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Gao Q, Chen J, Wang B, Hang Y, Gao S, Yang J, Dai Y. Application of the sexual therapy combined with vacuum negative pressure hydropneumatic/pneumatic bubble massage in primary intravaginal anejaculation. Andrology 2024. [PMID: 38439166 DOI: 10.1111/andr.13622] [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: 07/19/2023] [Revised: 01/19/2024] [Accepted: 02/18/2024] [Indexed: 03/06/2024]
Abstract
INTRODUCTION Primary intravaginal anejaculation (PIAJ) is a relatively uncommon male sexual dysfunction characterized by an inability to achieve intravaginal ejaculation during all sexual intercourse. Effective treatment options for this condition are lacking. We aimed to explore the clinical effect of the sexual therapy combined with vacuum negative pressure hydropneumatic/pneumatic bubble massage (VNPHP/PBM) on primary intravaginal anejaculation, and its possible mechanism. METHODS A total of 95 PIAJ patients were randomly divided into three groups, including group A with 32 patients treated with the sexual therapy combined with VNPHP/PBM, group B with 32 patients treated with the sexual therapy and group C with 31 patients treated with VNPHP/PBM. The efficacy of therapeutic regimes, latency of the somatosensory evoked potentials of dorsal nerve (DNSEP), glans penis (GPSEP) and penile shaft sensory threshold (PSST), measures of sexual behavior of patients, as well as the self-rating anxiety scale (SAS) sores of patients and their partners, were compared before and after treatment among three groups. RESULTS The total effective rate of group A (84.38%) was higher than those of groups B and C (53.13% and 41.94%), however, no differences were found between groups B and C. The ratios of patients and their partners with anxiety, frequency of observing erotic films of patients, ratios of patients with special self-masturbation and frequency of masturbation decreased significantly in the three groups after the treatment. The decrease in the ratios of patients and their partners with anxiety, frequency of observing erotic films of patients in groups A and B were higher than those of group C, however, no differences were identified between groups A and B. The decrease in the ratios of patients with special self-masturbation and frequency of masturbation in group A were higher than those of group B, however, no differences were found between groups A and C, B and C. There were no differences in the latency of DNSEP, GPSEP, and PSST among the three groups before and after treatment. CONCLUSION The sexual therapy combined with VNPHP/PBM has good therapeutic effects on PIAJ, which might be achieved by reducing the anxiety level of patients and their partners, improving sexual behavioral patterns, rather than increasing the sensitivity of penis including dorsal nerve and glans penis.
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Affiliation(s)
- Qingqiang Gao
- Nanjing Drum Tower Hospital Clinical College of Nanjing Medical University, Nanjing, China
| | - Jianhuai Chen
- Department of Andrology, Jiangsu Province Hospital of Chinese Medicine, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, China
| | - Bin Wang
- Department of Andrology, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, China
| | - Youfeng Hang
- Department of Andrology, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, China
| | - Songzhan Gao
- Department of Andrology, The Third Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Jie Yang
- Department of Urology, Jiangsu Provincial People's Hospital, First Affiliated Hospital of Nanjing Medical University, Nanjing, China
- Department of Urology, People's Hospital of Xinjiang Kizilsu Kirgiz Autonomous Prefecture, Xinjiang uygur autonomous region, China
| | - Yutian Dai
- Nanjing Drum Tower Hospital Clinical College of Nanjing Medical University, Nanjing, China
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Bernaschina-Rivera SA, López-Chaim AI, Cordero-Pacheco JA, Fernández-Crespo R, Quesada-Olarte J, Carrión R. Circumcision and Sexual Medicine. Sex Med Rev 2023; 11:412-420. [PMID: 37085961 DOI: 10.1093/sxmrev/qead009] [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: 06/22/2022] [Revised: 01/26/2023] [Accepted: 02/18/2023] [Indexed: 04/23/2023]
Abstract
INTRODUCTION Male circumcision is one of the most frequently performed and debated urological procedures due to its possible implications for sexual health. OBJECTIVES The objective of this article is to review the literature on male circumcision and reconcile the scientific evidence to improve the quality of care, patient education, and clinician decision-making regarding the effects on sexual function of this procedure. METHODS A review of the published literature regarding male circumcision was performed on PubMed. The criteria for selecting resources prioritized systematic reviews and cohort studies pertinent to sexual dysfunction, with a preference for recent publications. RESULTS Despite the conflicting data reported in articles, the weight of the scientific evidence suggests there is not sufficient data to establish a direct association between male circumcision and sexual dysfunction. CONCLUSION This review provides clinicians with an updated summary of the best available evidence on male circumcision and sexual dysfunction for evidenced-based quality of care and patient education.
