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Britto-Júnior J, Uramoto EHS, Lima AT, Ribeiro LF, de Souza VB, Schenka AA, de Almeida Magalhães JC, Antunes E, Fregonesi A, De Nucci G. Epithelium-derived 6-nitrodopamine modulates noradrenaline-induced contractions in human seminal vesicles. Life Sci 2024; 348:122695. [PMID: 38710285 DOI: 10.1016/j.lfs.2024.122695] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2024] [Revised: 04/18/2024] [Accepted: 05/03/2024] [Indexed: 05/08/2024]
Abstract
AIMS To evaluate the basal release of 6-nitrodopamine (6-ND) from human isolated seminal vesicles (HISV) and to characterize its action and origin. MAIN METHODS Left HISV obtained from patients undergoing prostatectomy surgery was suspended in a 3-mL organ bath containing warmed (37 °C) and gassed (95%O2:5%CO2) Krebs-Henseleit's solution (KHS) with ascorbic acid. An aliquot of 2 mL of the supernatant was used to quantify catecholamines by LC-MS/MS. For functional studies, concentration-responses curves to catecholamines were obtained, and pEC50 and Emax values were calculated. Detection of tyrosine hydroxylase and S100 protein were also carried out by both immunohistochemistry and fluorescence in-situ hybridization assays (FISH). KEY FINDINGS Basal release of 6-ND was higher than the other catecholamines (14.76 ± 14.54, 4.99 ± 6.92, 3.72 ± 4.35 and 5.13 ± 5.76 nM for 6-ND, noradrenaline, adrenaline, and dopamine, respectively). In contrast to the other catecholamines, the basal release of 6-ND was not affected by the sodium current (Nav) channel inhibitor tetrodotoxin (1 μM; 10.4 ± 8.9 and 10.4 ± 7.9 nM, before and after tetrodotoxin, respectively). All the catecholamines produced concentration-dependent HISV contractions (pEC50 4.1 ± 0.2, 4.9 ± 0.3, 5.0 ± 0.3, and 3.9 ± 0.8 for 6-ND, noradrenaline, adrenaline, and dopamine, respectively), but 6-ND was 10-times less potent than noradrenaline and adrenaline. However, preincubation with very low concentration of 6-ND (10-8 M, 30 min) produced significant leftward shifts of the concentration-response curves to noradrenaline. Immunohistochemical and FISH assays identified tyrosine hydroxylase in tissue epithelium of HISV strips. SIGNIFICANCE Epithelium-derived 6-ND is the major catecholamine released from human isolated seminal vesicles and that modulates smooth muscle contractility by potentiating noradrenaline-induced contractions.
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Affiliation(s)
- José Britto-Júnior
- Department of Pharmacology, Faculty of Medical Sciences, State University of Campinas (UNICAMP), Campinas, Brazil.
| | | | - Antonio Tiago Lima
- Department of Pharmacology, Faculty of Medical Sciences, State University of Campinas (UNICAMP), Campinas, Brazil
| | - Luiz Fernando Ribeiro
- Department of Pharmacology, Faculty of Medical Sciences, State University of Campinas (UNICAMP), Campinas, Brazil; Clinical Pharmacology Unit, Drug Research and Development Center, Federal University of Ceará (UFC), Fortaleza, Brazil
| | - Valéria Barbosa de Souza
- Department of Pharmacology, Faculty of Medical Sciences, State University of Campinas (UNICAMP), Campinas, Brazil
| | - Andre Almeida Schenka
- Department of Pharmacology, Faculty of Medical Sciences, State University of Campinas (UNICAMP), Campinas, Brazil
| | | | - Edson Antunes
- Department of Pharmacology, Faculty of Medical Sciences, State University of Campinas (UNICAMP), Campinas, Brazil
| | - Adriano Fregonesi
- Department of Surgery, Faculty of Medicine of Jundiaí, Jundiaí, Brazil; Division of Urology, Department of Surgery, Faculty of Medical Sciences, State University of Campinas (UNICAMP), Campinas, Brazil
| | - Gilberto De Nucci
- Department of Pharmacology, Faculty of Medical Sciences, State University of Campinas (UNICAMP), Campinas, Brazil; Department of Surgery, Faculty of Medicine of Jundiaí, Jundiaí, Brazil; Department of Pharmacology, Institute of Biomedical Sciences, University of São Paulo (USP), São Paulo, Brazil
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2
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Multiple flow cytometry analysis for assessing human sperm functional characteristics. Reprod Toxicol 2023; 117:108353. [PMID: 36804582 DOI: 10.1016/j.reprotox.2023.108353] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Revised: 02/10/2023] [Accepted: 02/15/2023] [Indexed: 02/21/2023]
Abstract
Multiparametric analysis by flow cytometry solves one of the major problems in sperm evaluation, the inability to test multiple attributes simultaneously in a single cell, which would increase the precision to predict fertility potential since several sperm parameters are tested. The association of fluorochromes and compounds conjugated to fluorochromes in multiparametric sperm analysis is well-established in microscopy techniques. However, these techniques are subjective and limit the assessment in small cell numbers, thereby harming analytic accuracy. Therefore, the current study aimed to present new possibilities for assessing the integrity and stability of the sperm plasma membrane, acrosome status, mitochondrial potential, and superoxide anion production in the mitochondrial matrix in only 2 cytometric assays using cytometers equipped with 2 and 3 lasers. For this, human semen samples collected by masturbation and selected by the swim-up technique were divided into 3 treatments: T0 (flash-frozen semen), T50 (flash-frozen semen + fresh semen, V: V), and T100 (fresh semen) for the validation of the multiparametric protocols by flow cytometry. For both protocols, sperm percentage with positive stain for all fluorophores differed significantly between treatments. The determination coefficients presented values close to 1, which validated objective, sensitive, rapid, and reproducible methodologies. Therefore, we concluded that the results reflect the status of analyzed structure, enabling a more accurate diagnosis of male infertility that has become an increasingly prevalent worldwide setback due to exposure to a variety of environmental toxicants.
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Chang X, Xu M, Chen Y, Che C, Du Y, Wang X. Selective serotonin reuptake inhibitors combined with traditional Chinese medicine for premature ejaculation: A systematic review and meta-analysis. Andrology 2023; 11:112-124. [PMID: 36193003 DOI: 10.1111/andr.13307] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2022] [Revised: 09/19/2022] [Accepted: 09/27/2022] [Indexed: 12/31/2022]
Abstract
BACKGROUND Premature ejaculation (PE) is still a tough problem in drug treatment. Many clinical trials have proven that traditional Chinese medicine (TCM) has a significant effect in the treatment of PE. This article aims to provide the latest evidence for the efficacy and safety of TCM combined with selective serotonin reuptake inhibitors (SSRIs) in the treatment of PE. METHODS We looked for randomized controlled trials (RCTs) from China National Knowledge Infrastructure, Wanfang, VIP Database, MEDLINE, PubMed, Web of Science, EMBASE, and Cochrane Library until June 30, 2022. STATA 15.1 software was used to analyze all data for this article. The quality of the included articles was evaluated using the Cochrane Reviewer's Handbook 5.3. RESULTS Finally, we selected 16 high-quality RCTs in our meta-analysis, which containing 889 patients. Meta-analysis suggested that, compared with SSRIs alone, combination of TCM with SSRIs increased significantly intravaginal ejaculation latencv time and the scores of ejaculation control ability, sexual life satisfaction, PE-related distress, and communication difficulties between partners related to PE. Also, there was no significant difference in adverse effects between the two groups. In addition, the results of publication bias test showed that no significant bias occurred. CONCLUSION The combined use of TCM and SSRIs has significant effect in the treatment of PE compared with SSRIs monotherapy and was generally well tolerated. Due to the small sample size, multicenter and large sample RCT is still needed in the future to further confirm the effectiveness and safety of TCM combined with SSRIs in the treatment of PE.
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Affiliation(s)
- Xuefeng Chang
- Fuyang People's Hospital, Anhui Medical University, Fuyang, China
| | - Mingwei Xu
- The Affiliated Hongqi Hospital, Mudanjiang Medical University, Mudanjiang, China
| | - Yuanzhe Chen
- Fuyang People's Hospital, Anhui Medical University, Fuyang, China
| | - Chunguang Che
- Fuyang People's Hospital, Anhui Medical University, Fuyang, China
| | - Yongqiang Du
- Fuyang People's Hospital, Anhui Medical University, Fuyang, China
| | - Xiao Wang
- Fuyang People's Hospital, Anhui Medical University, Fuyang, China
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Gul M, Bocu K, Serefoglu EC. Current and emerging treatment options for premature ejaculation. Nat Rev Urol 2022; 19:659-680. [PMID: 36008555 DOI: 10.1038/s41585-022-00639-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/20/2022] [Indexed: 11/08/2022]
Abstract
Premature ejaculation (PE) is a prevalent male sexual dysfunction. Current standard treatment regimens include behavioural therapies, topical anaesthetics, dapoxetine and other selective serotonin reuptake inhibitors (SSRIs). Most of the pharmacotherapeutic options target neurotransmitters (such as serotonin and oxytocin) that have a role in the ejaculation mechanism. However, these treatments are mildly effective and only provide a temporary delay in the ejaculation latency time, and PE recurs when the treatment is stopped. Thus, a treatment for PE is urgently needed and research is ongoing to find the ideal PE therapy. The efficacy and safety of topical anaesthetics and SSRIs in delaying ejaculation have been confirmed in many well-designed controlled trials. Both preclinical and clinical studies on new-generation SSRIs are ongoing. Moreover, promising results came from clinical trials in which the efficacy of on-demand PE therapies targeting neurotransmitters other than serotonin, such as α1-adrenoceptor antagonists and oxytocin antagonists, was assessed. Surgical intervention and neuromodulation have been proposed as potential treatment options for PE; however, current PE guidelines do not recommend these treatments owing to safety concerns.
