1
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Deger MD, Gül M, Serefoglu EC. Surgical treatment of premature ejaculation: a narrative review. Int J Impot Res 2024; 36:474-479. [PMID: 37798540 DOI: 10.1038/s41443-023-00771-9] [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: 05/14/2023] [Revised: 09/22/2023] [Accepted: 09/25/2023] [Indexed: 10/07/2023]
Abstract
Recurrence after drug cessation is the biggest drawback of medical premature ejaculation (PE) treatments. Although these treatments are demonstrated to be safe and effective, most of the PE patients are interested in a more permanent solution. Despite the fact that currently available guidelines do not recommend surgical treatment for PE, some surgical interventions have been commonly performed for many years, especially in the Asian countries. The main purpose of these surgical treatments is to decrease the sensitivity of the glans penis. However, they are associated with irreversible complications such as penile deformity, sensory loss and erectile dysfunction. The aim of this narrative review is to summarize the advantages and disadvantages of various surgical interventions introduced for the treatment of PE. PubMed, Scopus and Web of Science have been utilized to search articles about glans penis augmentation and penile dorsal nerve interventions. A total of 11 articles were included, three articles excluded because they were in non-English languages. Glans penis augmentation offered a less invasive treatment that avoids severe side effects but requires retreatment in time. Selective dorsal neurectomy provided a more invasive but curative treatment alternative. However, more clinical data are necessary before surgical treatment options can be recommended to patients with PE.
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Affiliation(s)
| | - Murat Gül
- Department of Urology, Selcuk University School of Medicine, Konya, Turkey
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Liu J, Bao T, Wang Q, Jiang H, Zhang X. Stigma and its associations with self-confidence and sexual relations in 4 types of premature ejaculation. Basic Clin Androl 2024; 34:11. [PMID: 38951750 PMCID: PMC11218248 DOI: 10.1186/s12610-024-00226-1] [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: 01/17/2024] [Accepted: 04/22/2024] [Indexed: 07/03/2024] Open
Abstract
BACKGROUND Although men with premature ejaculation (PE) always show more negative emotions, including embarrassment, guilt and worry, this may be related to the stigma of PE. To investigated stigma and its associations with self-confidence and sexual relations in 4 PE syndromes, a survey was conducted in our hospital from December 2018 to December 2019 among 350 men with self-reported PE and 252 men without self-reported PE. The stigma, self-confidence and sexual relations were assessed by the Social Impact Scale (SIS) and Self-Esteem and Relationship questionnaire (SEAR), respectively. Ejaculation control, sexual life satisfaction and distress caused by PE were evaluated by the Index of PE. RESULTS Men with self-reported PE had higher internalized shame and social isolation scores and lower SEAR scores than control subjects. The highest score of internalized shame and social isolation and the lowest score of SEAR appeared in men with lifelong PE (LPE). After age adjustment, the positive relationships were stronger between distress about PE and internalized shame. Whereas, the stronger negative associations were found between social isolation and sexual satisfaction. The strongest association was observed between social isolation and sexual relationship. Therefore, the stigma associated with PE adversely affects the self-confidence, self-esteem, and sexual relationships of men with PE. CONCLUSION Men with PE, especially LPE, have a high level of stigma and disharmonious sexual relations, and often lack self-confidence and self-esteem, which have a certain negative impact on their physical and mental health and life. These will be the key issues to be considered when we formulate a personalized treatment plan for PE.
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Affiliation(s)
- Jishuang Liu
- Department of Urology, Anhui Province Key Laboratory of Genitourinary Diseases, The Institute of Urology, The First Affiliated Hospital of Anhui Medical UniversityAnhui Medical University, Hefei, Anhui, China
- Department of Urology, Anqing Municipal Hospital, Anqing Medical Center of Anhui Medical University, Renmin Road No. 352, Yingjiang District, Anqing, 246003, Anhui, People's Republic of China
| | - Tong Bao
- Department of Urology, Anqing Municipal Hospital, Anqing Medical Center of Anhui Medical University, Renmin Road No. 352, Yingjiang District, Anqing, 246003, Anhui, People's Republic of China
| | - Qunfeng Wang
- Department of Urology, Anqing Municipal Hospital, Anqing Medical Center of Anhui Medical University, Renmin Road No. 352, Yingjiang District, Anqing, 246003, Anhui, People's Republic of China
| | - Hui Jiang
- Department of Urology, Peking University First Hospital Institute of Urology, Peking University Andrology Center, Peking University First Hospital, No. 8 Xishiku Street Xicheng District, Beijing, China.
| | - Xiansheng Zhang
- Department of Urology, The First Affiliated Hospital of Anhui Medical University, Hefei, China.
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Nguyen HB, Nguyen CT, Pham MQ, Hoang L, Sansone A, Jannini EA. Perceived intravaginal ejaculation latency time: The diagnosis of premature ejaculation among Vietnamese men. Andrology 2024; 12:618-623. [PMID: 37615496 DOI: 10.1111/andr.13516] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2023] [Revised: 08/04/2023] [Accepted: 08/14/2023] [Indexed: 08/25/2023]
Abstract
INTRODUCTION Premature ejaculation (PE) is a prevalent sexual dysfunction in men that greatly affects their quality of life. In PE, the duration of sexual performance is considered an important aspect. However, a self-estimated value of intravaginal ejaculation latency time (perceived IELT, PIELT) as a criterion for diagnosis has not been specified. AIM This study aimed to determine the validity and a threshold value for PIELT in PE diagnosis. METHOD In our cross-sectional study, we recruited 550 men from March 2019 to January 2020 and interviewed them regarding their general demographic characteristics, sexual habits, PIELT and completed a premature ejaculation diagnostic tool (PEDT) questionnaire. Eventually, a combination of a clinical diagnosis and PEDT score was used, in which those with PEDT ≥ 11 and diagnosed with possible PE were assigned to the final PE(+) group; those with PEDT score ≤ 8 and diagnosed with no PE were included in the final PE(-) group. RESULTS Men PE(-) had more frequent sexual intercourse (9.74 ± 5.38 vs. 6.69 ± 5.38 episodes per month, p < 0.001) and had higher marriage rate (72.7% vs. 60.4%, p = 0.002) than PE(+) patients. No significant difference was noted regarding age, smoking habit, age of first sexual experience, and number of sexual partners between the two groups. The mean PIELT of control subjects and PE(+) patients were 11.69 ± 6.83 min and 2.01 ± 1.21 min, respectively. On receiver operating characteristic curve analysis, the cut-off value of PIELT of 3.75 min can be used to distinguish PE men (area under the curve = 0.982, sensitivity/specificity = 0.961/0.909), which means that men with a PIELT ≤ 3.5 min is suggestive of PE. CONCLUSION The impact of PE is dramatic both from a social and a personal perspective. PE(+) patients married significantly less and have significantly lower sexual activity compared to a PE(-) population. Furthermore, a PIELT of ≤ 3.5 min predicts PE demonstrating the need to revise its taxonomy and definition.
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Affiliation(s)
- Hoai Bac Nguyen
- Department of Andrology and Sexual Medicine, Hanoi Medical University's Hospital, Hanoi, Vietnam
| | - Cao Thang Nguyen
- Department of Andrology and Sexual Medicine, Hanoi Medical University's Hospital, Hanoi, Vietnam
| | - Minh Quan Pham
- Department of Andrology and Sexual Medicine, Hanoi Medical University's Hospital, Hanoi, Vietnam
| | - Long Hoang
- Department of Urology, Hanoi Medical University's Hospital, Hanoi, Vietnam
| | - Andrea Sansone
- Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy
| | - Emmanuele A Jannini
- Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy
- Honorary Chair of Sexual Medicine, Hanoi Medical University, Hanoi, Vietnam
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Sansone A, Yuan J, Hou G, Zhang L, Gao M, Zhang Z, Jiang H, Wang F, Guo J, Geng Q, Wang M, Zhang X, Yu X, Zhang Y, Liu JC, Duan YG, Nagrale D, Chen Z, Jannini EA, Colonnello E, Ciocca G, Limoncin E, Mollaioli D, Dun X, Yuan J, Lin H, Zhang H. From Waterloo to the Great Wall: A retrospective, multicenter study on the clinical practice and cultural attitudes in the management of premature ejaculation, in China. Andrology 2024; 12:247-258. [PMID: 36748824 DOI: 10.1111/andr.13403] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2022] [Revised: 12/30/2022] [Accepted: 01/27/2023] [Indexed: 02/08/2023]
Abstract
Premature ejaculation (PE), despite its wide prevalence, is largely underdiagnosed and undertreated. Being a multifactorial dysfunction with strong cultural characteristics, PE requires skillful attitudes in the psychosexological support, necessary to manage the patient's and the couple's expectations, as well as in the medical treatment. Dapoxetine is a short-acting selective serotonin reuptake inhibitor approved for use in lifelong and acquired PE in a number of countries. Opinions, not always generated by the evidence-based medicine, impacted the attitudes of Western andrologists, as a nocebo effect which produced a drug's Waterloo, characterized by low prescription rates much more built on the patients' and doctors' expectations than on costs, side effects, and efficacy. In the present study, we retrospectively reviewed real-life data from eight Andrology and Sexual Medicine Public Centers in China to assess the prevalence of PE among attending patients, its association with erectile dysfunction, its subtype, and the proposed treatments. In 2019, among 156,486 patients coming to the centers, 32,667 visits having PE as the chief complaint were performed (20.9%). Almost all patients received treatment prescriptions (32,641 patients, 99.92%); 23,273 patients came back for a follow-up visit in the subsequent 12 months (71.2% of those who initially received treatment). Dapoxetine, either alone or in combination with another therapy, was the most prevalent treatment, prescribed to 22,767 patients (69.7% of treated patients), followed by traditional Chinese medicine (TCM) (39.4%). At follow-up, 8174 patients were unsatisfied with treatment, and a new treatment was proposed (35.12%). Dapoxetine was the best treatment, with an overall 27.1% switching rate when used either alone or in combination: Although the switching rate for Dapoxetine alone was 44.2%, the association of the same drug with psychotherapy resulted in much lower rates (19.5%) and reached a minimum of 12% when also combined with TCM demonstrating how cultural aspects and medical attitudes may dramatically impact on the therapy of a multifaceted, complex, and culture-grounded sexual symptom such as PE. In conclusion, taking switching rates as surrogate markers of treatment failure, this real-life study-the largest in the field-shows that in a more patient-oriented (as in Chinese medical culture), and less symptom-oriented (as in Western medical attitudes), Dapoxetine is a successful treatment for PE patients, with higher reliability when used alone or as part of combined and integrated therapies.
