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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] [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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Sayed Ahmed HA, Abdallah EM, Mohamed MAE, Aboelfotoh TM, Nour-Eldein H, Fouad AM. Association between erectile dysfunction and subjective well-being in primary care patients with type 2 diabetes. Diabetol Int 2024; 15:421-432. [PMID: 39101170 PMCID: PMC11291785 DOI: 10.1007/s13340-024-00699-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/20/2023] [Accepted: 01/31/2024] [Indexed: 08/06/2024]
Abstract
Objectives To assess the association between erectile dysfunction and subjective well-being among primary care patients with type 2 diabetes mellitus. Methods This cross-sectional study included 340 men with type 2 diabetes treated in primary health care settings in the Ismailia governorate between April 2021 and April 2022. A multistage random cluster sampling technique was used. Sociodemographic data, disease characteristics, lifestyle, surgical and sexual history, and the Arabic translations of the abridged 5-item version of the International Index of Erectile Function (IIEF-5) Questionnaire, and the 5-item World Health Organization Well-Being Index (WHO-5) were gathered. Results Erectile dysfunction was identified in 72.94% of diabetic patients, with 55% mild or mild-to-moderate (ED I), and 17.9% moderate or severe (ED II). Twenty percent had Poor subjective well-being, with a mean WHO-5 index of 63.4 (± 15.4). Binary logistic regression analysis showed that education, diabetes duration, insufficient income, dyslipidemia, benign prostate hyperplasia, and IIEF-5 score were significantly associated with poor subjective well-being. Increasing IIEF-5 score was significantly associated with a 22% decrease in the odds of poor subjective well-being (OR: 0.78; 95% CI 0.66-0.93). Multinomial regression analysis showed that increasing score of the WHO-5 well-being index was associated with a 11% and 14% reduction in the odds of ED I and II, respectively (OR: 0.89 (95% CI 0.86-0.93), and 0.86 (95% CI 0.81-0.92), respectively). Conclusion Erectile dysfunction and subjective well-being were interrelated. Early detection of erectile dysfunction is essential for improving the positive mental health of men with type 2 diabetes in primary care.
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Affiliation(s)
- Hazem A. Sayed Ahmed
- Department of Family Medicine, Faculty of Medicine, Suez Canal University, Ismailia, Egypt
| | | | | | | | - Hebatallah Nour-Eldein
- Department of Family Medicine, Faculty of Medicine, Suez Canal University, Ismailia, Egypt
| | - Ahmed Mahmoud Fouad
- Department of Public Health, Occupational and Environmental Medicine, Faculty of Medicine, Suez Canal University, Ismailia, Egypt
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Chung E, Hui J, Xin ZC, Kim SW, Moon DG, Yuan Y, Nagao K, Hakim L, Chang HC, Mak SK, Duarsa GWK, Dai Y, Yao B, Son H, Huang W, Lin H, Nguyen Q, Mai DBT, Park K, Lee J, Tantiwongse K, Sato Y, Jiann BP, Ho C, Park HJ. Management of Male Infertility with Coexisting Sexual Dysfunction: A Consensus Statement and Clinical Recommendations from the Asia-Pacific Society of Sexual Medicine (APSSM) and the Asian Society of Men's Health and Aging (ASMHA). World J Mens Health 2024; 42:471-486. [PMID: 37853539 PMCID: PMC11216964 DOI: 10.5534/wjmh.230180] [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: 06/24/2023] [Revised: 07/01/2023] [Accepted: 07/09/2023] [Indexed: 10/20/2023] Open
Abstract
Male infertility (MI) and male sexual dysfunction (MSD) can often coexist together due to various interplay factors such as psychosexual, sociocultural and relationship dynamics. The presence of each form of MSD can adversely impact male reproduction and treatment strategies will need to be individualized based on patients' factors, local expertise, and geographical socioeconomic status. The Asia Pacific Society of Sexual Medicine (APSSM) and the Asian Society of Men's Health and Aging (ASMHA) aim to provide a consensus statement and practical set of clinical recommendations based on current evidence to guide clinicians in the management of MI and MSD within the Asia-Pacific (AP) region. A comprehensive, narrative review of the literature was performed to identify the various forms of MSD and their association with MI. MEDLINE and EMBASE databases were searched for the following English language articles under the following terms: "low libido", "erectile dysfunction", "ejaculatory dysfunction", "premature ejaculation", "retrograde ejaculation", "delayed ejaculation", "anejaculation", and "orgasmic dysfunction" between January 2001 to June 2022 with emphasis on published guidelines endorsed by various organizations. This APSSM consensus committee panel evaluated and provided evidence-based recommendations on MI and clinically relevant MSD areas using a modified Delphi method by the panel and specific emphasis on locoregional socio-economic-cultural issues relevant to the AP region. While variations exist in treatment strategies for managing MI and MSD due to geographical expertise, locoregional resources, and sociocultural factors, the panel agreed that comprehensive fertility evaluation with a multidisciplinary management approach to each MSD domain is recommended. It is important to address individual MI issues with an emphasis on improving spermatogenesis and facilitating reproductive avenues while at the same time, managing various MSD conditions with evidence-based treatments. All therapeutic options should be discussed and implemented based on the patient's individual needs, beliefs and preferences while incorporating locoregional expertise and available resources.
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Affiliation(s)
- Eric Chung
- Department of Urology, Princess Alexandra Hospital, University of Queensland, Brisbane, QLD, Australia
- AndroUrology Centre, Brisbane, QLD, Australia.
| | - Jiang Hui
- Department of Urology, Peking University Third Hospital, Beijing, China
| | - Zhong Cheng Xin
- Male Reproductive and Sexual Medicine, Department of Urology, The Second Hospital of Tianjin Medical University, Tianjin, China
| | - Sae Woong Kim
- Department of Urology, The Catholic University of Korea, Seoul St. Mary's Hospital, Seoul, Korea
| | - Du Geon Moon
- Department of Urology, Korea University Guro Hospital, Seoul, Korea
| | - Yiming Yuan
- Andrology Centre, Peking University First Hospital, Peking University, Beijing, China
| | - Koichi Nagao
- Department of Urology, Toho University, Tokyo, Japan
| | - Lukman Hakim
- Department of Urology, Universitas Airlangga Teaching Hospital, Faculty of Medicine, Universitas Airlangga, Surabaya, Indonesia
| | - Hong-Chiang Chang
- Department of Urology, National Taiwan University Hospital, Taipei, Taiwan
| | - Siu King Mak
- Department of Surgery, Union Hospital, Hong Kong, China
| | | | - Yutian Dai
- The Department of Andrology, Drum Tower Hospital, Medical School of Nanjing University, Nanjing, China
| | - Bing Yao
- Department of Urology, Affiliated Jinling Hospital, School of Medicine, Nanjing University, Nanjing, China
| | - Hwancheol Son
- Department of Urology, Seoul National University College of Medicine, Seoul, Korea
| | - William Huang
- Department of Urology, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Haocheng Lin
- Department of Urology, Peking University Third Hospital, Beijing, China
| | - Quang Nguyen
- Centre of Andrology and Sexual Medicine, Viet Duc University Hospital, Hanoi, Vietnam
| | - Dung Ba Tien Mai
- Department of Urology, Binh Dan Hospital, Ho Chi Minh City, Vietnam
| | - Kwangsung Park
- Department of Urology, Chonnam National University Medical School, Gwangju, Korea
| | - Joe Lee
- Department of Urology, National University Hospital, Singapore
| | | | - Yoshikazu Sato
- Department of Urology, Sanjukai Hospital, Sapporo, Japan
| | - Bang-Ping Jiann
- Department of Urology, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan
| | - Christopher Ho
- School of Medicine, Taylor's University, Subang, Selangor, Malaysia
| | - Hyun Jun Park
- Pusan National University Hospital, Pusan National University School of Medicine, Busan, Korea
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Fasanghari M, Keramat A, Tansaz M, Moini A, Chaman R. Effect of alternative and complementary medicine on male infertility: An umbrella review. Health Sci Rep 2024; 7:e2118. [PMID: 38915352 PMCID: PMC11194475 DOI: 10.1002/hsr2.2118] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2023] [Revised: 04/08/2024] [Accepted: 04/26/2024] [Indexed: 06/26/2024] Open
Abstract
Background and Aims There is increasing interest worldwide in using alternative and complementary approaches for treating male infertility. This interest has spawned a multitude of published systematic reviews and meta-analyses. The aim of this Umbrella review was to consolidate the available evidence regarding the effect of complementary and alternative medicine on male infertility to inform clinical decision-making processes. Methods A comprehensive search was conducted to identify systematic reviews and meta-analyses pertaining to the effects of complementary and alternative medicine on male infertility. This search encompassed various databases including MEDLINE, CINAHL, PubMed, Scopus, Proquest, Google Scholar, SID, EMBASE, Magiran, Cochrane Library, Iranmedex, ScienceDirect, SAGE. Subsequently, two researchers independently extracted the data from the selected meta-analyses and systematic reviews, and evaluated their methodological quality using the assessment of multiple systematic reviews 2 (AMSTAR2). Results This analysis encompassed 11 studies, with four originating from Iran, two from Korea and five from China. The results regarding the effectiveness of complementary and alternative medicine are controversial, indicating a need for further research. The methodological quality of the systematic reviews and meta-analyses appraised by AMSTAR 2 was rated as low or critically low. This assessment is attributed to inadequate examination of publication biases in the reviews and a lack of discussion regarding the effect of risk of bias. Conclusion The existing evidence regarding the effectiveness of alternative and complementary medicine in addressing male infertility is limited. Furthermore, the overall methodological quality of the published systematic reviews and meta-analyses may have been underestimated as the use of AMSTAR2 appears to be a more precise appraisal instrument compared to its predecessor.
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Affiliation(s)
- Maryam Fasanghari
- Student Research Committee, School of Nursing and MidwiferyShahroud University of Medical SciencesShahroudIran
| | - Afsaneh Keramat
- Center for Health Related Social and Behavioral Sciences ResearchShahroud University of Medical SciencesShahroudIran
| | - Mojgan Tansaz
- Department of Traditional Medicine, School of Traditional MedicineShahid Beheshti University of Medical SciencesTehranIran
| | - Ashraf Moini
- Department of Gynecology & Obstetrics, Arash Women's HospitalTehran University of Medical SciencesTeranIran
- Breast Disease Research Center (BDRC)Tehran University of Medical SciencesTeranIran
- Department of Endocrinology & Female Infertility at ReproductionBiomedicine Research Center, Royan Institute for Reproduction ACERTehranIran
| | - Reza Chaman
- Department of Community Medicine, Faculty of MedicineShahroud University of Medical SciencesShahroudIran
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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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Cilio S, Boeri L, Pozzi E, Fallara G, Belladelli F, Corsini C, Capogrosso P, d'Arma A, Imbimbo C, Palmieri A, Mirone V, Montorsi F, Salonia A. Prevalence and predictors of unrecognised low sexual desire/interest in men with new onset erectile dysfunction: findings from a cross-sectional, real-life study. Int J Impot Res 2024; 36:83-88. [PMID: 36496478 DOI: 10.1038/s41443-022-00647-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2022] [Revised: 11/22/2022] [Accepted: 11/22/2022] [Indexed: 12/14/2022]
Abstract
The interrelationship between male sexual desire and erectile dysfunction (ED) has been scantly investigated. Thus, we aimed at investigating the prevalence of and the predictors of unrecognised low sexual desire/interest (uLSD/I) in a cohort of men with new onset ED. Complete data from 1587 men seeking for first medical help for ED between 2010 and 2021 were analysed. Comorbidities were scored with the Charlson Comorbidity Index (CCI). At entrance, all patients were asked to self-report low sexual desire/interest and completed the International Index of Erectile Function (IIEF) and the Beck Depression Inventory (BDI) (depressive symptoms scored as BDI ≥ 11). The IIEF-erectile function (IIEF-EF) domain was categorised according to Cappelleri's criteria. The median value of the IIEF-sexual desire domain (IIEF-SD) was used to dichotomise men with uLSD/I along with ED (IIEF-SD < 7) vs. ED-only (IIEF-SD ≥ 7). Circulating hormones were measured in every patient. Hypogonadism was defined as total testosterone (tT) <3.0 ng/mL. Descriptive statistics and logistic regression models tested the association between clinical variables and uLSD/I. Of 1197 patients not self-reporting LSD/I, 369 (30.8%) had IIEF-SD < 7. Patients with ED + uLSD/I were older [median (IQR) 54(41-63) vs. 49(36-59) years], had lower IIEF-EF [10.5(5-22) vs. 22(11-28)] but higher BDI [6(3-12) vs. 4(1-8)] and lower tT [4.3(3.2-5.7) vs. 4.8(3.2-6.3) ng/mL] compared to ED-only men (all p < 0.05). Overall, ED + uLSD/I men had higher rate of severe ED (49.9% vs. 23.9%), and of BDI ≥ 11 (30.6% vs. 18.2%) (all p < 0.05). At multivariable logistic regression analysis, lower tT (OR: 0.82), lower IIEF-EF scores (OR:0.95) and BDI ≥ 11 (OR:2.51) were independently associated with ED + uLSD/I, after accounting for age (all p < 0.05). Almost 30% of men seeking first medical help for ED-only had also uLSD/I. Men with both conditions were older, had higher rates of severe ED and more depressive symptoms. A detailed investigation of sexual desire should be always included in men self-complaining only of ED.
