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Huyghe E, Grellet L, Faix A, Almont T, Cuzin B, Burte C. Recommendations for the diagnosis and evaluation of premature ejaculation. THE FRENCH JOURNAL OF UROLOGY 2024; 34:102697. [PMID: 39002734 DOI: 10.1016/j.fjurol.2024.102697] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/28/2024] [Revised: 06/25/2024] [Accepted: 07/05/2024] [Indexed: 07/15/2024]
Abstract
OBJECTIVES The Association Interdisciplinaire Post-Universitaire de Sexologie (AIUS) has brought together a panel of experts to draw up French recommendations for the management of premature ejaculation. This article presents the recommendations for the diagnosis and evaluation of premature ejaculation. METHODS Systematic review of the literature between 01/1995 and 02/2022. Using the method of recommendations for clinical practice (RPC). RESULTS We recommend using the SIAMS definition for everyday clinical practice. PE is defined as: (i) a persistent and recurrent subjective perception of loss of control (management) of the ejaculatory mechanism in the presence of appropriate erotic stimuli; (ii) subjective, PE-related distress induced in the patient and sexual dissatisfaction or PE-related anorgamy in the partner; (iii) a short intravaginal ejaculatory latency time, whether subjectively perceived by the patient and the partner or objectively measured as less than 180seconds (generally). We suggest that the same definition be applied to practices other than vaginal penetration, such as masturbation, oral or anal intercourse, as well as to non-heterosexual contexts. We suggest using information reported by the patient, possibly supplemented by assessment tests/questionnaires (IPE, PEP, PEDT). We recommend investigating the presence of other sexual dysfunctions, in particular erectile dysfunction (ED), as well as any sexual dysfunctions of partners. We recommend taking a medical and psychosexological history, and carrying out a targeted physical examination in patients complaining of PE. CONCLUSION These recommendations should help to improve the management of PE.
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Affiliation(s)
- Eric Huyghe
- Médecine de la Reproduction, CHU de Toulouse, site de Paule de Viguier, Toulouse, France; Département d'urologie, transplantation rénale et andrologie, Hôpital Rangueil, CHU de Toulouse, Toulouse, France; UMR DEFE Inserm 1203, université de Toulouse III, université de Montpellier, Montpellier, France.
| | - Laure Grellet
- Cabinet de sexologie, 19 bis, rue Magnol, 34000 Montpellier, France
| | - Antoine Faix
- Cabinet d'Urologie, 265, avenue des États du Languedoc, Montpellier, France
| | - Thierry Almont
- Service d'oncologie, CHU de Martinique, Fort de France, France
| | - Béatrice Cuzin
- Service d'Urologie, chirurgie de la transplantation, Hôpital Édouard Herriot, CHU de Lyon, Lyon, France; Service de médecine de la reproduction, Hôpital Femme Mère Enfant, HCL, Bron, France
| | - Carol Burte
- Cabinet de médecine sexuelle, 4, rue des États-Unis, Cannes, France
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Rowland DL, Tamas S, Hevesi K. Updating, correcting, and calibrating the narrative about premature ejaculation. Sex Med Rev 2024; 12:401-410. [PMID: 38798049 DOI: 10.1093/sxmrev/qeae036] [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: 03/14/2024] [Revised: 04/20/2024] [Accepted: 05/06/2024] [Indexed: 05/29/2024]
Abstract
INTRODUCTION The narrative surrounding premature ejaculation (PE) has developed and solidified over the past 25 years. Unfortunately, portions of that narrative are outdated and do not reflect more recent conceptualizations or empirical findings regarding this disorder. OBJECTIVE In this review we sought to identify existing narratives about PE in need of updating and to provide revised narratives based on the recent research literature. METHOD Five PE narratives in need of revision were identified, including: the prevalence of PE, age-related differences in PE prevalence, a validated ejaculation latency (EL) for diagnosing PE, differences between lifelong and acquired PE subtypes, and the application of PE definitions beyond penile-vaginal intercourse. Extensive literature searches provided information supporting both the original narrative and the need for a revised narrative based on both consideration of more recent studies and reinterpretation of studies conducted since the establishment of the original narratives. RESULTS For each selected topic, the prevailing narrative based on the extant literature was first presented, followed by discussion of accumulating evidence that challenges the existing narrative. Each section ends with a suggested revised PE narrative. In 2 instances, the revised narrative required significant corrections (eg, PE prevalence, validated EL for diagnosing PE); in 2 instances, it expanded on the existing narrative (eg, PE subtype differences, inclusion of partnered sexual activities beyond penile-vaginal intercourse); and in 2 other instances, it backed off prior conclusions that have since required rethinking (eg, age-related changes in PE, PE subtype differences). Finally, a brief review of the 3-pronged criteria for PE (EL, ejaculatory control, and bother/distress) is presented and discussed. CONCLUSION This review reiterates the dynamic state of research on PE and demonstrates the need for and value of ongoing research that not only addresses new issues surrounding this dysfunction but also challenges and revises some of the existing narratives about PE.
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Affiliation(s)
- David L Rowland
- Department of Psychology, Valparaiso University, Valparaiso, IN 46383, United States
| | - Stella Tamas
- Institute of Psychology, Eötvös Loránd University, Budapest 1075, Hungary
| | - Krisztina Hevesi
- Institute of Psychology, Eötvös Loránd University, Budapest 1075, Hungary
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Herkommer K, Meissner VH, Dinkel A, Jahnen M, Schiele S, Kron M, Ankerst DP, Gschwend JE. Prevalence, lifestyle, and risk factors of erectile dysfunction, premature ejaculation, and low libido in middle-aged men: first results of the Bavarian Men's Health-Study. Andrology 2024; 12:801-808. [PMID: 37676020 DOI: 10.1111/andr.13524] [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: 04/27/2023] [Revised: 07/18/2023] [Accepted: 08/28/2023] [Indexed: 09/08/2023]
Abstract
BACKGROUND Erectile dysfunction (ED), premature ejaculation (PE), and low libido (LL) are reported as the most common male sexual dysfunctions. OBJECTIVE To evaluate the prevalence of ED, PE, and LL and associations with lifestyle risk factors and comorbidities in middle-aged men. MATERIALS AND METHODS This study included a population-based random sample of 2500 50-year-old men who completed validated questionnaires, including the International Index of Erectile Function, the Erection Hardness Score, the Sexual Complaints Screener, and further questionnaires. Multiple logistic regression of outcomes ED, PE, and LL was used to model the association with explanatory factors. RESULTS The prevalence of at least one sexual dysfunction was 30%. 21%, 5.2%, and 7.2% of men had ED, PE, and LL, respectively. The risk of ED increased with PE (odds ratio [OR]: 1.94, 95% confidence interval [95%CI]: 1.22-3.08), LL (OR: 2.04, 95%CI: 1.26-3.29), higher waist circumference (OR: 2.23, 95%CI: 1.67-2.96), and lower urinary tract symptoms (LUTS) (OR: 1.88, 95%CI: 1.39-2.55), partnership was associated with a lower risk (OR: 0.57, 95%CI: 0.39-0.85). The risk of PE increased with ED (OR: 1.94, 95%CI: 1.23-3.07), partnership (OR:5.42, 95%CI: 1.30-22.60), depression (OR: 2.37, 95%CI: 1.09-5.14), and LUTS (OR: 2.42, 95%CI: 1.52-3.87), and decreased with physical activity (OR: 0.44, 95%CI: 0.21-0.93). The risk of LL increased with ED (OR: 2.09, 95%CI: 1.31-3.34) and poorer self-rated health (OR: 2.97, 95%CI: 1.54-5.71). DISCUSSION AND CONCLUSIONS Roughly one in three 50-year-old men experience some form of sexual dysfunction and risk factors identified in this study underline the multifactorial nature of ED, PE, and LL. Many risk factors are modifiable which underlines the role of patient education. Modifiable risk factors should be addressed in patient education and men should take active measures to remove the risk posed by these factors.
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Affiliation(s)
- Kathleen Herkommer
- Department of Urology, School of Medicine, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
| | - Valentin H Meissner
- Department of Urology, School of Medicine, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
| | - Andreas Dinkel
- Department of Psychosomatic Medicine and Psychotherapy, School of Medicine, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
| | - Matthias Jahnen
- Department of Urology, School of Medicine, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
| | - Stefan Schiele
- Department of Urology, School of Medicine, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
| | - Martina Kron
- Institute of Epidemiology and Medical Biometrics, University of Ulm, Ulm, Germany
| | - Donna P Ankerst
- Departments of Mathematics and Life Science Systems, Munich Data Science Institute, Technical University of Munich, Garching, Germany
| | - Jürgen E Gschwend
- Department of Urology, School of Medicine, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
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Nguyen HB, Nguyen CT, Pham MQ, Hoang L, Sansone A, Jannini EA. Perceived intravaginal ejaculation latency time: The diagnosis of premature ejaculation among Vietnamese men. Andrology 2024; 12:618-623. [PMID: 37615496 DOI: 10.1111/andr.13516] [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: 04/25/2023] [Revised: 08/04/2023] [Accepted: 08/14/2023] [Indexed: 08/25/2023]
Abstract
INTRODUCTION Premature ejaculation (PE) is a prevalent sexual dysfunction in men that greatly affects their quality of life. In PE, the duration of sexual performance is considered an important aspect. However, a self-estimated value of intravaginal ejaculation latency time (perceived IELT, PIELT) as a criterion for diagnosis has not been specified. AIM This study aimed to determine the validity and a threshold value for PIELT in PE diagnosis. METHOD In our cross-sectional study, we recruited 550 men from March 2019 to January 2020 and interviewed them regarding their general demographic characteristics, sexual habits, PIELT and completed a premature ejaculation diagnostic tool (PEDT) questionnaire. Eventually, a combination of a clinical diagnosis and PEDT score was used, in which those with PEDT ≥ 11 and diagnosed with possible PE were assigned to the final PE(+) group; those with PEDT score ≤ 8 and diagnosed with no PE were included in the final PE(-) group. RESULTS Men PE(-) had more frequent sexual intercourse (9.74 ± 5.38 vs. 6.69 ± 5.38 episodes per month, p < 0.001) and had higher marriage rate (72.7% vs. 60.4%, p = 0.002) than PE(+) patients. No significant difference was noted regarding age, smoking habit, age of first sexual experience, and number of sexual partners between the two groups. The mean PIELT of control subjects and PE(+) patients were 11.69 ± 6.83 min and 2.01 ± 1.21 min, respectively. On receiver operating characteristic curve analysis, the cut-off value of PIELT of 3.75 min can be used to distinguish PE men (area under the curve = 0.982, sensitivity/specificity = 0.961/0.909), which means that men with a PIELT ≤ 3.5 min is suggestive of PE. CONCLUSION The impact of PE is dramatic both from a social and a personal perspective. PE(+) patients married significantly less and have significantly lower sexual activity compared to a PE(-) population. Furthermore, a PIELT of ≤ 3.5 min predicts PE demonstrating the need to revise its taxonomy and definition.