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Affiliation(s)
| | | | | | - Raúl Fernández-Crespo
- University of South Florida, Morsani College of Medicine, Tampa, FL 33602, United States
| | - José Quesada-Olarte
- University of South Florida, Morsani College of Medicine, Tampa, FL 33602, United States
| | - Rafael Carrión
- University of South Florida, Morsani College of Medicine, Tampa, FL 33602, United States
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Ongun S, Esen EC, Özer MS, Yildirim Ö, Hasirci E, Sah C, Sahin B, Duran MB, Cinar O, Cihan A, Kazaz IO, Gul U, Deliktas H, Kizilkan Y, Altunkol A, Kurt HA, Tosun C, Bozkurt O, Turunc T, Akkus E. The relationship between premature ejaculation and the timing of pre-adult circumcision. Andrologia 2021; 53:e14048. [PMID: 33709439 DOI: 10.1111/and.14048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2021] [Revised: 02/18/2021] [Accepted: 02/25/2021] [Indexed: 11/26/2022] Open
Abstract
We aimed to investigate the relationship between premature ejaculation and the age when men had been circumcised before adulthood. A total of 2,768 sexually active male patients aged between 18 and 65 years were included in this study. A multicentre study was conducted prospectively with the participation of 20 centres. A survey consisting of 12 questions prepared by the researchers, as well as the validated Turkish versions of the five-item Premature Ejaculation Diagnostic Tool, was administered to all participants. The study included 1,603 participants who met the inclusion criteria. There was no significant difference in the Premature Ejaculation Diagnostic Tool and self-reported ejaculation time between the participants who had been circumcised at different ages during childhood. Remembering circumcision experience with fear or anxiety did not increase the risk of sexual dysfunction compared to the participants who described their experience with happiness or with no particular emotion. There was no significant difference in Premature Ejaculation Diagnostic Tool scores or the self-reported ejaculation time of the participants circumcised at different ages. The age of childhood circumcision, having a fearful or anxious circumcision experience, does not affect the risk of premature ejaculation in adult life.
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Affiliation(s)
- Sakir Ongun
- Department of Urology, Balikesir University Scholl of Medicine, Balikesir, Turkey
| | - Emre Cem Esen
- Department of Psychiatry, Balikesir University Scholl of Medicine, Balikesir, Turkey
| | | | - Ömer Yildirim
- Department of Urology, Istanbul University Cerrahpasa Faculty of Medicine, Fatih, Turkey
| | - Eray Hasirci
- Department of Urology, Baskent University Faculty of Medicine, Ankara, Turkey
| | - Cem Sah
- Urology, Medline Hospital Adana, Adana, Turkey
| | - Bahadir Sahin
- Urology, Marmara University Training and Research Hospital, Istanbul, Turkey
| | | | - Onder Cinar
- Urology, ZonguldakBülent Ecevit University Training and Research Hospital, Zonguldak, Turkey
| | - Ahmet Cihan
- Urology, Nigde Research Training Hospital, Nigde, Turkey
| | - Ilke Onur Kazaz
- Urology, Karadeniz Technical University Faculty of Medicine, Trabzon, Turkey
| | - Umit Gul
- Urology, Baskent University Adana Medical and Research Center, Adana, Turkey
| | | | - Yalcin Kizilkan
- Urology, Ministry of Health Ankara City Hospital, Cankaya, Turkey
| | - Adem Altunkol
- Urology, University of Health Sciences, Adana City Teaching and Research Hospital, Adana, Turkey
| | - Hasan Anil Kurt
- Urology, Çanakkale Onsekiz Mart University, Çanakkale, Turkey
| | - Cagatay Tosun
- Urology, Istanbul Haydarpasa Numune Training and Research Hospital, Istanbul, Turkey
| | - Ozan Bozkurt
- Department of Urology, Dokuz Eylul University Scholl of Medicine, Izmir, Turkey
| | - Tahsin Turunc
- Urology, Iskenderun Gelisim Hospital, Iskenderun, Turkey
| | - Emre Akkus
- Department of Urology, Istanbul University Cerrahpasa Faculty of Medicine, Fatih, Turkey
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Czajkowski M, Czajkowska K, Zarańska K, Giemza A, Kłącz J, Sokołowska-Wojdyło M, Matuszewski M. Male Circumcision Due to Phimosis as the Procedure That Is Not Only Relieving Clinical Symptoms of Phimosis But Also Improves the Quality of Sexual Life. Sex Med 2021; 9:100315. [PMID: 33545503 PMCID: PMC8072165 DOI: 10.1016/j.esxm.2020.100315] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2020] [Revised: 12/21/2020] [Accepted: 12/28/2020] [Indexed: 01/12/2023] Open
Abstract