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Affiliation(s)
- Andrea Sansone
- Endocrinology and Medical Sexology (ENDOSEX), Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy
| | - Jianlin Yuan
- Department of Urology, Xijing Hospital, Fourth Military Medical University, Xi'an, China
| | - Guangdong Hou
- Department of Urology, Xijing Hospital, Fourth Military Medical University, Xi'an, China
- Department of Andrology, Xi'an Daxing Hospital, Xi'an, China
| | - Lei Zhang
- Department of Urology, Xijing Hospital, Fourth Military Medical University, Xi'an, China
| | - Ming Gao
- Department of Andrology, Xi'an Daxing Hospital, Xi'an, China
| | - Zhe Zhang
- Peking University 3rd Hospital, Beijing, China
| | - Hui Jiang
- Peking University 1st Hospital, Beijing, China
| | - Fu Wang
- Xiyuan Hospital of China Academy of Chinese Medical Sciences, Beijing, China
| | - Jun Guo
- Xiyuan Hospital of China Academy of Chinese Medical Sciences, Beijing, China
| | - Qiang Geng
- First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin, China
- National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion, Tianjin, China
| | - Ming Wang
- Department of Urology, First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China
| | - Xiansheng Zhang
- Department of Urology, First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China
| | - Xi Yu
- Department of Infertility and Sexual Medicine, 3rd Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Yan Zhang
- Department of Infertility and Sexual Medicine, 3rd Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Jin-Chuan Liu
- Shenzhen Key Laboratory of Fertility Regulation, Center of Assisted Reproduction and Embryology, The University of Hong Kong-Shenzhen Hospital, Shenzhen, China
| | - Yong-Gang Duan
- Shenzhen Key Laboratory of Fertility Regulation, Center of Assisted Reproduction and Embryology, The University of Hong Kong-Shenzhen Hospital, Shenzhen, China
| | - Dinesh Nagrale
- A. Menarini Asia-Pacific Medical Affairs, Singapore, Singapore
| | - Zhiguo Chen
- A. Menarini China Medical Affairs, Shanghai, China
| | - Emmanuele A Jannini
- Endocrinology and Medical Sexology (ENDOSEX), Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy
| | - Elena Colonnello
- Endocrinology and Medical Sexology (ENDOSEX), Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy
| | - Giacomo Ciocca
- Endocrinology and Medical Sexology (ENDOSEX), Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy
| | - Erika Limoncin
- Endocrinology and Medical Sexology (ENDOSEX), Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy
| | - Daniele Mollaioli
- Endocrinology and Medical Sexology (ENDOSEX), Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy
| | - Xinlong Dun
- Department of Urology, Xijing Hospital, Fourth Military Medical University, Xi'an, China
| | - Jiarui Yuan
- Department of Urology, Xijing Hospital, Fourth Military Medical University, Xi'an, China
| | | | - Hui Zhang
- Endocrinology and Medical Sexology (ENDOSEX), Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy
- Department of Urology, First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China
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Li Y, Li X, Wang Z, Chen X, Sescousse G, Santtila P, Dai Y, Zhang B. Altered reward processing in patients with lifelong premature ejaculation. Sci Rep 2023; 13:17539. [PMID: 37845325 PMCID: PMC10579392 DOI: 10.1038/s41598-023-44914-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2023] [Accepted: 10/13/2023] [Indexed: 10/18/2023] Open
Abstract
Given that sexual behavior is usually pleasurable and highly rewarding, it is surprising that there is as yet no known research to empirically assess how premature ejaculation (PE) patients respond to the rewarding aspect of sexual behavior. This study was designed to address this issue by evaluating how these men respond to the anticipation and hedonic experience of sexual rewards in comparison to non-sexual rewards. Thirty lifelong PE patients and thirty healthy controls (HCs) performed the incentive delay task manipulating both erotic and monetary rewards. Compared to HCs, lifelong PE patients exhibited significantly faster RTs to erotic cues than to monetary cues during reward anticipation. Meanwhile, hedonic experience ratings after obtaining the actual reward showed that erotic rewards were rated as more pleasant than monetary rewards only by lifelong PE patients, which was driven by a decreased sensitivity to experienced monetary rewards in lifelong PE patients compared to HCs. These findings indicate the existence of dysfunctional reward processing in lifelong PE patients, which is characterized by increased incentive motivation elicited by sexual cues and reduced hedonic impact of nonsexual rewards. This study may offer an insightful clue regarding how PE is related to the abnormal regulation of the rewarding aspect of sexual behavior.
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Affiliation(s)
- Yansong Li
- Department of Radiology, The Affiliated Drum Tower Hospital, Nanjing University Medical School, Nanjing, China.
- Reward, Competition, and Social Neuroscience Lab, Department of Psychology, School of Social and Behavioral Sciences, Nanjing University, Nanjing, 210023, China.
- Institute for Brain Sciences, Nanjing University, Nanjing, China.
| | - Xiaojun Li
- School of Teacher Education, NanJing XiaoZhuang University, Nanjing, China
| | - Zixiang Wang
- Reward, Competition, and Social Neuroscience Lab, Department of Psychology, School of Social and Behavioral Sciences, Nanjing University, Nanjing, 210023, China
| | - Xi Chen
- Reward, Competition, and Social Neuroscience Lab, Department of Psychology, School of Social and Behavioral Sciences, Nanjing University, Nanjing, 210023, China
| | - Guillaume Sescousse
- Lyon Neuroscience Research Center-INSERM U1028-CNRS UMR5292, PSYR2 Team, University Lyon 1, Lyon, France
| | - Pekka Santtila
- Faculty of Arts and Sciences, New York University (NYU) Shanghai, Shanghai, China
| | - Yutian Dai
- Department of Andrology, The Affiliated Drum Tower Hospital, Nanjing University Medical School, Nanjing, China.
| | - Bing Zhang
- Department of Radiology, The Affiliated Drum Tower Hospital, Nanjing University Medical School, Nanjing, China.
- Institute for Brain Sciences, Nanjing University, Nanjing, China.
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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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7
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Zhang H, Colonnello E, Sansone A, Wang F, Guo J, Wang C, Zhang Y, Jannini EA. Acupuncture for premature ejaculation: a systematic review and meta-analysis. Sex Med 2023; 11:qfad034. [PMID: 37397031 PMCID: PMC10308367 DOI: 10.1093/sexmed/qfad034] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2023] [Revised: 05/24/2023] [Accepted: 05/31/2023] [Indexed: 07/04/2023] Open
Abstract
Background Although acupuncture is widely used to treat premature ejaculation (PE), its effectiveness remains highly controversial. Aim To evaluate the efficacy and safety of acupuncture on PE. Methods According to the relevant keywords, 11 major English and Chinese databases were searched for randomized controlled trials (RCTs) of acupuncture alone or in combination with other treatments for PE. The quality of evidence across studies was assessed by the GRADEpro tool. Outcomes Study outcome measures included the intravaginal ejaculation latency time (IELT), the Premature Ejaculation Diagnostic Tool (PEDT), the Chinese Index of Premature Ejaculation-5 (CIPE-5), treatment success rate, and adverse events. Results Seven trials were included in this review for a total of 603 participants. A low quality of evidence suggests that it is not possible to determine whether acupuncture, as compared with a selective serotonin reuptake inhibitor, has an advantage in improving the IELT (standardized mean difference [SMD], -1.75; 95% CI, -6.12 to 2.63; P = .43, I2 = 98%), PEDT scores (SMD, 0.32; 95% CI, -0.68 to 1.32; P = .53, I2 = 85%), and treatment success rate (risk ratio, 0.69; 95% CI, 0.41-1.14; P = .15). However, participants receiving acupuncture had a lower CIPE-5 (SMD, -1.06; 95% CI, -1.68 to -0.44; P < .01). As compared with sham acupuncture, acupuncture significantly improved the IELT (SMD, 1.47; 95% CI, 1.01-1.92; P < .01, I2 = 0%) and PEDT scores (SMD, -1.23; 95% CI, -1.78 to -0.67; P < .01, I2 = 37%). When compared with other treatments alone, a combined treatment with acupuncture can significantly improve the IELT (SMD, 7.06; 95% CI, 2.53-11.59; P < .01, I2 = 97%), CIPE-5 (SMD, 0.84; 95% CI, 0.45-1.22; P < .01, I2 = 0%), and treatment success rate (SMD, 1.60; 95% CI, 1.18-2.16; P < .01, I2 = 53). Clinical Implications The results suggest a significant effect of acupuncture in the treatment of certain important indicators of PE; however, this finding needs to be treated with caution because of the quality of the RCTs included. Strengths and Limitations Comprehensive inclusion of available RCTs has been performed. However, limitations include a low number of studies and a lack of detailed information to allow subgroup analysis. Conclusion The present systematic review and meta-analysis show that acupuncture has a significant effect on several subjective PE parameters, such as improving the feeling of control over ejaculation and distress, particularly when used in an integrated way. However, due to the low quality of evidence, acupuncture still needs larger well-designed RCTs to be confirmed.
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Affiliation(s)
- Hui Zhang
- Department of Experimental Medicine, University of Rome Tor Vergata, Rome 00133, Italy
| | - Elena Colonnello
- Department of Experimental Medicine, University of Rome Tor Vergata, Rome 00133, Italy
- Section of Medical Pathophysiology, Food Science and Endocrinology, Sapienza University of Rome, Rome 00133, Italy
| | - Andrea Sansone
- Department of Experimental Medicine, University of Rome Tor Vergata, Rome 00133, Italy
| | - Fu Wang
- Department of Andrology, Xiyuan Hospital of China Academy of Chinese Medical Sciences, Beijing 100091, China
| | - Jun Guo
- Department of Andrology, Xiyuan Hospital of China Academy of Chinese Medical Sciences, Beijing 100091, China
| | - Chunling Wang
- Department of Infertility and Sexual Medicine, Third Affiliated Hospital of Sun Yat-sen University, Guangzhou 510630, China
| | - Yan Zhang
- Department of Infertility and Sexual Medicine, Third Affiliated Hospital of Sun Yat-sen University, Guangzhou 510630, China
| | - Emmanuele A Jannini
- Corresponding author: Department of Experimental Medicine, University of Rome Tor Vergata, Italy.