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Affiliation(s)
- Hoai Bac Nguyen
- Department of Andrology and Sexual Medicine, Hanoi Medical University's Hospital, Hanoi, Vietnam
| | - Cao Thang Nguyen
- Department of Andrology and Sexual Medicine, Hanoi Medical University's Hospital, Hanoi, Vietnam
| | - Minh Quan Pham
- Department of Andrology and Sexual Medicine, Hanoi Medical University's Hospital, Hanoi, Vietnam
| | - Long Hoang
- Department of Urology, Hanoi Medical University's Hospital, Hanoi, Vietnam
| | - Andrea Sansone
- Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy
| | - Emmanuele A Jannini
- Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy
- Honorary Chair of Sexual Medicine, Hanoi Medical University, Hanoi, Vietnam
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Cilio S, Pozzi E, Fallara G, Belladelli F, Corsini C, d'Arma A, Boeri L, Capogrosso P, Imbimbo C, Mirone V, Montorsi F, Salonia A. Premature ejaculation among men with erectile dysfunction-findings from a real-life cross-sectional study. Int J Impot Res 2023; 35:558-563. [PMID: 35915329 DOI: 10.1038/s41443-022-00601-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2022] [Revised: 07/08/2022] [Accepted: 07/12/2022] [Indexed: 01/23/2023]
Abstract
Concomitant sexual disorders have progressively shown increased prevalence in men at first outpatient presentation. We sought to i) estimate the prevalence of unreported premature ejaculation (PE) in a homogenous cohort of 1258 men seeking first medical help for erectile dysfunction (ED) as their primary compliant; ii) compare the baseline sociodemographic and clinical characteristics of men with only ED(ED-only) compared to those with ED and PE(ED + PE); and, iii) investigate the likelihood of detecting PE among men self-reporting only ED over a 16-year period at a single tertiary-referral centre. Descriptive statistics compared sociodemographic and clinical characteristics between ED-only patients and those with unreported concomitant primary/secondary PE(ED + PE). Logistic regression models predicted the risk of having ED + PE at baseline. Local polynomial regression models graphically explored the probability of reporting PE among ED men with ≤40 vs. 41-60 vs. >60 years over the analysed timeframe. Of all, 932 (74.1%) were ED-only and 326 (25.9%) ED + PE patients, respectively. ED + PE patients were younger, presented with fewer comorbidities, and lower rates of severe ED (all p ≤ 0.04). At multivariable logistic regression analysis, younger age (OR:0.98) and low sexual desire/interest (OR:1.54) were independently associated with ED + PE at first clinical assessment (all p = 0.03). The likelihood of detecting unreported concomitant primary/secondary PE among patients complaining of only ED at first presentation worrisomely increased among younger and middle-aged men over the last 16 years.
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Affiliation(s)
- Simone Cilio
- Division of Experimental Oncology/Unit of Urology, URI; IRCCS Ospedale San Raffaele, Milan, Italy
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, Urology Unit, University of Naples "Federico II", Naples, Italy
| | - Edoardo Pozzi
- Division of Experimental Oncology/Unit of Urology, URI; IRCCS Ospedale San Raffaele, Milan, Italy
- University Vita-Salute San Raffaele, Milan, Italy
| | - Giuseppe Fallara
- Division of Experimental Oncology/Unit of Urology, URI; IRCCS Ospedale San Raffaele, Milan, Italy
- University Vita-Salute San Raffaele, Milan, Italy
| | - Federico Belladelli
- Division of Experimental Oncology/Unit of Urology, URI; IRCCS Ospedale San Raffaele, Milan, Italy
- University Vita-Salute San Raffaele, Milan, Italy
| | - Christian Corsini
- Division of Experimental Oncology/Unit of Urology, URI; IRCCS Ospedale San Raffaele, Milan, Italy
- University Vita-Salute San Raffaele, Milan, Italy
| | - Alessia d'Arma
- Division of Experimental Oncology/Unit of Urology, URI; IRCCS Ospedale San Raffaele, Milan, Italy
| | - Luca Boeri
- Department of Urology, Foundation IRCCS Ca' Granda -Ospedale Maggiore Policlinico, University of Milan, Milan, Italy
| | - Paolo Capogrosso
- Department of Urology, Circolo & Fondazione Macchi Hospital -ASST Sette Laghi, Varese, Italy
| | - Ciro Imbimbo
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, Urology Unit, University of Naples "Federico II", Naples, Italy
| | - Vincenzo Mirone
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, Urology Unit, University of Naples "Federico II", Naples, Italy
| | - Francesco Montorsi
- Division of Experimental Oncology/Unit of Urology, URI; IRCCS Ospedale San Raffaele, Milan, Italy
- University Vita-Salute San Raffaele, Milan, Italy
| | - Andrea Salonia
- Division of Experimental Oncology/Unit of Urology, URI; IRCCS Ospedale San Raffaele, Milan, Italy.
- University Vita-Salute San Raffaele, Milan, Italy.
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de Mello Ferreira Dos Reis M, Barros EAC, Monteiro L, Pazeto CL, Baccaglini WRC, Glina S. Premature ejaculation prevalence among young men who have sex with men: a cross-sectional study with internet users in the metropolitan region of São Paulo, Brazil. Sex Med 2023; 11:qfac016. [PMID: 36910706 PMCID: PMC9978591 DOI: 10.1093/sexmed/qfac016] [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: 10/25/2022] [Revised: 11/18/2022] [Accepted: 11/23/2022] [Indexed: 03/06/2023] Open
Abstract
Background There are only a few studies about the prevalence and correlates of premature ejaculation (PE) among men who have sex with men (MSM). Aim (1) To estimate PE prevalence according to 3 assessment methods: self-reported time from penetration to ejaculation (ejaculation latency time [ELT]); Premature Ejaculation Diagnostic Tool (PEDT); and a direct question about the self-perception of ejaculation as being normal, too early (premature), or retarded. (2) To assess the agreement of the 3 assessment methods and identify factors associated with PE according to each method and their combination. Methods We evaluated data from 226 MSM who participated in a cross-sectional study about sexual behavior among men living in the metropolitan region of São Paulo, Brazil. They responded anonymously to an online survey between May 2019 and March 2020. We calculated the agreement of the 3 assessment methods and their association with other characteristics using logistic regression models. Outcomes Outcomes included the prevalence of PE according to the assessment methods and the association measures (PE vs sociodemographic characteristics and sexual behavior). Results The prevalence of PE among MSM was 21.2% (95% CI, 16.1%-27.1%) according to the PEDT, 17.3% (95% CI, 12.6%-22.8%) per self-report, and 6.2% (95% CI, 3.4%-10.2%) by estimated ELT ≤2 minutes. The agreement among the 3 assessments was fair (kappa, 0.31; 95% CI, 0.25-0.37; P < .001). Association with PE varied by assessment method: obesity and shorter time for ejaculation with anal sex vs masturbation were associated with PE according to the PEDT and ELT but not self-evaluation. Perception about ideal time to ejaculate ≤5 minutes increased the chance of PE based on ELT. Higher chances of self-reported PE were associated with trying to hold back ejaculation, and lower chances were associated with higher frequencies of masturbation. Clinical Implications Combining tools to investigate PE allows the identification of characteristics associated with this condition and may result in improvement in the care of MSM. Strengths and Limitations This anonymous online survey provided the privacy necessary for participants to respond freely about sensitive questions, with a low risk of social adequacy bias. However, as it was a secondary analysis of a larger study, it could not evaluate comorbidities (eg, erectile dysfunction, prostatitis, depression) and the use of condoms. Conclusion The prevalence of PE among MSM is high and varies according to the instrument used for the assessment, and the agreement among the 3 assessments was only fair.
