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Arshad A, Irfan M, Inam M, Hussain NHN, Ismail SB. Levosulpiride for Premature Ejaculation: A Systematic Review and Meta-Analysis. Am J Mens Health 2022; 16:15579883221124832. [PMID: 36154321 PMCID: PMC9515538 DOI: 10.1177/15579883221124832] [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] [Indexed: 01/26/2023] Open
Abstract
Premature ejaculation (PE) is one of the major causes of sexual dysfunction. Levosulpiride is an off-label medicine used to treat PE, but no review on its efficacy exists. A systematic review and meta-analysis was performed to determine the efficacy of levosulpiride in treating PE. Databases PubMed, Science Direct, and Google Scholar were searched. Randomized control trials (RCTs) comparing levosulpiride with placebo or other medicine were selected. Odds ratio (OR) of improved intravaginal ejaculation latency time (IELT) was calculated. A total of 97 articles were retrieved from database search, of which only four RCTs containing 203 men met the selection criteria. All four RCTs were included in systematic review while only two were included in meta-analysis. A high selection and detection bias was found in both of these studies. Meta-analysis also showed the odds of improving IELT in PE patients using levosulpiride to be significantly higher (p < .05) compared with those who used placebo, OR: 100.81, 95% confidence interval (CI) [13.12-774.90], I2 = 0%. Odds of improving IELT for > 5 min (500% improvement) were also significantly higher (p < .05) compared with the placebo groups (OR: 38.88, 95% CI [5.12-295.29], I2 = 0%). The odds of improving IELT for > 1 min, but < 5 min were also significantly higher (p < .05) than placebo groups (OR: 32.84, 95% CI [4.15-259.75], I2 = 0%). Levosulpiride improved IELT, but even so, limited studies are available on this topic. Additional research is thus required to support the present review's findings.
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Affiliation(s)
- Adina Arshad
- Department of Zoology, Wildlife
and Fisheries, Pir Mehr Ali Shah, Arid Agriculture University, Rawalpindi,
Pakistan
| | - Muhammad Irfan
- Department of Zoology, Wildlife
and Fisheries, Pir Mehr Ali Shah, Arid Agriculture University, Rawalpindi,
Pakistan
| | - Muhammad Inam
- Department of Zoology, University
of the Punjab, Lahore, Pakistan,BISP, C & T Wing, Pakistan
Secretariat, Islamabad, Pakistan
| | - Nik Hazlina Nik Hussain
- Women’s Health Development Unit,
School of Medical Sciences, Health Campus, Universiti Sains Malaysia, Kubang
Kerian, Malaysia
| | - Shaiful Bahari Ismail
- Department of Family Medicine,
School of Medical Sciences, Health Campus, Universiti Sains Malaysia, Kubang
Kerian, Malaysia,Shaiful Bahari Ismail, Department
of Family Medicine, School of Medical Sciences, Health Campus,
Universiti Sains Malaysia, 16150 Kubang Kerian, Kelantan, Malaysia.
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Jannini TB, Lorenzo GD, Bianciardi E, Niolu C, Toscano M, Ciocca G, Jannini EA, Siracusano A. Off-label Uses of Selective Serotonin Reuptake Inhibitors (SSRIs). Curr Neuropharmacol 2022; 20:693-712. [PMID: 33998993 PMCID: PMC9878961 DOI: 10.2174/1570159x19666210517150418] [Citation(s) in RCA: 22] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2021] [Revised: 04/22/2021] [Accepted: 05/05/2021] [Indexed: 11/22/2022] Open
Abstract
Psychiatric drugs have primacy for off-label prescribing. Among those, selective serotonin reuptake inhibitors (SSRIs) are highly versatile and, therefore, widely prescribed. Moreover, they are commonly considered as having a better safety profile compared to other antidepressants. Thus, when it comes to off-label prescribing, SSRIs rank among the top positions. In this review, we present the state of the art of off-label applications of selective serotonin reuptake inhibitors, ranging from migraine prophylaxis to SARS-CoV-2 antiviral properties. Research on SSRIs provided significant evidence in the treatment of premature ejaculation, both with the on-label dapoxetine 30 mg and the off-label paroxetine 20 mg. However, other than a serotoninergic syndrome, serious conditions like increased bleeding rates, hyponatremia, hepatoxicity, and post-SSRIs sexual dysfunctions, are consistently more prominent when using such compounds. These insidious side effects might be frequently underestimated during common clinical practice, especially by nonpsychiatrists. Thus, some points must be addressed when using SSRIs. Among these, a psychiatric evaluation before every administration that falls outside the regulatory agencies-approved guidelines has to be considered mandatory. For these reasons, we aim with the present article to identify the risks of inappropriate uses and to advocate the need to actively boost research encouraging future clinical trials on this topic.
