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Li J, Liao Z, Xu Z, Huang X. Clinical value of penile sympathetic skin response to assess the efficacy of sertraline in the treatment of patients with sympathetic hyperexcitability in primary premature ejaculation. Sex Med 2023; 11:qfac012. [PMID: 37007857 PMCID: PMC10065178 DOI: 10.1093/sexmed/qfac012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2022] [Revised: 09/29/2022] [Accepted: 11/06/2022] [Indexed: 01/22/2023] Open
Abstract
Abstract
Background
The pathogenesis of primary premature ejaculation (PPE) is complex, and the pathologic basis may be an overactive sympathetic nervous system.
Aim
To investigate sertraline efficacy in patients with sympathetic hyperexcitability in PPE and clarify the value of penile sympathetic skin response (PSSR) in assessing the efficacy of sertraline for PPE treatment.
Methods
Sixty-three patients with PPE were recruited in the outpatient clinic and asked to take 50 mg of oral sertraline daily for a 4-week treatment period. Changes in intravaginal ejaculation latency time (IELT), Premature Ejaculation Diagnostic Tool, International Index of Erectile Function (IIEF-5), and PSSR latency and wave amplitude were compared before and after treatment.
Outcomes
The principal aim was to determine the relationships among sertraline efficacy, IELT, and PSSR latency and amplitude.
Results
After sertraline treatment, patients with PPE demonstrated a significant decrease in Premature Ejaculation Diagnostic Tool scores (P < .001); a significant increase in IELT, PSSR latency, and wave amplitude (P < .001); and no significant change in International Index of Erectile Function scores (P > .05). Moreover, the latency changes of PSSR were positively correlated with the increment of IELT (r = 0.550, P < .001). In addition, there was some degree of improvement vs pretreatment, although IELT and PSSR latencies were significantly shorter after drug discontinuation when compared with posttreatment (both P < .001).
Clinical Implications
We aimed to find an objective test that accurately reflects the efficacy of treatment for sympathetic hyperexcitability in PPE.
Strengths and Limitations
The strengths include a well-powered study, use of validated instruments, and self-assessment of treatment benefit. The limitations include the single-center design, relatively short-term follow-up, and lack of more comprehensive monitoring between treatment and drug discontinuation.
Conclusion
These findings suggest that sertraline is effective for PPE treatment, that its efficacy can be partially maintained even after drug discontinuation, and that PSSR may be reliable for evaluating treatment success in patients with PPE.
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Affiliation(s)
- Jiacheng Li
- The Second Clinical Medical College, Zhejiang Chinese Medical University , Hangzhou 310053, China
| | - Zedong Liao
- Department of Urology, the Second Affiliated Hospital, Zhejiang University School of Medicine , Hangzhou 310009, China
| | - Zilei Xu
- The Second Clinical Medical College, Zhejiang Chinese Medical University , Hangzhou 310053, China
| | - Xiaojun Huang
- Department of Urology, the Second Affiliated Hospital, Zhejiang University School of Medicine , Hangzhou 310009, China
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Chen J, Yang J, Huang X, Ni L, Fan Q, Liu T, Yao Z, Chen Y. Reduced segregation and integration of structural brain network associated with sympathetic and dorsal penile nerve activity in anejaculation patients: a graph‐based connectome study. Andrology 2019; 8:392-399. [PMID: 31610095 DOI: 10.1111/andr.12715] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2019] [Revised: 09/11/2019] [Accepted: 10/08/2019] [Indexed: 12/14/2022]
Affiliation(s)
- J. Chen
- Department of Andrology Jiangsu Province Hospital of Chinese Medicine Affiliated Hospital of Nanjing University of Chinese Medicine Nanjing China
| | - J. Yang
- Department of Urology Jiangsu Provincial People's Hospital First Affiliated Hospital of Nanjing Medical University Nanjing China
| | - X. Huang
- Department of Andrology Jiangsu Province Hospital of Chinese Medicine Affiliated Hospital of Nanjing University of Chinese Medicine Nanjing China
| | - L. Ni
- Department of Andrology Jiangsu Province Hospital of Chinese Medicine Affiliated Hospital of Nanjing University of Chinese Medicine Nanjing China
| | - Q. Fan
- Department of Andrology 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