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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
| | - Luca Boeri
- Department of Urology, Foundation IRCCS Ca' Granda -Ospedale Maggiore Policlinico, Milan, 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
| | - Paolo Capogrosso
- Department of Urology, Circolo & Fondazione Macchi Hospital -ASST Sette Laghi, Varese, Italy
| | - Alessia d'Arma
- Division of Experimental Oncology/Unit of Urology, URI; IRCCS Ospedale San Raffaele, Milan, Italy
| | - Ciro Imbimbo
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, Urology Unit, University of Naples "Federico II", Naples, Italy
| | - Alessandro Palmieri
- 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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Rowland DL. Response to Commentary on Rowland et al "Does Ejaculatory Latency Vary Between Men With Lifelong vs Acquired PE?". Urology 2024; 184:120-121. [PMID: 38123434 DOI: 10.1016/j.urology.2023.09.070] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2023]
Affiliation(s)
- David L Rowland
- Department of Psychology, Valparaiso University, Valparaiso, IN.
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8
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Cabo JJ, Kaufman MR, Johnsen NV. Impact of sexual function domains on sexual satisfaction and quality of life: Importance across the age spectrum. Andrology 2024. [PMID: 38226963 DOI: 10.1111/andr.13594] [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: 04/08/2023] [Revised: 12/29/2023] [Accepted: 01/02/2024] [Indexed: 01/17/2024]
Abstract
BACKGROUND Sexual satisfaction is an important component of global quality life for many adult men. Substantial gaps exist in our appreciation of how age mediates sexual satisfaction in the context of functional sexual measures. We sought to evaluate modifiable factors associated with overall sexual satisfaction and health-related quality of life (HRQoL) in a large, age-stratified community-based sample of adult men. METHODS A sample of adult males registered with the online research service ResearchMatch completed a 75-item online questionnaire in this cross-sectional study. Queries included demographics, general health data, and validated sexual health measures including International Index of Erectile Function-5 (IIEF-5) and Premature Ejaculation Diagnostic Tool (PEDT). Multivariable regression was performed to assess associations with self-reported sexual satisfaction (defined by "moderately satisfied" or "very satisfied" on the 5-level Likert scale) and overall HRQoL (as measured by the EQ-5D-visual analog scale (VAS) stratified by age. RESULTS One thousand thirty-three men completed the survey and were stratified by age cohorts. IIEF-5 and PEDT scores were higher in younger cohorts. On multivariable regression analysis, higher IIEF-5, lower PEDT, better overall health-related quality of life, and the presence of a sexual partner within the last month were associated with an increased likelihood of overall sexual satisfaction. When stratified by age cohort, higher IIEF-5 scores were consistently positively associated with sexual satisfaction (Odds Ratio (OR) 1.18, 95% CI 1.15-1.22, P < 0.001), as well as independently associated with improved overall HRQoL by EQ-5D-VAS (β = 0.71, Standard Error (SE) = 0.08, P < 0.001). CONCLUSIONS The erectile function was independently associated with sexual satisfaction and quality of life across all age strata and predictive of both sexual satisfaction and global HRQoL. Low overall rates of sexual satisfaction across cohorts highlight the critical importance of evaluation and treatment of sexual health, regardless of age.
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Affiliation(s)
- Jackson J Cabo
- Department of Urology, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Melissa R Kaufman
- Department of Urology, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Niels V Johnsen
- Department of Urology, Vanderbilt University Medical Center, Nashville, Tennessee, USA
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Liao WC, Cheng WM, Fan YH, Liou YJ. Impact of type D personality and depressive symptoms on premature ejaculation in young adult males. Sex Med 2023; 11:qfad055. [PMID: 38028734 PMCID: PMC10661336 DOI: 10.1093/sexmed/qfad055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2023] [Revised: 09/08/2023] [Accepted: 09/29/2023] [Indexed: 12/01/2023] Open
Abstract
Background Premature ejaculation (PE) is one of the most common male sexual dysfunctions with prominent psychological consequences. Type D personality (TDP) is also associated with multiple psychological disorders, such as depression and anxiety. However, the correlation between PE and TDP remains unknown. Aim The study sought to investigate the relationships between depressive symptoms, TDP, and PE. Methods Adult males in Taiwan who were 20 to 40 years of age and who had sexual intercourse in the past 6 months were recruited to complete online questionnaires composed of general demographics, the Premature Ejaculation Diagnostic Tool (PEDT), 5-item International Index of Erectile Function (IIEF-5), Type D Scale-14, and Depression and Somatic Symptom Scale (DSSS). Chi-square test and independent Student's t test were used to compare the parameters between the TDP and non-TDP groups. Univariate and multivariate logistic regression analyses were conducted to evaluate factors related to PE. Outcomes Outcomes were the prevalence of PE and TDP in young Taiwanese men, the associations between depressive symptoms and PE and TDP, and the predictive factors of PE. Results In total, 2558 men with a mean age of 31.3 ± 5.3 years were included in the present study. Among them, 315 (12.3%) and 767 (30.1%) participants were classified as having PE and moderate-to-severe erectile dysfunction (ED), respectively. In total, 1249 (48.8%) participants met the criteria for TDP. The PEDT, IIEF-5, and DSSS, including the total scores and depression and somatic subscales, were significantly higher in men with TDP (all P < .001). PE prevalence was significantly greater in men with TDP than in those without TDP (16.2% vs 8.6%; P < .001). Most parameters, including age, moderate-to-severe ED, the Type D Scale-14 subscales, and the DSSS somatic and depressive subscales, were significantly associated with PE in the univariate analysis. Only the depressive subscale of the DSSS and moderate-to-severe ED (IIEF-5 ≤16) were the independent predictors of PE in the multivariate analysis. Clinical Implications The results suggest that it is important to consider the psychological effects of PE in young men, and the study has provided a biopsychosocial aspect to manage patients with PE. Strengths and Limitations This is the first study to evaluate the association between PE, TDP, and depression in a large population of young adult males. However, the cross-sectional design may have limited the investigation of causality, and selection bias may be present. Conclusion Men with TDP tended to have higher PEDT scores and a prevalence of PE and ED. Moderate-to-severe ED and depressive symptoms are the independent predictive factors of PE.
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Affiliation(s)
- Wei-Chuang Liao
- Division of Urology, Department of Surgery, Taipei City Hospital, Zhongxiao Branch, Taipei 115, Taiwan
| | - Wei-Ming Cheng
- Division of Urology, Department of Surgery, Taipei City Hospital, Zhongxiao Branch, Taipei 115, Taiwan
- Department of Urology, College of Medicine, National Yang Ming Chiao Tung University, Taipei 112, Taiwan
- Program in Molecular Medicine, School of Life Sciences, National Yang Ming Chiao Tung University, Taipei 112, Taiwan
- Institute of Biopharmaceutical Science, School of Life Science, National Yang Ming Chiao Tung University, Taipei 112, Taiwan
| | - Yu-Hua Fan
- Department of Urology, College of Medicine, National Yang Ming Chiao Tung University, Taipei 112, Taiwan
- Department of Urology, Taipei Veterans General Hospital, Taipei 112, Taiwan
| | - Ying-Jay Liou
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei 112,Taiwan
- Department of Psychiatry, College of Medicine, National Yang Ming Chiao Tung University, Taipei 112, Taiwan
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10
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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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11
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Değer MD, Gül M. Comment on "Premature ejaculation among men with erectile dysfunction-findings from a real-life cross-sectional study". Int J Impot Res 2023; 35:579-580. [PMID: 36167822 DOI: 10.1038/s41443-022-00623-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2022] [Revised: 09/13/2022] [Accepted: 09/20/2022] [Indexed: 11/08/2022]
Affiliation(s)
- Müslim Doğan Değer
- Edirne Sultan 1st Murat State Hospital, Department of Urology, Edirne, Turkey
| | - Murat Gül
- Department of Urology, Selcuk University School of Medicine, Konya, Turkey.
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12
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Przydacz M, Chlosta M, Rajwa P, Chlosta P. Population-level prevalence, effect on quality of life, and treatment behavior for erectile dysfunction and premature ejaculation in Poland. Sci Rep 2023; 13:13168. [PMID: 37580405 PMCID: PMC10425435 DOI: 10.1038/s41598-023-39968-9] [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: 04/11/2023] [Accepted: 08/02/2023] [Indexed: 08/16/2023] Open
Abstract
The prevalence of erectile dysfunction (ED) and premature ejaculation (PE) has been investigated in many population-based studies in different regions of the world. However, reliable data are lacking for Eastern Europe. Therefore, the aim of this study was to analyze the prevalence, effect on quality of life, and treatment-related behaviors for ED and PE in a population-representative sample of Polish men. We used an Internet interview format and rigorously adapted, widely accepted instruments for ED and PE evaluation. The study included 3001 men, representative for age and place of residence and adequate proportions of respondents from urban and rural areas. The prevalence of ED was 30.1-61.1%, and the prevalence of PE was 19.3-38.1%; there were no differences between urban and rural areas. Whereas the prevalence of ED increased with age, the prevalence of PE did not increase. More than 50% of respondents with ED and more than 60% of respondents with PE had concerns about their quality of life. However, less than one fourth of participants with ED and PE were seeking treatment, most of whom received treatment. The results of our nationwide analysis, reflecting the entire Polish population of men, are consistent with other epidemiologic studies of ED and PE and may support educational campaigns and health improvement programs in Poland.
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Affiliation(s)
- Mikolaj Przydacz
- Department of Urology, Jagiellonian University Medical College, ul. Macieja Jakubowskiego 2, 30-688, Krakow, Poland.
| | - Marcin Chlosta
- Department of Urology, Jagiellonian University Medical College, ul. Macieja Jakubowskiego 2, 30-688, Krakow, Poland
| | - Pawel Rajwa
- Department of Urology, Medical University of Silesia, Zabrze, Poland
- Department of Urology, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria
| | - Piotr Chlosta
- Department of Urology, Jagiellonian University Medical College, ul. Macieja Jakubowskiego 2, 30-688, Krakow, Poland
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13
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Corona G, Cucinotta D, Di Lorenzo G, Ferlin A, Giagulli VA, Gnessi L, Isidori AM, Maiorino MI, Miserendino P, Murrone A, Pivonello R, Rochira V, Sangiorgi GM, Stagno G, Foresta C, Lenzi A, Maggi M, Jannini EA. The Italian Society of Andrology and Sexual Medicine (SIAMS), along with ten other Italian Scientific Societies, guidelines on the diagnosis and management of erectile dysfunction. J Endocrinol Invest 2023; 46:1241-1274. [PMID: 36698034 PMCID: PMC9876440 DOI: 10.1007/s40618-023-02015-5] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/16/2022] [Accepted: 01/16/2023] [Indexed: 01/27/2023]
Abstract
PURPOSE Erectile dysfunction (ED) is one of the most prevalent male sexual dysfunctions. ED has been in the past mistakenly considered a purely psycho-sexological symptom by patients and doctors. However, an ever-growing body of evidence supporting the role of several organic factors in the pathophysiological mechanisms underlying ED has been recognized. METHODS The Italian Society of Andrology and Sexual Medicine (SIAMS) commissioned an expert task force involving several other National Societies to provide an updated guideline on the diagnosis and management of ED. Derived recommendations were based on the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) system. RESULTS Several evidence-based statements were released providing the necessary up-to-date guidance in the context of ED with organic and psychosexual comorbidities. Many of them were related to incorrect lifestyle habits suggesting how to associate pharmacotherapies and counseling, in a couple-centered approach. Having the oral therapy with phosphodiesterase type 5 inhibitors as the gold standard along with several other medical and surgical therapies, new therapeutic or controversial options were also discussed. CONCLUSIONS These are the first guidelines based on a multidisciplinary approach that involves the most important Societies related to the field of sexual medicine. This fruitful discussion allowed for a general agreement on several recommendations and suggestions to be reached, which can support all stakeholders in improving couple sexual satisfaction and overall general health.
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Affiliation(s)
- G Corona
- Endocrinology Unit, Medical Department, Maggiore-Bellaria Hospital, Azienda Usl, Bologna, Italy
| | - D Cucinotta
- Chair of Internal Medicine, Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy
| | - G Di Lorenzo
- Section of Psychiatry, Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy
- IRCCS Fondazione Santa Lucia, Rome, Italy
| | - A Ferlin
- Unit of Andrology and Reproductive Medicine, Department of Medicine, University of Padova, Padua, Italy
| | - V A Giagulli
- Interdisciplinary Department of Medicine-Section of Internal Medicine, Geriatrics, Endocrinology and Rare Diseases, University of Bari "Aldo Moro", Bari, Italy
- Santa Maria Hospital, GVM Care & Research, Bari, Italy
| | - L Gnessi
- Section of Food Science, Department of Experimental Medicine, Sapienza University of Rome, Rome, Italy
| | - A M Isidori
- Section of Endocrinology, Department of Experimental Medicine, Sapienza University of Rome, Rome, Italy
| | - M I Maiorino
- Division of Endocrinology and Metabolic Diseases, Department of Advanced Medical and Surgical Sciences, University of Campania Luigi Vanvitelli, Naples, Italy
| | - P Miserendino
- Diabetology and Endocrinology Unit, ASP #, Caltanissetta, Italy
| | - A Murrone
- Cardiology Unit, Città di Castello and Gubbio-GualdoTadino Hospitals, Azienda Usl Umbria 1, Gubbio, Italy
| | - R Pivonello
- Dipartimento di Medicina Clinica e Chirurgia, Sezione di Endocrinologia, Unità di Andrologia e Medicina della Riproduzione e della Sessualità Maschile e Femminile, Università Federico II di Napoli, Naples, Italy
- Staff of UNESCO Chair for Health Education and Sustainable Development, Federico II University, Naples, Italy
| | - V Rochira
- Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy
| | - G M Sangiorgi
- Department of Biomedicine and Prevention, Policlinico Tor Vergata, Rome, Italy
| | - G Stagno
- Diabetology Unit, ASP Reggio Calabria, Reggio Calabria, Italy
| | - C Foresta
- Unit of Andrology and Reproductive Medicine, Department of Medicine, University of Padova, Padua, Italy
| | - A Lenzi
- Section of Food Science, Department of Experimental Medicine, Sapienza University of Rome, Rome, Italy
| | - M Maggi
- Endocrinology Unit, Department of Experimental, Clinical and Biomedical Sciences, University of Florence, Florence, Italy
| | - E A Jannini
- Chair of Endocrinology and Sexual Medicine (ENDOSEX), Department of Systems Medicine, University of Rome Tor Vergata, E Tower South Floor 4, Room E413, Via Montpellier 1, 00133, Rome, Italy.