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8
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Demirci A, Hızlı F, Hamurcu HD, Başar H. Erectile dysfunction, anxiety, perceived stress, and insomnia are more common among acquired premature ejaculation patients compared to other premature ejaculation syndromes. Andrology 2023; 11:425-432. [PMID: 36417491 DOI: 10.1111/andr.13341] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2022] [Revised: 11/03/2022] [Accepted: 11/14/2022] [Indexed: 11/27/2022]
Abstract
BACKGROUND Premature ejaculation (PE) is the most common ejaculatory function disorder. To date, four types of PE have been identified depending on the severity, onset, and course of the problem. OBJECTIVES The aim of this study was to investigate whether or not there is a difference between these types in respect of anxiety, perceived stress, insomnia severity, and sleep chronotype. MATERIALS AND METHODS The study included 112 patients diagnosed with PE in our clinic between October 2021 and May 2022. The patients were separated into groups according to PE types of lifelong (LPE, n = 39), acquired (APE, n = 45), variable (VPE, n = 10), and subjective (SPE, n = 18). In addition to the demographic and clinical data, the scores were recorded of all participants in the International Index of Erectile Function-5, Hospital Anxiety and Depression Scale, Premature Ejaculation Diagnostic Tool (PEDT), Insomnia Severity Index (ISI), Perceived Stress Scale (PSS), and Morningness Eveningness Questionnaire (MEQ). RESULTS SPE was determined more in university graduate patients (42.1% vs. LPE, 21.1%; APE, 36.8%; VPE, 0%; p = 0.01). In patients with APE, erectile dysfunction was more severe (80.0% vs. LPE, 8.0%; SPE, 12.0%; VPE, 0%; p < 0.001). The median (IQR) PEDT score was determined to be higher in APE than in LPE and SPE (16(5), 13(7), 11(5), p = 0.001, respectively). Patients with APE were determined to have higher median (IQR) ISI (21(9) vs. LPE, 8(7); SPE, 5(8); VPE 8(4), p < 0.001) and PSS scores (35(12) vs. LPE, 22 (7); SPE,22(5); VPE 21(6), p < 0.001), the sleep chronotype was more eveningness according to the MEQ (80.8% vs. LPE, 19.2%; VPE, 0%; SPE, 0%; p < 0.001), and there were seen be more anxiety symptoms (75.5% vs. LPE,12.2%; VPE, 0%; SPE, 12.2%; p < 0.001). CONCLUSION Psychological status and sleep health were concluded to be important factors for PE patients, and the patients with acquired PE were the group most affected by these factors.
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Affiliation(s)
- Aykut Demirci
- Department of Urology, Abdurrahman Yurtaslan Ankara Oncology Training and Research Hospital, Ankara, Turkey
| | - Fatih Hızlı
- Department of Urology, Abdurrahman Yurtaslan Ankara Oncology Training and Research Hospital, Ankara, Turkey
| | - Hayriye Dilek Hamurcu
- Department of Psychiatry, Abdurrahman Yurtaslan Ankara Oncology Training and Research Hospital, Ankara, Turkey
| | - Halil Başar
- Department of Urology, Abdurrahman Yurtaslan Ankara Oncology Training and Research Hospital, Ankara, Turkey
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9
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The Influence of Smartphone Screen Time on Acquired Premature Ejaculation: A Prospective Preliminary Study. Andrologia 2023. [DOI: 10.1155/2023/3949522] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
This prospective study is aimed at investigating the relationship between smartphone screen time and the intravaginal ejaculation latency time (IELT) in patients with acquired PE and to contribute to the literature. Thirty patients who had been diagnosed with acquired PE in our clinic between March 2022 and May 2022 were included in the study. Carrying similar demographic characteristics to the patient group, a total of 30 healthy volunteers were included as the control group. Patients who were using Huawei or iPhone brand of smartphones and who had data of at least one week of screen time were included in the study. The data were collected from the applications on the phones. PE was evaluated using PEDT, the Turkish validation of which had been carried out. The patients and the controls also underwent the application of the Quality-of-Life Questionnaire-Short Form (SF-36), which has also been validated for Turkish. The patients and the controls were compared with regard to smartphone screen time, IELT, PEDT scores, and the SF-36 scores. The mean screen time was found to be statistically significantly higher in the PE group compared to that of controls (
,
, respectively,
). In the correlation analysis between the IELT and the PEDT scores of the patients, a significant negative correlation was found between the screen time and the IELT, and a significant positive correlation was found between the screen time and the mean PEDT scores (
,
, respectively). Our results showed that smartphone screen time negatively affected the IELT values and PE severity in patients with acquired PE.
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10
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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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11
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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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12
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Chen J, Wang Q, Huang X, Xu Y, Xiang Z, Liu S, Yang J, Chen Y. Potential biomarkers for distinguishing primary from acquired premature ejaculation: A diffusion tensor imaging based network study. Front Neurosci 2022; 16:929567. [PMID: 36340794 PMCID: PMC9626512 DOI: 10.3389/fnins.2022.929567] [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: 04/27/2022] [Accepted: 10/03/2022] [Indexed: 11/24/2022] Open
Abstract
Introduction Premature ejaculation (PE) is classified as primary and acquired and may be facilitated by different pathophysiology. Brain plays an important role in PE, however, differences in the central neuropathological mechanisms among subtypes of PE are unknown. Materials and methods We acquired diffusion tensor imaging (DTI) data from 44 healthy controls (HC) and 47 PE patients (24 primary PE and 23 acquired PE). Then, the whole-brain white matter (WM) structural networks were constructed and between-group differences of nodal segregative parameters were identified by the method of graph theoretical analysis. Moreover, receiver operating characteristic (ROC) curves were performed to determine the suitability of the altered parameters as potential neuroimaging biomarkers for distinguishing primary PE from acquired PE. Results PE patients showed significantly increased clustering coefficient C(i) in the left inferior frontal gyrus (triangular part) (IFGtriang.L) and increased local efficiency Eloc(i) in the left precental gyrus (PreCG.L) and IFGtriang.L when compared with HC. Compared to HC, primary PE patients had increased C(i) and Eloc(i) in IFGtriang.L and the left amygdala (AMYG.L) while acquired PE patients had increased C(i) and Eloc(i) in IFGtriang.L, and decreased C(i) and Eloc(i) in AMYG.L. Compared to acquired PE, primary PE patients had increased C(i) and Eloc(i) in AMYG.L. Moreover, ROC analysis revealed that PreCG.L, IFGtriang.L and AMYG.L might be helpful for distinguishing different subtypes of PE from HC (PE from HC: sensitivity, 61.70–78.72%; specificity, 56.82–77.27%; primary PE from HC: sensitivity, 66.67–87.50%; specificity, 52.27–77.27%; acquired PE from HC: sensitivity, 34.78–86.96%; specificity, 54.55–100%) while AMYG.L might be helpful for distinguishing primary PE from acquired PE (sensitivity, 83.33–91.70%; specificity, 69.57–73.90%). Conclusion These findings improved our understanding of the pathophysiological processes that occurred in patients with ejaculatory dysfunction and suggested that the abnormal segregation of left amygdala might serve as a useful marker to help clinicians distinguish patients with primary PE from those with acquired PE.
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Affiliation(s)
- Jianhuai Chen
- Department of Andrology, Jiangsu Province Hospital of Chinese Medicine, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, China
| | - Qing Wang
- Department of Andrology, Jiangsu Province Hospital of Chinese Medicine, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, China
| | - Xinfei Huang
- Department of Andrology, Jiangsu Province Hospital of Chinese Medicine, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, China
| | - Yan Xu
- Department of Andrology, Jiangsu Province Hospital of Chinese Medicine, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, China
| | - Ziliang Xiang
- Department of Andrology, Jiangsu Province Hospital of Chinese Medicine, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, China
| | - Shaowei Liu
- Department of Radiology, Jiangsu Province Hospital of Chinese Medicine, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, China
| | - Jie Yang
- Department of Urology, Jiangsu Provincial People’s Hospital, First Affiliated Hospital of Nanjing Medical University, Nanjing, China
- Department of Urology, People’s Hospital of Xinjiang Kizilsu Kirgiz Autonomous Prefecture, Xinjiang, China
- Jie Yang,
| | - Yun Chen
- Department of Andrology, Jiangsu Province Hospital of Chinese Medicine, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, China
- *Correspondence: Yun Chen,
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13
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Liu G, Zhang Y, Zhang W, Wu X, Gao H, Jiang H, Dai Y, Zhang X. Novel Marker for Premature Ejaculation: Serum Leptin Level. Sex Med 2022; 10:100509. [PMID: 35398789 PMCID: PMC9177876 DOI: 10.1016/j.esxm.2022.100509] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2021] [Revised: 02/25/2022] [Accepted: 03/01/2022] [Indexed: 10/26/2022] Open
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14
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Orsolini F, Prete A, Falcetta P, Canale D, Basolo F, Alì G, Manassero F, Vitti P, Elisei R, Molinaro E. Bilateral testicular metastases of medullary thyroid carcinoma in an adult male with multiple endocrine neoplasia 2A syndrome: case report and review of literature. Eur Thyroid J 2022; 11:e210016. [PMID: 35174786 PMCID: PMC8963169 DOI: 10.1530/etj-21-0016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/07/2022] [Accepted: 02/16/2022] [Indexed: 11/23/2022] Open
Abstract
INTRODUCTION Medullary thyroid cancer (MTC) is a rare endocrine tumor, which can be sporadic or familial, as a component of multiple endocrine neoplasia 2 (MEN2). Overall, 10% of MTC cases have already developed at presentation or will develop metastasis during follow-up. Testicular metastases are exceptional and only one case of unilateral testis involvement by metastatic MTC has been already reported in literature. We described the first known case of asymptomatic bilateral testicular MTC metastases, discovered incidentally at testicular ultrasound (US) performed for unrelated reasons. CASE PRESENTATION A Latin American 32-year-old man with MEN 2A syndrome and metastatic MTC underwent andrological and urological examination due to premature ejaculation. US imaging showed two symmetrical hypoechoic lesions involving both testes. Suspecting a bilateral testicular cancer, the patient underwent excision biopsy of both testicular lesions. Histopathology and immunohistochemical examinations documented metastatic MTC of both testicular lesions. CONCLUSION Beyond its rarity, testis should be considered as a potential metastatic site of MTC, especially in patients with advanced disease. ESTABLISHED FACTS Distant metastases are present at the diagnosis in 10-15% of patients with medullary thyroid carcinoma (MTC). Testicular metastases are anecdotal. Only one case of unilateral testis involvement by metastatic MTC has been reported in the literature. NOVEL INSIGHTS Testis should be considered as a possible site of metastases in patients with diffuse metastatic MTC. Testicular ultrasound could be considered as an useful tool for the evaluation and follow-up of metastatic MTC.