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Affiliation(s)
| | | | - Leonardo Monteiro
- Urology Department, Faculdade de Medicina do ABC, Santo André (SP), Brazil
| | | | | | - Sidney Glina
- Urology Department, Faculdade de Medicina do ABC, Santo André (SP), Brazil
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Vallejo-Medina P, Saffon JP, Álvarez-Muelas A. Translation, adaptation, and clinical validation of the Premature Ejaculation Diagnostic Tool in Spanish (Colombia). Sex Med 2023; 11:qfac017. [PMID: 37007852 PMCID: PMC10065186 DOI: 10.1093/sexmed/qfac017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2022] [Revised: 11/30/2022] [Accepted: 12/06/2022] [Indexed: 02/04/2023] Open
Abstract
Background Premature ejaculation is the most prevalent form of sexual dysfunction in men. The Premature Ejaculation Diagnostic Tool (PEDT) is an instrument used to evaluate premature ejaculation. It offers adequate psychometric properties and good reliability. Aim To adapt and validate a Colombian version of the PEDT in Colombian clinical and nonclinical samples. Methods Two samples were used in this study. The first was made up of 1110 men who were recruited to evaluate validity and reliability. Their ages ranged from 19 to 65 years (mean ± SD, 39.71 ± 12.53). The second sample included 123 men (66.7%) who did not meet diagnostic criteria for premature ejaculation per the International Statistical Classification of Diseases and Related Health Problems (ICD-10), while 33.3% met ICD-10 criteria for this dysfunction. Their ages ranged from 18 to 65 years (34.19 ± 12.65). Scores were used to calculate the cutoff. Outcomes A translated and adapted version of the PEDT was developed specifically for Colombia. All participants completed the Colombian version of the PEDT, a sociodemographic questionnaire, the Colombian version of the Massachusetts General Hospital-Sexual Functioning Questionnaire, and a semistructured interview based on the ICD-10. Results The results showed adequate psychometric properties and satisfactory internal consistency and confirmed the 1-dimensional factorization of the scale. According to ICD-10 criteria, the study also confirmed significant differences between participants who self-reported premature ejaculation and those who did not. In addition, it showed adequate evidence of convergent validity, with a moderate correlation with sexual functioning scores. As a result, the cutoff point was set to 10.5, with an area under the curve of 96.8%. Therefore, a score ≥11 points suggested the presence of premature ejaculation. Clinical Translation The current Colombian version of the PEDT is a useful instrument that determines the presence of premature ejaculation that is compatible with ICD-10 criteria. Strengths and Limitations The Colombian version of the PEDT presents evidence of reliability and validity, a confirmed 1-dimensional factorization, and a cutoff point for Hispanic populations. More in-depth evaluation of the diagnosis of premature ejaculation is required, and further research among other Spanish-speaking countries and sexual minorities is recommended. Conclusion The Colombian version of the PEDT is a psychometric adequacy tool for evaluating and diagnosing premature ejaculation, following the ICD-10 criteria.
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Affiliation(s)
- Pablo Vallejo-Medina
- SexLabKL, School of Psychology, Fundación Universitaria Konrad Lorenz, Bogotá, Colombia
| | | | - Ana Álvarez-Muelas
- Centro de Investigación Mente, Cerebro y Comportamiento, Universidad de Granada, 18011, Granada, Spain
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Schifano N, Capogrosso P, Antonini G, Baldini S, Scroppo F, Salonia A, Zerbinati N, Dehò F. The Application of Hyaluronic Acid Injections in Functional and Aesthetic Andrology: A Narrative Review. Gels 2023; 9:gels9020118. [PMID: 36826290 PMCID: PMC9957416 DOI: 10.3390/gels9020118] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2023] [Revised: 01/25/2023] [Accepted: 01/26/2023] [Indexed: 02/04/2023] Open
Abstract
Hyaluronic acid (HA) is a glycosaminoglycan widely utilised in different fields of medicine. We aimed to provide a comprehensive overview of the scientific evidence on the use of HA in andrology. A review of the literature to identify pertinent studies concerning the use of HA in andrology was carried out on the Medline, EMBASE, and the Cochrane databases, with no time restriction up to December 2022. Penile girth enlargement (PGE) using HA proved to be safe and effective in enhancing the diameter of the penis, with durable and satisfactory outcomes in long-term follow-up. Injection of HA in the glans seems to represent an alternative treatment option for those patients with premature ejaculation (PE) who fail to respond to conventional medications. HA intra-plaque injections represent a valid option which may contribute to restore sexual activity in patients with Peyronie's disease (PD). The adoption of HA filler injections should always be tailored to the patient's peculiar anatomy and underlying condition. More robust evidence is required to achieve a uniformed consensus regarding the use of HA in andrology, and further efforts should continue to improve the current injection techniques and HA products.
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Affiliation(s)
- Nicolò Schifano
- ASST Sette Laghi–Circolo e Fondazione Macchi Hospital, 21100 Varese, Italy
| | - Paolo Capogrosso
- ASST Sette Laghi–Circolo e Fondazione Macchi Hospital, 21100 Varese, Italy
| | - Gabriele Antonini
- ASST Sette Laghi–Circolo e Fondazione Macchi Hospital, 21100 Varese, Italy
- Antonini Urology, 00185 Rome, Italy
| | - Sara Baldini
- ASST Sette Laghi–Circolo e Fondazione Macchi Hospital, 21100 Varese, Italy
| | - Fabrizio Scroppo
- ASST Sette Laghi–Circolo e Fondazione Macchi Hospital, 21100 Varese, Italy
| | - Andrea Salonia
- Department of Urology, Università Vita-Salute San Raffaele, 20132 Milan, Italy
- Unit of Urology, Division of Experimental Oncology, Urology Research Institute (URI), IRCCS Ospedale San Raffaele, 20132 Milan, Italy
| | - Nicola Zerbinati
- ASST Sette Laghi–Circolo e Fondazione Macchi Hospital, 21100 Varese, Italy
| | - Federico Dehò
- ASST Sette Laghi–Circolo e Fondazione Macchi Hospital, 21100 Varese, Italy
- Correspondence:
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Cai T, Gallelli L, Verze P, Salonia A, Palmieri A. Prilocaine/lidocaine spray for the treatment of premature ejaculation: a dose- and time-finding study for clinical practice use. Int J Impot Res 2022:10.1038/s41443-022-00554-8. [PMID: 35314817 DOI: 10.1038/s41443-022-00554-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2021] [Revised: 02/24/2022] [Accepted: 03/03/2022] [Indexed: 11/09/2022]
Abstract
A eutectic mixture of prilocaine/lidocaine spray (Fortacin™, Recordati, Milan, Italy) has been approved for the management of patients affected by life-long premature ejaculation (PE), but to date, there is a lack of dose- or time-finding studies in the literature that indicate the best method of intake to optimize treatment outcomes. In this multicentre, randomized, two-phase study, we aimed to compare, in terms of treatment effectiveness (primary objective) and safety (secondary objective), different treatment regimens (various doses and times of drug delivery) of Fortacin™ in 91 patients affected with lifelong PE who were recruited at four different centres and randomized (1:1:1 ratio) into three different groups. The study included two phases: during the first phase (focused on time-finding), the same drug dose (three sprays) was taken at different intervals before intercourse (5, 15, 30 min). In the second phase (focused on dose finding), different drug doses (1, 3, 5 sprays) were taken at the same interval before intercourse (5 min). The main outcome measure instruments were self-measured intravaginal ejaculation latency time (sm-IELT), the premature ejaculation diagnostic tool (PEDT), and the International Index of Erectile Function-5 (IIEF-5). Furthermore, patients were asked to report any side effects that appeared during the study period. Our main study findings showed that the treatment regimen with three sprays of Fortacin™ administered 5 min before sexual intercourse showed the best results in terms of ejaculation time and control (Phase I, IELT 221 ± 3.4, PEDT 7.7 ± 0.3; Phase II, IELT 213 ± 4.9, PEDT 7.8 ± 0.4) with a safety profile that was identical to other treatment regimens. Based on these data, patients who are prescribed Fortacin™ should stick to this regimen to optimize treatment results.
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Affiliation(s)
- Tommaso Cai
- Department of Urology, Santa Chiara Regional Hospital, Trento, Italy. .,Institute of Clinical Medicine, University of Oslo, Oslo, Norway.
| | - Luca Gallelli
- Department of Health Sciences, University of Catanzaro, Catanzaro, Italy.,Clinical Pharmacology and Pharmacovigilance Unit, Mater Domini Hospital, Catanzaro, Italy
| | - Paolo Verze
- Department of Medicine, Surgery, Dentistry "Scuola Medica Salernitana", -University of Salerno, Baronissi, Italy
| | - Andrea Salonia
- Division of Experimental Oncology/Unit of Urology, URI; IRCCS Ospedale San Raffaele, Milan, Italy.,University Vita-Salute San Raffaele, Milan, Italy
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Zhang T, Yuan P, Cui Y, Yuan W, Jiang D. Convergent and Divergent Structural Connectivity of Brain White Matter Network Between Patients With Erectile Dysfunction and Premature Ejaculation: A Graph Theory Analysis Study. Front Neurol 2022; 13:804207. [PMID: 35273555 PMCID: PMC8902049 DOI: 10.3389/fneur.2022.804207] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2021] [Accepted: 01/20/2022] [Indexed: 11/13/2022] Open
Abstract
Background Sexual dysfunction, namely, erectile dysfunction (ED) and premature ejaculation (PE), has been found to be associated with abnormal structural connectivity in the brain. Previous studies have mainly focused on a single disorder, however, convergent and divergent structural connectivity patterns of the brain network between ED and PE remain poorly understood. Methods T1-weighted structural data and diffusion tensor imaging data of 28 patients with psychological ED, 28 patients with lifelong PE (LPE), and 28 healthy controls (HCs) were obtained to map the white matter (WM) brain networks. Then, the graph-theoretical method was applied to investigate the differences of network properties (small-world measures) of the WM network between patients with ED and LPE. Furthermore, nodal segregative and integrative parameters (nodal clustering coefficient and characteristic path length) were also explored between these patients. Results Small-world architecture of the brain networks were identified for both psychological ED and LPE groups. However, patients with ED exhibited increased average characteristic path length of the brain network when compared with patients with LPE and HCs. No significant difference was found in the average characteristic path length between patients with LPE and HCs. Moreover, increased nodal characteristic path length was found in the right middle frontal gyrus (orbital part) of patients with ED and LPE when compared with HCs. In addition, patients with ED had increased nodal characteristic path length in the right middle frontal gyrus (orbital part) when compared with patients with LPE. Conclusion Together, our results demonstrated that decreased integration of the right middle frontal gyrus (orbital part) might be a convergent neuropathological basis for both psychological ED and LPE. In addition, patients with ED also exhibited decreased integration in the whole WM brain network, which was not found in patients with LPE. Therefore, altered integration of the whole brain network might be the divergent structural connectivity patterns for psychological ED and LPE.