INTRODUCTION Male circumcision is recognized as the most effective method of phimosis treatment. Analyzing the literature, the information about the influence of male circumcision due to phimosis for patients' subjective symptoms such as itching, burning, penile pain, pain during intercourse, and quality of sexual life is insufficient. AIM To investigate the effect of male circumcision due to phimosis to patients' subjective symptoms, including erectile function and satisfaction with their genitals. METHODS The single-center prospective study began in January 2018 and ended in January 2020. Sixty-nine male, adult patients, who were qualified for circumcision due to phimosis, were included in the study. MAIN OUTCOMES MEASURES The study outcomes were obtained using questionnaires such as visual analog scale 0-10 for itching, burning, penile pain, and penile pain during intercourse; International Index of Erectile Function (IIEF-5) and Male Genital Self Image Scale 7 (MGSIS-7) to assess the changes in patients sexual functioning. RESULTS Before the circumcision of the 69 patients included in the study, 59 patients (86%) reported some subjective symptoms of phimosis. The most frequent and most severe complaint was pain during intercourse, then itching and burning of the penis. Penile pain at rest was the least frequent. After 3 months from circumcision, subjective symptoms almost completely disappeared. All of 69 patients declared to have a sexual partner. 3 months after circumcision, all patients achieved significant improvement in both obtaining and maintaining an erection based on IIEF-5 score. Their sexual intercourse was more satisfying for them. All patients suffering from phimosis were embarrassed about their genitals before surgery. 3 months after circumcision, satisfaction with genital self-image increased significantly. CONCLUSION Male circumcision due to phimosis is not only relieving the clinical symptoms of phimosis, but it also improves the quality of sexual life. Czajkowski M, Czajkowska K, Zarańska K, et al. Male Circumcision Due to Phimosis as the Procedure That Is Not Only Relieving Clinical Symptoms of Phimosis But Also Improves the Quality of Sexual Life. Sex Med 2021;9:100315.
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Affiliation(s)
| | - Katarzyna Czajkowska
- Department of Dermatology, Venerology and Allergology, Medical University of Gdańsk, Gdańsk, Poland
| | - Karolina Zarańska
- Student Research Group at the Department of Urology, Medical University of Gdańsk, Gdańsk, Poland
| | - Alicja Giemza
- Student Research Group at the Department of Urology, Medical University of Gdańsk, Gdańsk, Poland
| | - Jakub Kłącz
- Department of Urology, Medical University of Gdańsk, Gdańsk, Poland
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Morris BJ, Krieger JN. The Contrasting Evidence Concerning the Effect of Male Circumcision on Sexual Function, Sensation, and Pleasure: A Systematic Review. Sex Med 2020; 8:577-598. [PMID: 33008776 PMCID: PMC7691872 DOI: 10.1016/j.esxm.2020.08.011] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2020] [Revised: 08/25/2020] [Accepted: 08/31/2020] [Indexed: 12/24/2022] Open
Abstract
INTRODUCTION Active debate concerns whether male circumcision (MC) affects sexual function, penile sensation, or sexual pleasure. AIM To perform a systematic review examining the effect of MC on these parameters. METHODS PRISMA-compliant searches of PubMed, EMBASE, the Cochrane Library, and Google Scholar were performed, with "circumcision" used together with appropriate search terms. Articles meeting the inclusion criteria were rated for quality by the Scottish Intercollegiate Guidelines Network system. MAIN OUTCOME MEASURE Evidence rated by quality. RESULTS Searches identified 46 publications containing original data, as well as 4 systematic reviews (2 with meta-analyses), plus 29 critiques of various studies and 15 author replies, which together comprised a total of 94 publications. There was overall consistency in conclusions arising from high- and moderate-quality survey data in randomized clinical trials, systematic reviews and meta-analyses, physiological studies, large longitudinal studies, and cohort studies in diverse populations. Those studies found MC has no or minimal adverse effect on sexual function, sensation, or pleasure, with some finding improvements. A consensus from physiological and histological studies was that the glans and underside of the shaft, not the foreskin, are involved in neurological pathways mediating erogenous sensation. In contrast to the higher quality evidence, data supporting adverse effects of MC on function, sensation, or pleasure were found to be of low quality, as explained in critiques of those studies. CONCLUSION The consensus of the highest quality literature is that MC has minimal or no adverse effect, and in some studies, it has benefits on sexual functions, sensation, satisfaction, and pleasure for males circumcised neonatally or in adulthood. Morris BJ, Krieger JN. The Contrasting Evidence Concerning the Effect of Male Circumcision on Sexual Function, Sensation, and Pleasure: A Systematic Review. Sex Med 2020;8:577-598.