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14
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Puigvert-Martínez AM, Prieto-Castro R, Artigas-Feliu R, Illán-Mateo P, Cruz-Culebra N, González-Ayala G. Management of erectile dysfunction and premature ejaculation: The perspective of Spanish urologists. Results of the PANDORA Project (Part II). Rev Int Androl 2023; 21:100353. [PMID: 37105006 DOI: 10.1016/j.androl.2023.100353] [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: 07/28/2021] [Revised: 02/01/2022] [Accepted: 04/12/2022] [Indexed: 04/29/2023]
Abstract
INTRODUCTION ED and PE are the most common male sexual dysfunctions, although they remain underdiagnosed and undertreated. AIM To ascertain how a group of Spanish urologists currently address ED and PE. METHODS Descriptive study based on a self-designed questionnaire about the clinical practice in ED and PE upon diagnosis, treatment and monitoring, patient-physician relationship and the role of the patient's partner. RESULTS The survey was completed by 188 experienced urologists. Most patients went to the urologist's office without a previous diagnosis (92% of the urologists found <10 PE-diagnosed patients in public settings). The diagnosis of ED and/or PE was mainly carried out by the current urologist and not by another professional, particularly in private centres as opposed to public centres (78.8% vs 57.0% for ED; 82.0% vs 62.6% for PE). Most urologists believed that these disorders are underdiagnosed and deemed them as general health issues. 38% of urologists acknowledged using validated questionnaires to diagnose ED. PE was considered a subjective problem rather than a true disease and the use of PRO-based diagnosis of PE was not generally accepted (14%). Treatment options of both disorders were chosen as expected. Referral to the andrologist is usually scheduled in moderate-to-severe PE or severe ED. The cohort seemed to be mostly neutral (50%-75% for ED and 40%-55% for PE) regarding patient reluctancy to talk about their sexual problem. Patients' partners play an important role in helping men seeking treatment. CONCLUSION Urologists should show more proactivity during anamnesis and routine visits to improve management of ED and PD.
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Affiliation(s)
| | - Rafael Prieto-Castro
- Andrology Unit, Sexual and Reproductive Medicine, Reina Sofía Regional University Hospital of Cordoba, Córdoba, Spain
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15
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Colonnello E, Sansone A, Jannini EA. Erectile dysfunction, anxiety, perceived stress, and insomnia are more common among acquired premature ejaculation patients in contrast to other premature ejaculation syndromes. Andrology 2023; 11:433-434. [PMID: 36705343 DOI: 10.1111/andr.13401] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2023] [Accepted: 01/23/2023] [Indexed: 01/28/2023]
Affiliation(s)
- Elena Colonnello
- Department of Systems Medicine, University of Rome Tor Vergata, Chair of Endocrinology and Medical Sexology (ENDOSEX), Via Montpellier, Italy
| | - Andrea Sansone
- Department of Systems Medicine, University of Rome Tor Vergata, Chair of Endocrinology and Medical Sexology (ENDOSEX), Via Montpellier, Italy
| | - Emmanuele A Jannini
- Department of Systems Medicine, University of Rome Tor Vergata, Chair of Endocrinology and Medical Sexology (ENDOSEX), Via Montpellier, Italy
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16
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Desai A, Chen R, Cayetano A, Jayasena CN, Minhas S. Understanding and treating ejaculatory dysfunction in men with diabetes mellitus. Andrology 2023; 11:379-398. [PMID: 35933708 DOI: 10.1111/andr.13262] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2022] [Revised: 07/27/2022] [Accepted: 08/02/2022] [Indexed: 01/24/2023]
Abstract
Diabetes mellitus is a rapidly rising metabolic disorder with important systemic complications. Global figures have demonstrated the prevalence of diabetes mellitus has almost quadrupled from 108 million in 1980 to 422 million in 2014, with a current prevalence of over 525 million. Of the male sexual dysfunction resulting from diabetes mellitus, significant focus is afforded to erectile dysfunction. Nevertheless, ejaculatory dysfunction constitutes important sexual sequelae in diabetic men, with up to 35%-50% of men with diabetes mellitus suffering from ejaculatory dysfunction. Despite this, aspects of its pathophysiology and treatment are less well understood than erectile dysfunction. The main disorders of ejaculation include premature ejaculation, delayed ejaculation, anejaculation and retrograde ejaculation. Although ejaculatory dysfunction in diabetes mellitus can have complex multifactorial aetiology, understanding its pathophysiological mechanisms has facilitated the development of therapies in the management of ejaculatory dysfunction. Most of our understanding of its pathophysiology is derived from diabetic animal models; however, observational studies in humans have also provided useful information in elucidating important associative factors potentially contributing to ejaculatory dysfunction in diabetic men. These have provided the potential for more tailored treatment regimens in patients depending on the ejaculatory disorder, other co-existing sequelae of diabetes mellitus, specific metabolic factors as well as the need for fertility treatment. However, evidence for treatment of ejaculatory dysfunction, especially delayed ejaculation and retrograde ejaculation, is based on low-level evidence comprising small sample-size series and retrospective or cross-sectional studies. Whilst promising findings from large randomised controlled trials have provided strong evidence for the licensed treatment of premature ejaculation, similar robust studies are needed to accurately elucidate factors predicting ejaculatory dysfunction in diabetes mellitus, as well as for the development of pharmacotherapies for delayed ejaculation and retrograde ejaculation. Similarly, more contemporary robust data are required for fertility outcomes in these patients, including methods of sperm retrieval and assisted reproductive techniques in retrograde ejaculation.
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Affiliation(s)
- Ankit Desai
- Department of Andrology, Imperial Healthcare NHS Trust, London, UK
| | - Runzhi Chen
- Department of Andrology, Imperial Healthcare NHS Trust, London, UK
| | - Axel Cayetano
- Department of Andrology, Imperial Healthcare NHS Trust, London, UK
| | - Channa N Jayasena
- Department of Reproductive Endocrinology, Imperial Healthcare NHS Trust, London, UK
| | - Suks Minhas
- Department of Andrology, Imperial Healthcare NHS Trust, London, UK
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17
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Niu C, Ventus D, Jern P, Santtila P. Premature ejaculation among Chinese urban men: prevalence and correlates. Sex Med 2023; 11:qfac015. [PMID: 37007854 PMCID: PMC10065173 DOI: 10.1093/sexmed/qfac015] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2022] [Revised: 11/13/2022] [Accepted: 11/23/2022] [Indexed: 01/15/2023] Open
Abstract
Abstract
Background
Premature ejaculation (PE) is a common male sexual dysfunction worldwide. It leads to substantial distress in men and their partners, constitutes a serious threat to the quality and stability of romantic relationships, and results in a decreased quality of life in a large part of the population.
Aim
We investigated the prevalence of PE and correlated factors in an urban sample of Chinese men.
Methods
In total, 1976 Chinese men aged 18 to 50 years responded to an online questionnaire regarding background information, present and previous sexual experience, frequency of different types of sex, as well as erectile and ejaculatory function.
Outcomes
Participants’ age, assigned sex at birth, sexual identity, relationship status, present and previous sexual experience, frequency of sexual activities, International Index of Erectile Function–5, and Checklist for Early Ejaculation Symptoms were used in the analyses.
Results
Forty-four (2.3%) participants had scores that were indicative or strongly indicative of PE, which was highly correlated with erectile problems. Men with more sexual experience (ie, more sexual partners and longer duration of being sexually active) had fewer ejaculatory problems. More frequent masturbation was associated with ejaculatory problems when controlling for age and education. More frequent partnered sex (ie, penile-vaginal sex) was associated with fewer ejaculatory problems. Ejaculation latency times for different types of sexual activities were positively correlated.
Clinical Translation
The results indicated that ejaculatory problems have complex relationships with sexual experience that clinicians should be aware of.
Strengths and Limitations
This study was the first to investigate PE with the Checklist for Early Ejaculation Symptoms as the measurement tool and the associations between PE and sexual experience, frequency of sexual activities, and sexual function in a large Chinese sample. However, self-reported ejaculation latency times may suffer from problems with validity.
Conclusion
Men’s sexual experience (ie, more sexual partners and longer duration of being sexually active) has an effect on their sexual function, which in turn affects their sexual activity.
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Affiliation(s)
- Caoyuan Niu
- East China Normal University School of Psychology and Cognitive Science, , Shanghai 200062, People’s Republic of China
- Faculty of Arts and Sciences, NYU Shanghai , Shanghai 200122, People’s Republic of China
| | - Daniel Ventus
- Åbo Akademi University Experience Lab, Faculty of Education and Welfare Studies, , Turku FI-20500 , Finland
| | - Patrick Jern
- Faculty of Arts, Psychology and Theology, Åbo Akademi University , Turku FI-20500 , Finland
| | - Pekka Santtila
- East China Normal University School of Psychology and Cognitive Science, , Shanghai 200062, People’s Republic of China
- Faculty of Arts and Sciences, NYU Shanghai , Shanghai 200122, People’s Republic of China
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18
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Shirai M, Ishikawa K, Hiramatsu I, Mizushima K, Tsuru T, Kurosawa M, Kure A, Uesaka Y, Nozaki T, Tsujimura A. The Men’s Training Cup Keep Training: a masturbation aid improves intravaginal ejaculatory latency time and Erection Hardness Score in patients who are unable to delay ejaculation. Sex Med 2023; 11:qfac010. [PMID: 37007846 PMCID: PMC10065175 DOI: 10.1093/sexmed/qfac010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Revised: 09/26/2022] [Accepted: 11/11/2022] [Indexed: 01/19/2023] Open
Abstract
Abstract
Introduction
Premature ejaculation (PE) has negative personal consequences, such as distress, bother, frustration, and/or the avoidance of sexual intimacy. In Japan, no oral drugs or devices are approved or used clinically to treat PE. The Men’s Training Cup Keep Training (MTCK), a masturbation aid, was developed for PE. MTCK offers 5 grades of tightness and strength.
Aim
We aimed to investigate the efficacy of the MTCK in patients who are unable to delay ejaculation.
Methods
Inclusion criteria were 20- to 60-year-old men feeling distressed and frustrated by PE and who had the same sexual partners throughout the study period. Exclusion criteria were neurologic disease and uncontrolled diabetes mellitus, as well as the use of antidepressants, α-blockers, and 5α-reductase inhibitors. The protocol comprised an 8-week training period with the MTCK from level 1 to level 5, with each level used twice before moving to the next level.
Outcome Measures
The main outcome measure was the extension of intravaginal ejaculation latency time (IELT). The secondary outcome measures were score improvements on the Premature Ejaculation Diagnostic Tool, Sexual Health Inventory for Men, Erection Hardness Score, and Difficulty in Performing Sexual Intercourse Questionnaire–5.
Results
We enrolled 37 patients, and after 19 patients withdrew, 18 concluded the study without experiencing any adverse events. The mean patient age was 39.9 years. Geometric IELT after the 8-week training with the MTCK increased significantly (mean ± SE; 232.10 ± 72.16 seconds) vs baseline (103.91 ± 50.61 seconds, P = .006). Mean scores on the Premature Ejaculation Diagnostic Tool, Difficulty in Performing Sexual Intercourse Questionnaire–5, and Erection Hardness Score after 8-week training improved significantly vs the baseline values. The mean score on the Sexual Health Inventory for Men did not improve significantly after the 8-week training, but domain 1 did significantly improve after 8 weeks of MTCK use.
Clinical Implications
The MTCK may be one possible treatment option for patients who are unable to delay ejaculation.
Strengths and Limitations
This is the first study to show that the MTCK is effective for patients who are unable to delay ejaculation. A major limitation is that the present study was not strictly limited to an IELT <3 minutes.
Conclusions
The MTCK may offer benefits not only for delay of ejaculation but also for erectile function.