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Affiliation(s)
- Murat Gul
- Department of Urology, Selcuk University School of Medicine, Konya, Turkey
| | - Kadir Bocu
- Department of Urology, Silopi State Hospital, Sirnak, Turkey
| | - Ege Can Serefoglu
- Department of Urology, Biruni University School of Medicine, Istanbul, Turkey.
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5
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Britto-Júnior J, da Silva-Filho WP, Amorim AC, Campos R, Moraes MO, Moraes MEA, Fregonesi A, Monica FZ, Antunes E, De Nucci G. 6-nitrodopamine is a major endogenous modulator of human vas deferens contractility. Andrology 2022; 10:1540-1547. [PMID: 35934935 DOI: 10.1111/andr.13263] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2022] [Revised: 07/30/2022] [Accepted: 08/04/2022] [Indexed: 11/30/2022]
Abstract
BACKGROUND Rat isolated vas deferens releases 6-nitrodopamine (6-ND), and the spasmogenic activity of this novel catecholamine is significantly reduced by tricyclic compounds such as amitriptyline, desipramine, and carbamazepine and by antagonists of the α1 -adrenergic receptors such as doxazosin, tamsulosin, and prazosin. OBJECTIVES To investigate the liberation of 6-ND by human epididymal vas deferens (HEVDs) and its pharmacological actions. METHODS The in vitro liberation of 6-ND, dopamine, noradrenaline, and adrenaline from human vas deferens was evaluated by LC-MS/MS. The contractile effect of the catecholamines in HEVDs was investigated in vitro. The action of tricyclic antidepressants was evaluated on the spasmogenic activity ellicited by the catecholamines and by the electric-field stimulation (EFS). The tissue was also incubated with the inhibitor of nitric oxide (NO) synthase L-NAME and the release of catecholamines and the contractile response to EFS were assessed. RESULTS 6-ND is the major catecholamine released from human vas deferens and its synthesis/release is inhibited by NO inhibition. The spasmogenic activity elicited by EFS in the human vas deferens was blocked by tricyclic antidepressants only at concentrations that selectively antagonize 6-ND induced contractions of the human vas deferens, without affecting the spasmogenic activity induced by dopamine, noradrenaline, and adrenaline in this tissue. Incubation of the vas deferens with L-NAME reduced both the 6-ND release and the contractions induced by EFS. DISCUSSION AND CONCLUSION 6-ND should be considered a major endogenous modulator of human vas deferens contractility and possibly plays a pivotal role in the emission process of ejaculation. It offers a novel and shared mechanism of action for tricyclic antidepressants and α1 -adrenergic receptor antagonists.
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Affiliation(s)
- José Britto-Júnior
- Department of Pharmacology, Faculty of Medical Sciences, State University of Campinas, Campinas, São Paulo, Brazil
| | - Walter Pinto da Silva-Filho
- Department of Pharmacology, Faculty of Medical Sciences, State University of Campinas, Campinas, São Paulo, Brazil
| | - Amanda Consulin Amorim
- Department of Pharmacology, Faculty of Medical Sciences, State University of Campinas, Campinas, São Paulo, Brazil
| | - Rafael Campos
- Clinical Pharmacology Unit, Drug Research and Development Center, Federal University of Ceará, Fortaleza, Ceará, Brazil.,Superior Institute of Biomedical Sciences, Ceará State University, Fortaleza, Ceará, Brazil
| | - Manoel Odorico Moraes
- Clinical Pharmacology Unit, Drug Research and Development Center, Federal University of Ceará, Fortaleza, Ceará, Brazil
| | - Maria Elisabete A Moraes
- Clinical Pharmacology Unit, Drug Research and Development Center, Federal University of Ceará, Fortaleza, Ceará, Brazil
| | - Adriano Fregonesi
- Department of Pharmacology, Faculty of Medical Sciences, State University of Campinas, Campinas, São Paulo, Brazil
| | - Fabiola Z Monica
- Department of Pharmacology, Faculty of Medical Sciences, State University of Campinas, Campinas, São Paulo, Brazil
| | - Edson Antunes
- Department of Pharmacology, Faculty of Medical Sciences, State University of Campinas, Campinas, São Paulo, Brazil
| | - Gilberto De Nucci
- Department of Pharmacology, Faculty of Medical Sciences, State University of Campinas, Campinas, São Paulo, Brazil.,Clinical Pharmacology Unit, Drug Research and Development Center, Federal University of Ceará, Fortaleza, Ceará, Brazil.,Department of Pharmacology, Institute of Biomedical Sciences, University of São Paulo, São Paulo, São Paulo, Brazil.,Deparment of Pharmacology, Faculty of Medicine, Metropolitan University of Santos, Santos, São Paulo, Brazil
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Maynard JP, Sfanos KS. P2 purinergic receptor dysregulation in urologic disease. Purinergic Signal 2022; 18:267-287. [PMID: 35687210 PMCID: PMC9184359 DOI: 10.1007/s11302-022-09875-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2022] [Accepted: 05/25/2022] [Indexed: 11/25/2022] Open
Abstract
P2 purinergic receptors are involved in the normal function of the kidney, bladder, and prostate via signaling that occurs in response to extracellular nucleotides. Dysregulation of these receptors is common in pathological states and often associated with disease initiation, progression, or aggressiveness. Indeed, P2 purinergic receptor expression is altered across multiple urologic disorders including chronic kidney disease, polycystic kidney disease, interstitial cystitis, urinary incontinence, overactive bladder syndrome, prostatitis, and benign prostatic hyperplasia. P2 purinergic receptors are likewise indirectly associated with these disorders via receptor-mediated inflammation and pain, a common characteristic across most urologic disorders. Furthermore, select P2 purinergic receptors are overexpressed in urologic cancer including renal cell carcinoma, urothelial carcinoma, and prostate adenocarcinoma, and pre-clinical studies depict P2 purinergic receptors as potential therapeutic targets. Herein, we highlight the compelling evidence for the exploration of P2 purinergic receptors as biomarkers and therapeutic targets in urologic cancers and other urologic disease. Likewise, there is currently optimism for P2 purinergic receptor-targeted therapeutics for the treatment of inflammation and pain associated with urologic diseases. Further exploration of the common pathways linking P2 purinergic receptor dysregulation to urologic disease might ultimately help in gaining new mechanistic insight into disease processes and therapeutic targeting.
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Affiliation(s)
- Janielle P Maynard
- Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, MD, USA. .,Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University School of Medicine, Baltimore, USA.
| | - Karen S Sfanos
- Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, MD, USA.,Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University School of Medicine, Baltimore, USA.,Department of Urology, James Buchanan Brady Urological Institute, Johns Hopkins University School of Medicine, Baltimore, MD, USA
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7
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Hu H, Cui Y, Yang J, Cao Y. Loss of the Sympathetic Signal Produces Sterile Inflammation of the Prostate. Front Mol Neurosci 2022; 15:855376. [PMID: 35620446 PMCID: PMC9127543 DOI: 10.3389/fnmol.2022.855376] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2022] [Accepted: 04/20/2022] [Indexed: 11/13/2022] Open
Abstract
Neural innervations exert essential roles in the prostate. However, spatial distribution and regulatory function of such neural inputs are incompletely characterized. Here, we exploited the advanced whole-tissue immunolabeling and optical clearing technique to assess the 3D anatomy of autonomic innervations in the mouse and human prostate for the first time. We observed that sympathetic and parasympathetic inputs in the mouse prostate remained unaffected during castration-induced tissue regression. However, the pharmacologic destruction of sympathetic innervations in the mouse prostate led to sterile inflammation of the tissue, mimicking the disease condition of chronic non-bacterial prostatitis. Also, the genetic ablation of sympathetic inputs produced a similar inflammatory response. Furthermore, we showed that treatment of the specific β2-adrenergic receptor agonists could effectively mitigate the prostate inflammation caused by such sympathetic loss. Together, these results have elucidated the new immunomodulatory function of the sympathetic signal via the β2-adrenergic receptor in prostate inflammatory disease.