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Affiliation(s)
- Brian J Morris
- School of Medical Sciences, University of Sydney, Sydney, New South Wales, Australia.
| | - John N Krieger
- Department of Urology, University of Washington School of Medicine, Seattle, WA, USA
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Wei S, Wu C, Yu B, Ma M, Qin F, Yuan J. Advantages and limitations of current premature ejaculation assessment and diagnostic methods: a review. Transl Androl Urol 2020; 9:743-757. [PMID: 32420180 PMCID: PMC7215025 DOI: 10.21037/tau.2019.12.08] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
Premature ejaculation (PE) is the most common male sexual dysfunction worldwide. Characteristic symptoms of PE are unexpected, rapid, complete ejaculation, which negatively impacts the sexual act for both sexual partners. Despite the existence of a definitive PE classification system and various diagnostic tools, diagnosing PE is still challenging due to the limitations associated with the assessment of this condition. Hence, it is necessary to review the diagnostic methods and processes of the physical examination that are currently performed in the medical setting. It is also important to analyze any controversial results of each main PE assessment method and propose novel diagnostic and assessment methods. To date, it is important to verify the accuracy of the PE evaluation method due to the ambiguity of previous definitions and proven invalidity of current examining techniques. Clinical diagnosis is based mainly on the patient history, patient-reported outcome scores, and diagnostic tools. Introduction of intravaginal ejaculatory latency time, penile biothesiometry, and the electrophysiological test provided objective means of evaluating PE. Due to the controversial and inconclusive findings in PE psychogenic and neurogenic etiology, utilizing a single parameter to describe and qualify PE using the aforementioned diagnostic methods provides valuable, but insufficient information for PE diagnosis. There is still a lack of a feasible and plausible means of objective measurement to evaluate the ejaculatory latency and control over ejaculation. Consequently, a comprehensive penile stimulation that simulates sexual intercourse could be useful to record intensity and duration parameters before the ejaculatory threshold, providing a more accurate method of describing and diagnosing PE versus a single chronological observation.
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Affiliation(s)
- Shanzun Wei
- The Andrology Laboratory, West China Hospital, Sichuan University, Chengdu 610041, China.,Department of Urology, West China Hospital, Sichuan University, Chengdu 610041, China
| | - Changjing Wu
- The Andrology Laboratory, West China Hospital, Sichuan University, Chengdu 610041, China
| | - Botao Yu
- The Andrology Laboratory, West China Hospital, Sichuan University, Chengdu 610041, China.,Department of Urology, West China Hospital, Sichuan University, Chengdu 610041, China
| | - Ming Ma
- The Andrology Laboratory, West China Hospital, Sichuan University, Chengdu 610041, China.,Department of Urology, West China Hospital, Sichuan University, Chengdu 610041, China
| | - Feng Qin
- The Andrology Laboratory, West China Hospital, Sichuan University, Chengdu 610041, China
| | - Jiuhong Yuan
- The Andrology Laboratory, West China Hospital, Sichuan University, Chengdu 610041, China.,Department of Urology, West China Hospital, Sichuan University, Chengdu 610041, China
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Abnormal White Matter Microstructure in Lifelong Premature Ejaculation Patients Identified by Tract–Based Spatial Statistical Analysis. J Sex Med 2018; 15:1272-1279. [DOI: 10.1016/j.jsxm.2018.07.012] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2017] [Revised: 07/20/2018] [Accepted: 07/23/2018] [Indexed: 10/28/2022]
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Women's finger pressure sensitivity at rest and recalled body awareness during partnered sexual activity. Int J Impot Res 2017; 29:157-159. [PMID: 28405028 DOI: 10.1038/ijir.2017.13] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2016] [Revised: 02/01/2017] [Accepted: 03/02/2017] [Indexed: 11/09/2022]
Abstract
Greater vibrotactile sensitivity has been related to better erectile function in men, and vibrotactile and pressure tactile sensitivity have been related to better sexual function in women. Our previous study found that, for both sexes, greater recalled body awareness during last sexual relation correlated with greater recalled desire and arousal. Using the same sample of that study (68 women and 48 men, recruited in the Lisbon area, Portugal), we tested if greater recalled body awareness during last sexual relation correlates with tactile pressure sensitivity, as assessed by von Frey microfilaments. In simple and partial correlations controlling for social desirability and smoking before last sex, the hypothesis was confirmed for women, but not for men. Greater tactile sensitivity might enhance sexual arousal through greater awareness of the body during sex, and/or more frequent and pleasant body sensations during sex might lead to greater tactile sensitivity in nonsexual situations. Pressure sensitivity might be more closely linked to sexual arousal in women than in men.
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Shi B. Response to Re: Resiniferatoxin for treatment of lifelong premature ejaculation: A preliminary study. Int J Urol 2017; 24:244. [PMID: 28147446 DOI: 10.1111/iju.13288] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Affiliation(s)
- Bentao Shi
- Department of Urology, Peking University Shenzhen Hospital, Shenzhen, Guangdong, China
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