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Affiliation(s)
- Tommaso B. Jannini
- Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy
| | - Giorgio D. Lorenzo
- Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy;,IRCCS-Fondazione Santa Lucia, Rome, Italy
| | | | - Cinzia Niolu
- Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy
| | - Massimiliano Toscano
- Department of Human Neurosciences, Sapienza University of Rome, Rome, Italy;,Department of Neurology, Fatebenefratelli Hospital, Isola Tiberina, Rome, Italy
| | - Giacomo Ciocca
- Department of Dynamic and Clinical Psychology, and Health Studies, Sapienza University of Rome, Rome, Italy
| | | | - Alberto Siracusano
- Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy;,Address correspondence to this author at the Department of Systems Medicine, University of Rome Tor Vergata, Via Montpellier 1, 00133 Rome, Italy; E-mail:
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Buchholz VN, Mühle C, Kornhuber J, Lenz B. Markers of Prenatal Androgen Exposure Correlate With Online Sexual Compulsivity and Erectile Function in Young Men. Front Psychiatry 2021; 12:517411. [PMID: 33889090 PMCID: PMC8055940 DOI: 10.3389/fpsyt.2021.517411] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/04/2019] [Accepted: 02/08/2021] [Indexed: 11/13/2022] Open
Abstract
Pornography addiction and sexual dysfunction are increasingly prevalent in young men. Previous studies suggest that prenatal androgen exposure plays a role in addiction and sexual functionality. Here, we tested whether lower second-to-fourth finger length ratio (2D:4D) and later age at spermarche, both putative indicators of higher androgen levels in utero, correlate with online sexual compulsivity (OSC scale of ISST), erectile function (IIEF-5), and ejaculatory control (PEPA) in 4,370 young men (age IQR: 25-26 years) of the Cohort Study on Substance Use Risk Factors. Statistical analyses revealed that lower 2D:4D correlated with higher scores on the OSC scale. Moreover, higher age at spermarche correlated with higher OSC scores and decreased erectile function. Interestingly, OSC severity, but not the frequency of pornography use, correlated negatively with erectile function and ejaculatory control. This is the first study to associate two independent proxies of prenatal testosterone level with OSC. These findings provide novel insight into intrauterine predisposition of sexual behavior and related sexual function in adulthood.