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Affiliation(s)
- Tielong Zhang
- Department of Urology, The Affiliated Jianhu Hospital of Nantong University, Jianhu People's Hospital, Yancheng, China
| | - Peng Yuan
- Department of Intervention, The Affiliated Jianhu Hospital of Nantong University, Jianhu People's Hospital, Yancheng, China
| | - Yonghua Cui
- Department of Neurosurgery, The Affiliated Jianhu Hospital of Nantong University, Jianhu People's Hospital, Yancheng, China
| | - Weibiao Yuan
- Department of Radiology, The Affiliated Jianhu Hospital of Nantong University, Jianhu People's Hospital, Yancheng, China
| | - Daye Jiang
- Department of Urology, The Affiliated Jianhu Hospital of Nantong University, Jianhu People's Hospital, Yancheng, China
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11
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Patients with chronic diseases: is sexual health brought up by general practitioners during appointments? A web-based study. Maturitas 2022; 160:16-22. [DOI: 10.1016/j.maturitas.2022.01.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2021] [Revised: 01/17/2022] [Accepted: 01/22/2022] [Indexed: 11/15/2022]
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12
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Bimbatti D, Lai E, Pierantoni F, Maruzzo M, Msaki A, De Toni C, Dionese M, Feltrin A, Basso U, Zagonel V. Patient Reported Outcomes, Paternity, Relationship, and Fertility in Testicular Cancer Survivors: Results from a Prospective Observational Single Institution Trial. Patient Prefer Adherence 2022; 16:3393-3403. [PMID: 36582267 PMCID: PMC9793790 DOI: 10.2147/ppa.s381812] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/15/2022] [Accepted: 10/29/2022] [Indexed: 12/24/2022] Open
Abstract
PURPOSE Testicular cancer (TC) is the most common solid tumor in young adults. 95% of patients are cured, but they may experience late adverse effects (anxiety, fear of recurrence, and sexual dysfunction) with an impact on daily life. We attempted to assess Patient Reported Outcomes (PROMs), long-term sexual disorders, and difficulties in achieving fatherhood in a cohort of TC survivors, as well as their possible correlation with previous cancer treatments. METHODS Different questionnaires, such as the Impact of Cancer (IOC) and the Body Image Scale (BIS), were used to investigate the distinct areas of the PROMs. International Index of Erectile Function (IIEF15) and the Premature Ejaculation Diagnostic Tool (PEDT) focused on sexuality and fertility. Patients were prospectively recruited between February 2020 and February 2022. RESULTS 144 participants completed all the questionnaires. Results showed a good QoL, a moderate fear of TC recurrence, a good satisfaction with their personal body image, low incidence of premature ejaculation and erectile dysfunction. 19.5% of patients who had a testicular implant reported general dissatisfaction. Only 18% of patients had unsuccessfully attempted fatherhood, while the majority had not yet tried, and 23.4% succeeded. A low percentage of patients used procedures assisted reproduction and adoption. CONCLUSION This trial supports the use of various questionnaires as a multifactorial tool capable of investigating all the aspects of long-term cancer survivorship. The assessment of medical and psychosocial sequelae is an essential part of patient care and is important for the development of a comprehensive care plan for TC survivors.
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Affiliation(s)
- Davide Bimbatti
- Oncology 1 Unit, Istituto Oncologico Veneto IOV – IRCCS, Padua, Italy
- Correspondence: Davide Bimbatti, Oncology 1 Unit, Istituto Oncologico Veneto, IOV - IRCCS, via Gattamelata 64, Padova, 35128, Italy, Email
| | - Eleonora Lai
- Oncology 1 Unit, Istituto Oncologico Veneto IOV – IRCCS, Padua, Italy
- Department of Surgery, Oncology, and Gastroenterology, University of Padua, Padua, Italy
| | - Francesco Pierantoni
- Department of Surgery, Oncology, and Gastroenterology, University of Padua, Padua, Italy
- Oncology 3 Unit, Istituto Oncologico Veneto IOV – IRCCS, Padua, Italy
| | - Marco Maruzzo
- Oncology 1 Unit, Istituto Oncologico Veneto IOV – IRCCS, Padua, Italy
| | - Aichi Msaki
- Oncology 1 Unit, Istituto Oncologico Veneto IOV – IRCCS, Padua, Italy
| | - Chiara De Toni
- Oncology 1 Unit, Istituto Oncologico Veneto IOV – IRCCS, Padua, Italy
| | - Michele Dionese
- Oncology 1 Unit, Istituto Oncologico Veneto IOV – IRCCS, Padua, Italy
- Department of Surgery, Oncology, and Gastroenterology, University of Padua, Padua, Italy
| | - Alessandra Feltrin
- Hospital Psychology Unit, Istituto Oncologico Veneto IOV – IRCCS, Padua, Italy
| | - Umberto Basso
- Oncology 1 Unit, Istituto Oncologico Veneto IOV – IRCCS, Padua, Italy
| | - Vittorina Zagonel
- Oncology 1 Unit, Istituto Oncologico Veneto IOV – IRCCS, Padua, Italy
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13
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Premature Ejaculation Among Internet Users Living in the Metropolitan Region of São Paulo, Brazil: A Cross-Sectional Comparison Between the Premature Ejaculation Diagnostic Tool (PEDT) and Patient-Reported Latency Time and Perception. Sex Med 2021; 10:100463. [PMID: 34894607 PMCID: PMC8847830 DOI: 10.1016/j.esxm.2021.100463] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2021] [Revised: 09/25/2021] [Accepted: 10/26/2021] [Indexed: 11/24/2022] Open
Abstract
Background Premature ejaculation (PE) prevalence can vary according to different definitions, assessment methods and populational demographics and culture. Aims To investigate the differences between men classified as having “probable PE” (PEDT≥11), “possible PE” (PEDT = 9 or 10) or “no PE” (PEDT≤8) according to the Premature Ejaculation Diagnostic Tool (PEDT) criteria in regard to sociodemographic characteristics, and sexual and relational behavior. To assess the agreement of prevalence of PE according to 3 assessment methods: (i) the ejaculation latency time (ELT) according to the participant's memory; (ii) PEDT and (iii) a direct question about the self-perception of ejaculation as being normal, too early (premature) or retarded. Methods In this web-based cross-sectional study, men aged ≥ 18 years living in the metropolitan region of São Paulo, Brazil, responded anonymously to an online survey. We used multinomial regression to estimate the association between PE according PEDT criteria and other features and the kappa coefficient to estimate agreement between the assessment methods. Outcomes Association between PEDT-PE, sociodemographic characteristics and sexual and relational behaviors; agreement between PEDT, ELT and self-perception of PE. Results Obesity, trying to hold back ejaculation, short or nonexistent foreplay and age <30 years were associated with PEDT ≥11. Men who considered that latency was shorter for oral, anal and vaginal sex than for masturbation were more likely to have probable PE according to PEDT. Possible PE (PEDT scores 9/10) was associated with trying to hold back ejaculation and considering time for ejaculation shorter for vaginal sex. There was fair agreement between assessments (kappa 0.39; CI:0.28 –0.42; P < .001). Conclusion PE prevalence varies according to instruments and cut-offs used, with fair agreement between them. This finding shows that the methods evaluate different aspects of the EP syndrome and they must be combined to allow the discrimination between the different types of PE and treatments. Clinical approaches should consider the sexual behavior and relationship of the patient and their distress. dos Reis M de MF, Barros EAC, Monteiro L, et al. Premature Ejaculation Among Internet Users Living in the Metropolitan Region of São Paulo, Brazil: A Cross-Sectional Comparison Between the Premature Ejaculation Diagnostic Tool (PEDT) and Patient-Reported Latency Time and Perception. Sex Med 2022;10:100463.
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Albakr A, Arafa M, Elbardisi H, ElSaid S, Majzoub A. Premature ejaculation: An investigative study into assumptions, facts and perceptions of patients from the Middle East (PEAP STUDY). Arab J Urol 2021; 19:303-309. [PMID: 34552781 PMCID: PMC8451653 DOI: 10.1080/2090598x.2021.1948159] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Objective: To determine the prevalence of premature ejaculation (PE) in Qatar as a representative of the Middle East region and the population perception of normal ejaculation. Subjects and methods: This study was a cross-sectional, observational, non-interventional, epidemiological study, conducted from February 2012 to February 2013. Randomly selected married males were asked to answer two questionnaires in a direct interview. The first questionnaire assessed the PE complaint, the time between ejaculation and intromission (actual intravaginal ejaculatory latency time [IELT-a]), and the perceived normal average time between intromission and ejaculation (IELT-p). The second questionnaire used was the Arabic Index of Premature Ejaculation (AIPE). Results: A total of 3042 subjects were included. The mean (SD) age was 37.09 (9.1) years. The prevalence of PE in Qatar using the self-report and AIPE score was 38.5% and 36.2%, respectively. The median (interquartile range) IELT-a and IELT-p were 5 (3–13.5) and 15 (5–15) min. In the AIPE-confirmed PE group, and according to the AIPE severity classification, the differences in IELT-a and IELT-p between the severity groups were highly significant, with the duration of both IELT-a and ILET-p being higher in AIPE-No-PE and mild-PE groups (P < 0.001 for both). A negative correlation was found between AIPE score and age in the PE group. Conclusion: The prevalence of PE in Qatar is high. PE prevalence was found to increase with age. The IELT and perception of normal IELT were both correlated with the severity of PE.
