manage patients with PE. Materials and Methods The e-mailing list was obtained from the Korean Urological Association Registry of Physicians. A specifically designed questionnaire was e-mailed to the 2,421 urologists in Korea from May 2012 to August 2012. Results Urologists in Korea diagnosed PE using various criteria: the definition of the International Society for Sexual Medicine (63.4%), Diagnostic and Statistical Manual of Mental Disorders (43.8%), International Statistical Classification of Disease, 10th edition (61.7%), or perceptional self-diagnosis by the patient himself (23.5%). A brief self-administered questionnaire, the Premature Ejaculation Diagnostic Tool, was used by only 42.5% of the urologists. Selective-serotonin reuptake inhibitor (SSRI) therapy was the main treatment modality (91.5%) for PE patients. 40.2% of the urologists used phosphodiesterase type 5 inhibitors, 47.6% behavior therapy, and 53.7% local anesthetics. Further, 286 (54.3%) urologists managed PE patients with a surgical modality such as selective dorsal neurotomy (SDN). Conclusions A majority of Korean urologists diagnose PE by a multidimensional approach using various diagnostic tools. Most urologists believe that medical treatment with an SSRI is effective in the management of PE. At the same time, surgical treatment such as SDN also investigated as one of major treatment modality despite the lack of scientific evidence.
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Affiliation(s)
- Dae Yul Yang
- Department of Urology, Hallym University College of Medicine, Seoul, Korea
| | - Kyungtae Ko
- Department of Urology, Hallym University College of Medicine, Seoul, Korea
| | - Won Ki Lee
- Department of Urology, Hallym University College of Medicine, Seoul, Korea
| | - Hyun Jun Park
- Department of Urology, Pusan National University Hospital, Busan, Korea
| | - Sung Won Lee
- Department of Urology, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Ki Hak Moon
- Department of Urology, Yeungnam University College of Medicine, Daegu, Korea
| | - Sae Woong Kim
- Department of Urology, The Catholic University of Korea, School of Medicine, Seoul, Korea
| | - Soo Woong Kim
- Department of Urology, Seoul National University College of Medicine, Seoul, Korea
| | - Kang Su Cho
- Department of Urology, Yonsei University College of Medicine, Seoul, Korea
| | - Du Geon Moon
- Department of Urology, Korea University College of Medicine, Seoul, Korea
| | - Kweonsik Min
- Department of Urology, Inje University College of Medicine, Busan, Korea
| | - Sang Kuk Yang
- Department of Urology, Konkuk University School of Medicine, Seoul, Korea
| | - Hwancheol Son
- Department of Urology, Seoul National University College of Medicine, Seoul, Korea
| | - Kwangsung Park
- Department of Urology, Chonnam National University Medical School, Gwangju, Korea
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Karsenty G, Marcelli F, Geoffroy R, Huygues E, Rigot JM, Droupy S, Bastide C, Guy L, Bruyère F. Les médicaments de la médecine sexuelle. Prog Urol 2013; 23:1299-311. [DOI: 10.1016/j.purol.2013.09.017] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2013] [Accepted: 09/18/2013] [Indexed: 11/16/2022]
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Hill BJ, Janssen E, Kvam P, Amick EE, Sanders SA. The effect of condoms on penile vibrotactile sensitivity thresholds in young, heterosexual men. J Sex Med 2013; 11:102-6. [PMID: 24168347 DOI: 10.1111/jsm.12362] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
INTRODUCTION Investigating the ways in which barrier methods such as condoms may affect penile sensory thresholds has potential relevance to the development of interventions in men who experience negative effects of condoms on sexual response and sensation. A quantitative, psychophysiological investigation examining the degree to which sensations are altered by condoms has, to date, not been conducted. AIM The objective of this study was to examine penile vibrotactile sensitivity thresholds in both flaccid and erect penises with and without a condom while comparing men who do and those who do not report condom-associated erection problems (CAEP). METHODS Penile vibrotactile sensitivity thresholds were assessed among a total of 141 young, heterosexual men using biothesiometry. An incremental two-step staircase method was used and repeated three times for each of four conditions. Intra-class correlation coefficients (ICCs) were calculated for all vibratory assessments. Penile vibratory thresholds were compared using a mixed-model analysis of variance. MAIN OUTCOME MEASURES Penile vibrotactile sensitivity thresholds with and without a condom, erectile function measured by International Index of Erectile Function Questionnaire, and self-reported degree of erection. RESULTS Significant main effects of condoms (yes/no) and erection (yes/no) were found. No main or interaction effects of CAEP were found. Condoms were associated with higher penile vibrotactile sensitivity thresholds (F[1,124] = 17.11, P < 0.001). Penile vibrotactile thresholds were higher with an erect penis than with a flaccid penis (F[1,124] = 4.21, P = 0.042). CONCLUSION The current study demonstrates the feasibility of measuring penile vibratory thresholds with and without a condom in both erect and flaccid experimental conditions. As might be expected, condoms increased penile vibrotactile sensitivity thresholds. Interestingly, erections were associated with the highest thresholds. Thus, this study was the first to document that erect penises are less sensitive to vibrotactile stimulation than flaccid penises.