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Affiliation(s)
- Verena N Buchholz
- Department of Psychiatry and Psychotherapy, Friedrich-Alexander University Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - Christiane Mühle
- Department of Psychiatry and Psychotherapy, Friedrich-Alexander University Erlangen-Nürnberg (FAU), Erlangen, Germany
| | | | - Johannes Kornhuber
- Department of Psychiatry and Psychotherapy, Friedrich-Alexander University Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - Bernd Lenz
- Department of Psychiatry and Psychotherapy, Friedrich-Alexander University Erlangen-Nürnberg (FAU), Erlangen, Germany.,Department of Addictive Behavior and Addiction Medicine, Central Institute of Mental Health (CIMH), Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
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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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Ur Rehman MF, Imran Zaidi A, Ul Haq T, Rafique S, Ali F. Comparison of the Efficacy of Tramadol and Paroxetine in the Management of Premature Ejaculation. Cureus 2020; 12:e10725. [PMID: 33145131 PMCID: PMC7599037 DOI: 10.7759/cureus.10725] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Objective The goal of this study was to compare the efficacy of tramadol and paroxetine in the treatment of primary premature ejaculation (PE). Study design This study was a randomized controlled trial performed in the outpatient department of Nishtar Hospital, Multan, from January 2017 to January 2018. Methodology One hundred six patients were diagnosed with PE and included in the study. The patients were categorized into two groups receiving either tramadol or paroxetine through a lottery randomization method. The main variables were baseline PE, baseline satisfaction after intercourse, baseline intravaginal ejaculatory latency time (IELT), ejaculation control, difficulty in ejaculation, and after-treatment satisfaction with sexual intercourse and IELT. We used IBM SPSS Statistics for Windows, Version 23.0 (Armonk, NY: IBM Corp.) for data analysis, and p≤0.05 was considered statistically significant. Results Ejaculation control, difficulty in ejaculation, and distress due to ejaculation in patients in the tramadol group was noted as 24.5%, 7.5%, and 7.5%, respectively. Ejaculation control, difficulty in ejaculation, and distress due to ejaculation in the paroxetine group was noted as 49.1%, 17%, and 24.5%, respectively. The differences were statistically significant within the groups at baseline and after treatment of PE (p<0.001). Conclusion Tramadol is an effective and useful drug as compared to paroxetine for the treatment of PE. Tramadol can be used as an alternative to other medications for the treatment of lifelong PE.
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Affiliation(s)
| | | | - Tanveer Ul Haq
- Urology, Multan Institute of Kidney Diseases, Multan, PAK
| | - Shoaib Rafique
- Urology, Multan Institute of Kidney Diseases, Multan, PAK
| | - Farman Ali
- Internal Medicine, District Headquarter Hospital, Khanewal, PAK
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Wei S, Wu C, Yu B, Ma M, Qin F, Yuan J. Advantages and limitations of current premature ejaculation assessment and diagnostic methods: a review. Transl Androl Urol 2020; 9:743-757. [PMID: 32420180 PMCID: PMC7215025 DOI: 10.21037/tau.2019.12.08] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
Premature ejaculation (PE) is the most common male sexual dysfunction worldwide. Characteristic symptoms of PE are unexpected, rapid, complete ejaculation, which negatively impacts the sexual act for both sexual partners. Despite the existence of a definitive PE classification system and various diagnostic tools, diagnosing PE is still challenging due to the limitations associated with the assessment of this condition. Hence, it is necessary to review the diagnostic methods and processes of the physical examination that are currently performed in the medical setting. It is also important to analyze any controversial results of each main PE assessment method and propose novel diagnostic and assessment methods. To date, it is important to verify the accuracy of the PE evaluation method due to the ambiguity of previous definitions and proven invalidity of current examining techniques. Clinical diagnosis is based mainly on the patient history, patient-reported outcome scores, and diagnostic tools. Introduction of intravaginal ejaculatory latency time, penile biothesiometry, and the electrophysiological test provided objective means of evaluating PE. Due to the controversial and inconclusive findings in PE psychogenic and neurogenic etiology, utilizing a single parameter to describe and qualify PE using the aforementioned diagnostic methods provides valuable, but insufficient information for PE diagnosis. There is still a lack of a feasible and plausible means of objective measurement to evaluate the ejaculatory latency and control over ejaculation. Consequently, a comprehensive penile stimulation that simulates sexual intercourse could be useful to record intensity and duration parameters before the ejaculatory threshold, providing a more accurate method of describing and diagnosing PE versus a single chronological observation.