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Affiliation(s)
- Ahmad Albakr
- Urology Department, Hamad Medical Corporation, Doha, Qatar
| | - Mohamed Arafa
- Urology Department, Hamad Medical Corporation, Doha, Qatar.,Andrology Department, Cairo University, Cairo, Egypt.,Urology Department, Weill Cornell Medicine-Qatar, Doha, Qatar.,American Center for Reproductive Medicine, Cleveland, OH, USA
| | - Haitham Elbardisi
- Urology Department, Hamad Medical Corporation, Doha, Qatar.,Urology Department, Weill Cornell Medicine-Qatar, Doha, Qatar
| | - Sami ElSaid
- Urology Department, Hamad Medical Corporation, Doha, Qatar.,Urology Department, Weill Cornell Medicine-Qatar, Doha, Qatar
| | - Ahmad Majzoub
- Urology Department, Hamad Medical Corporation, Doha, Qatar.,Urology Department, Weill Cornell Medicine-Qatar, Doha, Qatar.,American Center for Reproductive Medicine, Cleveland, OH, USA
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15
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Califano G, Arcaniolo D, Ruvolo CC, Manfredi C, Smarrazzo F, Cilio S, Verze P. Glans penis augmentation: when, how, and why? Int J Impot Res 2021; 34:343-346. [PMID: 34400809 DOI: 10.1038/s41443-021-00464-1] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2021] [Revised: 07/10/2021] [Accepted: 07/28/2021] [Indexed: 11/09/2022]
Abstract
The growing demand for glans penis augmentation (GPA) makes it a hot topic in the field of andrological surgery, albeit still widely debated. The lack of high supporting evidence and its technically challenging aspects are the main concerns. The aim of this study was to review the current literature about GPA in order to provide an easy and comprehensive overview of the topic. GPA is suitable for managing both cosmetic and functional issues. Counseling should be the cornerstone of the decision-making process. A thorough understanding of the glans anatomy and treatment strategies remain essential to safely and effectively address the patient's needs. GPA can be performed using injectable fillers or surgical grafting. Glans-shaft penis asymmetries, small glans size, and loss of glans tumescence can be managed by both injectable fillers and surgery. On the other hand, patients with lifelong premature ejaculation can mainly benefit from using injectable fillers. Currently, available studies show promising results but are limited by small sample's size and non-randomized design. Furthermore, treatment-related complications are poorly reported. The long-term efficacy and safety profiles of GPA techniques should be further investigated.
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Affiliation(s)
- Gianluigi Califano
- Urology Unit, Department of Neurosciences, Reproductive Sciences and Odontostomatology, University of Naples Federico II, Naples, Italy
| | - Davide Arcaniolo
- Urology Unit, Department of Medicine and Surgery, University of Naples Luigi Vanvitelli, Naples, Italy
| | - Claudia Collà Ruvolo
- Urology Unit, Department of Neurosciences, Reproductive Sciences and Odontostomatology, University of Naples Federico II, Naples, Italy
| | - Celeste Manfredi
- Urology Unit, Department of Medicine and Surgery, University of Naples Luigi Vanvitelli, Naples, Italy
| | - Francesco Smarrazzo
- Urology Unit, Department of Medicine, Surgery, Dentistry "Scuola Medica Salernitana"-University of Salerno, Baronissi, Italy
| | - Simone Cilio
- Urology Unit, Department of Neurosciences, Reproductive Sciences and Odontostomatology, University of Naples Federico II, Naples, Italy
| | - Paolo Verze
- Urology Unit, Department of Medicine, Surgery, Dentistry "Scuola Medica Salernitana"-University of Salerno, Baronissi, Italy.
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16
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Tannenbaum J, Youssef M, Attia AS, Hsieh TC, Raheem O. Hyperthyroidism as an Underlying Cause of Premature Ejaculation. Sex Med Rev 2021; 10:108-112. [PMID: 34219006 DOI: 10.1016/j.sxmr.2021.03.005] [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: 12/18/2020] [Revised: 03/12/2021] [Accepted: 03/16/2021] [Indexed: 11/25/2022]
Abstract
INTRODUCTION Hormonal imbalances have been associated with various sexual dysfunction disorders. In particular, the connection of hyperthyroidism has been discovered to correlate to premature ejaculation (PE) but has yet to been thoroughly elucidated. As one of the most frequently self-reported sexual dysfunctions, it is imperative for health care professionals to evaluate possible underlying conditions in regard to treatment options for individuals with PE. OBJECTIVES To review the literature regarding hyperthyroidism effects on sexual dysfunction, with a focus on hyperthyroidism and PE. METHODS A literature review of articles and clinical studies was performed to define the classification, pathophysiology, diagnostic considerations, and management of hyperthyroidism on PE. Search terms included "hyperthyroidism" and/or "premature ejaculation," "treatment of premature ejaculation," "defining premature ejaculation," and "management of premature ejaculation." RESULTS To improve the accuracy of diagnosing PE, there needs to be a set definition amongst the different guidelines, as using these guidelines can help determine possible underlying etiologies of PE. The correlation of hyperthyroidism and PE has been described in a limited number of studies. It has been reported that individuals with hyperthyroidism are much more likely to have PE than individuals with euthryoidism. Management of hyperthyroidism has been shown to alleviate the symptoms of PE. CONCLUSION Further understanding of hyperthyroidism as an underlying cause of PE could lead to increased efficacy of treatment and management of PE. Tannenbaum J, Youssef M, Attia AS, et al. Hyperthyroidism as an Underlying Cause of Premature Ejaculation. Sex Med Rev 2021;XX:XXX-XXX.
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Affiliation(s)
- Jacob Tannenbaum
- Tulane University School of Medicine, Department of Urology, New Orleans, USA
| | - Mohanad Youssef
- Tulane University School of Medicine, Department of Surgery, New Orleans, USA
| | - Abdallah S Attia
- Tulane University School of Medicine, Department of Surgery, New Orleans, USA
| | | | - Omer Raheem
- Tulane University School of Medicine, Department of Urology, New Orleans, USA.
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17
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Pavone C, Di Fede AS, Mannone P, Tulone G, Bishqemi A, Abrate A, La Milia V, Serretta V, Simonato A. Sexual dysfunction in dialytic patients. A prospective cross-sectional observational study in two hemodialysis centers. ACTA ACUST UNITED AC 2021; 93:215-220. [PMID: 34286559 DOI: 10.4081/aiua.2021.2.215] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2020] [Accepted: 12/28/2020] [Indexed: 11/23/2022]
Abstract
OBJECTIVES Incidence and prevalence of patients in dialytic therapy increased considerably in recent years. The onset of new issues, once overshadowed, linked to a lower quality of life like sexual dysfunction became increasingly common. The first study in this area, dating back to the 1970s, shows the high prevalence of sexual dysfunction among patients in dialytic therapy of both sexes. Later studies proved an association of sexual dysfunction with psyche disorders, anxiety, depression and lack of self-confidence. The aim of this study is to describe the incidence of male and female sexual main dysfunctions, the latter not least in literature, in patients in hemodialytic therapy. With this aim two dialytic centers have been compared, one located in northern Italy and one in southern Italy, and the different prevalence has been compared to the general population. METHODS We conducted a prospective cross-sectional observational study in patients undergoing dialytic therapy in two hemodialysis centers, one located in Palermo and one in Lecco. Male sexual dysfunction was investigated by the International Index of Erectile Function-15 (IIEF15) questionnaire and the Premature Ejaculation Diagnotic Tool (PEDT) questionnaire, and the female dysfunction by Female Sexual Function Index (FSFI) questionnaire. Criteria for inclusion in our study were: age < 75 years and dialytic age > 3 months; exclusion criteria were: advanced cancer diseases, life expectancy < 6 months, previous urological manipulation, anti-androgenic therapy, sexual dysfunction unrelated to kidney disease, psychiatric disorders. Data were compared with mean-standard deviation (SD) and with the variance analysis (ANOVA). A value of p < 0.05 is considered significant. Discrete data were analyzed with contingency analysis. A chi2 < 0.05 was considered significant. RESULTS Data of 78 patients have been collected. Mean age and dialytic time were 54 ± 12 years and 42 ± 35 month; 33 patients were from Palermo and 24 from Lecco; 21 patients were excluded. Age and dialytic age of the two subgroups did not demonstrate statistically significant differences. Between the two centers there was a statistically significant difference (p < 0.005) in the distribution of basic nephropathy: an higher incidence of diabetic and obstructive nephropathy has been observed in the southern center compared to northern center, while glomerulonephritis and polycystic kidney disease had an higher incidence in the northern center compared to southern one. The main sexual dysfunctions in both sexes, erectile dysfunction (ED) and premature ejaculation (PE) in men and orgasm disorder and pelvic pain in women, have been investigated. ED was present in 70% of hemodialyzed patients, which is an higher incidence compared to the general population. The severity of ED between patients of the two groups was significantly different (chi2 < 0.001) with higher incidence of moderate/severe forms in northern Italy. The score, in addition to discrete data (severe, moderate, mild, absence), of ED was significantly different (p < 0.001) between patients of the two centers (22 ± 7 Palermo vs. 9 ± 8, Lecco). The PE was absent in 20 patients (54%), present in 12 patients (32%) and probable in 5 patients (14%) (scores of 7.6 ± 4.0 and 8.9 ± 6.8, respectively in Palermo and Lecco patients). For women, orgasmic dysfunction was severe in 10 patients (50%), mild in 4 patients (20%), very mild in 5 patients (25%), while it was normal in 1 patient (5%), with a statistically significant difference (p< 0.05) between Palermo and Lecco patients (3.0 ± 1.4 vs 1.2 ± 2.0). Sexual pain in women was severe in 11 patients (55%), moderate in 4 patients (20%) and mild in 5 patients (25%). Sexual pain was present in all patients (p < 0.05). CONCLUSIONS Regardless of sex, sexual dysfunction is one of the most common side effect in patients with end stage renal disease in dialytic therapy. Our study confirms literature data. The growing number of the dialytic population with sexual disorders needs specialist support to improve quality of life of these patients.