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Affiliation(s)
- Hao Hu
- Department of Urology, Peking University People’s Hospital, Beijing, China
| | - Yiwen Cui
- Peking University-Tsinghua University-National Institute of Biological Sciences Joint Graduate Program, Peking University, Beijing, China
- Academy for Advanced Interdisciplinary Studies, Peking University, Beijing, China
| | - Jing Yang
- Shenzhen Bay Laboratory, Shenzhen, China
| | - Ying Cao
- Academy for Advanced Interdisciplinary Studies, Peking University, Beijing, China
- Center for Life Sciences, Peking University, Beijing, China
- *Correspondence: Ying Cao,
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Uzun H, Akça N, Hüner M, Sönmez B, Yüksel AO, Özsağır YÖ. Suprapubic bladder aspiration: A novel method in the diagnosis of retrograde ejaculation. Rev Int Androl 2022; 20:189-195. [DOI: 10.1016/j.androl.2021.02.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2020] [Revised: 01/20/2021] [Accepted: 02/20/2021] [Indexed: 11/27/2022]
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Soni KK, Jeong HS, Jang S. Neurons for Ejaculation and Factors Affecting Ejaculation. BIOLOGY 2022; 11:biology11050686. [PMID: 35625414 PMCID: PMC9138817 DOI: 10.3390/biology11050686] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/25/2022] [Revised: 04/27/2022] [Accepted: 04/28/2022] [Indexed: 12/31/2022]
Abstract
Simple Summary Sexual dysfunctions are rarely discussed in our current society. Males experience different sexual dysfunctions, including erectile, infertility, and ejaculatory dysfunctions. In this review only the ejaculatory dysfunction will be discussed. Ejaculation is defined as the ejection of contents collectively from the vas deferens, seminal vesicle, prostate and Cowper’s glands. It is completely controlled by a population of neurons present in the lumbar spinal cord. The presence of lesion in these neurons ceases the ejaculatory behavior in males. This population of neurons was first identified in rats; however, recently it was confirmed that these neurons are present in human males as well. The issues are known as ejaculatory dysfunction. The following are the different types of ejaculatory dysfunctions: early ejaculation, ejaculation into the urinary bladder, late ejaculation and no ejaculation. Abstract Ejaculation is a reflex and the last stage of intercourse in male mammals. It consists of two coordinated phases, emission and expulsion. The emission phase consists of secretions from the vas deferens, seminal vesicle, prostate, and Cowper’s gland. Once these contents reach the posterior urethra, movement of the contents becomes inevitable, followed by the expulsion phase. The urogenital organs are synchronized during this complete event. The L3–L4 (lumbar) segment, the spinal cord region responsible for ejaculation, nerve cell bodies, also called lumbar spinothalamic (LSt) cells, which are denoted as spinal ejaculation generators or lumbar spinothalamic cells [Lst]. Lst cells activation causes ejaculation. These Lst cells coordinate with [autonomic] parasympathetic and sympathetic assistance in ejaculation. The presence of a spinal ejaculatory generator has recently been confirmed in humans. Different types of ejaculatory dysfunction in humans include premature ejaculation (PE), retrograde ejaculation (RE), delayed ejaculation (DE), and anejaculation (AE). The most common form of ejaculatory dysfunction studied is premature ejaculation. The least common forms of ejaculation studied are delayed ejaculation and anejaculation. Despite the confirmation of Lst in humans, there is insufficient research on animals mimicking human ejaculatory dysfunction.
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Ates E, Yildiz AE, Kazici HG, Sulaimanov S, Kol A, Erol H. The importance of inquiring the ejaculation function in men with premature ejaculation who do not actively seek treatment. Arch Ital Urol Androl 2022; 94:80-86. [PMID: 35352531 DOI: 10.4081/aiua.2022.1.80] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2021] [Accepted: 10/14/2021] [Indexed: 11/23/2022] Open
Abstract
PURPOSE To evaluate the clinical characteristics of men presenting for other complaints whose ejaculatory function inquiry indicated premature ejaculation (PE). METHODS The data of 536 PE patients, including those who presented with the complaint of PE (group 1) and those presenting with other complaints who were diagnosed with PE (group 2) as a result of ejaculatory function inquiry using estimated intravaginal ejaculation latency time (IELT) and Premature Ejaculation Diagnostic Tool (PEDT), were retrospectively evaluated. Age, PE type, comorbidities, recommended treatments, and treatment acceptance status of all patients were recorded. These characteristics were compared for each group. RESULTS Among all the patients, those who presented with PE complaints constituted 22.4%. Among the patients with both PE and ED, 98.1% applied with ED complaint and only 1.9% with PE complaint. The percentage of patients with one comorbidity was significantly higher in group 2 (p = 0.032). 90.1% of all patients and 88.5% of patients in group 2 accepted the recommended treatment for PE. The mean age and comorbidities were significantly higher in patients that refused the treatment. The most common reason for treatment refusal was the patients' lack of expectation for treatment. CONCLUSIONS This study shows that men more frequently tend to seek treatment for ED than PE, and treatment acceptance rate may be higher when the patients with PE complaints who don't seek treatment are reached through ejaculatory function inquiry. The presence of comorbidities negatively affects the treatment expectation and acceptance as well as treatment seeking behavior of men with PE.
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Affiliation(s)
- Erhan Ates
- Aydin Adnan Menderes University School of Medicine, Department of Urology, Aydin.
| | - Ahmet Emre Yildiz
- Aydin Adnan Menderes University School of Medicine, Department of Urology, Aydin.
| | - Hakan Gorkem Kazici
- Aydin Adnan Menderes University School of Medicine, Department of Urology, Aydin.
| | - Saparali Sulaimanov
- Aydin Adnan Menderes University School of Medicine, Department of Urology, Aydin.
| | - Arif Kol
- Aydin Adnan Menderes University School of Medicine, Department of Urology, Aydin.
| | - Haluk Erol
- Aydin Adnan Menderes University School of Medicine, Department of Urology, Aydin.
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Gunderson S, Eskew AM, Stoutenburg D, Riley JK, Stout MJ, Schrimpf J, Jungheim ES, Wylie KM. Association of the human semen DNA virome with successful in vitro fertilization. F&S SCIENCE 2022; 3:2-9. [PMID: 35559992 DOI: 10.1016/j.xfss.2021.10.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/26/2021] [Revised: 10/27/2021] [Accepted: 10/29/2021] [Indexed: 06/15/2023]
Abstract
OBJECTIVE To comprehensively characterize the DNA virome in semen samples collected for in vitro fertilization (IVF). DESIGN A descriptive clinical study. SETTING Single academic fertility center. PATIENT(S) Twenty-four male partners from couples undergoing IVF. INTERVENTION(S) Couples were randomized to receive 1 g of azithromycin (standard of care) or no azithromycin at the time of baseline IVF assessment. Semen samples were collected at the time of the female partners' egg retrieval, and 100 μL of the sample was used for the virome analysis. MAIN OUTCOME MEASURE(S) Detection of viruses by ViroCap enrichment of viral nucleic acid and sequencing. Association between the virome, semen parameters, and pregnancy outcomes. RESULT(S) We detected viruses in 58% of the participants. Viruses included polyomaviruses, papillomaviruses, herpesviruses, and anelloviruses. Viromes detected in semen had little overlap with the viromes detected in vaginal samples from their female partners collected at the time of embryo transfer, which were analyzed in a previous study. A lower viral diversity in semen samples was positively associated with pregnancy (Hodges-Lehmann estimate of difference, 1; 95% confidence interval, 2-0.00003). There was no association between viral diversity and sperm concentration, motility, or fertilization rates. CONCLUSION(S) This comprehensive characterization of the DNA virome in semen reveals an association between virome diversity and pregnancy in couples undergoing IVF. However, no association was found with specific semen parameters or fertilization rates, suggesting that viral exposure may negatively affect pregnancy after fertilization. Future studies should be undertaken to evaluate the associations between the semen virome with IVF outcomes in larger cohorts.
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Affiliation(s)
- Stephanie Gunderson
- Department of Obstetrics and Gynecology, Division of Reproductive Endocrinology and Infertility, Washington University in St Louis, St Louis, Missouri
| | - Ashley M Eskew
- Department of Obstetrics and Gynecology, Division of Reproductive Endocrinology and Infertility, Washington University in St Louis, St Louis, Missouri
| | - Dylan Stoutenburg
- Department of Pediatrics, Division of Infectious Diseases, Washington University in St Louis, St. Louis, Missouri
| | - Joan K Riley
- Department of Obstetrics and Gynecology, Division of Reproductive Endocrinology and Infertility, Washington University in St Louis, St Louis, Missouri
| | - Molly J Stout
- Department of Obstetrics and Gynecology, Division of Maternal Fetal Medicine, Washington University in St Louis, St. Louis, Missouri
| | - Jane Schrimpf
- Department of Pediatrics, Division of Infectious Diseases, Washington University in St Louis, St. Louis, Missouri
| | - Emily S Jungheim
- Department of Obstetrics and Gynecology, Division of Reproductive Endocrinology and Infertility, Washington University in St Louis, St Louis, Missouri
| | - Kristine M Wylie
- Department of Pediatrics, Division of Infectious Diseases, Washington University in St Louis, St. Louis, Missouri; McDonnell Genome Institute, Washington University in St Louis, St Louis, Missouri.