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Affiliation(s)
- Brandon J Hill
- The Kinsey Institute for Research in Sex, Gender, and Reproduction, Indiana University, Bloomington, IN, USA; Department of Gender Studies, Indiana University, Bloomington, IN, USA
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Abstract
With the progressive increase in the proportion of older people, there is an increasing interest in characterizing the modifications of sexual health and the effect of its perturbations as a function of the aging process. The aim of this review is to summarize the available evidence regarding the age-dependent modifications of male sexual function and their interaction with general health and age-dependent modification of endocrine function. Elderly patients are often affected by multiple organic diseases which can interfere with sexual function. Despite this evidence, several studies have indicated that, with advancing age, normal erections are not an absolute prerequisite to remain sexually active. Good physical health, the availability of a partner, and a regular and stable pattern of sexual activity earlier in life predict the maintenance of sexual activity in old age. Conversely, there are no convincing data that hormonal changes, associated with aging, have a primary role in underlying changes in sexual function in healthy aging men. Nonetheless, sexual dysfunctions especially in elderly people are poor investigated. Asking about sexual health remains difficult or embarrassing for many primary care physicians. In addition, many patients find it difficult to raise sexual issues with their doctor. This situation often results in sexual issues not being adequately addressed thus resulting in depression, social withdrawal and delayed diagnosis of underlying medical conditions often resulting in forthcoming cardiovascular events. Education and permission from a health care professional may help to alter such misconceptions. Information from physicians regarding normal age-related changes in sexuality and encouragement, together with advice on how to continue meaningful sexual relations, may play a key role in altering such negative attitudes.
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Affiliation(s)
- Giovanni Corona
- Endocrinology Unit, Medical Department, Azienda Usl, Maggiore-Bellaria Hospital, Bologna, Italy
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Sirt3 modulation may be beneficial in the treatment of ejaculation dysfunction. Med Hypotheses 2013; 81:448-9. [PMID: 23838127 DOI: 10.1016/j.mehy.2013.06.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2013] [Accepted: 06/05/2013] [Indexed: 11/21/2022]
Abstract
Disorders of ejaculation are the most common form of sexual dysfunction. The ejaculatory reflex consists of two phases: emission and expulsion. Premature ejaculation (PE) can arise from overactivity of the smooth muscles responsible for ejaculation. On the other side of the spectrum, delayed ejaculation occurs when an individual is unable to either reach orgasm within an adequate time frame or experiences no ejaculation. While premature ejaculation and to a lesser degree delayed ejaculation have been recognized for quite some time, no FDA approved treatment has been developed. Since both types of ejaculatory dysfunction have an underlying neuro-muscular component, this may be a target for future treatment strategies. We thereby hypothesize that modulation of the rhythmic contraction of the ejaculatory smooth muscles with either a Sirt3 activator or inhibitor may prove beneficial in treating either premature or delayed ejaculation.
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Puppo V. Sexual dysfunctions induced by stress of timed intercourse and medical treatment. BJU Int 2013; 111:E267-9. [DOI: 10.1111/bju.12128_8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Affiliation(s)
- Vincenzo Puppo
- Centro Italiano di Sessuologia (CIS); Via Regnoli 74; 40138; Bologna; Italy
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