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Affiliation(s)
- Carlo Pavone
- Department of Surgical, Oncological and Oral Sciences, Section of Urology, University of Palermo.
| | - Antonio Simone Di Fede
- Department of Surgical, Oncological and Oral Sciences, Section of Urology, University of Palermo.
| | - Piero Mannone
- Department of Surgical, Oncological and Oral Sciences, Section of Urology, University of Palermo.
| | - Gabriele Tulone
- Department of Surgical, Oncological and Oral Sciences, Section of Urology, University of Palermo.
| | - Arjan Bishqemi
- Department of Surgical, Oncological and Oral Sciences, Section of Urology, University of Palermo.
| | - Alberto Abrate
- Department of Surgery, Urology Unit, ASST Valtellina e Alto Lario, Sondrio.
| | | | - Vincenzo Serretta
- Department of Surgical, Oncological and Oral Sciences, Section of Urology, University of Palermo.
| | - Alchiede Simonato
- Department of Surgical, Oncological and Oral Sciences, Section of Urology, University of Palermo.
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Corona G, Rastrelli G, Bartfai G, Casanueva FF, Giwercman A, Antonio L, Slowikowska J, Tournoy J, Punab M, Huhtaniemi IT, Vanderschueren D, O'Neill TW, Wu FCW, Maggi M. Self-Reported Shorter Than Desired Ejaculation Latency and Related Distress-Prevalence and Clinical Correlates: Results From the European Male Ageing Study. J Sex Med 2021; 18:908-919. [PMID: 33820727 DOI: 10.1016/j.jsxm.2021.01.187] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2020] [Revised: 01/25/2021] [Accepted: 01/29/2021] [Indexed: 01/23/2023]
Abstract
BACKGROUND Few data have looked at the occurrence and clinical correlates of self-reported shorter than desired ejaculation latency (rapid ejaculation, RE) and its related distress in the general population. AIM To determine the prevalence and clinical correlates of self-reported RE and RE- related distress in middle age and older European men. METHODS Subjects were recruited from population samples of men aged 40-79 years across 8 European centers. OUTCOMES Self-reported RE and its related distress were derived from the European male Aging Study (EMAS) sexual function questionnaire (EMAS-SFQ). Beck's depression Inventory (BDI) was used for the quantification of depressive symptoms, the Short Form 36 health survey (SF-36) for the assessment of the quality of life, the International Prostate Symptom Score (IPSS) for the evaluation of lower urinary tract symptoms. RESULTS About 2,888 community dwelling men aged 40-79 years old (mean 58.9 ± 10.8 years) were included in the analysis. Among the subjects included, 889 (30.8%) self-reported RE. Among them, 211 (7.3%) claimed to be distressed (5.9% and 1.4% reported mild or moderate-severe distress, respectively). Increasing levels of RE-related distress were associated with a progressive worse sexual functioning, higher risk of ED and with couple impairment, along with a higher prevalence of depressive symptoms (all P < 0.05). Furthermore, a worse quality of life and higher IPSS score were associated with RE-related distress (all P < 0.05). The aforementioned results were confirmed even when patients using drugs possibly interfering with ejaculation or those without a stable relationship were excluded from the analysis. CLINICAL IMPLICATIONS RE is a frequent condition in men from the general population; however, its related distress is relatively modest. Nonetheless, men with any degree of self-reported RE show increasing levels of depression, worse quality of life and worse couple satisfaction. STRENGTHS & LIMITATIONS This is the first study estimating the prevalence of self-reported RE and its related distress, along with their biological and psychological correlates, in a population sample of European middle age and older men. However, is should be recognized that the diagnosis of RE was derived from patient reports and not supported by Intra-ejaculatory-Latency-Time (IELT) measurements. CONCLUSION Self-reported RE is relatively common in European men aged more than 40 years. The reported limited RE-related distress may explain the relatively low number of medical consultations for RE. RE-related distress is associated with worse sexual function, couple impairment, and more LUTS resulting in a worse quality of life and mood disturbances. Corona G, Rastrelli G, Bartfai G, et al. Self-Reported Shorter Than Desired Ejaculation Latency and Related Distress-Prevalence and Clinical Correlates: Results From the European Male Ageing Study. J Sex Med Rev 2021;18:908-919.
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Affiliation(s)
- Giovanni Corona
- Endocrinology Unit, Medical Department, AziendaUsl, Maggiore-Bellaria Hospital, Bologna, Italy
| | - Giulia Rastrelli
- Andrology, Women's Endocrinology and Gender Incongruence Unit, Mario Serio" Department of Experimental and Clinical Biomedical Sciences, University of Florence, Florence, Italy
| | - Gyorgy Bartfai
- Department of Obstetrics, Gynaecology and Andrology, Albert Szent-Gyorgy Medical University, Szeged, Hungary
| | - Felipe F Casanueva
- Department of Medicine, Santiago de Compostela University, Complejo Hospitalario Universitario deSantiago (CHUS), Santiago de Compostela, Spain; CIBER de Fisiopatología Obesidad y Nutricion (CB06/03), Instituto Salud Carlos III, Santiago deCompostela, Spain
| | - Aleksander Giwercman
- Reproductive Medicine Centre, Malmö University Hospital, University of Lund, Lund, Sweden
| | - Leen Antonio
- Department of Andrology and Endocrinology, Katholieke Universiteit Leuven, Leuven, Belgium
| | - Jolanta Slowikowska
- Department of Andrology and Reproductive Endocrinology, Medical University of Lodz, Lodz, Poland
| | - Jos Tournoy
- Department of Andrology and Endocrinology, Katholieke Universiteit Leuven, Leuven, Belgium
| | - Margus Punab
- Andrology Unit, United Laboratories of Tartu University Clinics, Tartu, Estonia
| | - Ilpo T Huhtaniemi
- Department of Metabolism, Digestion and Reproduction, Institute of Reproductive and Developmental Biology, Imperial College London, London, UK; Institute of Biomedicine, Research Centre for Integrative Physiology and Pharmacology, University of Turku, Turku, Finland
| | - Dirk Vanderschueren
- Department of Andrology and Endocrinology, Katholieke Universiteit Leuven, Leuven, Belgium
| | | | - Frederick C W Wu
- Department of Endocrinology, Manchester Royal Infirmary, The University of Manchester, Manchester, UK
| | - Mario Maggi
- Endocrinology Unit, Mario Serio" Department of Experimental and Clinical Biomedical Sciences, University of Florence, Florence, Italy.
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Verze P, La Rocca R, Spirito L, Califano G, Venturino L, Napolitano L, Cardi A, Arcaniolo D, Rosati C, Palmieri A, Mirone V. Premature Ejaculation patients and their partners: arriving at a clinical profile for a real optimization of the treatment. ACTA ACUST UNITED AC 2021; 93:42-47. [PMID: 33754608 DOI: 10.4081/aiua.2021.1.42] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2020] [Accepted: 05/15/2020] [Indexed: 11/23/2022]
Abstract
The aim of the study is to extrapolate clinical features of Premature Ejaculation (PE) patients and female partners of men affected with PE, in order to get a profile that can be of assistance for physicians within the dynamics of a couple, one of which is a PE patient. An observational, non-interventional, cross-sectional epidemiological study entitled IPER (Italian Premature Ejaculation Research) was conducted and included two different cohorts of subjects that were randomly sampled from a patient dataset of selected General Practitioners: 1. IPER-M sub-cohort (1.104 subjects) was made of male subjects in which they were then distinguished patients with or without PE based on the score of the PEDT questionnaire; IPER-F sub-cohort (1.109 subjects) was made of female subjects from an independent sample of women (therefore not the partners of the IPER-M males) in which they then distinguished those partners of a male subject with PE or not. In addition to an identical general questionnaire to explore demographic aspects and habits, each subcohort was then evaluated using validated questionnaires. No differences were noted between PE+/PE- patients in terms of alcohol consumption, smoking habits, physical activity nor stress condition in everyday life, employment, socio-economic class and marital status. While the prevalence of PE proportionally increased with age, excluding the 50-59 and 70-80 years decades, in the IPER-M group an overall statistically significant difference for the mean age between the PE+ and PE- groups (p = 0.002) was detected, but without reaching any difference amongst the different age classes in the IPER-F group. The PE+ patients reported a significantly lower frequency rate of sexual intercourse, worse QoL (p = 0.006 and p < 0.0001, respectively), and increased anxiety status (p < 0.0001 for both subgroups). This study shows that, rather than talking with a patient affected by PE it would be advisable to introduce the concept of couple counseling with the person patient and his partner, because it is only through classification of both partners as one couple and a full understanding of their mutual sexual experience that PE treatment can be optimized and its results measured accurately.