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Affiliation(s)
- Shanzun Wei
- The Andrology Laboratory, West China Hospital, Sichuan University, Chengdu 610041, China.,Department of Urology, West China Hospital, Sichuan University, Chengdu 610041, China
| | - Changjing Wu
- The Andrology Laboratory, West China Hospital, Sichuan University, Chengdu 610041, China
| | - Botao Yu
- The Andrology Laboratory, West China Hospital, Sichuan University, Chengdu 610041, China.,Department of Urology, West China Hospital, Sichuan University, Chengdu 610041, China
| | - Ming Ma
- The Andrology Laboratory, West China Hospital, Sichuan University, Chengdu 610041, China.,Department of Urology, West China Hospital, Sichuan University, Chengdu 610041, China
| | - Feng Qin
- The Andrology Laboratory, West China Hospital, Sichuan University, Chengdu 610041, China
| | - Jiuhong Yuan
- The Andrology Laboratory, West China Hospital, Sichuan University, Chengdu 610041, China.,Department of Urology, West China Hospital, Sichuan University, Chengdu 610041, China
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Soldati L, Bianchi-Demicheli F, Schockaert P, Köhl J, Bolmont M, Hasler R, Perroud N. Sexual Function, Sexual Dysfunctions, and ADHD: A Systematic Literature Review. J Sex Med 2020; 17:1653-1664. [PMID: 32402814 DOI: 10.1016/j.jsxm.2020.03.019] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2019] [Revised: 03/20/2020] [Accepted: 03/28/2020] [Indexed: 12/29/2022]
Abstract
BACKGROUND The scientific literature on sexuality among mentally ill patients clearly shows a higher prevalence of sexual disorders for many mental disorders, but little is known about sexuality in individuals suffering from ADHD. Clinicians will often assume that specific difficulties of ADHD are bound to affect sexual functioning. AIM The aim of this study was to provide a review of the literature to gain better knowledge about sexuality in subjects with ADHD and to discuss screening and management of their potential sexual problems. METHODS A systematic review of the literature was performed in Pubmed, PsychInfo, and Embase databases. MAIN OUTCOME MEASURES The main outcome measures were sexual function and sexual dysfunctions. RESULTS The studies indicated that subjects with ADHD report more sexual desire, more masturbation frequency, less sexual satisfaction, and more sexual dysfunctions than the general population. CLINICAL IMPLICATIONS Clinicians working with subjects with ADHD should explore the quality of their sexual life. STRENGTHS & LIMITATIONS This is the first systematic review of the sexuality of individuals with ADHD. However, the results are limited by the small number of studies, by the small sample size of many studies, and the potential for bias. CONCLUSIONS ADHD is a mental disorder affecting sexual health. Further studies are warranted to learn more about sexuality in subjects with ADHD. Soldati L, Bianchi-Demicheli F, Schockaert P, et al. Sexual Function, Sexual Dysfunctions, and ADHD: A Systematic Literature Review. J Sex Med 2020;17:1653-1664.
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Affiliation(s)
- Lorenzo Soldati
- Sexual Medicine and Sexology unit, Division of Psychiatric Specialties, Department of Psychiatry, University Hospital of Geneva, Geneva, Switzerland.