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Affiliation(s)
- Francesca Orsolini
- Department of Clinical and Experimental Medicine, Endocrine Unit, University of Pisa, Pisa, Italy
| | - Alessandro Prete
- Department of Clinical and Experimental Medicine, Endocrine Unit, University of Pisa, Pisa, Italy
| | - Pierpaolo Falcetta
- Department of Clinical and Experimental Medicine, Endocrine Unit, University of Pisa, Pisa, Italy
| | - Domenico Canale
- Department of Clinical and Experimental Medicine, Endocrine Unit, University of Pisa, Pisa, Italy
| | - Fulvio Basolo
- Department of Surgical, Medical and Molecular Pathology and Critical Care Medicine, University of Pisa, Pisa, Italy
| | - Greta Alì
- Department of Surgical, Medical and Molecular Pathology and Critical Care Medicine, University of Pisa, Pisa, Italy
| | - Francesca Manassero
- Division of Urology, Department of Translational Research and of New Surgical and Medical Technologies, University of Pisa, Pisa, Italy
| | - Paolo Vitti
- Department of Clinical and Experimental Medicine, Endocrine Unit, University of Pisa, Pisa, Italy
| | - Rossella Elisei
- Department of Clinical and Experimental Medicine, Endocrine Unit, University of Pisa, Pisa, Italy
- Correspondence should be addressed to R Elisei:
| | - Eleonora Molinaro
- Department of Clinical and Experimental Medicine, Endocrine Unit, University of Pisa, Pisa, Italy
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15
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Ma M, Yin S, Zhu M, Fan Y, Wen X, Lin T, Song T. Wikipedia provides better quality medical information on male sexual dysfunctions than Baidu Encyclopedia (Preprint). J Med Internet Res 2022; 24:e37339. [PMID: 35943768 PMCID: PMC9399830 DOI: 10.2196/37339] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2022] [Revised: 05/17/2022] [Accepted: 07/05/2022] [Indexed: 11/22/2022] Open
Abstract
Background Sexual dysfunction is a private set of disorders that may cause stigma for patients when discussing their private problems with doctors. They might also feel reluctant to initiate a face-to-face consultation. Internet searches are gradually becoming the first choice for people with sexual dysfunction to obtain health information. Globally, Wikipedia is the most popular and consulted validated encyclopedia website in the English-speaking world. Baidu Encyclopedia is becoming the dominant source in Chinese-speaking regions; however, the objectivity and readability of the content are yet to be evaluated. Objective Hence, we aimed to evaluate the reliability, readability, and objectivity of male sexual dysfunction content on Wikipedia and Baidu Encyclopedia. Methods The Chinese Baidu Encyclopedia and English Wikipedia were investigated. All possible synonymous and derivative keywords for the most common male sexual dysfunction, erectile dysfunction, premature ejaculation, and their most common complication, chronic prostatitis/chronic pelvic pain syndrome, were screened. Two doctors evaluated the articles on Chinese Baidu Encyclopedia and English Wikipedia. The Journal of the American Medical Association (JAMA) scoring system, DISCERN instrument, and Global Quality Score (GQS) were used to assess the quality of disease-related articles. Results The total DISCERN scores (P=.002) and JAMA scores (P=.001) for Wikipedia were significantly higher than those of Baidu Encyclopedia; there was no statistical difference between the GQS scores (P=.31) for these websites. Specifically, the DISCERN Section 1 score (P<.001) for Wikipedia was significantly higher than that of Baidu Encyclopedia, while the differences between the DISCERN Section 2 and 3 scores (P=.14 and P=.17, respectively) were minor. Furthermore, Wikipedia had a higher proportion of high total DISCERN scores (P<.001) and DISCERN Section 1 scores (P<.001) than Baidu Encyclopedia. Baidu Encyclopedia and Wikipedia both had low DISCERN Section 2 and 3 scores (P=.49 and P=.99, respectively), and most of these scores were low quality. Conclusions Wikipedia provides more reliable, higher quality, and more objective information than Baidu Encyclopedia. Yet, there are opportunities for both platforms to vastly improve their content quality. Moreover, both sites had similar poor quality content on treatment options. Joint efforts of physicians, physician associations, medical institutions, and internet platforms are needed to provide reliable, readable, and objective knowledge about diseases.
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Affiliation(s)
- Ming Ma
- Department of Urology and Organ Transplantation Center, West China Hospital, Sichuan University, Chengdu, Sichuan Province, China
| | - Saifu Yin
- Department of Urology and Organ Transplantation Center, West China Hospital, Sichuan University, Chengdu, Sichuan Province, China
| | - Mengli Zhu
- Core Facilities, West China Hospital, Sichuan University, Chengdu, Sichuan Province, China
| | - Yu Fan
- Department of Urology and Organ Transplantation Center, West China Hospital, Sichuan University, Chengdu, Sichuan Province, China
| | - Xi Wen
- Department of Urology, West China Hospital, Sichuan University, Chengdu, Sichuan Province, China
| | - Tao Lin
- Department of Urology and Organ Transplantation Center, West China Hospital, Sichuan University, Chengdu, Sichuan Province, China
| | - Turun Song
- Department of Urology and Organ Transplantation Center, West China Hospital, Sichuan University, Chengdu, Sichuan Province, China
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16
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Luca G, Parrettini S, Sansone A, Calafiore R, Jannini EA. The Inferto-Sex Syndrome (ISS): sexual dysfunction in fertility care setting and assisted reproduction. J Endocrinol Invest 2021; 44:2071-2102. [PMID: 33956331 PMCID: PMC8421318 DOI: 10.1007/s40618-021-01581-w] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/22/2021] [Accepted: 04/19/2021] [Indexed: 12/20/2022]
Abstract
PURPOSE Infertility represents a peculiar social burden affecting more than 15% of couples, provoking it a real threat to the general quality of life and to the sexual health. The medicalization (diagnosis, therapy and follow up) of the lack of fertility is frequently a challenge in term of personal and couple's involvement. In particular, while the Assisted Reproductive Technology (ART) has allowed many infertile couples to achieve pregnancy, the therapeutic process faced by the couple bears a strong psychological stress that can affect the couple's quality of life, relationship and sexuality. Despite infertility affects both female and male sexual health, only recently the interest in the effects of ART on the couple's sexuality has grown, especially for women. METHODS A literature research on the sexual dysfunction in fertility care and particularly in ART setting was performed. RESULTS Literature largely found that intimacy and sexuality appear specifically impaired by intrusiveness of treatments and medical prescriptions. Moreover, there is a close relationship between emotional, psychological and sexual aspects, which can be integrated in the new concept of Inferto-Sex Syndrome (ISS) that can impair the ART treatment outcomes. Evidence demonstrates that the assessment of sexual function is necessary in couples undergoing diagnosis of infertility and ART. CONCLUSION A close relationship between infertility and sexuality, both in the female and male partners, was detected. ART treatments may heavily impact on the couple's psychosexual health. A couple-centred program for the integrated management of psychological and sexual dysfunction should be considered in the context of ART programs.
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Affiliation(s)
- G Luca
- Unit of Andrology and Endocrinology of Reproduction, Department of Experimental Medicine, University Medical School, 06129, Perugia, Italy
| | - S Parrettini
- Section of Endocrinology and Metabolism, Department of Medicine, Perugia, University Medical School, 06129, Perugia, Italy
| | - A Sansone
- Chair of Endocrinology and Medical Sexology (ENDOSEX), Department of Systems Medicine, University of Rome Tor Vergata, Via Montpellier, 1, E Tower South. Floor 4, Room E413, 00133, Rome, Italy
| | - R Calafiore
- Section of Endocrinology and Metabolism, Department of Medicine, Perugia, University Medical School, 06129, Perugia, Italy
| | - E A Jannini
- Chair of Endocrinology and Medical Sexology (ENDOSEX), Department of Systems Medicine, University of Rome Tor Vergata, Via Montpellier, 1, E Tower South. Floor 4, Room E413, 00133, Rome, Italy.
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17
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Wei S, Ma M, Wen X, Wu C, Zhu G, Zhou X. Online Public Attention Toward Premature Ejaculation in Mainland China: Infodemiology Study Using the Baidu Index. J Med Internet Res 2021; 23:e30271. [PMID: 34435970 PMCID: PMC8430863 DOI: 10.2196/30271] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2021] [Revised: 07/05/2021] [Accepted: 07/05/2021] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Premature ejaculation (PE) is one of the most described psychosocial stress and sexual complaints worldwide. Previous investigations have focused predominantly on the prospective identification of cases that meet researchers' specific criteria. The genuine demand from patients with regard to information on PE and related issues may thus be neglected. OBJECTIVE This study aims to examine the online search trend and user demand related to PE on a national and regional scale using the dominant major search engine in mainland China. METHODS The Baidu Index was queried using the PE-related terms for the period of January 2011 to December 2020. The search volume for each term was recorded to analyze the search trend and demographic distributions. For user interest, the demand and trend data were collected and analyzed. RESULTS Of the 36 available PE search keywords, 4 PE searching topics were identified. The Baidu Search Index for each PE topic varied from 46.30% (86,840,487/187,558,154) to 6.40% (12,009,307/187,558,154). The annual percent change (APC) for the complaint topic was 48.80% (P<.001) for 2011 to 2014 and -16.82% (P<.001) for 2014 to 2020. The APC for the inquiry topic was 16.21% (P=.41) for 2011 to 2014 and -11.00% (P<.001) for 2014 to 2020. For the prognosis topic, the annual APC was 11.18% (P<.001) for 2011 to 2017 and -19.86% (P<.001) for 2017 to 2020. For the treatment topic, the annual APC was 14.04% (P<.001) for 2011 to 2016 and -38.83% (P<.001) for 2016 to 2020. The age distribution of those searching for topics related to PE showed that the population aged 20 to 40 years comprised nearly 70% of the total search inquiries (second was 17.95% in the age group younger than 19 years). People from East China made over 50% of the total search queries. CONCLUSIONS The fluctuating online popularity of PE searches reflects the real-time population demands. It may help medical professionals better understand population interest, population concerns, regional variations, and gender differences on a nationwide scale and make disease-specific health care policies. The internet search data could be more reliable when the insufficient and lagging registry data are completed.