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Affiliation(s)
- Masato Shirai
- Juntendo University Urayasu Hospital Department of Urology, , 2-1-1 Tomioka, Urayasu, Chiba 279-0021, Japan
| | - Keisuke Ishikawa
- Juntendo University Urayasu Hospital Department of Urology, , 2-1-1 Tomioka, Urayasu, Chiba 279-0021, Japan
- Graduate School of Medicine, Juntendo University Department of Urology, , 2-1-1 Hongo, Bunkyo-ku, Tokyo 113-8431, Japan
| | - Ippei Hiramatsu
- Juntendo University Urayasu Hospital Department of Urology, , 2-1-1 Tomioka, Urayasu, Chiba 279-0021, Japan
- Graduate School of Medicine, Juntendo University Department of Urology, , 2-1-1 Hongo, Bunkyo-ku, Tokyo 113-8431, Japan
| | - Kazuhiko Mizushima
- Juntendo University Urayasu Hospital Department of Urology, , 2-1-1 Tomioka, Urayasu, Chiba 279-0021, Japan
| | - Takamitsu Tsuru
- Juntendo University Urayasu Hospital Department of Urology, , 2-1-1 Tomioka, Urayasu, Chiba 279-0021, Japan
- Graduate School of Medicine, Juntendo University Department of Urology, , 2-1-1 Hongo, Bunkyo-ku, Tokyo 113-8431, Japan
| | - Makoto Kurosawa
- Juntendo University Urayasu Hospital Department of Urology, , 2-1-1 Tomioka, Urayasu, Chiba 279-0021, Japan
| | - Akimasa Kure
- Juntendo University Urayasu Hospital Department of Urology, , 2-1-1 Tomioka, Urayasu, Chiba 279-0021, Japan
| | - Yuka Uesaka
- Juntendo University Urayasu Hospital Department of Urology, , 2-1-1 Tomioka, Urayasu, Chiba 279-0021, Japan
| | - Taiji Nozaki
- Juntendo University Urayasu Hospital Department of Urology, , 2-1-1 Tomioka, Urayasu, Chiba 279-0021, Japan
| | - Akira Tsujimura
- Juntendo University Urayasu Hospital Department of Urology, , 2-1-1 Tomioka, Urayasu, Chiba 279-0021, Japan
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19
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Wang M, Wang Q, Jiang H, Du Y, Zhang X. Exploring the pharmacological mechanism of Shengjing capsule on male infertility by a network pharmacology approach. BMC Complement Med Ther 2022; 22:299. [DOI: 10.1186/s12906-022-03774-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2020] [Accepted: 10/28/2022] [Indexed: 11/19/2022] Open
Abstract
Abstract
Background
Shengjing capsule (SJC) is a traditional Chinese medicine (TCM) and has gained widespread clinical application for the treatment of male infertility (MI). However, the pharmacological mechanism of SJC against MI remains vague to date.
Method
The active ingredients of SJC and their targets were identified from the database, and MI-related genes were retrieved from several databases. Protein–protein interaction (PPI) data were obtained to construct the PPI networks. The candidate targets of SJC against MI were identified through topological analysis of the PPI network. Functional enrichment analysis of candidate targets was performed, and the key target genes were identified from the gene-pathway network.
Results
We identified 154 active ingredients and 314 human targets of SJC, as well as 564 MI-related genes. Eight pharmacological network diagrams illustrating the interactions among herbs, active ingredients, targets, and pathways, were constructed. The four dominating network maps included a compound-target network of SJC, a compound-anti-MI targets network, a candidate targets PPI network, a pathway-gene network, and a drug-key compounds-hub targets-pathways network. Systematic analysis indicated that the targets of SJC in the treatment of MI mainly involved RPS6, MAPK1, MAPK3, MDM2, and DDX5. Pathway enrichment analysis showed that SJC had the potential to impact multiple biological pathways, such as cancer-related pathways, viral/bacterial infection-related pathways, and signal transduction-related pathways.
Conclusion
Our results preliminarily revealed the pharmacological basis and molecular mechanism SJC in treating MI, but further experimental research is required to verify these findings.
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Gul M, Bocu K, Serefoglu EC. Current and emerging treatment options for premature ejaculation. Nat Rev Urol 2022; 19:659-680. [PMID: 36008555 DOI: 10.1038/s41585-022-00639-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/20/2022] [Indexed: 11/08/2022]
Abstract
Premature ejaculation (PE) is a prevalent male sexual dysfunction. Current standard treatment regimens include behavioural therapies, topical anaesthetics, dapoxetine and other selective serotonin reuptake inhibitors (SSRIs). Most of the pharmacotherapeutic options target neurotransmitters (such as serotonin and oxytocin) that have a role in the ejaculation mechanism. However, these treatments are mildly effective and only provide a temporary delay in the ejaculation latency time, and PE recurs when the treatment is stopped. Thus, a treatment for PE is urgently needed and research is ongoing to find the ideal PE therapy. The efficacy and safety of topical anaesthetics and SSRIs in delaying ejaculation have been confirmed in many well-designed controlled trials. Both preclinical and clinical studies on new-generation SSRIs are ongoing. Moreover, promising results came from clinical trials in which the efficacy of on-demand PE therapies targeting neurotransmitters other than serotonin, such as α1-adrenoceptor antagonists and oxytocin antagonists, was assessed. Surgical intervention and neuromodulation have been proposed as potential treatment options for PE; however, current PE guidelines do not recommend these treatments owing to safety concerns.
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Affiliation(s)
- Murat Gul
- Department of Urology, Selcuk University School of Medicine, Konya, Turkey
| | - Kadir Bocu
- Department of Urology, Silopi State Hospital, Sirnak, Turkey
| | - Ege Can Serefoglu
- Department of Urology, Biruni University School of Medicine, Istanbul, Turkey.
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Corona G. Erectile dysfunction and premature ejaculation: a continuum movens supporting couple sexual dysfunction. J Endocrinol Invest 2022; 45:2029-2041. [PMID: 35503598 PMCID: PMC9063256 DOI: 10.1007/s40618-022-01793-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/07/2022] [Accepted: 03/21/2022] [Indexed: 12/12/2022]
Abstract
PURPOSE The specific underlying mechanisms supporting the association between erectile dysfunction (ED) and premature ejaculation (PE) are still not completely clarified. To summarize and discuss all available data supporting the relationship between PE and ED. METHODS A comprehensive narrative review was performed. In addition, to better clarify the specific factors underlining ED and PE, a meta-analytic approach of the selected evidence was also performed. In particular, the meta-analytic method was selected in order to minimize possible sources of bias derived from a personal interpretation of the data. RESULTS Current data confirm the close association between ED and PE and the bidirectional nature of their relationship. In particular, PE was associated with a fourfold increased risk of ED independently of the definition used. In addition, the risk increased in older patients and in those with lower education, and it was associated with higher anxiety and depressive symptoms. Conversely, ED-related PE was characterized by lower associations with organic parameters such as diabetes mellitus, arterial hypertension, dyslipidemia and with smoking habit. Finally, when ED was defined according to the International Index of Erectile Function questionnaire, the presence of a stable relationship increased the risk. CONCLUSIONS ED and PE should be considered in a dimensional prospective way considering the possibility that both clinical entities can overlap and influence each. Correctly recognizing the underlying factors and sexual complaint can help the clinician in deciding the more appropriate diagnostic and therapeutic work-up.
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Affiliation(s)
- G Corona
- Endocrinology Unit, Medical Department, Azienda Usl, Maggiore-Bellaria Hospital, Largo Nigrisoli, 2, 40133, Bologna, Italy.
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22
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Prevalence of sexual dysfunction among the male populations who seeking medical care for infertility, pregnancy loss and preconception care: a cross-sectional study. Sci Rep 2022; 12:12969. [PMID: 35902712 PMCID: PMC9334580 DOI: 10.1038/s41598-022-17201-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2022] [Accepted: 07/21/2022] [Indexed: 11/16/2022] Open
Abstract
The link between sexual dysfunction and male infertility has been well established. In addition to male infertility, male patients with couple pregnancy loss and preconception care are the most frequent reasons for the treatment of andrology outpatients. However, there is a paucity of information simultaneously investigating male sexual dysfunction in these males with different reproduction situations. A cross-sectional study was performed in consecutive series of 1256 participants, including 509 men with infertility, 437 couples with pregnancy loss, and 310 men for preconception care. All men completed a questionnaire on baseline demographic information, sexual behavior characteristics and validated research tools, including Premature Ejaculation Diagnostic Tool, seven-item Generalized Anxiety Disorder Scale, and International Index of Erectile Function. The prevalence of erectile dysfunction and premature ejaculation was 30.6%, 20.8% in the infertility population and 27.0%, 18.5% in pregnancy loss individuals, was much lower in preconception care men, at 9.3%, 11.9% (p < 0.05), respectively. Infertility and pregnancy loss couples were more biased toward choosing timed intercourse than preconception care couples, with rates of 19.6% in Infertility group and 17.4% in pregnancy loss groups, versus 10.0% (p < 0.05) in preconception care couples. The infertile and pregnancy loss men also reported higher rate of anxiety state than the preconception care group. The prevalence of erectile dysfunction increased gradually with the duration of infertility and the frequency of pregnancy loss, with a highest odds ratio of 7.346 (95% CI:4.329–12.467; P < 0.001) among men with ≥5 years of infertility, 6.282 (95% CI:3.446–11.453; P < 0.001) among couples ≥3 pregnancy loss when compared with preconception care group. The prevalence of erectile dysfunction, premature ejaculation and timed intercourse were comparable in pregnancy loss and infertile males, were all noticeably higher than preconception care group. There was also a trend toward a higher incidence of erectile dysfunction with longer duration of infertility or the more frequent of pregnancy loss.
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McNabney SM, Weseman CE, Hevesi K, Rowland DL. Are the Criteria for the Diagnosis of Premature Ejaculation Applicable to Gay Men or Sexual Activities Other than Penile-Vaginal Intercourse? Sex Med 2022; 10:100516. [PMID: 35477122 PMCID: PMC9177880 DOI: 10.1016/j.esxm.2022.100516] [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: 01/27/2022] [Revised: 03/14/2022] [Accepted: 03/20/2022] [Indexed: 11/04/2022] Open
Abstract
Introduction The criteria for premature ejaculation (PE) have generally been limited to the diagnosis of heterosexual men engaging in penile-vaginal intercourse and therefore the applicability of PE diagnostic criteria to gay men and to activities beyond penile-vaginal intercourse has yet to be explored in depth. Aim To compare the prevalence of PE in gay and straight men and to assess whether PE-related diagnostic measures (ejaculatory control, ejaculation latency [EL], and bother/distress) can be applied with confidence to gay men or to men engaging in sexual activities other than penile-vaginal intercourse. Methods Gay and straight participants (n = 3878) were recruited to take an online survey assessing sexual orientation, sexual function/dysfunction (including specific PE-related measures), sexual relationship satisfaction, and various other sexual behaviors during partnered sex or masturbation. Outcomes Comparison of ejaculatory control, EL, and bother/distress across gay and straight men, as well as across different types of sexual activities. Results A slightly lower PE prevalence among gay men became undetectable when other predictors of prevalence were included in a multivariate analysis (aOR = 0.87 [95% CI: 0.60–1.22]). Gay men with PE reported longer typical ELs (zU = -3.35, P < .001) and lower distress (zU = 3.68, P < .001) relative to straight men, but longer ELs and lower distress were also associated with anal sex. Clinical Translation Clinicians can feel confident about using existing criteria for the diagnosis of PE in gay men but should be aware of potentially longer ELs and lower PE-related bother/distress—probably related to the practice of anal sex—compared with straight men. Strengths and Limitations Although well-powered and international in scope, this study was limited by biases inherent to online surveys, the lack of a sizable sample of bisexual men, and a lack of differentiation between men with acquired vs lifelong PE. Conclusions Irrespective of sexual orientation, gay and straight men with PE reported shorter ELs, lower satisfaction, and greater bother/distress than functional counterparts. While PE-related diagnostic criteria (ejaculatory control, EL, and bother/distress) are applicable to gay men, accommodation for longer ELs and lower bother/distress in gay men should be considered. McNabney SM, Weseman CE, Hevesi K, et al. Are the Criteria for the Diagnosis of Premature Ejaculation Applicable to Gay Men or Sexual Activities Other than Penile-Vaginal Intercourse?. Sex Med 2022;10:100516.
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Affiliation(s)
- Sean M McNabney
- Department of Psychology, Valparaiso University, Valparaiso, IN, USA; Department of Applied Health Science, School of Public Health, Indiana University, Bloomington, IN, USA
| | - Claire E Weseman
- Department of Psychology, Valparaiso University, Valparaiso, IN, USA
| | - Kriszta Hevesi
- Institute of Psychology, Eötvös Loránd University, Budapest, Hungary
| | - David L Rowland
- Department of Psychology, Valparaiso University, Valparaiso, IN, USA.
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Rowland DL, Althof SE, McMahon CG. The Unfinished Business of Defining Premature Ejaculation: The Need for Targeted Research. Sex Med Rev 2022; 10:323-340. [PMID: 34996746 DOI: 10.1016/j.sxmr.2021.11.003] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2021] [Revised: 11/17/2021] [Accepted: 11/22/2021] [Indexed: 01/23/2023]
Abstract
INTRODUCTION Fifteen years have passed since the International Society of Sexual Medicine first established the 3-pronged criteria for premature ejaculation (PE): a short ejaculation latency, lack of ejaculatory control, and bother/distress. Although the process of establishing valid criteria for any condition or disorder is an ongoing one, a dearth of targeted research on these criteria has hindered professional societies from updating and revising them. OBJECTIVES To review and critique existing criteria used in the diagnosis of PE, to identify specific problems with them, and to recommend studies that will address shortcomings. METHODS Each of the PE criteria was evaluated and compared against standard procedures for establishing validated measures. Following each analysis, targeted research to address the gaps has been recommended. RESULTS Each PE criterion has shortcomings and each can be improved by using standard validation procedures, as noted by the targeted research outcomes. Professional societies can play an important role by encouraging broad participation in research that generates new and relevant data supporting, validating, or challenging the existing criteria. CONCLUSION The concepts underlying the diagnostic criteria for PE have both broad consensus and functional utility. Nevertheless, much of the research investigating PE has uncritically adopted these criteria without concomitantly recognizing their limitations. These limitations prevent determining accurate prevalence rates, interpreting research findings with confidence, and establishing efficacious treatment outcomes. Rowland DL, Althof SE, McMahon CG. The Unfinished Business of Defining Premature Ejaculation: The Need for Targeted Research. Sex Med Rev 2021;XX:XXX-XXX.