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Affiliation(s)
- Paolo Verze
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, Urology Section, University of Naples Federico II, Naples.
| | - Roberto La Rocca
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, Urology Section, University of Naples Federico II, Naples.
| | - Lorenzo Spirito
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, Urology Section, University of Naples Federico II, Naples.
| | - Gianluigi Califano
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, Urology Section, University of Naples Federico II, Naples.
| | - Luca Venturino
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, Urology Section, University of Naples Federico II, Naples.
| | - Luigi Napolitano
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, Urology Section, University of Naples Federico II, Naples.
| | | | | | - Claudia Rosati
- Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples.
| | - Alessandro Palmieri
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, Urology Section, University of Naples Federico II, Naples.
| | - Vincenzo Mirone
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, Urology Section, University of Naples Federico II, Naples.
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Xi Y, Colonnello E, Ma G, Limoncin E, Ciocca G, Zhang H, Jannini EA, Zhang Y. Validity of Erectile Function Assessment Questionnaires in Premature Ejaculation Patients: A Comparative Study Between the Abridged Forms of the International Index of Erectile Function and Proposal for Optimal Cutoff Redefinition. J Sex Med 2020; 18:440-447. [PMID: 33384239 DOI: 10.1016/j.jsxm.2020.11.018] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2020] [Revised: 11/28/2020] [Accepted: 11/30/2020] [Indexed: 01/23/2023]
Abstract
BACKGROUND Patients with premature ejaculation (PE) are often diagnosed as having a comorbid erectile dysfunction (ED). When evaluating erectile function in PE patients with the popular International Index of Erectile Function-5 (IIEF-5, or Sexual Health Inventory for Men [SHIM]), question #5 (Q5) about sexual satisfaction in the intercourse often lowers the total score of the questionnaire, giving false-positive results for the presence of ED. AIM We aimed to compare SHIM with the other abridged form of IIEF, which is IIEF-EF, and to discriminate which tool has the best diagnostic accuracy in the evaluation of erectile function in PE patients. METHODS The study was conducted from March 2019 to January 2020. A total of 189 heterosexual males with lifelong PE (117, 61.9%) or acquired PE (72, 38.1%) were included. They all compiled Premature Ejaculation Diagnostic Tool, IIEF-15, SHIM, and IIEF-EF and underwent a full clinical examination to evaluate their erectile function. OUTCOMES The scores of the 2 erectile function assessment questionnaires (SHIM and IIEF-EF) were compared in terms of their sensitivity and specificity in the diagnosis of ED in PE patients. RESULTS In terms of diagnosing ED in PE patients, the sensitivity of SHIM is 100% while the specificity is only 36%; meanwhile, the sensitivity of IIEF-EF is 100% but specificity is 77.2%. Further analysis demonstrates that decreasing cutoff of SHIM to 17.5 would provide an increased specificity of 82.5%, while sensitivity would lower to 96.0%. However, the highest area under the curve (0.966 vs 0.941) is given by the IIEF-EF with 100% sensitivity and 80.7% specificity at the cutoff of 24.5, which is one point lower than the usual cutoff value of 25.5. CLINICAL IMPLICATIONS Our study suggests that when evaluating erection function in PE patients, the cutoff of both SHIM and IIEF-EF should be amended. STRENGTHS & LIMITATIONS We proposed the solution for the bias of erectile function assessment in PE patients. However, other trials are needed to further validate in larger cohorts of PE patients. CONCLUSION We suggest that the cutoff of SHIM and IIEF-EF should be amended (SHIM at 17.5 and IIEF-EF at 24.5, respectively) when assessing erectile function among PE population. Xi Y, Colonnello E, Ma G, et al. Validity of Erectile Function Assessment Questionnaires in Premature Ejaculation Patients: A Comparative Study Between the Abridged Forms of the International Index of Erectile Function and Proposal for Optimal Cutoff Redefinition. J Sex Med 2021;18:440-447.
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Affiliation(s)
- Yu Xi
- Department of Infertility and Sexual Medicine, The Third Affiliated Hospital of Sun Yat-sen University
| | - Elena Colonnello
- Chair of Endocrinology & Medical Sexology (ENDOSEX), Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy
| | - Gongchao Ma
- Department of Infertility and Sexual Medicine, The Third Affiliated Hospital of Sun Yat-sen University
| | - Erika Limoncin
- Chair of Endocrinology & Medical Sexology (ENDOSEX), Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy
| | - Giacomo Ciocca
- Chair of Endocrinology & Medical Sexology (ENDOSEX), Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy; Clinical Psychosexology, Department of Dynamic and Clinical Psychology, University of Rome Sapienza, Rome, Italy
| | - Hui Zhang
- Department of Infertility and Sexual Medicine, The Third Affiliated Hospital of Sun Yat-sen University
| | - Emmanuele A Jannini
- Chair of Endocrinology & Medical Sexology (ENDOSEX), Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy
| | - Yan Zhang
- Department of Infertility and Sexual Medicine, The Third Affiliated Hospital of Sun Yat-sen University.
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Sánchez-Sánchez F, Ferrer-Casanova C, Ponce-Buj B, Sipán-Sarrión Y, Jurado-López A, San Martin-Blanco C, Tijeras-Úbeda M, Pascual Regueiro N. Diseño y validación del Cuestionario de Función Sexual del Hombre, FSH. Semergen 2020; 46:441-447. [DOI: 10.1016/j.semerg.2019.12.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2019] [Revised: 12/01/2019] [Accepted: 12/03/2019] [Indexed: 11/16/2022]
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Trends in reported male sexual dysfunction over the past decade: an evolving landscape. Int J Impot Res 2020; 33:596-602. [PMID: 32612274 DOI: 10.1038/s41443-020-0324-7] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2020] [Revised: 05/29/2020] [Accepted: 06/17/2020] [Indexed: 12/14/2022]
Abstract
We investigated changes in patterns of reported male SDs at a single academic centre over a 10-year time frame. Comprehensive data of 2013 patients consecutively assessed for the first time by a single Sexual Medicine expert between 2006 and 2019 has been analysed. All patients were assessed with a thorough sexual and medical history. Primary reason for seeking medical help at first assessment was recorded for all patients and categorized as: erectile dysfunction (ED), premature ejaculation (PE), low/reduced sexual desire/interest (LSD/I), Peyronie's disease (PD), and other SDs. Linear and logistic regression models tested the association between different reasons for seeking medical help and the time at first evaluation. Local polynomial regression model explored the probability of reporting different SDs over the analysed time frame. Median (IQR) age at first clinical assessment was 50 (38-61) years. Overall, most patients were assessed for ED (824; 41%), followed by PD (369; 18%), PE (322; 16%), LSD/I (204; 10%) and other SDs (294; 15%). Significant changes in terms of reported SD over the analysed time frame were observed. The likelihood of assessing patients for ED significantly increased up to 2013, with a decrease in the past 5 years (p < 0.001). PE assessment at presentation linearly decreased over time (OR: 0.94; 95% CI: 0.91-0.96; p < 0.001). Patients assessed during the past few years were more likely to report PD (OR: 1.20; 95% CI: 1.15-1.25; p < 0.001) and LSD/I (OR: 1.21; 95% CI: 1.16-1.26; p < 0.001), with a linear increase over the evaluated time frame. Likewise, patients were also more likely to report other SDs (Coeff: 1.06; 95% CI: 1.02-1.10; p = 0.004), with a linear increase over time. These results may reflect real changes in SD incidence, increased public awareness towards different SDs and the possible impact of novel treatments available on the market throughout the same time frame.