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Affiliation(s)
- Shanzun Wei
- Department of Urology, The Third Affiliated Hospital, Sun Yat-Sen University, Guangzhou, China
| | - Ming Ma
- Department of Urology, West China Hospital, Sichuan University, Chengdu, China
| | - Xi Wen
- Andrology Laboratory, West China Hospital, Sichuan University, Chengdu, China
| | - Changjing Wu
- Andrology Laboratory, West China Hospital, Sichuan University, Chengdu, China
| | - Guonian Zhu
- Institutes for Systems Genetics, Frontiers Science Center for Disease-Related Molecular Network, West China Hospital, Sichuan University, Chengdu, China
| | - Xiangfu Zhou
- Department of Urology, The Third Affiliated Hospital, Sun Yat-Sen University, Guangzhou, China
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18
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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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19
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Tannenbaum J, Youssef M, Attia AS, Hsieh TC, Raheem O. Hyperthyroidism as an Underlying Cause of Premature Ejaculation. Sex Med Rev 2021; 10:108-112. [PMID: 34219006 DOI: 10.1016/j.sxmr.2021.03.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2020] [Revised: 03/12/2021] [Accepted: 03/16/2021] [Indexed: 11/25/2022]
Abstract
INTRODUCTION Hormonal imbalances have been associated with various sexual dysfunction disorders. In particular, the connection of hyperthyroidism has been discovered to correlate to premature ejaculation (PE) but has yet to been thoroughly elucidated. As one of the most frequently self-reported sexual dysfunctions, it is imperative for health care professionals to evaluate possible underlying conditions in regard to treatment options for individuals with PE. OBJECTIVES To review the literature regarding hyperthyroidism effects on sexual dysfunction, with a focus on hyperthyroidism and PE. METHODS A literature review of articles and clinical studies was performed to define the classification, pathophysiology, diagnostic considerations, and management of hyperthyroidism on PE. Search terms included "hyperthyroidism" and/or "premature ejaculation," "treatment of premature ejaculation," "defining premature ejaculation," and "management of premature ejaculation." RESULTS To improve the accuracy of diagnosing PE, there needs to be a set definition amongst the different guidelines, as using these guidelines can help determine possible underlying etiologies of PE. The correlation of hyperthyroidism and PE has been described in a limited number of studies. It has been reported that individuals with hyperthyroidism are much more likely to have PE than individuals with euthryoidism. Management of hyperthyroidism has been shown to alleviate the symptoms of PE. CONCLUSION Further understanding of hyperthyroidism as an underlying cause of PE could lead to increased efficacy of treatment and management of PE. Tannenbaum J, Youssef M, Attia AS, et al. Hyperthyroidism as an Underlying Cause of Premature Ejaculation. Sex Med Rev 2021;XX:XXX-XXX.
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Affiliation(s)
- Jacob Tannenbaum
- Tulane University School of Medicine, Department of Urology, New Orleans, USA
| | - Mohanad Youssef
- Tulane University School of Medicine, Department of Surgery, New Orleans, USA
| | - Abdallah S Attia
- Tulane University School of Medicine, Department of Surgery, New Orleans, USA
| | | | - Omer Raheem
- Tulane University School of Medicine, Department of Urology, New Orleans, USA.
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20
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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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21
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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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22
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Peng J, Yang L, Liu L, Zhou R, Liu J, Li N, Li L, Jiang Y, Liu Y, Zhu Z, Zhang X, Shi G, Jain S, Jannini EA, Zhang Z. Safety and Effectiveness of Dapoxetine On Demand in Chinese Men With Premature Ejaculation: Results of a Multicenter, Prospective, Open-Label Phase IV Study. Sex Med 2021; 9:100296. [PMID: 33529810 PMCID: PMC8072166 DOI: 10.1016/j.esxm.2020.100296] [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: 08/12/2020] [Revised: 11/23/2020] [Accepted: 11/27/2020] [Indexed: 10/28/2022] Open
Abstract
INTRODUCTION Dapoxetine on demand has been approved for premature ejaculation (PE) management in China; however, studies on the efficacy and safety of this treatment in the Chinese population are scarce. AIM The aim of this study was to evaluate the safety and effectiveness of dapoxetine 30 mg and 60 mg on demand in Chinese men with PE. METHODS Phase IV real-world study on 1,252 patients with PE. If men reported no response to dapoxetine 30 mg after 4 weeks treatment, dapoxetine has been uptitrated at 60 mg for 4 weeks more. MAIN OUTCOME MEASURE Self-reported data were collected for demographics, general and sexual health characteristics, PE severity, and treatment safety and effectiveness, as measured by the PE profile questionnaire. RESULTS Adverse events (AEs), such as nausea, thirst, headache, and dizziness, similarly to previous literature, were detected. The treatment-emergent AEs rate was higher in the patients treated with 30 and 60 mg (n = 192) compared with those treated with the dapoxetine 30 mg only (n = 1060) (34.4% vs 15.8%, respectively). No new safety concerns were observed. The overall effectiveness rates were 88.2% in subjects using 30 mg of dapoxetine, whereas a rescue from the previous failure was in 55.7% in the patients who received 60 mg after the initial 30 mg. Overall, 83.2% responded to dapoxetine at dosages equal to or lower than 60 mg. CONCLUSION The results in this study demonstrated in a large Chinese population that on-demand dapoxetine is a safe and effective symptomatic treatment in patients with PE. J Peng, L Yang, L Liu, et al. Safety and Effectiveness of Dapoxetine On Demand in Chinese Men With Premature Ejaculation: Results of a Multicenter, Prospective, Open-Label Phase IV Study. Sex Med 2021;9:100296.
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Affiliation(s)
- Jing Peng
- Andrology Center, Department of Urology, Peking University First Hospital, Peking University, Beijing, China
| | - Lin Yang
- Department of Urology, First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Long Liu
- Department of Urology, North Theater General Hospital, Shenyang, China
| | - Renyuan Zhou
- Department of Urology, Shanghai Jingan District Central Hospital, Shanghai, China
| | - Jihong Liu
- Department of Urology, Tongji Hospital Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Ningchen Li
- Department of Urology, Peking University Shougang Hospital, Beijing, China
| | - Liming Li
- Department of Urology, General Hospital of Tianjin Medical University, Tianjin, China
| | - Yongguang Jiang
- Department of Urology, Beijing Anzhen Hospital of Capital Medical University, Beijing, China
| | - Yuqiang Liu
- Department of Urology, Second Hospital of Shandong University, Ji'nan, China
| | - Zhaohui Zhu
- Department of Urology, Union Hospital of Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China
| | - Xiaodong Zhang
- Department of Urology, Beijing Chaoyang Hospital of Capital Medical University, Beijing, China
| | - Guowei Shi
- Department of Urology, Shanghai Fifth People's Hospital of Fudan University, Shanghai, China
| | - Suyog Jain
- Medical Department, A Menarini Asia Pacific, Singapore
| | - Emmanuele A Jannini
- Chair of Endocrinology and Medical Sexology (ENDOSEX), Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy
| | - Zhichao Zhang
- Andrology Center, Department of Urology, Peking University First Hospital, Peking University, Beijing, China.
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23
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Xi Y, Colonnello E, Ma G, Limoncin E, Ciocca G, Zhang H, Jannini EA, Zhang Y. Validity of Erectile Function Assessment Questionnaires in Premature Ejaculation Patients: A Comparative Study Between the Abridged Forms of the International Index of Erectile Function and Proposal for Optimal Cutoff Redefinition. J Sex Med 2020; 18:440-447. [PMID: 33384239 DOI: 10.1016/j.jsxm.2020.11.018] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2020] [Revised: 11/28/2020] [Accepted: 11/30/2020] [Indexed: 01/23/2023]
Abstract
BACKGROUND Patients with premature ejaculation (PE) are often diagnosed as having a comorbid erectile dysfunction (ED). When evaluating erectile function in PE patients with the popular International Index of Erectile Function-5 (IIEF-5, or Sexual Health Inventory for Men [SHIM]), question #5 (Q5) about sexual satisfaction in the intercourse often lowers the total score of the questionnaire, giving false-positive results for the presence of ED. AIM We aimed to compare SHIM with the other abridged form of IIEF, which is IIEF-EF, and to discriminate which tool has the best diagnostic accuracy in the evaluation of erectile function in PE patients. METHODS The study was conducted from March 2019 to January 2020. A total of 189 heterosexual males with lifelong PE (117, 61.9%) or acquired PE (72, 38.1%) were included. They all compiled Premature Ejaculation Diagnostic Tool, IIEF-15, SHIM, and IIEF-EF and underwent a full clinical examination to evaluate their erectile function. OUTCOMES The scores of the 2 erectile function assessment questionnaires (SHIM and IIEF-EF) were compared in terms of their sensitivity and specificity in the diagnosis of ED in PE patients. RESULTS In terms of diagnosing ED in PE patients, the sensitivity of SHIM is 100% while the specificity is only 36%; meanwhile, the sensitivity of IIEF-EF is 100% but specificity is 77.2%. Further analysis demonstrates that decreasing cutoff of SHIM to 17.5 would provide an increased specificity of 82.5%, while sensitivity would lower to 96.0%. However, the highest area under the curve (0.966 vs 0.941) is given by the IIEF-EF with 100% sensitivity and 80.7% specificity at the cutoff of 24.5, which is one point lower than the usual cutoff value of 25.5. CLINICAL IMPLICATIONS Our study suggests that when evaluating erection function in PE patients, the cutoff of both SHIM and IIEF-EF should be amended. STRENGTHS & LIMITATIONS We proposed the solution for the bias of erectile function assessment in PE patients. However, other trials are needed to further validate in larger cohorts of PE patients. CONCLUSION We suggest that the cutoff of SHIM and IIEF-EF should be amended (SHIM at 17.5 and IIEF-EF at 24.5, respectively) when assessing erectile function among PE population. Xi Y, Colonnello E, Ma G, et al. Validity of Erectile Function Assessment Questionnaires in Premature Ejaculation Patients: A Comparative Study Between the Abridged Forms of the International Index of Erectile Function and Proposal for Optimal Cutoff Redefinition. J Sex Med 2021;18:440-447.