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Affiliation(s)
- David L Rowland
- Department of Psychology, Valparaiso University, Valparaiso, IN, USA.
| | - Stanley E Althof
- Center for Marital and Sexual Health of South Florida, Greenacres, FL, USA and Case Western Reserve School of Medicine, Cleveland, OH, USA
| | - Chris G McMahon
- Australian Centre for Sexual Health, St Leonards, New South Wales, Australia
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Mohamed AH, Mohamud HA, Yasar A. The prevalence of premature ejaculation and its relationship with polygamous men: a cross-sectional observational study at a tertiary hospital in Somalia. BMC Urol 2021; 21:175. [PMID: 34915878 PMCID: PMC8680334 DOI: 10.1186/s12894-021-00942-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2021] [Accepted: 12/06/2021] [Indexed: 01/23/2023] Open
Abstract
Background Premature ejaculation (PE) is the most common and prevalent sexual disorder among men. To the best of our knowledge, this is the first study aimed at evaluating the relationship of PE among polygamous men. Method Over a 1-year period, a cross-sectional observational study was carried out among 202 married men who visited the urology polyclinic due to different clinical conditions and contributed by completing a standardized structured questionnaire regarding their sociodemographic data, as well as sexual and past medical history. Results In our study, the prevalence of PE was 37.1%; half of the monogamous men (50%) complained of PE, while 22% of men with two wives, 20% of men with three wives, and 12% of men with four wives complained of PE (p < 0.0001, 95% CI 0.122–1.920). Seventy percent of erectile dysfunction (ED) patients had PE concurrence (p < 0.0001, 95% CI 0.057–5.543). Regarding frequency of sexual intercourse, 48% of patients who complained of PE performed sexual intercourse less than two times/week, while two-thirds of the participants who did not complain of PE had sexual intercourse two to four times/week (p < 0.0001, 95% CI 0.203–0.568). Among the men who reported ED, 42% had one wife, 21.5% had two wives, 40% had three wives, and 12.5% had four wives (p < 0.029, 95% CI 0.417–0.962). Conclusions We report that polygamous men have a lower incidence of premature ejaculation and higher sexual satisfaction than monogamous men. There is a significant association between ED and PE, showing a complex and bidirectional relationship between the two conditions. The new taxonomic entity called loss of control of erection and ejaculation (LCEE) views the two sexual symptoms as deeply interrelated. The study results indicate that a sexual intercourse frequency of two or more times per week significantly lowers the risk of PE.
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Affiliation(s)
| | - Hussein Ali Mohamud
- Mogadishu Somalia Turkish Training and Research Hospital, Mogadishu, Somalia
| | - Adem Yasar
- Mogadishu Somalia Turkish Training and Research Hospital, Mogadishu, Somalia
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Chin CW, Tsai CM, Lin JT, Chen YS, Chen IH, Jiann BP. A Cross-Sectional Observational Study on the Coexistence of Erectile Dysfunction and Premature Ejaculation. Sex Med 2021; 9:100438. [PMID: 34571325 PMCID: PMC8766268 DOI: 10.1016/j.esxm.2021.100438] [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] [Received: 06/07/2021] [Revised: 08/11/2021] [Accepted: 08/20/2021] [Indexed: 01/23/2023] Open
Abstract
INTRODUCTION The interplay between erectile dysfunction (ED) and premature ejaculation (PE) needs more studies to clarify. AIM To evaluate the risk factors and temporal relationship for the coexistence of ED and PE. METHODS The data were derived from clinical history. MAIN OUTCOME MEASURE The diagnosis of ED and PE was based on self-report and validated questionnaires. RESULTS Based on the chief complaint, 1,893 participants were recruited as ED group and 483 participants as PE group from 2014 to 2020. One third of ED and PE groups reported comorbid PE and ED. Of the ED group, 4.1% (n = 77) had lifelong PE, 18.0% (n = 341) had acquired PE and 9.7% (n = 184) had subjective or natural variable PE. Of the PE group, ED was reported in 22.0% (n = 40) of lifelong PE, 33.9% (n = 65) of acquired PE, and 37.6% (n = 41) of subjective or natural variable PE, P < .01. With adjustment of potential confounders, the ED severity was associated with increased risk of acquired PE, while acquired PE was associated with higher risk of ED than lifelong PE. In cases of comorbid lifelong PE and ED (n = 117), 22.2% reported the onset of both dysfunctions being about the same time, whereas 77.8% reported ED occurred behind PE with an average 23.3 years lag. In cases of comorbid acquired PE and ED (n = 406), 52.2% reported the onset of both dysfunctions being about the same time, 34.2% reported ED happened behind PE and 13.5% reported PE emerged behind ED. CONCLUSION Organic pathogenesis was least likely to be responsible for the link between PE and ED. When acquired PE and ED coexist, treating ED first or concomitantly according to their temporal order is an appropriate management algorithm. Chieh‑Wen Chin, Chia Mu Tsai, Jen-Tai Lin, et al. A Cross-Sectional Observational Study on the Coexistence of Erectile Dysfunction and Premature Ejaculation. Sex Med 2021;9:100438.
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Affiliation(s)
- Chieh-Wen Chin
- Division of Urology, Department of Surgery, Kaohsiung Veterans General Hospital, Kaohsiung City, Taiwan
| | - Chia Mu Tsai
- Division of Urology, Department of Surgery, Kaohsiung Veterans General Hospital, Kaohsiung City, Taiwan
| | - Jen-Tai Lin
- Division of Urology, Department of Surgery, Kaohsiung Veterans General Hospital, Kaohsiung City, Taiwan
| | - Yin-Shen Chen
- Division of Urology, Department of Surgery, Kaohsiung Veterans General Hospital, Kaohsiung City, Taiwan
| | - I-Hsuan Chen
- Division of Urology, Department of Surgery, Kaohsiung Veterans General Hospital, Kaohsiung City, Taiwan
| | - Bang-Ping Jiann
- Division of Urology, Department of Surgery, Kaohsiung Veterans General Hospital, Kaohsiung; School of Medicine, National Yang-Ming University, Taipei; and College of Health and Nursing, Meiho University, Pingtung, Taiwan.
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Comorbidities Among Sexual Problems in Men: Results From an Internet Convenience Sample. Sex Med 2021; 9:100416. [PMID: 34348218 PMCID: PMC8498964 DOI: 10.1016/j.esxm.2021.100416] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2021] [Revised: 06/23/2021] [Accepted: 07/02/2021] [Indexed: 01/23/2023] Open
Abstract
INTRODUCTION Men suffering from one sexual problem sometimes report having another sexual problem, but few studies have determined concordance rates among dysfunctions in non-clinical samples. AIM This study determined comorbidities among sexual dysfunctions based on an internet convenience sample of 4432 men from Hungary, the USA, and other world regions that visit social media fora. METHOD Participants completed an online 55-item questionnaire that included questions assessing erectile dysfunction (ED), premature ejaculation (PE), delayed ejaculation (DE), and lack of sexual interest (LSI). MAIN OUTCOME MEASURES Concordance rates and odds ratios among sexual dysfunctions. RESULTS Approximately 8% of men suffered from two or more sexual problems; men with a severe sexual problem were significantly more likely to suffer from a second sexual problem; concordance between PE and erectile dysfunction ranged from 23-29%, with subtypes of lifelong vs acquired PE showing patterns similar to one another; and most men with delayed ejaculation reported minimal problems with LSI, although LSI was generally key to understanding all other dysfunctions. CONCLUSION The percentage of men with one sexual problem having a second sexual problem was substantial, ranging from 23-40%. These findings will help clinicians better understand the intertwined nature of sexual problems and assist them in developing management protocols that address concomitant inadequacies in sexual response. Rowland DL, Oosterhouse LB, Kneusel JA, et al. Comorbidities Among Sexual Problems in Men: Results From an Internet Convenience Sample. Sex Med 2021;XX:XXXXXX.
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Mostafa T, Abdel-Hamid IA. Ejaculatory dysfunction in men with diabetes mellitus. World J Diabetes 2021; 12:954-974. [PMID: 34326948 PMCID: PMC8311479 DOI: 10.4239/wjd.v12.i7.954] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/30/2021] [Revised: 05/06/2021] [Accepted: 06/15/2021] [Indexed: 02/06/2023] Open
Abstract
Diabetes mellitus (DM) is a metabolic disorder that is characterized by elevated blood glucose levels due to absolute or relative insulin deficiency, in the background of β-cell dysfunction, insulin resistance, or both. Such chronic hyperglycemia is linked to long-term damage to blood vessels, nerves, and various organs. Currently, the worldwide burden of DM and its complications is in increase. Male sexual dysfunction is one of the famous complications of DM, including abnormal orgasmic/ejaculatory functions, desire/libido, and erection. Ejaculatory dysfunction encompasses several disorders related to DM and its complications, such as premature ejaculation, anejaculation (AE), delayed ejaculation, retrograde ejaculation (RE), ejaculatory pain, anesthetic ejaculation, decreased ejaculate volume, and decreased force of ejaculation. The problems linked to ejaculatory dysfunction may extend beyond the poor quality of life in diabetics as both AE and RE are alleged to alter the fertility potential of these patients. However, although both diabetes patients and their physicians are increasingly aware of diabetic ejaculatory dysfunction, this awareness still lags behind that of other diabetes complications. Therefore, all these disorders should be looked for thoroughly during the clinical evaluation of diabetic men. Besides, introducing the suitable option and/or maneuvers to treat these disorders should be tailored according to each case. This review aimed to explore the most important findings regarding ejaculatory dysfunction in diabetes from pre-clinical and clinical perspectives.
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Affiliation(s)
- Taymour Mostafa
- Department of Andrology & Sexology, Faculty of Medicine, Cairo University, Cairo 11562, Egypt
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29
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Zhang J, Su H, Ma C, Li H. Premature Ejaculation, True or False? Clinical evaluation of PE patients with multiple intercourse in one day. Andrologia 2021; 53:e14097. [PMID: 33964032 DOI: 10.1111/and.14097] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2021] [Revised: 04/17/2021] [Accepted: 04/20/2021] [Indexed: 11/27/2022] Open
Abstract
Clinical characteristics of 216 adult males previously diagnosed with premature ejaculation (PE) were studied. Using a survey questionnaire, characteristics included intravaginal ejaculation latency time (IELT), penile hardness scores and the refractory period (RP). Ninety-four PE patients reported they had experienced vaginal intercourse more than once (2 to 4 times) in one day (~44%). IELT was significantly increased at the second and subsequent intercourses, and IIEF-15 (International Index of Erectile Function-15) and relevant subclass scores were markedly improved compared to their first intercourse and also compared to the single intercourse group in this cohort study. Overall sexual satisfaction was achieved in the PE patients with multiple intercourse experiences. The same trend was observed in both the patients diagnosed with lifelong and acquired PE. Based on the evidence, the argument is that the PE patients who were diagnosed using their performance at the first intercourse but who have the ability to participate in multiple vaginal intercourses in one day are unlikely to be true PE. The false PE may account for over 40% of PE patients diagnosed by current guidelines and definitions.
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Affiliation(s)
- Jianzhong Zhang
- Department of Urology, Chinese Academy of Medical Science, Peking Union Medical College, Peking Union Medical College Hospital, Beijing, China.,Department of Urology, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Hao Su
- Department of Urology, Chinese Academy of Medical Science, Peking Union Medical College, Peking Union Medical College Hospital, Beijing, China
| | - Chengquan Ma
- Department of Urology, Chinese Academy of Medical Science, Peking Union Medical College, Peking Union Medical College Hospital, Beijing, China
| | - Hongjun Li
- Department of Urology, Chinese Academy of Medical Science, Peking Union Medical College, Peking Union Medical College Hospital, Beijing, China
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Sansone A, Aversa A, Corona G, Fisher AD, Isidori AM, La Vignera S, Limoncin E, Maggi M, Merico M, Jannini EA. Management of premature ejaculation: a clinical guideline from the Italian Society of Andrology and Sexual Medicine (SIAMS). J Endocrinol Invest 2021; 44:1103-1118. [PMID: 33128158 DOI: 10.1007/s40618-020-01458-4] [Citation(s) in RCA: 43] [Impact Index Per Article: 14.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/03/2020] [Accepted: 10/20/2020] [Indexed: 12/25/2022]
Abstract
Premature ejaculation (PE) is the most prevalent male sexual dysfunction, and the most recently defined. PE is often mistakenly considered a purely psychosexological symptom by patients: the lacking awareness in regards to the pathophysiology and treatments often lead to resignation from the patients' side, making PE the most underdiagnosed sexual complaint. However, an ever-growing body of evidence supporting several organic factors has been developed in the last decades and several definitions have been suggested to encompass all defining features of PE. In the present document by the Italian Society of Andrology and Sexual Medicine (SIAMS), we propose 33 recommendations concerning the definition, pathophysiology, treatment and management of PE aimed to improve patient care. These evidence-based clinical guidelines provide the necessary up-to-date guidance in the context of PE secondary to organic and psychosexological conditions, such as prostate inflammation, endocrine disorders, and other sexual dysfunctions, and suggest how to associate pharmacotherapies and cognitive-behavioral therapy in a couple-centered approach. New therapeutic options, as well as combination and off-label treatments, are also described.