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Consulting “Dr Google” for sexual dysfunction: a contemporary worldwide trend analysis. Int J Impot Res 2019; 32:455-461. [DOI: 10.1038/s41443-019-0203-2] [Citation(s) in RCA: 34] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2019] [Revised: 09/02/2019] [Accepted: 09/13/2019] [Indexed: 11/09/2022]
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The Comorbidity Between Premature Ejaculation and Erectile Dysfunction-A Cross-Sectional Internet Survey. Sex Med 2019; 7:451-458. [PMID: 31540883 PMCID: PMC6963126 DOI: 10.1016/j.esxm.2019.06.014] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2018] [Revised: 06/16/2019] [Accepted: 06/19/2019] [Indexed: 12/21/2022] Open
Abstract
Introduction The comorbidity between premature ejaculation (PE) and erectile dysfunction (ED) has not yet been clarified. Aim To assess the comorbidity between PE and ED. Methods Male members of a shopping club in Taiwan aged 20–60 years with stable sexual relationships were invited to complete an online questionnaire. Main Outcome Measures Self-estimated intravaginal ejaculatory latency time (IELT), Premature Ejaculation Diagnostic Tool, Sexual Health Inventory for Men, Self-Esteem and Relationship, and Hospital Anxiety and Depression Scale results were used. Results A total of 937 participants with a mean age of 41.1 ± 10.2 years were enrolled. The prevalence rates of ED (Sexual Health Inventory for Men ≤ 21), PE (Premature Ejaculation Diagnostic Tool ≥11), and IELT ≤1 minute were 24.7%, 6.3%, and 6.4%, respectively. Prevalence of acquired PE and IELT ≤1 minute increased marginally with age. Participants with ED had a greater prevalence of PE than those without ED (19.5% vs 2.0%, P < .001), and participants with PE had a greater prevalence of ED than those without PE (76.3% vs 19.4%, P < .001). Compared with participants without PE, participants with PE had greater adjusted odds of ED (odds ratio [OR] = 12.7, 95% CI = 6.7–24.2). Relative to participants without ED, participants with ED had increased adjusted odds of PE (OR = 7.2, 95% CI = 3.5–14.6 with mild ED and OR = 36.7, 95% CI = 16.2–83.0 with ED severity greater than a mild degree). Poor sexual relationships and self-esteem, depression, and anxiety were reported more frequently in those with PE or ED, especially in those with both problems compared with those without PE and ED. Conclusions This study confirmed a high prevalence of PE and ED coexistence, indicating a complicated relationship between the 2 conditions and the importance of screening for their co-occurrence in practice. Tsai W-K, Chiang P-K, Lu C-C, et al. The Comorbidity Between Premature Ejaculation and Erectile Dysfunction—A Cross-Sectional Internet Survey. Sex Med 2019;7:451–458
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Frequency of etiological factors among patients with acquired premature ejaculation: prospective, observational, single-center study. Int J Impot Res 2019; 32:352-357. [PMID: 31477853 DOI: 10.1038/s41443-019-0188-x] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2019] [Revised: 07/04/2019] [Accepted: 07/31/2019] [Indexed: 12/31/2022]
Abstract
Although premature ejaculation (PE) is a common male sexual dysfunction, its pathophysiology has not been fully elucidated. Several medical problems such as erectile dysfunction, depression, anxiety, hormonal disorders and chronic prostatitis may play a role in the etiology of acquired PE. This study aims to evaluate the frequency of these etiologic factors among patients with acquired PE. Between May and July 2016, 53 men with acquired PE were included in the study. Self-estimated intravaginal ejaculation latency time (IELT) of these patients was recorded along with their medical history and physical examination findings. Moreover, 5-item version of the International Index of Erectile Function (IIEF-5), premature ejaculation profile (PEP), anxiety and depression scales (STAI-1, STAI-2, and BECK), and chronic prostatitis symptom index (NIH-CPSI) were administered. Fasting plasma glucose, follicle stimulating hormone (FSH), luteinizing hormone (LH), prolactin, total and free testosterone, total prostate specific antigen, thyroid and thyroid stimulating hormone levels were measured. Urine analysis and 2 cup tests were also studied. Mean age of the patients was 42.41 ± 11.14 (22-60). Mean duration of the PE complaint was 34.18 ± 36.76 (3-144) months. Mean IELT time of the patients was 38.28 ± 30.79 (3-180) s. Of the patients; 69.81%, 62.26%, 56.60%, 45.28%, 30.19%, 24.53%, 16.98%, 15.09%, and 7.55% had depression, chronic prostatitis, erectile dysfunction, anxiety, diabetes mellitus, abnormal FSH or LH, hypoprolactinemia, hyperthyroidism, and high testosterone levels, respectively. The results of our study revealed that anxiety disorders, depression, erectile dysfunction, and chronic prostatitis are common among patients with acquired PE and may play role in the etiology of this problem. There is a need for further researches related to the exact pathophysiology of acquired PE with larger number of patients.
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Eleuteri S, Aminoff D, Lucidi F, Violani C, Grano C. Sexual well-being in adolescent and young adults born with arm: the perspective of the patients. Pediatr Surg Int 2019; 35:945-951. [PMID: 31263957 DOI: 10.1007/s00383-019-04507-z] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/20/2019] [Indexed: 12/27/2022]
Abstract
PURPOSE Sexual well-being and sexual functioning are understudied in patients born with ARM. The aim of this exploratory study was to investigate sexual history, main fears, and problems encountered during sexual relationships. METHODS Before participating in a sexual education intervention, 21 adolescents or young adults (12 males; mean 28.8; SD 10.6) born with ARM, answered a ten-item questionnaire specifically developed to evaluate sexual well-being. Percentages and Chi-square were calculated. RESULTS 52.4% were married/had a partner. The majority (71%) declared that had sexual relationships. Mean age of the first sexual relationship was 18.8 (2.7) and 22.7 (3.8) for males and females, respectively. Females reported both more fear and experience of pain during sexual intercourse, compared to males. Main experienced problems and fears for male patients were loss of feces and premature ejaculation, followed by the fear of lack of erection and managing contraception. Main experienced problems and fears in females were loss of feces, pain, lack of desire, and lack of lubrication. In only few cases, patients asked for advices to a pediatric surgeon or to an adult surgeon specialized in ARM. CONCLUSIONS Adult and adolescent patients may benefit of andrological/gynecological evaluation, psychological support, and sexual counseling to improve their sexual well-being.
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Affiliation(s)
- Stefano Eleuteri
- Italian Parents and Patients Organization for Anorectal Malformations (AIMAR), Rome, Italy.,Department of Psychology, Sapienza University, Via dei Marsi, 78, 00185, Rome, Italy
| | - Dalia Aminoff
- Italian Parents and Patients Organization for Anorectal Malformations (AIMAR), Rome, Italy
| | - Fabio Lucidi
- Department of Developmental and Social Psychology, Sapienza University, Rome, Italy
| | - Cristiano Violani
- Department of Psychology, Sapienza University, Via dei Marsi, 78, 00185, Rome, Italy
| | - Caterina Grano
- Italian Parents and Patients Organization for Anorectal Malformations (AIMAR), Rome, Italy. .,Department of Psychology, Sapienza University, Via dei Marsi, 78, 00185, Rome, Italy.
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rb. [Not Available]. MMW Fortschr Med 2019; 161:16-17. [PMID: 31037690 DOI: 10.1007/s15006-019-0430-y] [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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Lower urinary tract symptoms and depressive symptoms among patients presenting for distressing early ejaculation. Int J Impot Res 2019; 32:207-212. [DOI: 10.1038/s41443-019-0147-6] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2018] [Revised: 01/01/2019] [Accepted: 03/04/2019] [Indexed: 11/08/2022]
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Rastrelli G, Cipriani S, Corona G, Vignozzi L, Maggi M. Clinical characteristics of men complaining of premature ejaculation together with erectile dysfunction: a cross‐sectional study. Andrology 2018; 7:163-171. [DOI: 10.1111/andr.12579] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2018] [Revised: 11/09/2018] [Accepted: 12/01/2018] [Indexed: 12/22/2022]
Affiliation(s)
- G. Rastrelli
- Sexual Medicine and Andrology Unit Department of Experimental Clinical and Biomedical Sciences ‘Mario Serio’ University of Florence Florence Italy
| | - S. Cipriani
- Sexual Medicine and Andrology Unit Department of Experimental Clinical and Biomedical Sciences ‘Mario Serio’ University of Florence Florence Italy
| | - G. Corona
- Sexual Medicine and Andrology Unit Department of Experimental Clinical and Biomedical Sciences ‘Mario Serio’ University of Florence Florence Italy
- Endocrinology Unit Medical Department Azienda Usl Bologna Maggiore‐Bellaria Hospital Bologna Italy
| | - L. Vignozzi
- Sexual Medicine and Andrology Unit Department of Experimental Clinical and Biomedical Sciences ‘Mario Serio’ University of Florence Florence Italy
- I.N.B.B. – Istituto Nazionale Biostrutture e Biosistemi Rome Italy
| | - M. Maggi
- Sexual Medicine and Andrology Unit Department of Experimental Clinical and Biomedical Sciences ‘Mario Serio’ University of Florence Florence Italy
- I.N.B.B. – Istituto Nazionale Biostrutture e Biosistemi Rome Italy
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Verze P, Arcaniolo D, Imbimbo C, Cai T, Venturino L, Spirito L, Califano G, La Rocca R, Mirone V. General and sex profile of women with partner affected by premature ejaculation: results of a large observational, non-interventional, cross-sectional, epidemiological study (IPER-F). Andrology 2018; 6:714-719. [PMID: 30120814 DOI: 10.1111/andr.12545] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2017] [Revised: 07/25/2018] [Accepted: 07/25/2018] [Indexed: 11/30/2022]
Affiliation(s)
- P. Verze
- Department of Neurosciences; Sciences of Reproduction and Odontostomatology; Urology Unit; University of Naples “Federico II”; Naples Italy
| | - D. Arcaniolo
- Urology Unit; Department of Woman, Child and General and Specialized Surgery; University of Campania “L. Vanvitelli”; Naples Italy
| | - C. Imbimbo
- Department of Neurosciences; Sciences of Reproduction and Odontostomatology; Urology Unit; University of Naples “Federico II”; Naples Italy
| | - T. Cai
- Department of Urology; Santa Chiara Regional Hospital; Trento Italy
| | - L. Venturino
- Department of Neurosciences; Sciences of Reproduction and Odontostomatology; Urology Unit; University of Naples “Federico II”; Naples Italy
| | - L. Spirito
- Department of Neurosciences; Sciences of Reproduction and Odontostomatology; Urology Unit; University of Naples “Federico II”; Naples Italy
| | - G. Califano
- Department of Neurosciences; Sciences of Reproduction and Odontostomatology; Urology Unit; University of Naples “Federico II”; Naples Italy
| | - R. La Rocca
- Department of Neurosciences; Sciences of Reproduction and Odontostomatology; Urology Unit; University of Naples “Federico II”; Naples Italy
| | - V. Mirone
- Department of Neurosciences; Sciences of Reproduction and Odontostomatology; Urology Unit; University of Naples “Federico II”; Naples Italy
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