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Affiliation(s)
- Yu Xi
- Department of Infertility and Sexual Medicine, The Third Affiliated Hospital of Sun Yat-sen University
| | - Elena Colonnello
- Chair of Endocrinology & Medical Sexology (ENDOSEX), Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy
| | - Gongchao Ma
- Department of Infertility and Sexual Medicine, The Third Affiliated Hospital of Sun Yat-sen University
| | - Erika Limoncin
- Chair of Endocrinology & Medical Sexology (ENDOSEX), Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy
| | - Giacomo Ciocca
- Chair of Endocrinology & Medical Sexology (ENDOSEX), Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy; Clinical Psychosexology, Department of Dynamic and Clinical Psychology, University of Rome Sapienza, Rome, Italy
| | - Hui Zhang
- Department of Infertility and Sexual Medicine, The Third Affiliated Hospital of Sun Yat-sen University
| | - Emmanuele A Jannini
- Chair of Endocrinology & Medical Sexology (ENDOSEX), Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy
| | - Yan Zhang
- Department of Infertility and Sexual Medicine, The Third Affiliated Hospital of Sun Yat-sen University.
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24
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Guo J, Wang F, Zhou Q, Geng Q, Gao Q, Zhang R, Zhang C, Xuan Z, Cai J, Bin B, Han Q, Guo B, Yan B, Zhang J, Colonnello E, Jannini EA. Safety and efficacy of traditional Chinese medicine, Qiaoshao formula, combined with dapoxetine in the treatment of premature ejaculation: An open-label, real-life, retrospective multicentre study in Chinese men. Andrologia 2020; 53:e13915. [PMID: 33236403 DOI: 10.1111/and.13915] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2020] [Revised: 10/20/2020] [Accepted: 11/01/2020] [Indexed: 01/23/2023] Open
Abstract
To evaluate the safety and efficacy of Chinese medicine, Qiaoshao formula combined with dapoxetine was used for the treatment of premature ejaculation in a real-life setting. Nine hundred and five males diagnosed with premature ejaculation were reviewed in this retrospective cohort study. We divided the patients into two groups: dapoxetine alone and Qiaoshao formula combined with dapoxetine according to actual interventions provided to patients in clinics. The perceived intravaginal ejaculation latency time and the premature ejaculation profile measures markedly improved in both groups. However, in men with severe premature ejaculation (baseline perceived intravaginal ejaculation latency time <1 min) and those with baseline age ≤30 years, the perceived intravaginal ejaculation latency time was slightly but significantly longer with combined therapy than with dapoxetine alone (p < .05). Therefore, combined therapy involving the Qiaoshao formula and dapoxetine proved to safe as well as effective for treating premature ejaculation while prolonging the perceived intravaginal ejaculation latency time, which significantly improved the overall satisfaction of the patient and likely that of the couple.
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Affiliation(s)
- Jun Guo
- Department of Andrology, Xiyuan Hospital of China Academy of Chinese Medical Sciences, Beijing, China
| | - Fu Wang
- Department of Andrology, Xiyuan Hospital of China Academy of Chinese Medical Sciences, Beijing, China
| | - Qing Zhou
- Department of Andrology, The First Hospital of Hunan University of Chinese Medicine, Changsha, China
| | - Qiang Geng
- Department of Andrology, The First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin, China
| | - Qinghe Gao
- Department of Andrology, Xiyuan Hospital of China Academy of Chinese Medical Sciences, Beijing, China
| | - Rui Zhang
- Department of Andrology, Heilongjiang University of Traditional Chinese Medicine, Harbin, China
| | - Chunhe Zhang
- Department of Andrology, Yunnan Provincial Hospital of Traditional Chinese Medicine, Kunming, China
| | - Zhihua Xuan
- Department of Andrology, Shunyi Hospital of Traditional Chinese Medicine, Beijing, China
| | - Jian Cai
- Department of Urology, The Affiliated Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Bin Bin
- Department of Andrology, The First Affiliated Hospital of Guangxi University of Chinese Medicine, Nanning, China
| | - Qiang Han
- Department of Andrology, Beijing Hospital of Traditional Chinese Medicine, Capital Medical University, Beijing, China
| | - Boda Guo
- Department of Urology, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, China.,Graduate School of Peking Union Medical College, Beijing, China
| | - Bin Yan
- Department of Andrology, Xiyuan Hospital of China Academy of Chinese Medical Sciences, Beijing, China
| | - Jiwei Zhang
- Department of Andrology, Xiyuan Hospital of China Academy of Chinese Medical Sciences, Beijing, China
| | - Elena Colonnello
- Chair of Endocrinology and Medical Sexology (ENDOSEX), Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy
| | - Emmanuele A Jannini
- Chair of Endocrinology and Medical Sexology (ENDOSEX), Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy.,Visiting Professor at the Department of Andrology, First Affiliated Hospital, Sun Yat-sen University School of Medicine, Guangzhou, China.,Visiting Professor at the Department of Andrology, First Affiliated Hospital, Anhui Medical University, Hefei, China.,Visiting Professor at the Department of Urology, Shanghai General Hospital, Jiao Tong University School of Medicine, Shanghai, China.,Academic Advisor, First Teaching Hospital, Tianjin University of Traditional Chinese Medicine, Tianjin, China
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25
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A Spotlight on Patient- and Physician-Driven Digital Health and Mobile Innovation in Male Reproductive Medicine. CURRENT SEXUAL HEALTH REPORTS 2020. [DOI: 10.1007/s11930-020-00280-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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26
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Hou G, Gao M, Zhang L, Dun X, Zheng Y, Wang F, Yan F, Zheng W, Yin C, Yuan J, Zhang G, Meng P, Jannini EA, Yuan J. An Internally Validated Nomogram for Predicting the Likelihood of Improvement of Clinical Global Impression in Patients With Lifelong Premature Ejaculation Treated With Dapoxetine. J Sex Med 2020; 17:2341-2350. [PMID: 33191185 DOI: 10.1016/j.jsxm.2020.09.005] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2020] [Revised: 09/14/2020] [Accepted: 09/18/2020] [Indexed: 12/23/2022]
Abstract
BACKGROUND Although the introduction of dapoxetine has ushered in a new era in the treatment of premature ejaculation, many patients with lifelong premature ejaculation (LPE) exhibit an unimproved clinical global impression even after treatment with dapoxetine. AIM To investigate independent predictors of the improvement of Clinical Global Impression (iCGI) in patients with LPE treated with dapoxetine and develop a nomogram to predict a patient's likelihood of achieving iCGI. METHODS Data of 243 patients with LPE diagnosed at Xijing Hospital (Xi'an, China) and Northwest Women's and Children's Hospital (Xi'an, China) from January 2019 to May 2020 were analyzed. Independent predictors of iCGI were identified, and a nomogram was developed using R software based on a multivariate logistic regression model. The predictive accuracy of the nomogram was measured using the area under the receiver operating characteristic curve. The nomogram was calibrated by comparing predictions with observations. MAIN OUTCOME MEASURES The primary outcome was the patient-rated Clinical Global Impression of Change scale score after a 4-week course of dapoxetine treatment, which was collected via an online questionnaire. A Clinical Global Impression of Change score of ≥1 was defined as iCGI in this study. RESULTS Patients with LPE with at least a bachelor's degree, a self-reported intravaginal ejaculation latency time of >1 minute, and an International Index of Erectile Function question 5 score of ≥3 were independent factors associated with achieving iCGI, whereas a Premature Ejaculation Diagnostic Tool question 1 score of ≥2 was an independent factor negatively associated with achieving iCGI. The predictive accuracy of the nomogram, which was developed by integrating all variables with independent predictive significance, was 0.710 (95% confidence interval: 0.702-0.718). In addition, the calibration plot demonstrated excellent agreement between predictions and observations. CLINICAL IMPLICATIONS If the predictive performance of our nomogram is further proven in multiple external validations, it can be used to select suitable patients for dapoxetine treatment, thereby reducing the number of patients discontinuing treatment. STRENGTHS & LIMITATIONS This study developed the first nomogram for predicting the likelihood of achieving iCGI in patients with LPE treated with dapoxetine. However, our nomogram was not externally validated using independent cohorts from other institutions. CONCLUSION This study identified several independent predictors of iCGI in patients with LPE treated with dapoxetine. An effective nomogram was developed to predict their likelihood of achieving iCGI. External validations using data of Western patients with LPE are required to test the broader applicability of this Chinese patient-based tool. Hou G, Gao M, Zhang L, et al. An Internally Validated Nomogram for Predicting the Likelihood of Improvement of Clinical Global Impression in Patients With Lifelong Premature Ejaculation Treated With Dapoxetine. J Sex Med 2020;17:2341-2350.
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Affiliation(s)
- Guangdong Hou
- Department of Urology, Xijing Hospital, Fourth Military Medical University, Xi'an, China
| | - Ming Gao
- Department of Andrology, Xi'an Daxing Hospital, Shaanxi University of Chinese Medicine, Xi'an, China; Assisted Reproduction Center, Northwest Women's and Children's Hospital, Xi'an, China
| | - Lei Zhang
- Department of Urology, Xijing Hospital, Fourth Military Medical University, Xi'an, China
| | - Xinlong Dun
- Department of Urology, Xijing Hospital, Fourth Military Medical University, Xi'an, China
| | - Yu Zheng
- Department of Urology, Xijing Hospital, Fourth Military Medical University, Xi'an, China
| | - Fuli Wang
- Department of Urology, Xijing Hospital, Fourth Military Medical University, Xi'an, China
| | - Fei Yan
- Department of Urology, Xijing Hospital, Fourth Military Medical University, Xi'an, China
| | - Wanxiang Zheng
- Department of Urology, Xijing Hospital, Fourth Military Medical University, Xi'an, China
| | - Chuanmin Yin
- Department of Urology, Xi'an Daxing Hospital, Shaanxi University of Chinese Medicine, Xi'an, China
| | - Jiarui Yuan
- St. George's University School of Medicine, West Indies, Grenada
| | - Geng Zhang
- Department of Urology, Xijing Hospital, Fourth Military Medical University, Xi'an, China
| | - Ping Meng
- Department of Urology, Xijing Hospital, Fourth Military Medical University, Xi'an, China
| | - Emmanuele A Jannini
- Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy.
| | - Jianlin Yuan
- Department of Urology, Xijing Hospital, Fourth Military Medical University, Xi'an, China.