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Affiliation(s)
- A Sansone
- Chair of Endocrinology and Medical Sexology (ENDOSEX), Department of Systems Medicine, University of Rome Tor Vergata, via Montpellier 1, 00133, Rome, Italy
| | - A Aversa
- Department of Experimental and Clinical Medicine, University of Catanzaro Magna Graecia, Catanzaro, Italy
| | - G Corona
- Endocrinology Unit, Medical Department, Azienda-Usl, Maggiore-Bellaria Hospital, Bologna, Italy
| | - A D Fisher
- Andrology, Women's Endocrinology and Gender Incongruence Unit, Florence University Hospital, Florence, Italy
| | - A M Isidori
- Department of Experimental Medicine, Sapienza University of Rome, Rome, Italy
| | - S La Vignera
- Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy
| | - E Limoncin
- Chair of Endocrinology and Medical Sexology (ENDOSEX), Department of Systems Medicine, University of Rome Tor Vergata, via Montpellier 1, 00133, Rome, Italy
| | - M Maggi
- Endocrinology Unit, Department of Experimental, Clinical and Biomedical Sciences, University of Florence, Florence, Italy
| | - M Merico
- Department of Medicine, Operative Unit of Andrology and Medicine of Human Reproduction, University of Padova, Padua, Italy
| | - E A Jannini
- Chair of Endocrinology and Medical Sexology (ENDOSEX), Department of Systems Medicine, University of Rome Tor Vergata, via Montpellier 1, 00133, Rome, Italy.
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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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Colonnello E, Ciocca G, Limoncin E, Sansone A, Jannini EA. Redefining a sexual medicine paradigm: subclinical premature ejaculation as a new taxonomic entity. Nat Rev Urol 2021; 18:115-127. [PMID: 33442049 DOI: 10.1038/s41585-020-00417-1] [Citation(s) in RCA: 30] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/02/2020] [Indexed: 01/29/2023]
Abstract
Premature ejaculation (PE) and poor ejaculatory control are multidimensional sexual symptoms estimated to affect almost one-third of men, severely impairing the overall quality of life of patients and their partners. However, patients who do not completely fulfil the definition criteria for PE rarely receive a diagnosis or adequate treatment, with the risk of subsequent progression from initial, subclinical symptoms to clinically overt PE, frequently with other sexual comorbidities. Thus, the current definitions of PE warrant review, in order to consider and propose a new taxonomy encompassing other unaddressed, crucial clinical aspects of PE. These newly proposed criteria include the recommendation for a primary screening for erectile dysfunction (ED), as PE and ED can be comorbid in up to 50% of patients but have never before been considered as a unified clinical entity. In order to facilitate clinical practice and improve clinical management of men with PE and comorbid conditions, we propose and define the new taxonomic clinical entities of subclinical PE (SPE) and loss of control of erection and ejaculation (LCEE). Application of these diagnoses to men who meet the criteria for SPE and/or LCEE, but not the overt conditions, could improve access to treatment for these patients and reduce progression to the more serious clinical disorder.
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Affiliation(s)
- Elena Colonnello
- Endocrinology & Medical Sexology (ENDOSEX), Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy
| | - Giacomo Ciocca
- 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
| | - Erika Limoncin
- Endocrinology & Medical Sexology (ENDOSEX), Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy
| | - Andrea Sansone
- Endocrinology & Medical Sexology (ENDOSEX), Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy
| | - Emmanuele A Jannini
- Endocrinology & Medical Sexology (ENDOSEX), Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy.
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Alotaibi FO, Alhakamy NA, Omar AM, El-Say KM. Clinical Pharmacokinetic Evaluation of Optimized Liquisolid Tablets as a Potential Therapy for Male Sexual Dysfunction. Pharmaceutics 2020; 12:pharmaceutics12121187. [PMID: 33297307 PMCID: PMC7762256 DOI: 10.3390/pharmaceutics12121187] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2020] [Revised: 11/24/2020] [Accepted: 12/02/2020] [Indexed: 01/23/2023] Open
Abstract
The study aimed at developing a liquisolid tablet (LST) containing tadalafil (TDL) and dapoxetine (DPX) with improved bioavailability as a potential therapy for male sexual dysfunction. A mixture of nonvolatile solvents, namely PEG 200 and Labrasol®, was utilized to prepare LSTs that were assessed for their quality characteristics. The Box–Behnken design (BBD) was employed to statistically explore the effect of the formulation factors on the quality attributes of LSTs. Furthermore, an in vivo pharmacokinetic study was carried out for the optimized LST in comparison with the marketed tablets on healthy human volunteers. The optimized LST revealed acceptable quality limits with enhanced dissolution for both APIs. The pharmacokinetic parameters after oral administration of the optimized LST indicated that the Cmax of TDL in LSTs was 122.61 ng/mL within 2h compared to the marketed tablets, which reached 91.72 ng/mL after 3 h, indicating the faster onset of action. The AUC was improved for TDL in LST (4484.953 vs. 2994.611 ng/mL∙h in the marketed tablet) and DPX in LST (919.633 vs. 794.699 ng/mL∙h in the marketed tablet). This enhancement in bioavailability potentially minimizes the associated side effects and improves the treatment of male sexual dysfunction, particularly for diabetic patients.
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Affiliation(s)
- Fayez O. Alotaibi
- Department of Pharmaceutics, Faculty of Pharmacy, King Abdulaziz University, Jeddah 21589, Saudi Arabia; (F.O.A.); (N.A.A.)
| | - Nabil A. Alhakamy
- Department of Pharmaceutics, Faculty of Pharmacy, King Abdulaziz University, Jeddah 21589, Saudi Arabia; (F.O.A.); (N.A.A.)
- Center of Excellence for Drug Research and Pharmaceutical Industries, King Abdulaziz University, Jeddah 21589, Saudi Arabia
| | - Abdelsattar M. Omar
- Department of Pharmaceutical Chemistry, Faculty of Pharmacy, King Abdulaziz University, Jeddah 21589, Saudi Arabia;
- Department of Pharmaceutical Chemistry, Faculty of Pharmacy, Al-Azhar University, Cairo 11884, Egypt
| | - Khalid M. El-Say
- Department of Pharmaceutics, Faculty of Pharmacy, King Abdulaziz University, Jeddah 21589, Saudi Arabia; (F.O.A.); (N.A.A.)
- Center of Excellence for Drug Research and Pharmaceutical Industries, King Abdulaziz University, Jeddah 21589, Saudi Arabia
- Correspondence: ; Tel.: +96-658-293-4511
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Zhang J, Li F, Li H, Zhang Z, Yang B, Li H. Clinical features of and couple's attitudes towards premature ejaculation: a multicenter cross-sectional study. Aging Male 2020; 23:946-952. [PMID: 31306035 DOI: 10.1080/13685538.2019.1640194] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/23/2023] Open
Abstract
INTRODUCTION The current study aimed to investigate the clinical features of and couple's attitudes towards premature ejaculation (PE). METHODS Qualified patients were continuously enrolled from 15 medical centers in different regions of China. Patient data were collected from March 1 2017 to July 31 2017. All men were assessed by the Premature Ejaculation Diagnostic Tool (PEDT) and Intravaginal Ejaculation Latency Time (IELT). Besides, sexual desire, force of ejaculation, and the five-item International Index of Erectile Function (IIEF-5) score were recorded. The couple's attitudes towards PE were evaluated by a self-designed questionnaire. RESULTS In total, 1033 males diagnosed with PE and their sexual partners and 3176 males without PE were enrolled. The mean PEDT and IELT scores of the patients with PE were 14.38 ± 3.68 and 1.59 ± 0.85, respectively. IIEF-5, sexual desire, and force of ejaculation significantly decreased in patients with PE. Among the 1033 couples, 44.3%, 21.39%, and 33.98% of the couples were seeking PE because of the dissatisfaction of the males, the females or both partners, respectively. In terms of the males who were dissatisfied with PE, 49.51% and 17.86% complained of short IELT and inability to control ejaculation. In terms of the females dissatisfied with PE, 41.61%, 19.93%, 21.68%, and 14.51% complained of arousal difficulty, weak sexual desire, failing to have organism and poor relationship, respectively. CONCLUSIONS PE has a negative impact on erectile function, sexual desire, and force of ejaculation. Sexual partners play important roles in the medical procedures for addressing PE.
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Affiliation(s)
- Jianzhong Zhang
- Department of Urology, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China
| | - Fubiao Li
- Department of Urology, First Hospital of Jilin University, Changchun, China
| | - Haisong Li
- Department of Andrology, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, China
| | - Zhichao Zhang
- Department of Urology, Peking University First Hospital, Peking University, Beijing, China
| | - Bin Yang
- Department of Urology, Affiliated Hospital of the Qingdao University, Qingdao, China
| | - Hongjun Li
- Department of Urology, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China
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Characteristics of men who are bothered by rapid ejaculation: results from clinical intake surveys. Int J Impot Res 2020; 33:369-375. [PMID: 32332929 DOI: 10.1038/s41443-020-0277-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2019] [Revised: 03/11/2020] [Accepted: 03/31/2020] [Indexed: 02/08/2023]
Abstract
The objective of this study is to identify factors associated with bother with rapid ejaculation in a cohort of men presenting to a sexual dysfunction clinic, independent of a diagnosis of PE. A prospective institutional database has been maintained on patients completing an 89-item intake questionnaire querying various areas of sexual dysfunction. Regarding ejaculatory dysfunction, patients are asked "Do you feel bothered, annoyed, and/or frustrated by ejaculating too quickly?" Statistical modeling was performed to identify associations. A total of 1359 men completed the intake survey, and 694 responded to the question on bother with rapid ejaculation. Overall, 42.9% (298/694) of respondents reported bother with rapid ejaculation. Men reporting bother were more likely to report lower intravaginal ejaculatory latency (IELT) time (4.2 vs 12.2 min, p < 0.0001), problems with depression (32% vs 21%, p = 0.001), negative impact on relationship (73% vs 51%, p < 0.0001), and negative impact on partner's sexual satisfaction (26% vs 15%, p < 0.001). These results highlight the importance of asking all men presenting with sexual health concerns about their bother with rapid ejaculation for complete assessment of sexual and mental wellbeing.
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Mollaioli D, Ciocca G, Limoncin E, Di Sante S, Gravina GL, Carosa E, Lenzi A, Jannini EAF. Lifestyles and sexuality in men and women: the gender perspective in sexual medicine. Reprod Biol Endocrinol 2020; 18:10. [PMID: 32066450 PMCID: PMC7025405 DOI: 10.1186/s12958-019-0557-9] [Citation(s) in RCA: 70] [Impact Index Per Article: 17.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/13/2017] [Accepted: 10/17/2018] [Indexed: 01/13/2023] Open
Abstract
Sexual health is strictly related with general health in both genders. In presence of a sexual dysfunction, the expert in sexual medicine aims to discover the specific weight of the physical and psychological factors can cause or con-cause the sexual problem. At the same time, a sexual dysfunction can represent a marker of the future development of a Non-communicable diseases (NCDss) as cardiovascular or metabolic diseases.In the evaluation phase, the sexual health specialist must focus on these aspects, focusing especially on the risk and protective factors that could impact on both male and female sexuality.This article presents a review of researches concerning healthy and unhealthy lifestyles and their contribute in the development of sexual quality of life in a gender-dependent manner.Among the unhealthy lifestyle, obesity contributes mostly to the development of sexual dysfunctions, due to its negative impact on cardiovascular and metabolic function. Tobacco smoking, alcohol - substance abuse and chronic stress lead to the development of sexual dysfunction in a med-long term.In order to guarantee a satisfying sexual quality of life, sexual health specialists have the responsibility to guide the patient through the adoption of healthy lifestyles, such as avoiding drugs, smoke and excessive alcohol, practicing a regular physical activity, following a balanced diet and use stress-management strategies, even before proposing both pharmaco- and/or psychotherapies.
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Affiliation(s)
- Daniele Mollaioli
- grid.6530.00000 0001 2300 0941Department of Systems Medicine, University of Rome Tor Vergata, Via Montpellier 1, 00133 Rome, Italy
| | - Giacomo Ciocca
- grid.6530.00000 0001 2300 0941Department of Systems Medicine, University of Rome Tor Vergata, Via Montpellier 1, 00133 Rome, Italy
| | - Erika Limoncin
- grid.6530.00000 0001 2300 0941Department of Systems Medicine, University of Rome Tor Vergata, Via Montpellier 1, 00133 Rome, Italy
| | - Stefania Di Sante
- grid.7841.aDepartment of Experimental Medicine, Section of Medical Pathophysiology, Food Science and Endocrinology, Sapienza - University of Rome, Viale Regina Elena 324, Rome, 00161 Italy
| | - Giovanni Luca Gravina
- grid.158820.60000 0004 1757 2611Department of Biotechnological and Applied Clinical Sciences, University of L’Aquila, Via Vetoio (Coppito 2), L’Aquila, 67100 Italy
| | - Eleonora Carosa
- grid.158820.60000 0004 1757 2611Department of Biotechnological and Applied Clinical Sciences, University of L’Aquila, Via Vetoio (Coppito 2), L’Aquila, 67100 Italy
| | - Andrea Lenzi
- grid.7841.aDepartment of Experimental Medicine, Section of Medical Pathophysiology, Food Science and Endocrinology, Sapienza - University of Rome, Viale Regina Elena 324, Rome, 00161 Italy
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ASSOCIATION OF ERECTILE DYSFUNCTION AND PREMATURE EJACULATION IN MEN WITH CHRONIC PROSTATITIS. JOURNAL OF MEN'S HEALTH 2020. [DOI: 10.15586/jomh.v16isp1.185] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
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Tahtali İN. Is testosterone replacement an effective treatment of secondary premature ejaculation? Andrologia 2019; 52:e13452. [DOI: 10.1111/and.13452] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2019] [Revised: 03/14/2019] [Accepted: 03/28/2019] [Indexed: 12/20/2022] Open
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Shechter A, Serefoglu EC, Gollan T, Springer S, Meiry G, Appel B, Gruenwald I. Transcutaneous functional electrical stimulation-a novel therapy for premature ejaculation: results of a proof of concept study. Int J Impot Res 2019; 32:440-445. [PMID: 31570825 DOI: 10.1038/s41443-019-0207-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2019] [Revised: 09/11/2019] [Accepted: 09/18/2019] [Indexed: 02/02/2023]
Abstract
Premature Ejaculation (PE) is a very common and disturbing sexual dysfunction in men. Currently available treatment modalities are associated with limited efficacy and low treatment adherence. In this prospective, single-blinded, self-controlled study, we evaluated the efficacy and safety of transcutaneous electrical stimulation (TES) for the treatment of (PE). We included 23 patients aged 20-60 (mean: 38.7) with lifelong PE. On the first visit, we delivered either TES or sham treatment to the perineum, based on the enrollment order. For stimulation, we used a commercial neuromuscular electrical stimulation device. The patients were invited for the second visit after at least 7 days for receiving the alternating treatment. During the treatment sessions, the patients were left alone in a privet silent room to masturbate and a stopwatch was used to measure their masturbation ejaculatory latency time (MELT). The patients also filled-out safety questionnaires after each visit and on each of the 3 following days. Of the 20 patients who completed the study, 17 (85%) experienced prolonged MELT under TES compared with the sham treatment. Mean MELT values increased 3.5-folds under TES (p = 0.0009). We demonstrated a significant increase in MELT in lifelong PE patients using TES. This therapeutic option may have the potential to become an on-demand treatment option for PE. Future studies with wireless devices are needed to confirm the efficacy and safety of this treatment concept during intercourse.