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12
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Britto-Júnior J, Ribeiro A, Ximenes L, Lima AT, Jacintho FF, Fregonesi A, Mónica FZ, Antunes E, De Nucci G. Alpha1-adrenergic antagonists block 6-nitrodopamine contractions on the rat isolated epididymal vas deferens. Eur J Pharmacol 2022; 915:174716. [PMID: 34951979 DOI: 10.1016/j.ejphar.2021.174716] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2021] [Revised: 11/25/2021] [Accepted: 12/20/2021] [Indexed: 01/12/2023]
Abstract
6-nitrodopamine (6-ND) is released from rat isolated vas deferens and modulates electrical-field stimulation (EFS) contractions of the rat isolated epididymal vas deferens (RIEVD) via a specific receptor which is blocked by tricyclic antidepressants. Here, the effects of selective α1-adrenergic receptor antagonists on RIEVD contractions induced by 6-ND, dopamine, noradrenaline, adrenaline and EFS were investigated. Doxazosin and tamsulosin (3-10 nM) caused significant rightward shifts of the concentration-response curve to 6-ND, but had no effect on dopamine-, noradrenaline- and adrenaline-induced contractions. Alfuzosin (10 nM) produced rightward shifts on concentration-response curves to all catecholamines. Silodosin (10 nM) and terazosin (100 nM) displaced to the right the noradrenaline, dopamine and adrenaline curves, but higher concentrations of both antagonists (100 and 300 nM, respectively) were required to displace the 6-ND curves. The EFS-induced contractions were significantly inhibited only at the concentrations that the α1-adrenergic receptor antagonists caused rightward shifts on the 6-ND concentration-response curves. The inhibition of EFS-induced contractions by doxazosin (10 nM), tamsulosin (10 nM), alfuzosin (10 nM), silodosin (100 nM) and terazosin (300 nM), were not observed in RIEVD obtained from animals chronically treated with L-NAME. This work demonstrates that α1-adrenoceptor antagonists act as 6-ND receptor antagonists in RIEVD, opening the possibility that many actions previously attributed to noradrenaline could be due to 6-ND antagonism. In addition, blockade of the 6-ND receptors by both tricyclic antidepressants and α1-adrenergic receptor antagonists may represent the common mechanism of action responsible for their therapeutic use in the treatment of premature ejaculation.
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Affiliation(s)
- José Britto-Júnior
- Department of Pharmacology, Faculty of Medical Sciences, State University of Campinas (UNICAMP), Campinas, SP, Brazil.
| | - André Ribeiro
- Department of Pharmacology, Faculty of Medical Sciences, State University of Campinas (UNICAMP), Campinas, SP, Brazil
| | - Luiz Ximenes
- Department of Pharmacology, Faculty of Medical Sciences, State University of Campinas (UNICAMP), Campinas, SP, Brazil
| | - Antonio Tiago Lima
- Department of Pharmacology, Faculty of Medical Sciences, State University of Campinas (UNICAMP), Campinas, SP, Brazil
| | - Felipe Fernandes Jacintho
- Department of Pharmacology, Faculty of Medical Sciences, State University of Campinas (UNICAMP), Campinas, SP, Brazil
| | - Adriano Fregonesi
- Department of Pharmacology, Faculty of Medical Sciences, State University of Campinas (UNICAMP), Campinas, SP, Brazil
| | - Fabíola Z Mónica
- Department of Pharmacology, Faculty of Medical Sciences, State University of Campinas (UNICAMP), Campinas, SP, Brazil
| | - Edson Antunes
- Department of Pharmacology, Faculty of Medical Sciences, State University of Campinas (UNICAMP), Campinas, SP, Brazil
| | - Gilberto De Nucci
- Department of Pharmacology, Faculty of Medical Sciences, State University of Campinas (UNICAMP), Campinas, SP, Brazil; Department of Pharmacology, Institute of Biomedical Sciences, University of São Paulo (USP), São Paulo, SP, Brazil; Department of Pharmacology, Faculty of Medicine, São Leopoldo Mandic, Campinas, SP, Brazil; Brazil University, Fernandópolis, SP, Brazil
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13
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Kempeneers P. Revue systématique des essais consacrés aux traitements psycho-comportementaux de l’éjaculation prématurée. SEXOLOGIES 2022. [DOI: 10.1016/j.sexol.2021.09.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Tan H, Zhou Z, Cui Y, Feng F, Zhang Y. A systematic review and meta-analysis of randomized controlled trials of "on-demand" use of tramadol vs "on-demand" use of paroxetine in the management of patients with premature ejaculation. Int J Clin Pract 2021; 75:e14825. [PMID: 34492139 DOI: 10.1111/ijcp.14825] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/28/2021] [Revised: 08/27/2021] [Accepted: 09/06/2021] [Indexed: 11/27/2022] Open
Abstract
AIM To evaluate the effect of "on-demand" use of tramadol vs "on-demand" use of paroxetine in the management of patients with premature ejaculation (PE). MATERIALS AND METHODS A systematic search of PubMed, EMBASE, Cochrane Library databases and original references of the included articles was performed. PRISMA checklist was followed. The Cochrane Handbook was used to evaluate the quality of the included research. RESULTS A total of seven articles including 663 patients were studied. The results indicated that patients who received on-demand therapy of tramadol or paroxetine showed significant improvement compared with those treated with placebo, as assessed by intravaginal ejaculatory latency time (IELT) (P < .00001 and P = .02, respectively) and sexual satisfaction score (P < .00001 and P < .00001, respectively). Furthermore, Patients who were treated with on-demand tramadol had a better effect than those treated with on-demand paroxetine in respect of IELT (P = .01) and sexual satisfaction score (P = .03). With regard to safety, the most common adverse event for the tramadol group was sleep disturbance and the most common adverse event for the paroxetine group was a headache. No serious adverse event was observed in both groups. CONCLUSIONS Compared with placebo, on-demand therapy of tramadol or paroxetine showed a better improvements in IELT and sexual satisfaction scores. Besides, on-demand tramadol revealed a better effect than on-demand paroxetine for patients with PE, and patients in both groups showed good tolerance.
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Affiliation(s)
- Haotian Tan
- Department of Urology, The Affiliated Yantai Yuhuangding Hospital of Qingdao University, Shandong, China
| | - Zhongbao Zhou
- Department of Urology, Beijing TianTan Hospital, Capital Medical University, Beijing, China
| | - Yuanshan Cui
- Department of Urology, The Affiliated Yantai Yuhuangding Hospital of Qingdao University, Shandong, China
- Department of Urology, Beijing TianTan Hospital, Capital Medical University, Beijing, China
| | - Fan Feng
- Department of Urology, The Affiliated Yantai Yuhuangding Hospital of Qingdao University, Shandong, China
| | - Yong Zhang
- Department of Urology, Beijing TianTan Hospital, Capital Medical University, Beijing, China
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15
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Vickram S, Rohini K, Srinivasan S, Veenakumari DN, Archana K, Anbarasu K, Jeyanthi P, Thanigaivel S, Gulothungan G, Rajendiran N, Srikumar PS. Role of Zinc (Zn) in Human Reproduction: A Journey from Initial Spermatogenesis to Childbirth. Int J Mol Sci 2021; 22:2188. [PMID: 33671837 PMCID: PMC7926410 DOI: 10.3390/ijms22042188] [Citation(s) in RCA: 30] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2021] [Revised: 02/19/2021] [Accepted: 02/19/2021] [Indexed: 02/08/2023] Open
Abstract
Zinc (Zn), the second-most necessary trace element, is abundant in the human body. The human body lacks the capacity to store Zn; hence, the dietary intake of Zn is essential for various functions and metabolism. The uptake of Zn during its transport through the body is important for proper development of the three major accessory sex glands: the testis, epididymis, and prostate. It plays key roles in the initial stages of germ cell development and spermatogenesis, sperm cell development and maturation, ejaculation, liquefaction, the binding of spermatozoa and prostasomes, capacitation, and fertilization. The prostate releases more Zn into the seminal plasma during ejaculation, and it plays a significant role in sperm release and motility. During the maternal, labor, perinatal, and neonatal periods, the part of Zn is vital. The average dietary intake of Zn is in the range of 8-12 mg/day in developing countries during the maternal period. Globally, the dietary intake of Zn varies for pregnant and lactating mothers, but the average Zn intake is in the range of 9.6-11.2 mg/day. The absence of Zn and the consequences of this have been discussed using critical evidence. The events and functions of Zn related to successful fertilization have been summarized in detail. Briefly, our current review emphasizes the role of Zn at each stage of human reproduction, from the spermatogenesis process to childbirth. The role of Zn and its supplementation in in vitro fertilization (IVF) opens opportunities for future studies on reproductive biology.