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Ozkan S, Yıldız H. Premature ejaculation in couples using contraceptive withdrawal and associations with characteristics of its use: A cross-sectional study. Andrologia 2020; 52:e13765. [PMID: 32814363 DOI: 10.1111/and.13765] [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: 04/07/2020] [Revised: 06/28/2020] [Accepted: 06/30/2020] [Indexed: 11/30/2022] Open
Abstract
This study aimed to investigate the Premature Ejaculation Profile (PEP) and its related factors in couples using contraceptive withdrawal (WD). The study sample was composed of 108 participants including 54 males and 54 females (their partners) who used WD. The data were collected via a questionnaire and the male and female forms of the PEP. The mean total PEP index score of the couples (female (F); 1.69 ± 0.55 and male (M); 1.65 ± 0.36) was below the average possible score. Although both males and their partners generally rated control over ejaculation (F; 57.4%, M; 61.1%) and satisfaction with sexual intercourse (F; 63%, M; 79.7%) as good/very good, they rate personal distress related to ejaculation (F; 64.8%, M; 83.4%) and interpersonal difficulty related to ejaculation (F; 81.5%, M; 92.6%) as 'extremely/quite a lot'. As the time of using WD increased, male control over ejaculation increased (p = .019); as the marriage duration (p = .045) and ages (F; p = .012, M; p = .045) of the couples increased, their problems related to ejaculation increased. According to the results, couples who use WD experience PE-related problems, and the problems they experience vary depending on the period of WD use, marriage duration and age.
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Affiliation(s)
- Safiye Ozkan
- Faculty of Health Sciences, Division of Midwifery, Amasya University, Amasya, Turkey
| | - Hatice Yıldız
- Faculty of Health Sciences, Division of Nursing, Department of Obstetrics and Gynecology Nursing, Marmara University, Istanbul, Turkey
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28
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Lu Y, Liang Z, Tian J, Li Z, Song Y, Wang X, Liu K, Zhou K, Yang Y, Liu X. The association between acquired premature ejaculation and metabolic syndrome in young Chinese men. Andrologia 2020; 52:e13787. [PMID: 32772416 DOI: 10.1111/and.13787] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2020] [Revised: 07/07/2020] [Accepted: 07/12/2020] [Indexed: 02/06/2023] Open
Abstract
We conducted the study to investigate the association between metabolic syndrome (MetS) and acquired premature ejaculation (APE). From January 2017 to December 2019, 1,000 subjects, 500 men with APE (APE group) and 500 men without APE (control group), were selected. Self-estimated intravaginal ejaculatory latency time (IELT) and Premature Ejaculation Diagnostic Tool (PEDT) were recorded from each participant to evaluate APE. Detailed physical examinations, body composition analysis and blood tests were all assessed. The neck circumference, waist circumference, visceral fat rating, fat mass, fasting blood glucose (FBG) and highly sensitive C-reactive protein (hs-CRP) in the APE group were significantly higher than the control group (p < .05 for all). Furthermore, the APE population had a higher prevalence of MetS than the control group (49.4% versus 35.6%, p = .000). Consistent results could also be observed in terms of the number of MetS components and each component of the MetS (both p < .05). Moreover, both the prevalence of APE and the severity of PE increased significantly as the number of MetS components increased. Finally, in the multivariate analysis, we found that both MetS and hs-CRP were independent risk factors for APE (both p < .01). The results indicated that APE was related to MetS but not its components.
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Affiliation(s)
- Yi Lu
- Department of Urology, Tianjin Medical University General Hospital, Tianjin, China
| | - Zhen Liang
- Department of Urology, Tianjin Medical University General Hospital, Tianjin, China
| | - Jia Tian
- Department of Urology, Tianjin Medical University General Hospital, Tianjin, China
| | - Zhongjia Li
- Department of Urology, Tianjin Medical University General Hospital, Tianjin, China
| | - Yuxuan Song
- Department of Urology, Tianjin Medical University General Hospital, Tianjin, China
| | - Xiao Wang
- Department of Urology, Tianjin Medical University General Hospital, Tianjin, China
| | - Kang Liu
- Department of Urology, Tianjin Medical University General Hospital, Tianjin, China
| | - Kechong Zhou
- Department of Urology, Tianjin Medical University General Hospital, Tianjin, China
| | - Yongjiao Yang
- Department of Urology, The Second Hospital of Tianjin Medical University, Tianjin, China
| | - Xiaoqiang Liu
- Department of Urology, Tianjin Medical University General Hospital, Tianjin, China
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Panda SK, Nirvanashetty S, Parachur VA, Mohanty N. A Randomized Double-Blind Placebo-Control Study to Assess the Efficacy and Safety of OLNP-05 Versus Placebo for the Treatment of Subjects with Premature Ejaculation. J Med Food 2020; 23:1006-1013. [PMID: 32654580 DOI: 10.1089/jmf.2019.4661] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Premature ejaculation (PE) is one of the foremost sex-related health problems among men. The global occurrence ranges from 20% to 30%, according to various studies. PE has a great impact on the men's quality of life, with deleterious effects such as embarrassment, frustration, and feeling of incompetence. Considering the necessity of treatment of PE, this study was planned to compare the efficacy and safety of OLNP-05 versus placebo for treating subjects suffering from PE. In this randomized clinical study, 60 men with PE were enrolled and randomly assigned to receive either OLNP-05 or placebo one capsule twice daily for a period of 8 weeks. Subjects were evaluated during visits on day 1, day 28, and day 56. Mean change from baseline in intravaginal ejaculatory latency time (IELT), improvement in premature ejaculation profile (PEP), and Clinical Global Impression-Improvement scale (CGI-I) were used to assess the efficacy of treatment. P-value <.05 was considered significant. At the end of the treatment, the improvement in IELT score in the OLNP-05 group was remarkably higher than the placebo. Subjects in the OLNP-05 treatment group also reported significantly greater improvement in PEP subscale score. Majority of OLNP-05-treated subjects were found to be in the "much improved" category as per CGI-I assessment. The result confirms the safety and efficacy of OLNP-05, therefore suggesting that OLNP-05 may be a safe and effective intervention for the management of PE. Trial registration: Clinical Trials Registry India (Registration No: CTRI/2017/08/009226, 02/08/2017).
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Fusco F, Creta M, Mangiapia F, Cirigliano L, Trama F, Pandolfo SD, Imbimbo C, Longo N, Mirone V. Perceptions, Expectations, Preferences, and Attitudes Toward Premature Ejaculation, Its Diagnosis and Topical Treatment with Fortacin™ Spray: Results from an Expert Panel Discussion. Res Rep Urol 2020; 12:211-216. [PMID: 32670915 PMCID: PMC7337443 DOI: 10.2147/rru.s250301] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2020] [Accepted: 06/18/2020] [Indexed: 12/19/2022] Open
Abstract
INTRODUCTION Premature ejaculation (PE) represents the most prevalent male sexual issue. Before beginning treatment, it is essential to discuss the patient's expectations thoroughly. METHODS Herein, we report the results of an expert panel discussion about perceptions, expectations, preferences, and attitudes towards PE, its diagnosis and treatment. The panel took place in October 2019 and involved 30 Italian urologists experienced in the management of male sexual dysfunction. It aimed at investigating physicians' points of view about selected aspects of PE management which emerged during the counselling of PE patients over the previous two years. Treatment-related questions were mainly focused on topical treatment with Fortacin™. RESULTS Overall, 83.3% of those interviewed declared that most of their patients perceive PE as a bother rather than a disease. The percentage of urologists interviewed perceived that improved subjective control over ejaculation and prolonged intravaginal ejaculatory latency time (IELT) as the main benefit expected by the majority of their patients was 56.5% and 10%, respectively. Eighty percent of urologists reported on-demand regimen as the dosage modality preferred by the majority of their patients and half of them reported the topical route to be the way of administration preferred in most cases. Moreover, 73.3% of urologists reported that adherence to treatment was higher in patients undergoing topical treatment. Finally, 80% of urologists perceived Fortacin to be efficacious in patients with acquired PE and 70% of them perceived its efficacy to be independent from IELT. DISCUSSION Most patients perceive PE as a bother rather than a disease and mainly advocate an improved control over ejaculation. Fortacin is perceived as efficacious in patients with acquired PE, and independent from IELT.
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Affiliation(s)
- Ferdinando Fusco
- Department of Urology, Luigi Vanvitelli University of Naples, Naples, Italy
| | - Massimiliano Creta
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, University of Naples Federico II, Naples, Italy
| | - Francesco Mangiapia
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, University of Naples Federico II, Naples, Italy
| | - Lorenzo Cirigliano
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, University of Naples Federico II, Naples, Italy
| | - Francesco Trama
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, University of Naples Federico II, Naples, Italy
| | - Savio Domenico Pandolfo
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, University of Naples Federico II, Naples, Italy
| | - Ciro Imbimbo
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, University of Naples Federico II, Naples, Italy
| | - Nicola Longo
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, University of Naples Federico II, Naples, Italy
| | - Vincenzo Mirone
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, University of Naples Federico II, Naples, Italy
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Zhang X, Chi N, Sun M, Shan Z, Zhang Y, Cui Y. Phosphodiesterase-5 Inhibitors for Premature Ejaculation: Systematic Review and Meta-Analysis of Placebo-Controlled Trials. Am J Mens Health 2020; 14:1557988320916406. [PMID: 32375542 PMCID: PMC7233005 DOI: 10.1177/1557988320916406] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
The purpose of this analysis is to assess the efficacy and safety of phosphodiesterase-5 inhibitors (PDE5Is) for the treatment of premature ejaculation (PE). A comprehensive search was performed to ascertain from trials about PDE5Is for the treatment of PE and compare the results, including intravaginal ejaculatory latency time (IVELT), score of sexual satisfaction scale, and side effects, between the group treated with PDE5Is and that treated with placebo. Seven studies involving a total of 471 patients were included in this meta-analysis. This analysis showed that patients who were treated with PDE5Is had significantly increased IVELT (mean difference [MD] 2.60; 95% CI [1.85, 3.36]; p < .00001) and score of sexual satisfaction scale (MD 2.04; 95% CI [0.78, 3.30]; p = .002) compared with the group on placebo. More patients had side effects while taking PDE5Is, such as headache, dizziness, flushing, and nasal congestion. PDE5Is were significantly more effective than placebo in the treatment of PE. Side effects were more common among patients who were treated with PDE5Is.