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Affiliation(s)
- Arik Shechter
- Neurourology Unit, Rambam Healthcare Campus, Haifa, Israel. .,Department of Family Medicine, Ruth and Bruce Rappaport Faculty of Medicine, Technion Institute of Technology, Clalit Health Services, Haifa, Israel.
| | - E C Serefoglu
- Department of Urology, Biruni University School of Medicine, Istanbul, Turkey
| | | | - Shmuel Springer
- Physical Therapy Department, Faculty of Health Sciences Ariel University, Ariel, Israel
| | | | - Boaz Appel
- Neurourology Unit, Rambam Healthcare Campus, Haifa, Israel
| | - Ilan Gruenwald
- Neurourology Unit, Rambam Healthcare Campus, Haifa, Israel
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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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Sansone A, Cignarelli A, Ciocca G, Pozza C, Giorgino F, Romanelli F, Jannini EA. The Sentiment Analysis of Tweets as a New Tool to Measure Public Perception of Male Erectile and Ejaculatory Dysfunctions. Sex Med 2019; 7:464-471. [PMID: 31395527 PMCID: PMC6963121 DOI: 10.1016/j.esxm.2019.07.001] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2019] [Revised: 06/21/2019] [Accepted: 07/08/2019] [Indexed: 02/07/2023] Open
Abstract
INTRODUCTION Twitter is a social network based on "tweets," short messages of up to 280 characters. Social media has been investigated in health care research to ascertain positive or negative feelings associated with several conditions but never in sexual medicine. AIM To assess perceptions related to erectile dysfunction (ED) and premature ejaculation (PE) among Twitter users. METHODS Data collection was performed on a daily basis between May 24-October 9, 2018 (138 days) via an automated script. Data collection was then performed after data cleaning. The statistical software R and the rtweet packages were used in both phases. RESULTS We collected 11,000 unique tweets for PE and 30,546 unique tweets for ED. After data cleaning, we analyzed 7,020 tweets on PE and 22,648 tweets on ED by analyzing the most recurring words and the clusters describing word associations. The most popular words for ED were "Treatment," "Health," and "Viagra," whereas "Sex," "Sexual," and "Cure" were the top 3 for PE. Word clusters suggest the presence of some recurring themes, such as medical terms being grouped together. Additionally, tweets reflect the general feelings triggered by specific events, such as pieces of news pertaining to sexual dysfunctions. CLINICAL IMPLICATIONS Tweets on sexual dysfunctions are posted every day, with more tweets on ED than on PE. Treatment is among the chief topics discussed for both conditions, although health concerns differ between PE and DE tweets. STRENGTH AND LIMITATIONS This is the first analysis conducted on Tweets in the field of andrology and sexual medicine. A significant number of tweets were collected and analyzed. However, quantitative assessment of the sentiment was not feasible. CONCLUSION Sexual dysfunctions are openly discussed on social media, and Twitter analysis could help understand the needs and interests of the general population on these themes. Sansone A, Cignarelli A, Ciocca G, et al. The Sentiment Analysis of Tweets as a New Tool to Measure Public Perception of Male Erectile and Ejaculatory Dysfunctions. Sex Med 2019;7:464-471.
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Affiliation(s)
- Andrea Sansone
- Department of Experimental Medicine, Section of Medical Pathophysiology, Food Science and Endocrinology, Sapienza University of Rome, Rome, Italy
| | - Angelo Cignarelli
- Department of Emergency and Organ Transplantation, Section of Internal Medicine, Endocrinology, Andrology, and Metabolic Diseases, University of Bari Aldo Moro, Bari, Italy
| | - Giacomo Ciocca
- Endocrinology and Sexual Medicine (ENDOSEX), Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy
| | - Carlotta Pozza
- Department of Experimental Medicine, Section of Medical Pathophysiology, Food Science and Endocrinology, Sapienza University of Rome, Rome, Italy
| | - Francesco Giorgino
- Department of Emergency and Organ Transplantation, Section of Internal Medicine, Endocrinology, Andrology, and Metabolic Diseases, University of Bari Aldo Moro, Bari, Italy
| | - Francesco Romanelli
- Department of Experimental Medicine, Section of Medical Pathophysiology, Food Science and Endocrinology, Sapienza University of Rome, Rome, Italy
| | - Emmanuele A Jannini
- Endocrinology and Sexual Medicine (ENDOSEX), Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy.
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Zucchi A, Costantini E, Scroppo FI, Silvani M, Kopa Z, Illiano E, Petrillo MG, Cari L, Nocentini G. The first-generation phosphodiesterase 5 inhibitors and their pharmacokinetic issue. Andrology 2019; 7:804-817. [PMID: 31350821 PMCID: PMC6790582 DOI: 10.1111/andr.12683] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2019] [Revised: 06/26/2019] [Accepted: 06/28/2019] [Indexed: 12/26/2022]
Abstract
Background Erectile dysfunction (ED) is a relatively frequent disease that negatively impacts the overall quality of life, well‐being, and relationships. Although the use of phosphodiesterase 5 inhibitors (PDE5is) has revolutionized the treatment of ED, a high percentage of ED patients discontinue PDE5i treatment. Objectives (i) To analyze the reasons for patient dissatisfaction leading to PDE5i discontinuation; (ii) analyze the pharmacokinetics of new formulations focusing on the time needed to reach an effective plasma concentration of PDE5is (Tonset) following drug intake; and (iii) summarize the physicochemical properties of sildenafil to understand which excipients may increase the absorption rate. Material and methods An online PubMed literature search was conducted to identify English language publications from inception to January 2019. Results The main reasons for patient dissatisfaction when using PDE5is on demand are the relatively long Tonset after taking vardenafil and sildenafil, including formulations such as film‐coated tablets, fine granules, orally disintegrating tablets (ODTs), and oral thin films (ODFs). The relatively long Tonset, further worsened when accompanied by eating, highlights the following: (i) the need for planning intercourse, determining partner‐related issues; (ii) issues when having sex before the maximum effect of the drug; and (iii) lower drug‐related placebo effects. Some data suggest that sildenafil is a ‘difficult’ molecule, but Tonset can be improved following absorption by buccal mucosa using appropriate excipients. Conclusions We conclude that several ODT and ODF formulations can improve the ‘discretion’ issue because they are taken without water, but they have similar pharmacokinetics to corresponding film‐coated tablet formulations. One ODF formulation of sildenafil was characterized by a shorter Tonset and could potentially increase patient satisfaction following treatment. However, more clinical studies are needed to confirm the findings. Surfactants and ascorbic acid appear to be crucial excipients for achieving a high absorption rate, but more studies are needed.
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Affiliation(s)
- A Zucchi
- Department of Surgical and Biomedical Sciences, Urology and Andrology Clinic, University of Perugia, Perugia, Italy
| | - E Costantini
- Andrology and Urogynecological Clinic, Santa Maria Hospital, University of Perugia, Perugia, Italy
| | - F I Scroppo
- Urology Unit, Ospedale di Circolo di Varese, Varese, Italy
| | - M Silvani
- Urology Department, Santa Rita Clinic, Vercelli, Italy
| | - Z Kopa
- Andrology Centre, Department of Urology, Semmelweis University, Budapest, Hungary
| | - E Illiano
- Andrology and Urogynecological Clinic, Santa Maria Hospital, University of Perugia, Perugia, Italy
| | - M G Petrillo
- Signal Transduction Laboratory, Department of Health and Human Services, NIEHS, NIH, Durham, NC, USA
| | - L Cari
- Department of Medicine, Section of Pharmacology, University of Perugia, Perugia, Italy
| | - G Nocentini
- Department of Medicine, Section of Pharmacology, University of Perugia, Perugia, Italy
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Sexual Dysfunctions and Their Association with the Dual Control Model of Sexual Response in Men and Women with High-Functioning Autism. J Clin Med 2019; 8:jcm8040425. [PMID: 30925683 PMCID: PMC6518023 DOI: 10.3390/jcm8040425] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2019] [Revised: 03/20/2019] [Accepted: 03/22/2019] [Indexed: 01/23/2023] Open
Abstract
Adults with an Autism Spectrum Disorder (ASD) are characterized by impairments in social interaction and communication, repetitive and stereotyped interests and behaviours as well as hyper- and/or hyposensitivities. These disorder specific symptoms could be associated with the development of sexual disorders. The Dual Control Model of Sexual Response presents one approach that is frequently used to explain the emergence of sexual dysfunctions. The aim of the present study was to assess the extent of symptoms of sexual dysfunctions in men and women with ASD and to evaluate their association with the individual propensity of sexual excitation and inhibition as defined by the Dual Control Model. Both men and women with ASD were more likely to report about sexual dysfunctions than individuals from the control group. In men with ASD, sexual inhibition was significantly correlated with the emergence of sexual dysfunctions, while there was no association between sexual functioning and sexual excitation. In women, the opposite pattern was found. Especially the peculiarities in sensitive perception could be responsible for the observed problems with sexual functioning in individuals with ASD. The present findings highlight the great need for specialized treatment programs addressing the frequently observed sexuality-related problems in individuals with ASD. However, up to now such treatment programs are lacking.
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Morgado A, Moura ML, Dinis P, Silva CM. Misdiagnosis And Undertreatment Of Erectile Dysfunction In The Portuguese Primary Health Care. Sex Med 2019; 7:177-183. [PMID: 30880000 PMCID: PMC6522934 DOI: 10.1016/j.esxm.2019.01.004] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2018] [Revised: 01/06/2019] [Accepted: 01/12/2019] [Indexed: 12/26/2022] Open
Abstract
Introduction The importance of erectile dysfunction (ED) diagnosis and treatment has been highlighted since the early 2000s. However, nearly 20 years after the first phosphodiesterase 5 inhibitor (PDE5i) was marketed, underdiagnosis and undertreatment of ED in the primary health care setting may still be present. Aim To assess the relative frequency of patients who are medically treated for ED before referral to specialized urology care. The secondary objectives were to evaluate possible reasons for non-treatment prior to referral and other signs of undertreatment, namely cardiovascular risk assessment and antihypertensive treatment. Methods 200 male patients referred for ED to specialist urology care by general practitioners were screened after consent between January 2016–December 2018. A full standardized medical and sexual history were taken. Previous medical treatment of ED, namely pharmacologic name and dosages, and cardiovascular risk factors were noted. Main Outcome Measures Of the 115 included patients, only 33.9% of patients had already taken PDE5i before referral, and none had taken alprostadil by intracavernous route. Results The mean patient age was 58.68 ± 10.01 years old. Only 45.2% had been prescribed the highest dose of PD5i. From the remaining untreated patients, only 19.7% had ≥3 cardiovascular risk factors, including 5.6% of patients who also presented moderate-to-severe stable or unstable angina requiring a stress test or cardiology assessment before treatment. Regarding the 54 patients with medical history of arterial hypertension, 43.4% and 30.2% were treated for hypertension with a diuretic and a beta blocker, respectively. Conclusion More focus on the primary healthcare continuous medical education regarding sexual dysfunction, namely ED, is needed because major undertreatment of ED is still present because low prescription of PD5i before referral is noted. Morgado A, Moura ML, Dinis P, et al. Misdiagnosis And Undertreatment Of Erectile Dysfunction In The Portuguese Primary Health Care. Sex Med 2019;7:177–183.