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Affiliation(s)
- Sundaram Vickram
- Department of Biotechnology, Saveetha School of Engineering, Saveetha Institute of Medical and Technical Sciences, Chennai, Tamil Nadu 602105, India; (S.V.); (S.T.)
| | - Karunakaran Rohini
- Unit of Biochemistry, Faculty of Medicine, AIMST University, Semeling, Bedong 08100, Kedah, Malaysia
| | - Subramanian Srinivasan
- Department of Biomedical Engineering, Saveetha School of Engineering, Saveetha Institute of Medical and Technical Sciences, Chennai, Tamil Nadu 602105, India; (S.S.); (G.G.); (N.R.)
| | | | - Kumar Archana
- Department of Agriculture Engineering, Saveetha School of Engineering, Saveetha Institute of Medical and Technical Sciences, Chennai, Tamil Nadu 602105, India;
| | - Krishnan Anbarasu
- Department of Bioinformatics, Saveetha School of Engineering, Saveetha Institute of Medical and Technical Sciences, Chennai, Tamil Nadu 602105, India;
| | - Palanivelu Jeyanthi
- Department of Biotechnology, Vel Tech Rangarajan Dr. Sagunthala R&D Institute of Science and Technology, Chennai, Tamil Nadu 600062, India;
| | - Sundaram Thanigaivel
- Department of Biotechnology, Saveetha School of Engineering, Saveetha Institute of Medical and Technical Sciences, Chennai, Tamil Nadu 602105, India; (S.V.); (S.T.)
| | - Govindarajan Gulothungan
- Department of Biomedical Engineering, Saveetha School of Engineering, Saveetha Institute of Medical and Technical Sciences, Chennai, Tamil Nadu 602105, India; (S.S.); (G.G.); (N.R.)
| | - Nanmaran Rajendiran
- Department of Biomedical Engineering, Saveetha School of Engineering, Saveetha Institute of Medical and Technical Sciences, Chennai, Tamil Nadu 602105, India; (S.S.); (G.G.); (N.R.)
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Buchholz VN, Mühle C, Kornhuber J, Lenz B. Markers of Prenatal Androgen Exposure Correlate With Online Sexual Compulsivity and Erectile Function in Young Men. Front Psychiatry 2021; 12:517411. [PMID: 33889090 PMCID: PMC8055940 DOI: 10.3389/fpsyt.2021.517411] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/04/2019] [Accepted: 02/08/2021] [Indexed: 11/13/2022] Open
Abstract
Pornography addiction and sexual dysfunction are increasingly prevalent in young men. Previous studies suggest that prenatal androgen exposure plays a role in addiction and sexual functionality. Here, we tested whether lower second-to-fourth finger length ratio (2D:4D) and later age at spermarche, both putative indicators of higher androgen levels in utero, correlate with online sexual compulsivity (OSC scale of ISST), erectile function (IIEF-5), and ejaculatory control (PEPA) in 4,370 young men (age IQR: 25-26 years) of the Cohort Study on Substance Use Risk Factors. Statistical analyses revealed that lower 2D:4D correlated with higher scores on the OSC scale. Moreover, higher age at spermarche correlated with higher OSC scores and decreased erectile function. Interestingly, OSC severity, but not the frequency of pornography use, correlated negatively with erectile function and ejaculatory control. This is the first study to associate two independent proxies of prenatal testosterone level with OSC. These findings provide novel insight into intrauterine predisposition of sexual behavior and related sexual function in adulthood.
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Affiliation(s)
- Verena N Buchholz
- Department of Psychiatry and Psychotherapy, Friedrich-Alexander University Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - Christiane Mühle
- Department of Psychiatry and Psychotherapy, Friedrich-Alexander University Erlangen-Nürnberg (FAU), Erlangen, Germany
| | | | - Johannes Kornhuber
- Department of Psychiatry and Psychotherapy, Friedrich-Alexander University Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - Bernd Lenz
- Department of Psychiatry and Psychotherapy, Friedrich-Alexander University Erlangen-Nürnberg (FAU), Erlangen, Germany.,Department of Addictive Behavior and Addiction Medicine, Central Institute of Mental Health (CIMH), Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
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17
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Zhang J, Han T, Cai Z, Wang Y, Shang X, Yang B, Li H. The Use of Delphi Method and Analytical Hierarchy Process in the Establishment of Assessment Tools in Premature Ejaculation: The Scoring System for Premature Ejaculation Treatment Outcomes. Am J Mens Health 2020; 14:1557988320975529. [PMID: 33256533 PMCID: PMC7711231 DOI: 10.1177/1557988320975529] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023] Open
Abstract
There is a lack of objective tools to comprehensively evaluate premature
ejaculation (PE) treatment results clinically. We aimed to describe the
development of a novel scoring system for PE treatment results as an example of
using the Delphi method and an analytical hierarchy process for complex
decision-making in the field of sexual medicine. A Delphi question survey was
adopted to collect expert opinions from 47 Chinese specialists in
andrology/urology on the assessment of PE treatment outcomes based on four
primary properties, that is, the improvement in intravaginal ejaculation latency
time, a couple’s mental status, the ability to control ejaculation, and sexual
intercourse satisfaction. Different weights on those primary properties were
assigned to create a mathematical hierarchy matrix and then perform an analysis.
The scores were assigned according to the calculated weights. The ratio among
the combined weights of the four primary properties was 1:3:2:3. The total
numerical score was 36. Scores above 27, between 26 and 18, and below 17
indicated significant improvement, moderate improvement, and no improvement in
PE, respectively, with selected treatments. The scoring system with 36 points
can be used by physicians, patients, and their sexual partners to
comprehensively and objectively assess quantitative PE treatment results.
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Affiliation(s)
- Jianzhong Zhang
- Department of Urology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China
| | - Taoli Han
- National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, China
| | - Zhonglin Cai
- Department of Urology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China
| | - Ying Wang
- National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, China
| | - Xuejun Shang
- Department of Andrology, Jinling Hospital Affiliated to Southern Medical University, Nanjing, China
| | - Bin Yang
- Department of Urology, Affiliated Hospital of the Qingdao University, Qingdao, China
| | - Hongjun Li
- Department of Urology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China
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18
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Contreras P, Bonanno N, Rios Pita H, Villasante N, Ameri CA, Blas L. Antegrade Ejaculation Preservation Technique with GreenLight XPS 180-W: Functional Ejaculatory Results. J Endourol 2020; 35:349-352. [PMID: 32942917 DOI: 10.1089/end.2020.0264] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Introduction: Ejaculatory dysfunction is a common complication of surgeries for benign prostatic obstruction. It causes a clear deterioration in quality of life. Techniques have been developed to attempt to preserve antegrade ejaculation (AE). Our objective was to analyze results of ejaculatory function using an AE preservation technique during anatomical vaporization with XPS 180-W. Methods: Between 2017 and 2019, sexually active patients were treated using this technique by the same surgical team. A questionnaire (MSHQ-EjD Short Form) was mailed, patients who did not answer were contacted by phone or personally during follow-up. Responses were analyzed. Voiding function was evaluated using International Prostatic Symptoms Score (IPSS), Qmax, and postvoid residual volume. t-Test for paired samples was used to compare conformity of patients with and without AE and voiding results. A p < 0.05 was considered statistically significant. Results: In total, 77 of 112 patients (68.8%) completed questionnaires and were included. Mean age was 64.1 years (standard deviation [SD] 6.9) and median prostate size was 57.2 g (interquartilic range 30-85). A total of 68 of 77 (88.3%) patients reported AE. Of these, 58 (85.3%) reported AE always or most of the time and 10 (14.7%) reported AE half of the time. In total, 42 (61.7%) patients had preserved strength or slightly less than before the procedure, and 33 (48.5%) reported the same or slightly less volume than before. In terms of satisfaction, the average response values of patients with preserved AE and ejaculatory disfunction were 0.97 (SD 1.12) and 2.7 (SD 1.78), respectively (p = 0.000). Pre- and postoperative variables were as follows: mean Qmax was 11.6 mL/sec vs 19.6 (p = 0.00), mean IPSS was 13.8 vs 8.9 (p = 0.000), and mean postvoiding residual urine was 125.3 vs 33.1 mL (p = 0.00), respectively. Conclusion: It is feasible to perform the AE preservation technique with anatomical vaporization XPS 180-W. In our medium size prostate series, we had a satisfactory patient perception of the ejaculatory function and satisfactory voiding function results.
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Affiliation(s)
- Pablo Contreras
- Servicio de Urología, Hospital Alemán, Ciudad Autónoma de Buenos Aires, Argentina
| | - Nicolas Bonanno
- Servicio de Urología, Hospital Alemán, Ciudad Autónoma de Buenos Aires, Argentina
| | - Hernando Rios Pita
- Servicio de Urología, Hospital Alemán, Ciudad Autónoma de Buenos Aires, Argentina
| | - Nicolas Villasante
- Servicio de Urología, Hospital Alemán, Ciudad Autónoma de Buenos Aires, Argentina
| | - Carlos Alberto Ameri
- Servicio de Urología, Hospital Alemán, Ciudad Autónoma de Buenos Aires, Argentina
| | - Leandro Blas
- Servicio de Urología, Hospital Alemán, Ciudad Autónoma de Buenos Aires, Argentina
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Ur Rehman MF, Imran Zaidi A, Ul Haq T, Rafique S, Ali F. Comparison of the Efficacy of Tramadol and Paroxetine in the Management of Premature Ejaculation. Cureus 2020; 12:e10725. [PMID: 33145131 PMCID: PMC7599037 DOI: 10.7759/cureus.10725] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Objective The goal of this study was to compare the efficacy of tramadol and paroxetine in the treatment of primary premature ejaculation (PE). Study design This study was a randomized controlled trial performed in the outpatient department of Nishtar Hospital, Multan, from January 2017 to January 2018. Methodology One hundred six patients were diagnosed with PE and included in the study. The patients were categorized into two groups receiving either tramadol or paroxetine through a lottery randomization method. The main variables were baseline PE, baseline satisfaction after intercourse, baseline intravaginal ejaculatory latency time (IELT), ejaculation control, difficulty in ejaculation, and after-treatment satisfaction with sexual intercourse and IELT. We used IBM SPSS Statistics for Windows, Version 23.0 (Armonk, NY: IBM Corp.) for data analysis, and p≤0.05 was considered statistically significant. Results Ejaculation control, difficulty in ejaculation, and distress due to ejaculation in patients in the tramadol group was noted as 24.5%, 7.5%, and 7.5%, respectively. Ejaculation control, difficulty in ejaculation, and distress due to ejaculation in the paroxetine group was noted as 49.1%, 17%, and 24.5%, respectively. The differences were statistically significant within the groups at baseline and after treatment of PE (p<0.001). Conclusion Tramadol is an effective and useful drug as compared to paroxetine for the treatment of PE. Tramadol can be used as an alternative to other medications for the treatment of lifelong PE.