| | - Francesco Bianchi-Demicheli
- Sexual Medicine and Sexology unit, Division of Psychiatric Specialties, Department of Psychiatry, University Hospital of Geneva, Geneva, Switzerland; Department of Psychiatry, Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | - Pauline Schockaert
- Sexual Medicine and Sexology unit, Division of Psychiatric Specialties, Department of Psychiatry, University Hospital of Geneva, Geneva, Switzerland
| | - John Köhl
- Sexual Medicine and Sexology unit, Division of Psychiatric Specialties, Department of Psychiatry, University Hospital of Geneva, Geneva, Switzerland
| | - Mylène Bolmont
- Sexual Medicine and Sexology unit, Division of Psychiatric Specialties, Department of Psychiatry, University Hospital of Geneva, Geneva, Switzerland; Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | - Roland Hasler
- Department of Psychiatry, Faculty of Medicine, University of Geneva, Geneva, Switzerland; TRE Unit, Division of Psychiatric Specialties, Department of Psychiatry, University Hospital of Geneva, Geneva, Switzerland
| | - Nader Perroud
- Department of Psychiatry, Faculty of Medicine, University of Geneva, Geneva, Switzerland; TRE Unit, Division of Psychiatric Specialties, Department of Psychiatry, University Hospital of Geneva, Geneva, Switzerland; Department of Psychiatry, Dalhousie University, Halifax, NS, Canada
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Bhat GS, Shastry A. Association Between Post-Ejaculatory Refractory Time (PERT) and Premature Ejaculation (PE). J Sex Med 2019; 16:1364-1370. [PMID: 31405769 DOI: 10.1016/j.jsxm.2019.06.016] [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: 03/21/2019] [Revised: 05/27/2019] [Accepted: 06/24/2019] [Indexed: 12/01/2022]
Abstract
INTRODUCTION Patients with premature ejaculation (PE) often complain of difficulty in having second erection, which is not yet investigated using scientific methodology. AIM Evaluation of the association between post-ejaculation refractory time (PERT) with PE by comparing PERT in premature ejaculators with their age-matched control subjects. METHODS After ethical committee approval and written informed consent from the participants were obtained, men in a monogamous stable sexual relationship and reporting PE were recruited into the study. Sexually active, matched control subjects were recruited for comparison. Exclusion criteria were erectile dysfunction, diabetes mellitus, cardiovascular diseases, hypogonadism, psychiatric conditions, instrumentation of the genitourinary tract, genitourinary anomalies, and genitourinary infections. Both the premature ejaculators and their control subjects were evaluated with the PE diagnostic tool before initiation of the study. They were asked to record their IELT and PERT over 4 weeks. The statistical analysis was done to obtain descriptive statistics, namely, mean and SD, paired t-tests, and logistic regression analysis. P < .001 was considered significant. MAIN OUTCOME MEASURE There was a statistically significant association between prolonged PERT and PE in patients with PE compared with their age-matched control subjects. RESULTS 102 premature ejaculators and an equal number of matched control subjects were evaluated from January 2016-December 2017. The average PERT in premature ejaculators and control subjects was 330 ± 296.63 minutes and 105.64 ± 98.59 minutes, respectively (P < .0001). Increasing age was associated with increasing PERT. PE was more common in patients when PERT exceeded a threshold of 590 minutes. CLINICAL IMPLICATIONS Until now, the association between PE and PERT with matched-pair analysis was not reported. Our study addresses this association, which can add a new paradigm in the evaluation and management of PE. STRENGTH & LIMITATIONS The association between PE and prolonged PERT using a statistically appropriate, adequately powered methodology is the strength of the study. The inability to address the causal association between prolonged PERT and PE because of the paucity of evidence at present is the limitation of the study. We believe that the results of this study could trigger further research into such an association, so the mystery of such an association can be unraveled. CONCLUSIONS The association between prolonged PERT and PE, as seen in our study, is a finding, that needs further research to establish a causal association. However, reporting such an association is necessary because it is contrary to the present understanding. Bhat GS, Shastry A. Association Between Post-Ejaculatory Refractory Time (PERT) and Premature Ejaculation (PE). J Sex Med 2019;16:1364-1370.
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Affiliation(s)
- Gajanan S Bhat
- Department of Urology, Andrology and Sexual Medicine, TSS Shripad Hegde Kadave Institute of Medical Sciences, Sirsi, Uttara Kannada District, Karnataka State, India.