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Affiliation(s)
- Afonso Morgado
- Serviço de Urologia, Centro Hospitalar São João, Porto, Portugal; Departamento de Biomedicina, Faculdade de Medicina da Universidade do Porto, Porto, Portugal.
| | | | - Paulo Dinis
- Serviço de Urologia, Centro Hospitalar São João, Porto, Portugal; Departamento de Cirurgia e Fisiologia, Faculdade de Medicina da Universidade do Porto, Porto, Portugal
| | - Carlos Martins Silva
- Serviço de Urologia, Centro Hospitalar São João, Porto, Portugal; Departamento de Cirurgia e Fisiologia, Faculdade de Medicina da Universidade do Porto, Porto, Portugal
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Efficacy and safety of dapoxetine/sildenafil combination tablets in the treatment of men with premature ejaculation and concomitant erectile dysfunction-DAP-SPEED Study. Int J Impot Res 2019; 31:92-96. [PMID: 30705437 DOI: 10.1038/s41443-019-0122-2] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2018] [Revised: 12/29/2018] [Accepted: 01/10/2019] [Indexed: 12/31/2022]
Abstract
Premature ejaculation (PE) and erectile dysfunction (ED) are the most prevalent sexual disorders in men. ED is commonly reported among patients with PE. Although recent guidelines recommend to treat ED first in men with both PE and ED, this recommendation is not based on evidence and there are limited data about the efficacy and safety of dapoxetine/sildenafil combination therapy for these patients. The aim of this study is to evaluate the clinical efficacy and safety of the dapoxetine/sildenafil combination (Dapoxil® 30/50 mg film-coated tablet) in the treatment of patients with PE and concomitant ED. In a single-center, single-arm, open-label clinical study conducted between October 2016 and September 2017, 74 patients with lifelong or acquired PE and ED were included. All patients were instructed to record their intravaginal ejaculatory latency time (IELT) with a stopwatch for 4 weeks. After the screening, they were requested to complete Premature Ejaculation Diagnostic Tool (PEDT), Premature Ejaculation Profile (PEP), and International Index of Erectile Function-Erectile Function (IIEF-EF) questionnaires before the treatment. The patients received on demand Dapoxil® 1-3 h before sexual intercourse for the next 4 weeks (2 days a week and no more than once a day). The patients were also assessed with global impression of change (GIC) question for the treatment satisfaction and the side effects were recorded. The study was completed with 53 patients (53/74, 71.62%). Mean age of the patients was 45.32 ± 10.05 years. At the end of the 4-week treatment period, the geometric mean IELT of the patients significantly increased (from 22.72 ± 15.16 to 68.25 ± 82.33 s; p < 0.001). Similarly, significant improvements were observed in the mean PEP index score (0.86 ± 0.72 vs. 2.36 ± 1.13; p < 0.001) and mean IIEF-EF domain score (13.17 ± 3.33 vs. 24.60 ± 3.96; p < 0.001). According to the GIC results, 81.13% of the patients were satisfied with the treatment. Non-serious adverse events occurred in 10 patients (18.87%) and 4 (7.55%) of these patients dropped out of the treatment. The most common adverse events were headache, palpitation, and flushing. The dapoxetine/sildenafil combination therapy significantly improves the IELT values and patient reported outcome measures of PE patients who also suffer from ED. Although several side effects were reported, these were mild and transient.
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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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Kamnerdsiri WA, Rodríguez Martinez JE, Fox C, Weiss P. Clinical correlation between erectile function and ejaculatory function in the Czech male population. PLoS One 2018; 13:e0199588. [PMID: 30001388 PMCID: PMC6042713 DOI: 10.1371/journal.pone.0199588] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2017] [Accepted: 06/11/2018] [Indexed: 01/23/2023] Open
Abstract
Introduction This study explores the relationship between erectile function and ejaculatory function, to inform the clinical psychosexological and sexual medicine practice treatment protocols. Materials and methods A total of 1,004 Czech males aged between 15 and 84 years (m = 42.8 yrs; sd = 17.6 years) completed a sexual behavior questionnaire. A cross-sectional design was adopted. Erectile function was measured with the International Index of Erectile Function (IIEF-5) and ejaculatory function measured using self-report intravaginal ejaculation latency time and the Index of Premature Ejaculation (IPE). Linear regression analyses were used to explore the relationships between premature ejaculation and erectile dysfunction. Results The sample mean self-reported intravaginal ejaculatory latency time was 9.34 minutes. The overall mean on the IPE was 19.44 (sd = 2.368). The Control domain mean was 81.13 (sd = 17.22); Sexual Satisfaction domain mean 78.60 (sd = 20.59); and the Distress domain mean was 86.86 (sd = 18.32). The mean score on the IIEF-5 was 19.28 (sd = 2.53). The results indicate a relationship between premature ejaculation and erectile dysfunction. With age significantly associated with all measures. Conclusions Higher levels of erectile function are associated with a better control and sexual satisfaction, and less distress about ejaculation. This association supports the consideration of this relationship in the development of new clinical practice guidelines for erectile dysfunction and premature ejaculation.
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Affiliation(s)
| | | | - Christopher Fox
- Westmead Clinical School, Faculty of Medicine and Health, University of Sydney, Sydney, Australia
| | - Petr Weiss
- Institute of Sexology, First Faculty of Medicine, Charles University, Prague, Czech Republic
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Verze P, Arcaniolo D, Palmieri A, Cai T, La Rocca R, Franco M, Venturino L, De Sio M, Mirone V. Premature Ejaculation Among Italian Men: Prevalence and Clinical Correlates From an Observational, Non-Interventional, Cross-Sectional, Epidemiological Study (IPER). Sex Med 2018; 6:193-202. [PMID: 29803639 PMCID: PMC6085227 DOI: 10.1016/j.esxm.2018.04.005] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2017] [Revised: 03/08/2018] [Accepted: 04/10/2018] [Indexed: 12/25/2022] Open
Abstract
Introduction There is a great variability in the prevalence of premature ejaculation (PE) worldwide and only few data are available about the Italian population. Aim To determine the prevalence of PE in the adult male population in Italy. Methods Adult men 18 to 80 years old who were sexually active were randomly sampled from patient lists of general practitioners in Italy and were included in this observational, non-interventional, cross-sectional epidemiologic study from January to July 2015. Main Outcome Measures Subjects were asked to complete general questionnaires on anthropometric data, lifestyle, education, occupation, economic conditions, general health status, comorbidities, and sexual habits: the Premature Ejaculation Diagnostic Tool (PEDT), the 5-item International Index of Erectile Function, and the Sexual Quality of Life Questionnaire–Male. Results 1,104 subjects were recruited. Mean age was 45.6 years. Mean prevalence of PE based on PEDT score (≥11) was 18.5%, and 12.4% self-reported an intravaginal ejaculatory latency time shorter than 1 minute. Prevalence of PE proportionally increased with age. 64.6% of patients presented lifelong PE vs 35.4% of patients who reported acquired PE. Estimated prevalence of coexisting PE and erectile dysfunction was 7.0%. Furthermore, overall quality of sexual life was significantly worse in men with PE (P = .006). Enrolled men reported an overall rate of sexual problems in their partners of approximately 30%. 31.3% of patients with PE did not seek help for their dysfunction. No significant differences were noted between patients with and without PE for body mass index, alcohol consumption, smoking habits, physical activity, education, economic conditions, and marital status. Conclusions PE has a high prevalence in the Italian male population, increases with age, and heavily affects quality of life in patients and their partners. Encouraging data exist concerning the percentage of patients seeking help for their condition. Verze P, Arcaniolo D, Palmieri A, et al. Premature Ejaculation Among Italian Men: Prevalence and Clinical Correlates From an Observational, Non-Interventional, Cross-Sectional, Epidemiological Study (IPER). Sex Med 2018;6:193–202.
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Affiliation(s)
- Paolo Verze
- Department of Neurosciences, Sciences of Reproduction and Odontostomatology, Urology Unit, University of Naples "Federico II," Naples, Italy
| | - Davide Arcaniolo
- Department of Woman, Child and General and Specialized Surgery, Urology Unit, University of Campania "Luigi Vanvitelli," Naples, Italy.
| | - Alessandro Palmieri
- Department of Neurosciences, Sciences of Reproduction and Odontostomatology, Urology Unit, University of Naples "Federico II," Naples, Italy
| | - Tommaso Cai
- Department of Urology, Santa Chiara Hospital, Trento, Italy
| | - Roberto La Rocca
- Department of Neurosciences, Sciences of Reproduction and Odontostomatology, Urology Unit, University of Naples "Federico II," Naples, Italy
| | - Marco Franco
- Department of Neurosciences, Sciences of Reproduction and Odontostomatology, Urology Unit, University of Naples "Federico II," Naples, Italy
| | - Luca Venturino
- Department of Neurosciences, Sciences of Reproduction and Odontostomatology, Urology Unit, University of Naples "Federico II," Naples, Italy
| | - Marco De Sio
- Department of Woman, Child and General and Specialized Surgery, Urology Unit, University of Campania "Luigi Vanvitelli," Naples, Italy
| | - Vincenzo Mirone
- Department of Neurosciences, Sciences of Reproduction and Odontostomatology, Urology Unit, University of Naples "Federico II," Naples, Italy
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Teixeira T, Nazima M, Hallak J. Male Sexual Quality Of Life Is Maintained Satisfactorily Throughout Life In The Amazon Rainforest. Sex Med 2018. [PMID: 29523489 PMCID: PMC5960027 DOI: 10.1016/j.esxm.2017.11.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023] Open
Abstract
INTRODUCTION The Amazon Rainforest is a cradle of biodiversity, where different ethnic groups have specific sexual habits. AIMS To define the average sexual quality of life of Amazonian men 18 to 69 years old, evaluate the influence of aging on their sexual function, and calculate the prevalence of premature ejaculation, delayed ejaculation, and hypoactive sexual desire disorder. METHODS A cross-sectional quantitative probability sample study was performed with a demographically representative population (N = 385), with data collected privately at participants' houses, including men who had been sexually active for a minimum of 6 months. The Male Sexual Quotient (MSQ) was used to measure sexual satisfaction and function. Statistical analysis was performed with SPSS 21.0 using the Kruskal-Wallis test (P < .05), and a multiple linear regression analysis was performed to investigate which factors could predict participants' quality of sexual life. MAIN OUTCOME MEASURES MSQ scores. RESULTS The response rate was 81.69%. The mean age was 36.00 ± 12.95 years, and most men had mixed ethnicity (63.11%), were self-employed (42.07%), had a monthly earned income of US$0 to US$460 (46.75%), and were single (36.10%). The mean MSQ score was 80.39 ± 12.14 (highly satisfied). None of the demographic characteristics showed a statistically significant influence on sexual satisfaction. The difference in quality of sexual life was statistically significant compared with age (P < .01). The domains of desire (P < .01), partner satisfaction (P = .04), and erection quality (P < .01, P = .03, P = .02) were statistically significant. Prevalences of sexual dysfunctions were 36.54% for premature ejaculation, 6.5% for delayed ejaculation, and 11.69% for hypoactive sexual desire disorder. CONCLUSIONS Independent of age, these men have an excellent quality of sexual life. Sexual domains such as desire, partner satisfaction, and erection quality are related to the correlation between sexual quality of life and aging. However, the prevalence of premature ejaculation seems to be slightly higher than in other parts of the world. Teixeira T, Nazima M, Hallak J. Male Sexual Quality Of Life Is Maintained Satisfactorily Throughout Life In The Amazon Rainforest. Sex Med 2018;6:90-96.
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Affiliation(s)
- Thiago Teixeira
- Urology Division, University of Sao Paulo Medical School, Sao Paulo, Brazil; Federal University of Amapa Medical School, Macapa, Brazil.
| | - Maira Nazima
- Federal University of Amapa Medical School, Macapa, Brazil
| | - Jorge Hallak
- Urology Division, University of Sao Paulo Medical School, Sao Paulo, Brazil; Androscience, Science and Innovation Center in Androloy and High-Complex Clinical and Andrology Laboratory, Sao Paulo, Brazil; Institute for Advanced Studies, University of Sao Paulo, Sao Paulo, Brazil
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50
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Chen X, Wang FX, Hu C, Yang NQ, Dai JC. Penile sensory thresholds in subtypes of premature ejaculation: implications of comorbid erectile dysfunction. Asian J Androl 2018; 20:330-335. [PMID: 29405168 PMCID: PMC6038158 DOI: 10.4103/aja.aja_62_17] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
Penile hypersensitivity plays an important role in premature ejaculation (PE), but differences in penile sensitivity among subtypes of PE are unknown. Therefore, we compared penile sensory thresholds in PE subtypes of lifelong and acquired PE, PE with and without erectile dysfunction (ED), PE with an intravaginal ejaculation latency time ≤1 min and >1 min, and PE with and without orgasmic pleasure perceptual dysfunction. During August 2014 to January 2016, 136 patients with PE were included. Penile warm, cold, and vibratory thresholds were measured. Data of clinical characteristics, sexual life, Premature Ejaculation Diagnostic Tool (PEDT) score, and the 5-item version of the International Index of Erectile Function (IIEF-5) score were collected. Vibratory thresholds of the PE with ED group were higher in the right coronal sulcus (median amplitude: 4.92 vs 3.65 μ m, P = 0.02) and the right penile shaft (median amplitude: 3.87 vs 3.30 μ m, P = 0.03), while differences in penile sensory thresholds between other subtypes were not significant. The median PEDT score was lower in the PE without ED group (12 vs 14, P < 0.001). The IIEF-5 and PEDT scores were negatively correlated (r = -0.29, P < 0.001). Patients with orgasmic pleasure perceptual dysfunction had a lower median IIEF-5 score (20 vs 21, P = 0.02). Patients with PE and ED had lower penile sensitivity, and ED was associated with more severe symptoms and weaker orgasmic pleasure perception. In men with PE, management of comorbid ED is necessary. In case of side effects in erectile function, topical anesthetics should be cautiously used in men with PE and ED.
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Affiliation(s)
- Xiang Chen
- Department of Urology, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai 200001, China.,Department of Urology, Zhongshan Hospital, Fudan University, Shanghai 200032, China
| | - Fei-Xiang Wang
- Shanghai Key Laboratory of Forensic Medicine, Shanghai Forensic Service Platform, Academy of Forensic Science, Shanghai 200063, China
| | - Chao Hu
- Department of Urology, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai 200001, China.,Department of Urology, Zhongshan Hospital, Fudan University, Shanghai 200032, China
| | - Nian-Qin Yang
- Department of Urology, Zhongshan Hospital, Fudan University, Shanghai 200032, China
| | - Ji-Can Dai
- Department of Urology, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai 200001, China
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