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Affiliation(s)
| | | | - Tanveer Ul Haq
- Urology, Multan Institute of Kidney Diseases, Multan, PAK
| | - Shoaib Rafique
- Urology, Multan Institute of Kidney Diseases, Multan, PAK
| | - Farman Ali
- Internal Medicine, District Headquarter Hospital, Khanewal, PAK
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20
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Fusco F, Creta M, Mangiapia F, Cirigliano L, Trama F, Pandolfo SD, Imbimbo C, Longo N, Mirone V. Perceptions, Expectations, Preferences, and Attitudes Toward Premature Ejaculation, Its Diagnosis and Topical Treatment with Fortacin™ Spray: Results from an Expert Panel Discussion. Res Rep Urol 2020; 12:211-216. [PMID: 32670915 PMCID: PMC7337443 DOI: 10.2147/rru.s250301] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2020] [Accepted: 06/18/2020] [Indexed: 12/19/2022] Open
Abstract
INTRODUCTION Premature ejaculation (PE) represents the most prevalent male sexual issue. Before beginning treatment, it is essential to discuss the patient's expectations thoroughly. METHODS Herein, we report the results of an expert panel discussion about perceptions, expectations, preferences, and attitudes towards PE, its diagnosis and treatment. The panel took place in October 2019 and involved 30 Italian urologists experienced in the management of male sexual dysfunction. It aimed at investigating physicians' points of view about selected aspects of PE management which emerged during the counselling of PE patients over the previous two years. Treatment-related questions were mainly focused on topical treatment with Fortacin™. RESULTS Overall, 83.3% of those interviewed declared that most of their patients perceive PE as a bother rather than a disease. The percentage of urologists interviewed perceived that improved subjective control over ejaculation and prolonged intravaginal ejaculatory latency time (IELT) as the main benefit expected by the majority of their patients was 56.5% and 10%, respectively. Eighty percent of urologists reported on-demand regimen as the dosage modality preferred by the majority of their patients and half of them reported the topical route to be the way of administration preferred in most cases. Moreover, 73.3% of urologists reported that adherence to treatment was higher in patients undergoing topical treatment. Finally, 80% of urologists perceived Fortacin to be efficacious in patients with acquired PE and 70% of them perceived its efficacy to be independent from IELT. DISCUSSION Most patients perceive PE as a bother rather than a disease and mainly advocate an improved control over ejaculation. Fortacin is perceived as efficacious in patients with acquired PE, and independent from IELT.
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Affiliation(s)
- Ferdinando Fusco
- Department of Urology, Luigi Vanvitelli University of Naples, Naples, Italy
| | - Massimiliano Creta
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, University of Naples Federico II, Naples, Italy
| | - Francesco Mangiapia
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, University of Naples Federico II, Naples, Italy
| | - Lorenzo Cirigliano
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, University of Naples Federico II, Naples, Italy
| | - Francesco Trama
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, University of Naples Federico II, Naples, Italy
| | - Savio Domenico Pandolfo
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, University of Naples Federico II, Naples, Italy
| | - Ciro Imbimbo
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, University of Naples Federico II, Naples, Italy
| | - Nicola Longo
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, University of Naples Federico II, Naples, Italy
| | - Vincenzo Mirone
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, University of Naples Federico II, Naples, Italy
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21
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Baskaran S, Finelli R, Agarwal A, Henkel R. Diagnostic value of routine semen analysis in clinical andrology. Andrologia 2020; 53:e13614. [PMID: 32400107 DOI: 10.1111/and.13614] [Citation(s) in RCA: 32] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2020] [Accepted: 04/01/2020] [Indexed: 01/11/2023] Open
Abstract
Infertility is a major health issue affecting over 48.5 million couples around the world, with the male factor accounting for about 50% of the cases. The conventional semen analysis recommended by the World Health Organization (WHO) is the cornerstone in the evaluation of male fertility status. It includes macroscopic and microscopic evaluation of the ejaculate, which reflects the production of spermatozoa in the testes, the patency of the duct system and the glandular secretory activity. Evaluation of seminal fructose, sperm vitality and leucocytes (Endtz test) are useful adjuncts to semen analysis that provide information on specific clinical conditions. Though several computer-assisted sperm analysis (CASA) systems have been developed, conventional methods for semen analysis are still widely accepted in clinical practice. This review summarises the conventional techniques used in routine semen analysis and their diagnostic value in clinical andrology.
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Affiliation(s)
- Saradha Baskaran
- American Center for Reproductive Medicine, Cleveland Clinic, Cleveland, OH, USA
| | - Renata Finelli
- American Center for Reproductive Medicine, Cleveland Clinic, Cleveland, OH, USA
| | - Ashok Agarwal
- American Center for Reproductive Medicine, Cleveland Clinic, Cleveland, OH, USA
| | - Ralf Henkel
- American Center for Reproductive Medicine, Cleveland Clinic, Cleveland, OH, USA.,Department of Medical Bioscience, University of the Western Cape, Bellville, South Africa
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Hur MS, Lee HW, Yang HM, Kwon HJ, O J, Lee S, Oh CS. Longitudinal muscular column in the prostatic urethral wall: Its form, shape, and possible function based on mathematical simulation in ejaculation. Prostate 2020; 80:471-480. [PMID: 32049374 DOI: 10.1002/pros.23961] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/26/2019] [Accepted: 02/04/2020] [Indexed: 11/06/2022]
Abstract
BACKGROUND The shape and function of the longitudinal muscular column (LMC) of the prostate have not been established in detail. The present study was undertaken to elucidate the roles of the LMC of the posterior wall of the prostatic urethra (PSU) in the emission phase of ejaculation by investigating the form and muscular arrangement of the LMC. METHODS Prostates and urinary bladders were obtained from 14 Korean adult cadavers. Nine specimens were histologically analyzed using hematoxylin and eosin, Masson's trichrome, and Verhoeff-van Gieson staining. Two specimens were scanned using microcomputed tomography (micro-CT), and all scanned images were reconstructed into a three-dimensional model. RESULTS At the proximal level of the prostate, the ejaculatory ducts (EDs) and prostatic utricle (PU) together were surrounded by circular smooth-muscle fibers. However, at the seminal colliculus (SC) where the EDs and PU opened, they were mainly surrounded by an abundance of longitudinal fibers. The longitudinal fibers posterior to the EDs and PU formed a distinctive LMC in the posterior urethral wall. In histologic sections and micro-CT images, the LMC extended distally from the level of the SC to the level of the membranous urethra (MBU). We simulated a potential mechanism of LMC using a mathematical model of its movements. CONCLUSIONS Comprehensive analyses based on in-depth assessment of histologic characteristics and micro-CT images demonstrated extension of the LMC from the level of the SC to the level of the MBU, enabling a better understanding of ejaculation physiology involving the LMC. These results suggest that the LMC in the posterior wall of the PSU is a critical component of ejaculation by facilitating the ejection of seminal vesicle fluid into the PSU via well-coordinated contractions.