| | - Anuradha Shastry
- Department of Urology, Andrology and Sexual Medicine, TSS Shripad Hegde Kadave Institute of Medical Sciences, Sirsi, Uttara Kannada District, Karnataka State, India
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Hyaluronic acid injection in glans penis for treatment of premature ejaculation: a randomized controlled cross-over study. Int J Impot Res 2019; 31:348-355. [PMID: 30610210 DOI: 10.1038/s41443-018-0104-9] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2018] [Revised: 11/04/2018] [Accepted: 11/26/2018] [Indexed: 02/08/2023]
Abstract
This randomized controlled cross-over study aimed to assess the efficacy and safety of glans penis injection with hyaluronic acid (HA) in treating premature ejaculation (PE). A total of 30 patients with PE were randomly allocated into two groups: group 1 (n = 15) which was subjected to glans penis HA injection and group 2 (n = 15) which was injected with saline as a control then both groups were subjected to follow-up at 1 week and 1 month after injection. These subjects were evaluated by intra-vaginal ejaculation latency time (IELT) and the Arabic validated index of premature ejaculation (AIPE). After a wash-out period, cross-over and re-evaluation of both groups were carried. Additionally, patients with reported improvement after 1 month of HA injection (n = 20) were subjected to extended evaluation by IELT at 3, 6, and 9 months intervals. Two-way repeated measures ANOVA indicated significant improvement after HA in comparison with saline across the follow-up periods (F(1.66: 91.37) = 24.85, p = 0.001). Post-hoc Bonferroni test indicated no significant difference after 1 week period in comparison with baseline IELT, but a significant difference after 1 month of injection in comparison with baseline IELT (p < 0.001) and after 1 week (p < 0.001). After 1 month of HA, IELT increased by a median of 2.6 folds while 1.1 folds increase was observed after 1 month of saline injection. Total AIPE scores improved significantly after HA injection compared with baseline (p = 0.003) and saline scores (p = 0.002). Reported adverse effects were minimal and self-limited. It could be concluded that glans penis injection with HA for treatment of PE is a safe method that ensures a modest but significant increase in IELT and improves couple sexual satisfaction.
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Atan A. Editorial to the paper entitled “pharmacotherapy of premature ejaculation: a systematic review and network meta-analysis”. Int Urol Nephrol 2018; 50:2015-2016. [DOI: 10.1007/s11255-018-1988-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2018] [Accepted: 09/17/2018] [Indexed: 11/25/2022]
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Cakir SS, Ozcan L, Besiroglu H, Dursun M, Polat EC, Otunctemur A, Ozbek E. Visceral adiposity index is associated with premature ejaculation inversely: a cross-sectional study. Aging Male 2018; 21:206-210. [PMID: 29338524 DOI: 10.1080/13685538.2018.1427712] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
Abstract
OBJECTIVE Visceral adiposity index (VAI) is a novel indicator for the assessment of visceral obesity. In this study, we aimed to evaluate the relationship between VAI and premature ejaculation (PE). MATERIALS AND METHOD A total of 300 men were included in the study. Hundred and fifty men with PE and 150 men without PE (control). All men were evaluated for PE by premature ejaculation diagnostic tool (PEDT). VAI levels were calculated using body mass index (BMI), high density lipoprotein and triglyceride (TG) levels. RESULTS Mean age of the study groups was 34.3 ± 5.2 (30-60) years and the mean age of the controls were 35.9 ± 5.3 (30-60) years. The men with PE had lower BMI, TG levels, waist circumference (WC) and higher high-density lipoprotein-cholesterol (HDL-C) levels. Mean VAI level was 4.13 ± 0.7 in study group and 5.72 ± 1.6 in control group, respectively. VAI levels were statistically higher in men without PE (p < .001). DISCUSSION Our cross-sectional study demonstrated a negative correlation between VAI and PE. VAI is superior index for the evaluation and calculation the relationship between obesity and PE.
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Affiliation(s)
| | - Levent Ozcan
- b Kocaeli Derince Egitim ve Arastirma Hastanesi , Kocaeli , Turkey
| | | | - Murat Dursun
- d Malatya Egitim ve Arastirma Hastanesi , Malatya , Turkey
| | - Emre Can Polat
- e Turkiye Cumhuriyeti Saglik Bakanligi Okmeydani Egitim ve Arastirma Hastanesi , Istanbul , Turkey
| | | | - Emin Ozbek
- f Istanbul Universitesi Cerrahpasa Tip Fakultesi , Istanbul , Turkey
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