| | - 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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Kati B, Ay H. Evaluation of dapoxetine treatment success in lifelong premature ejaculation patients with penile sympathetic skin response. Andrologia 2018; 50:e13076. [DOI: 10.1111/and.13076] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2018] [Revised: 05/16/2018] [Accepted: 05/17/2018] [Indexed: 11/30/2022] Open
Affiliation(s)
- Bulent Kati
- Faculty of Medicine; Urology Department; Harran University; Sanliurfa Turkey
| | - Halil Ay
- Faculty of Medicine; Neurology Department; Harran University; Sanliurfa Turkey
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Tavares RS, Martins S, Almeida-Santos T, Sousa AP, Ramalho-Santos J, da Cruz E Silva OA. Alzheimer's disease-related amyloid-β 1-42 peptide induces the loss of human sperm function. Cell Tissue Res 2017; 369:647-651. [PMID: 28776187 DOI: 10.1007/s00441-017-2665-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2017] [Accepted: 06/23/2017] [Indexed: 11/25/2022]
Abstract
Characteristically identified as the main component of senile plaques present in patients suffering from Alzheimer's disease, Aβ has been detected in human testis and reproductive fluids, but its effect on spermatozoa has not been addressed. The present study evaluated whether the most toxic and aggregant amyloid precursor protein (APP)-proteolytic product, amyloid-β1-42 (Aβ1-42), was capable of affecting sperm functionality. Normozoospermic samples were either exposed to different Aβ1-42 doses or to the untreated and scrambled controls for a maximum of 48 h at 37 °C and 5%CO2, and motility, viability and mitochondrial status were evaluated. Additionally, tyrosine phosphorylation was analyzed by immunocytochemistry and acrosomal integrity through PSA-FITC. A shorter treatment period was used to monitor prompt Ca2+ responses. Aβ1-42 peptide decreased motility before inducing mitochondrial impairment (p < 0.05; n = 6). Both outcomes became more pronounced with time, reaching their maximal decrease at 48 h, where even 1 μM produced undesirable effects (p < 0.05; n = 6). Aβ1-42 peptide also decreased cell survival (p < 0.05; n = 6). Furthermore, although no effects on tyrosine phosphorylation were observed (p > 0.05; n = 6), reduced acrosomal integrity was detected (p < 0.05; n = 7), which was not correlated with viability loss (p > 0.05). In parallel, all Aβ1-42 concentrations elicited a [Ca2+]i rise but a significant difference was only observed at 20 μM (p < 0.05; n = 7) and a tendency was obtained with 10 μM (p = 0.053; n = 7). In conclusion, Aβ1-42 peptide oligomers impair sperm function in vitro, although further studies are required to determine the clinical relevance of these findings.
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Affiliation(s)
- R S Tavares
- Neuroscience and Cell Signalling Group, Department of Medical Sciences, Institute of Biomedicine - iBiMED, University of Aveiro, 3810-193, Aveiro, Portugal.,Biology of Reproduction and Stem Cell Group, CNC- Center for Neuroscience and Cell Biology, University of Coimbra, 3004-504, Coimbra, Portugal
| | - S Martins
- Neuroscience and Cell Signalling Group, Department of Medical Sciences, Institute of Biomedicine - iBiMED, University of Aveiro, 3810-193, Aveiro, Portugal
| | - T Almeida-Santos
- Biology of Reproduction and Stem Cell Group, CNC- Center for Neuroscience and Cell Biology, University of Coimbra, 3004-504, Coimbra, Portugal.,Reproductive Medicine Service, University Hospitals of Coimbra, 3000-075, Coimbra, Portugal.,Faculty of Medicine, University of Coimbra, 3000-548, Coimbra, Portugal
| | - A P Sousa
- Biology of Reproduction and Stem Cell Group, CNC- Center for Neuroscience and Cell Biology, University of Coimbra, 3004-504, Coimbra, Portugal.,Reproductive Medicine Service, University Hospitals of Coimbra, 3000-075, Coimbra, Portugal
| | - J Ramalho-Santos
- Biology of Reproduction and Stem Cell Group, CNC- Center for Neuroscience and Cell Biology, University of Coimbra, 3004-504, Coimbra, Portugal. .,Department of Life Sciences, Faculty of Sciences and Technology, University of Coimbra, Calçada Martins de Freitas, 3000-456, Coimbra, Portugal.
| | - O A da Cruz E Silva
- Neuroscience and Cell Signalling Group, Department of Medical Sciences, Institute of Biomedicine - iBiMED, University of Aveiro, 3810-193, Aveiro, Portugal.,Department of Medical Sciences, University of Aveiro, 3810-193, Aveiro, Portugal
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