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Affiliation(s)
- Mi-Sun Hur
- Department of Anatomy, Catholic Kwandong University College of Medicine, Gangneung, Korea
| | - Hye Won Lee
- Department of Hospital Medicine, College of Medicine, Yonsei University, Seoul, Korea
| | - Hun-Mu Yang
- Department of Anatomy, Yonsei University College of Medicine, Seoul, Korea
| | - Hyun-Jin Kwon
- Department of Anatomy, Yonsei University College of Medicine, Seoul, Korea
| | - Jehoon O
- Department of Anatomy, Yonsei University College of Medicine, Seoul, Korea
| | - Seunggyu Lee
- Department of Mathematics and Research Institute of Natural Science, Gyeongsang National University, Jinju, Korea
| | - Chang-Seok Oh
- Department of Anatomy and Cell Biology, Sungkyunkwan University School of Medicine, Suwon, Korea
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Moore BC, Francis R, Foster A, Kelly DA, Does M, Kim DK, Groenewald HB, Myburgh JG. Morphological changes associated with Nile crocodile (Crocodylus niloticus) phallic glans inflation. J Morphol 2020; 281:636-645. [PMID: 32271493 DOI: 10.1002/jmor.21126] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2019] [Revised: 03/27/2020] [Accepted: 03/30/2020] [Indexed: 12/23/2022]
Abstract
The crocodylian phallic glans is the distal inflatable structure that makes the most direct contact with the female cloacal and associated reproductive tract openings during copulation. Therefore, its form and function directly impact female tissue sensory interactions and insemination mechanics. Compared to mammals, less is known about glans functional anatomy among other amniotes, including crocodylians. Therefore, we paired an ex vivo inflation technique with magnetic resonance imaging 3D-reconstructions and corresponding histological analyses to better characterize the morphological glans restructuring occurring in the Nile crocodile (Crocodylus niloticus) at copulation. The expansion of contiguous inflatable spongiform glans tissues is variably constrained by adjacent regions of dense irregular collagen-rich tissues. Therefore, expansion shows regional differences with greater lateral inflation than dorsal and ventral. Furthermore, this enlargement elaborates the cup-like glans lumen, dorsally reorients the glans ridge, stiffens the blunt and bifid glans tip, and putatively works to seal the ventral sulcus spermaticus semen conduit groove. We suggest how these dynamic male structures may interact with structures of the female cloacal urodeum and how these morphological changes, in concert with the varying material properties of the structural tissue compartments visualized in this study, aid copulatory gamete transfer and resulting fecundity. RESEARCH HIGHLIGHTS: Nile crocodile glans inflation produces a reproductively relevant copulatory structure directing insemination and female tissue interactions. Pairing magnetic resonance imaging 3D reconstruction with corresponding histology effectively studies functional anatomy.
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Affiliation(s)
- Brandon C Moore
- College of Veterinary Medicine, Department of Biomedical Science, University of Missouri, Columbia, Missouri, USA.,Biology Department, Sewanee: The University of the South, Sewanee, Tennessee, USA
| | - Rachel Francis
- Biology Department, Sewanee: The University of the South, Sewanee, Tennessee, USA
| | - Adam Foster
- Biology Department, Sewanee: The University of the South, Sewanee, Tennessee, USA
| | - Diane A Kelly
- Psychological and Brain Sciences, University of Massachusetts, Amherst, Massachusetts, USA
| | - Mark Does
- Department of Biomedical Engineering, Vanderbilt University School of Medicine, Nashville, Tennessee, USA
| | - Dong K Kim
- Department of Biomedical Engineering, Vanderbilt University School of Medicine, Nashville, Tennessee, USA
| | - Herman B Groenewald
- Department of Anatomy and Physiology, Faculty of Veterinary Science, University of Pretoria, Onderstepoort, South Africa
| | - Jan G Myburgh
- Department of Paraclinical Sciences, Faculty of Veterinary Science, University of Pretoria, Onderstepoort, South Africa
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Abstract
OBJECTIVE Premature ejaculation (PE) is regarded as one of the most common male sexual dysfunctions. This review introduced several pharmaceutical and surgical methods for the management of PE. The definition, etiology, behavioral, and psychological therapy of PE were also discussed. DATA SOURCES "Premature," "ejaculation," or "sexual dysfuction" were used as the medical subject headings (MeSH) to obtain relevant articles before June 2019 on Pubmed, Google Scholar and CNKI. Most articles used were written in English and several Chinese articles were also cited. STUDY SELECTION Full-text articles of retrospective/prospective/randomized controlled trials were analyzed. Animal experiments and letters were excluded. RESULTS There are four PE sub-types: lifelong PE, acquired PE, natural variable PE, and subjective PE. Behavioral therapy, psychotherapy, medication, topical anesthetics, and surgery are currently used for the treatment of PE. However, all the above treatments have limitations. Therefore, novel ways should be investigated to more efficiently control PE. CONCLUSIONS The pharmaceutical therapy that is currently being used in clinical practice for the management of PE is still the main choice globally due to its good efficacy. Surgery may be a choice for patients who are resistant to medication. However, it should be performed cautiously.
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Cheung F, Fathollahi A, Vertosick E, Jarvis TR, Katz D, Sandhu JS, Favorito LA. Editorial Comment: Dorsolateral fibromuscular tissue preservation during artificial urinary sphincter cuff placement is associated with low infection and erosion rates. Int Braz J Urol 2020; 46:124-125. [PMID: 31851469 PMCID: PMC6968916 DOI: 10.1590/s1677-5538.ibju.2020.01.04] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Affiliation(s)
- F Cheung
- Memorial Sloan Kettering Cancer Center, USA
| | | | | | - TR Jarvis
- Prince of Wales Clinical School, Australia
| | - D Katz
- Men's Health Melbourne, USA
| | - JS Sandhu
- Memorial Sloan Kettering Cancer Center, USA
| | - Luciano A Favorito
- Universidade Estadual do Rio de Janeiro - Uerj, Brasil; Hospital Federal da Lagoa, Brasil
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Alves EF, Gallo CM, Costa WS, Sampaio FJ, Favorito LA. Structural Analysis of the Bulbospongiosus Muscle in Patients With Bulbar Urethral Strictures. Urology 2020; 137:183-189. [PMID: 31926195 DOI: 10.1016/j.urology.2019.11.046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2019] [Revised: 11/21/2019] [Accepted: 11/25/2019] [Indexed: 10/25/2022]
Abstract
OBJECTIVE To characterize the bulbospongiosus muscle (BSM) in patients with bulbar urethral strictures. MATERIALS AND METHODS We studied 21 patients divided into 2 groups: Stricture Group (n = 14; mean age = 62.00 years) with bulbar stricture submitted to open urethroplasty; and Control Group (n = 7; mean age = 60.14 years) with penile strictures (hypospadias cripples, penile cancer and/or penile infection) who were submitted to perineal urethrostomy. Samples of the BSM were dissected and histologic sections were stained by histochemical and immunohistochemical techniques. Histomorphometric analyzes were performed on photomicrographs. Means were statistically compared using the unpaired Student t test and the Mann-Whitney test (P <.05). RESULTS The etiology of bulbar urethral stricture was idiopathic in 2 cases (14.29%), post-TURP in 6 (42.86%), post open radical prostatectomy in 5 (35.71%) and post open prostatectomy in 1 case (7.14%). The average length of the stricture was 2.08 cm. The only parameter analyzed with significant difference between the groups was the vessels (significant difference between the control group: 5.11 ± 1.98% and stricture group: 3.57 ± 1.32%, P = .0460). The quantitative analysis of collagen (Control Group: 10.63 ± 5.37% and Stricture Group: 10.83 ± 4.55%, P = .9296); diameter of BSM muscle fibers (Control Group: 41.71 ± 14.63 µm and Stricture Group: 40.11 ± 8.59 µm, P = .76 and elastic system fibers (Control Group; 3.83 ± 1.54% and Stricture Group: 5.43 ± 2.90%, P = .2601) showed no significant difference. CONCLUSIONS Histologic analysis showed a significant decrease of the BSM vessels in urethral stricture, without changes in elastic fibers, collagen, nerves, and muscle fiber diameter. These findings show that the bulbar urethral stricture causes minimal alterations in the structure of the BSM.
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Affiliation(s)
- Edilaine F Alves
- Universidade do Estado do, Rio de Janeiro, Faculdade de Ciencias Medicas, Rio de janeiro, Brazil
| | - Carla M Gallo
- Universidade do Estado do, Rio de Janeiro, Faculdade de Ciencias Medicas, Rio de janeiro, Brazil
| | - Waldemar S Costa
- Universidade do Estado do, Rio de Janeiro, Faculdade de Ciencias Medicas, Rio de janeiro, Brazil
| | - Francisco J Sampaio
- Universidade do Estado do, Rio de Janeiro, Faculdade de Ciencias Medicas, Rio de janeiro, Brazil
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Chen J, Huang X, Lu C, Liu T, Dai Y, Yao Z, Chen Y. Graph analysis of
DTI
‐based connectome: decreased local efficiency of subcortical regions in
PE
patients with high sympathetic activity. Andrology 2019; 8:400-406. [PMID: 31532583 DOI: 10.1111/andr.12701] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2019] [Revised: 07/31/2019] [Accepted: 08/06/2019] [Indexed: 12/18/2022]
Affiliation(s)
- J. Chen
- Department of Andrology Jiangsu Province Hospital of Chinese Medicine Affiliated Hospital of Nanjing University of Chinese Medicine Nanjing China
| | - X. Huang
- Department of Andrology Jiangsu Province Hospital of Chinese Medicine Affiliated Hospital of Nanjing University of Chinese Medicine Nanjing China
| | - C. Lu
- Department of Radiology Jiangsu Province Hospital of Chinese Medicine Affiliated Hospital of Nanjing University of Chinese Medicine Nanjing China
| | - T. Liu
- Department of Andrology Jiangsu Province Hospital of Chinese Medicine Affiliated Hospital of Nanjing University of Chinese Medicine Nanjing China
| | - Y. Dai
- Department of Andrology Nanjing Drum Tower Hospital Affiliated Hospital of Nanjing University Medical School Nanjing China
| | - Z. Yao
- Department of Psychiatry Nanjing Brain Hospital Affiliated Hospital of Nanjing Medical University Nanjing China
| | - Y. Chen
- Department of Andrology Jiangsu Province Hospital of Chinese Medicine Affiliated Hospital of Nanjing University of Chinese Medicine Nanjing China
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28
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rb. [Not Available]. MMW Fortschr Med 2019; 161:17. [PMID: 31037689 DOI: 10.1007/s15006-019-0431-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
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Zhang D, Cheng Y, Wu K, Ma Q, Jiang J, Yan Z. Paroxetine in the treatment of premature ejaculation: a systematic review and meta-analysis. BMC Urol 2019; 19:2. [PMID: 30606186 PMCID: PMC6318994 DOI: 10.1186/s12894-018-0431-7] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2018] [Accepted: 12/12/2018] [Indexed: 12/17/2022] Open
Abstract
Background Paroxetine is one of the selective serotonin reuptake inhibitors (SSRIs) used in the treatment of premature ejaculation (PE). However, this use is not approved in many countries. The purpose of this systematic review and meta-analysis is to review the efficacy and safety of paroxetine for PE patients. Methods We searched relevant randomized, controlled trials through May 2018, using PubMed, Embase and Cochrane Central Register. The main endpoint included intra-vaginal ejaculatory latency time (IELT) and side effects in the treatment of PE. Cochrane Collaboration’s Revman software, version 5.3, was used for statistical analysis. Results Out of 493 unique articles, a total of 19 randomized, controlled trials (RCTs) were reviewed. Quite a few RCTs were considered to have unclear risk of bias because of limited information. Pooled outcomes suggested that paroxetine was more effective than placebo, fluoxetine and escitalopram at increasing IELT (all p < 0.05). However, there existed a high level of heterogeneity in the paroxetine vs. fluoxetine groups and the paroxetine vs. placebo groups. Comparing paroxetine with tramadol, sertraline, phosphodiesterase 5 inhibitors (PDE5Is), local lidocaine gel, behaviour therapy or dapoxetine, we found that the increase in IELT was not statistically significant between groups. Paroxetine combined with tadalafil or behaviour therapy was more efficacious than paroxetine alone (all p < 0.05). Although the side effects in the combination group were more common than in the paroxetine alone group, the most common adverse events, such as nausea, muscle soreness, palpitation and flushing, were mild and tolerable. The main limitations of this systematic review and meta-analysis were the different definitions of PE and short follow-up times. Conclusions According to this systematic review and meta-analysis, paroxetine provided better efficacy than placebo, fluoxetine and escitalopram in the treatment of PE, with well-tolerated side effects. The combination group had better efficacy than the paroxetine alone group. Trial registration This review was reported in agreement with the PRISMA statement and was registered on PROSPERO 2018CRD42018097014.
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Affiliation(s)
- Dong Zhang
- Department of Urology & Nephrology, Ningbo First Hospital, The affiliated hospital of ZheJiang University, 59, Liuting Street, Ningbo, Zhejiang, China
| | - Yue Cheng
- Department of Urology & Nephrology, Ningbo First Hospital, The affiliated hospital of ZheJiang University, 59, Liuting Street, Ningbo, Zhejiang, China
| | - Kerong Wu
- Department of Urology & Nephrology, Ningbo First Hospital, The affiliated hospital of ZheJiang University, 59, Liuting Street, Ningbo, Zhejiang, China
| | - Qi Ma
- Department of Urology & Nephrology, Ningbo First Hospital, The affiliated hospital of ZheJiang University, 59, Liuting Street, Ningbo, Zhejiang, China
| | - Junhui Jiang
- Department of Urology & Nephrology, Ningbo First Hospital, The affiliated hospital of ZheJiang University, 59, Liuting Street, Ningbo, Zhejiang, China
| | - Zejun Yan
- Department of Urology & Nephrology, Ningbo First Hospital, The affiliated hospital of ZheJiang University, 59, Liuting Street, Ningbo, Zhejiang, China.
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Male Orgasmic Dysfunction Post-Radical Pelvic Surgery. Sex Med Rev 2018; 6:429-437. [DOI: 10.1016/j.sxmr.2017.12.003] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2017] [Revised: 12/08/2017] [Accepted: 12/11/2017] [Indexed: 01/13/2023]
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31
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Kalejaiye O, Almekaty K, Blecher G, Minhas S. Premature ejaculation: challenging new and the old concepts. F1000Res 2017; 6:2084. [PMID: 29259775 PMCID: PMC5717471 DOI: 10.12688/f1000research.12150.1] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/27/2017] [Indexed: 01/23/2023] Open
Abstract
Premature ejaculation remains a difficult condition to manage for patients, their partners, and the clinician. Whilst prevalence rates are estimated to be 20-40%, determining a diagnosis of premature ejaculation is difficult, as the definition remains both subjective and ill-defined in the clinical context. As our understanding of the ejaculatory pathway has improved, new opportunities to treat the condition have evolved with mixed results. In this review, we explore some of these controversies surrounding the aetiology, diagnosis, and treatment of this condition and discuss potential novel therapeutic options.
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Affiliation(s)
- Odunayo Kalejaiye
- Department of Andrology, University College London Medical School, London, W1G 8PH, UK
| | - Khaled Almekaty
- Department of Andrology, University College London Medical School, London, W1G 8PH, UK
- Urology Department, University of Tanta, Tanta, Egypt
| | - Gideon Blecher
- Department of Andrology, University College London Medical School, London, W1G 8PH, UK
| | - Suks Minhas
- Department of Andrology, University College London Medical School, London, W1G 8PH, UK
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Petri-Kelvasa M, Schulte-Herbrüggen O. Disinhibited Exposing Behavior, Hypersexuality, and Erectile Dysfunction as a Consequence of Posttraumatic Stress in a 42-Year-Old Male Patient. ARCHIVES OF SEXUAL BEHAVIOR 2017; 46:2197-2205. [PMID: 28484862 DOI: 10.1007/s10508-017-0985-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/13/2015] [Revised: 03/25/2017] [Accepted: 03/26/2017] [Indexed: 06/07/2023]
Abstract
Research into sexual dysfunction and its explanations within a cognitive behavioral framework in patients with posttraumatic stress is sparse. In this report, we present the case of a 42-year-old male with severe posttraumatic stress symptoms who displayed apparent exhibitionistic behavior, hypersexual behavior in the form of excessive masturbation, and erectile dysfunction. Differential diagnostics showed that the presented exhibitionistic behavior could be more accurately classified as non-paraphilic disinhibited exposing behavior. Functional behavioral analysis of his sexual behavior suggested that disinhibited exposing and hypersexual behavior served as dysfunctional coping strategies for trauma-associated negative emotions. Erectile dysfunction seemed to be the result of trauma-associated hyperarousal and excessive masturbation. Within the context of operant learning processes, we propose that his sexual behaviors became highly automated and were used as the main strategies to regulate trauma-associated negative emotions. Implications for the diagnoses and suggestions for the conceptualization and incorporation into a cognitive behavioral therapy treatment of posttraumatic stress disorder are made.
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Affiliation(s)
- Mirja Petri-Kelvasa
- Department of Psychiatry and Psychotherapy, Charité-University Medicine, Charité Campus Mitte, Große Hamburger Straße 5-11, 10115, Berlin, Germany.
| | - Olaf Schulte-Herbrüggen
- Department of Psychiatry and Psychotherapy, Charité-University Medicine, Charité Campus Mitte, Große Hamburger Straße 5-11, 10115, Berlin, Germany
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Cruz-Navarro N, Prieto-Castro R, Cabello-Santamaría F, García-José F, Fernández-Lozano A, Larrazábal-Murillo M, Martín-Morales A, Sánchez-Sánchez F, San Martín-Blanco C, Viladoms-Fuster J. From the definition to the social impact of premature ejaculation. Expert consensus. Actas Urol Esp 2017; 41:281-283. [PMID: 27908635 DOI: 10.1016/j.acuro.2016.09.010] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2016] [Revised: 09/26/2016] [Accepted: 09/28/2016] [Indexed: 11/30/2022]
Affiliation(s)
- N Cruz-Navarro
- ANDROMEDI, Uróloga, andróloga y Medicina Sexual, Sevilla, España.
| | - R Prieto-Castro
- Unidad de Andrología, Medicina Sexual y Reproductiva, Unidad Clínica de Urología, Hospital Regional Universitario Reina Sofía, Córdoba, España
| | | | - F García-José
- Servicio de Andrología, Instituto Marqués, Barcelona, España
| | | | | | | | | | | | - J Viladoms-Fuster
- Servicio de Andrología-Urología, Centro Médico Teknon, Barcelona, España
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34
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Affiliation(s)
| | - Hisham Sharif
- Tunisian Center for Sexual Scientific Study and Research; Tunis Tunisia
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35
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Puppo V, Puppo G. Re: Simões Paço J, Jorge Pereira B.: New Therapeutic Perspectives in Premature Ejaculation (Urology 2016; 88:87–92). A Rebuttal: Premature Ejaculation is Not a Male Sexual Dysfunction. Urology 2016; 90:224. [DOI: 10.1016/j.urology.2015.12.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2015] [Revised: 12/07/2015] [Accepted: 12/07/2015] [Indexed: 10/22/2022]
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