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Affiliation(s)
- Xuebao Zhang
- Department of Urology, The Affiliated Yantai Yuhuangding Hospital of Qingdao University, Yantai, Shandong, China
| | - Nan Chi
- Department of Neurosurgery, The Affiliated Yantai Yuhuangding Hospital of Qingdao University, Yantai, Shandong, China
| | - Miao Sun
- Pharmaceutical Analysis Laboratory, Shandong Qidu Pharmaceutical Co., Ltd, Zibo, China
| | - Zhengfei Shan
- Department of Urology, The Affiliated Yantai Yuhuangding Hospital of Qingdao University, Yantai, Shandong, China
| | - Yulian Zhang
- Department of Gynecology, The Affiliated Hospital of Qingdao University, Qingdao, Shandong, China
| | - Yuanshan Cui
- Department of Urology, The Affiliated Yantai Yuhuangding Hospital of Qingdao University, Yantai, Shandong, China.,Department of Urology, Beijing Tian Tan Hospital, Capital Medical University, China
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Koolwal A, Agarwal S, Manohar S, Koolwal GD, Gupta A. Obsessive–Compulsive Disorder and Sexuality: A Narrative Review. JOURNAL OF PSYCHOSEXUAL HEALTH 2020. [DOI: 10.1177/2631831819896171] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Obsessive–compulsive disorder (OCD) is one of the common psychiatric disorders. Despite being one of the basic aspects of biology, the sexual functioning in OCD patients has not received much attention, with there being very limited research on sexuality in these patients. In this review article, we try to take a look at the research on sexual functioning, sexual dysfunctions, and neurobiology of sexual dysfunctions in the anxiety disorders in general and in OCD specifically. We also take a look at the research on relationship functioning in the patients with OCD, a recently proposed entity, relationship-related obsessive compulsive phenomenon, at the sexual obsessions, and the sexual functioning in patients on active treatment for OCD. The overall research suggests that we should always take into account the sexual life and functioning of patients presenting with OCD.
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Affiliation(s)
- Arpit Koolwal
- Department of Psychiatry, JSS Medical College and Hospital, JSS Academy of Higher Education and Research, Mysuru, Karnataka, India
| | - Supriya Agarwal
- Department of Psychiatry, Subharti Medical College, Meerut, Uttar Pradesh, India
| | - Shivanand Manohar
- Department of Psychiatry, JSS Medical College and Hospital, JSS Academy of Higher Education and Research, Mysuru, Karnataka, India
| | | | - Anubha Gupta
- Department of Pathology, PGIMS, Rohtak, Haryana, India
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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: 77] [Impact Index Per Article: 19.3] [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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Russo GI, Serefoglu EC. Premature Ejaculation: 2020 Update. CURRENT SEXUAL HEALTH REPORTS 2019. [DOI: 10.1007/s11930-019-00232-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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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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Premature Ejaculation: Aetiology and Treatment Strategies. Med Sci (Basel) 2019; 7:medsci7110102. [PMID: 31731516 PMCID: PMC6915345 DOI: 10.3390/medsci7110102] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2019] [Revised: 10/16/2019] [Accepted: 10/23/2019] [Indexed: 12/15/2022] Open
Abstract
Premature ejaculation (PE) is a highly prevalent male sexual dysfunction that is often neglected, presenting a currently unmet therapeutic need. The classification of PE has historically been varied and at times ambiguous, contributing to inaccurate prevalence estimates. This review uses the International Society for Sexual Medicine (ISSM) definition of PE, which includes reduced ejaculatory latency, lack of control and associated negative personal consequences. Patient assessment and management options differ depending on the classification of PE and it is the role of the clinician to appropriately classify patients and be aware of the correct management strategies. This review provides an overall background of PE in terms of classification and underlying physiology, patient assessment and management strategies along with the scientific rationale for treatment. Patients with lifelong and acquired PE are most likely to benefit from combination therapy of pharmacological treatment in the form of selective serotonin re-uptake inhibitor dapoxetine, psychosexual behavioural therapy and psychological therapy.
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Burgio G, Giammusso B, Calogero AE, Mollaioli D, Condorelli RA, Jannini EA, La Vignera S. Evaluation of the Mistakes in Self-Diagnosis of Sexual Dysfunctions in 11,000 Male Outpatients: A Real-Life Study in An Andrology Clinic. J Clin Med 2019; 8:jcm8101679. [PMID: 31615034 PMCID: PMC6832924 DOI: 10.3390/jcm8101679] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2019] [Revised: 10/06/2019] [Accepted: 10/10/2019] [Indexed: 12/16/2022] Open
Abstract
Purpose: The aim of this study was to compare the initial request for sexual consultation with the final diagnosis and to evaluate the limits of the active andrological anamnesis concerning unclassified male sexual dysfunction. Methods: In this 12-year observational retrospective study, we collected data from patients referring to an andrological outpatient clinic, evaluating the requests, perceptions, needs, and self-diagnosis at their first visit and comparing them with the final diagnosis reached after a complete clinical, laboratory, and instrumental investigation. Results: A total of 11,200 patients were evaluated. The main request of andrological consultation was erectile dysfunction (ED) (52%), followed by premature ejaculation (PE) (28%), and low sexual desire (11.5%). Among the patients seeking help for ED, about 30% were ultimately found to have a different type of dysfunction and 24% were diagnosed with an “unmet need”, which included issues not present in the current nosography nonetheless affecting sexual and relational life. Among the patients referring for PE, the final diagnosis was lifelong PE for the large majority of them, regardless of whether initially they thought to have an acquired form. Several of those who sought consultation for acquired PE were frequently found to be able to compensate for lifelong PE by a subsequent coitus or were able to induce orgasm in the partner with different modalities. Among the patients referring for low sexual desire, only 57.5% were confirmed to have it; 23% had ED and 18.5% showed a raised threshold of penile sensitivity. Conclusions: The results of this study show that the reason for consultation is frequently misleading and raise the relevance of being aware of the so-called “unmet needs” and to discuss with the patient and the couple to explore the sexual history behind the self-diagnosis. These findings also suggest the need to expand the current taxonomy of male sexual dysfunctions.
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Affiliation(s)
- Giovanni Burgio
- Department of Clinical and Experimental Medicine, University of Catania, 95125 Catania, Italy.
| | - Bruno Giammusso
- Urology Clinic, Policlinic "Morgagni", 95125 Catania, Italy.
| | - Aldo E Calogero
- Department of Clinical and Experimental Medicine, University of Catania, 95125 Catania, Italy.
| | - Daniele Mollaioli
- Chair of Endocrinology and Medical Sexology (ENDOSEX), Department of Systems Medicine, University of Rome Tor Vergata, 00133 Rome, Italy.
| | - Rosita A Condorelli
- Department of Clinical and Experimental Medicine, University of Catania, 95125 Catania, Italy.
| | - Emmanuele A Jannini
- Chair of Endocrinology and Medical Sexology (ENDOSEX), Department of Systems Medicine, University of Rome Tor Vergata, 00133 Rome, Italy.
| | - Sandro La Vignera
- Department of Clinical and Experimental Medicine, University of Catania, 95125 Catania, Italy.
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Frequency of etiological factors among patients with acquired premature ejaculation: prospective, observational, single-center study. Int J Impot Res 2019; 32:352-357. [PMID: 31477853 DOI: 10.1038/s41443-019-0188-x] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2019] [Revised: 07/04/2019] [Accepted: 07/31/2019] [Indexed: 12/31/2022]
Abstract
Although premature ejaculation (PE) is a common male sexual dysfunction, its pathophysiology has not been fully elucidated. Several medical problems such as erectile dysfunction, depression, anxiety, hormonal disorders and chronic prostatitis may play a role in the etiology of acquired PE. This study aims to evaluate the frequency of these etiologic factors among patients with acquired PE. Between May and July 2016, 53 men with acquired PE were included in the study. Self-estimated intravaginal ejaculation latency time (IELT) of these patients was recorded along with their medical history and physical examination findings. Moreover, 5-item version of the International Index of Erectile Function (IIEF-5), premature ejaculation profile (PEP), anxiety and depression scales (STAI-1, STAI-2, and BECK), and chronic prostatitis symptom index (NIH-CPSI) were administered. Fasting plasma glucose, follicle stimulating hormone (FSH), luteinizing hormone (LH), prolactin, total and free testosterone, total prostate specific antigen, thyroid and thyroid stimulating hormone levels were measured. Urine analysis and 2 cup tests were also studied. Mean age of the patients was 42.41 ± 11.14 (22-60). Mean duration of the PE complaint was 34.18 ± 36.76 (3-144) months. Mean IELT time of the patients was 38.28 ± 30.79 (3-180) s. Of the patients; 69.81%, 62.26%, 56.60%, 45.28%, 30.19%, 24.53%, 16.98%, 15.09%, and 7.55% had depression, chronic prostatitis, erectile dysfunction, anxiety, diabetes mellitus, abnormal FSH or LH, hypoprolactinemia, hyperthyroidism, and high testosterone levels, respectively. The results of our study revealed that anxiety disorders, depression, erectile dysfunction, and chronic prostatitis are common among patients with acquired PE and may play role in the etiology of this problem. There is a need for further researches related to the exact pathophysiology of acquired PE with larger number of patients.
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Pereira-Lourenço M, Brito DVE, Pereira BJ. Premature Ejaculation: From Physiology to Treatment. J Family Reprod Health 2019; 13:120-131. [PMID: 32201486 PMCID: PMC7072026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022] Open
Abstract
Objective: To review in literature about the concept of premature ejaculation from physiology to treatment. Materials and methods: A literature search conducted with Pubmed and Cochrane. Results: An accurate clinical history is the best diagnostic method, and in the majority of the cases it is enough to differentiate between primary and acquired premature ejaculation. Nowadays the treatment is not curative but is effective in increasing the Intravaginal Ejaculatory Latency Time, improving the couple's sexual satisfaction. Conclusion: Although PE is the most frequent sexual dysfunction, it is still sub-diagnosed. Combining behavioural techniques with pharmacotherapy is the best way of treatment.
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Affiliation(s)
- Mário Pereira-Lourenço
- Urology Department, Francisco Gentil Portuguese Institute of Oncology, Coimbra, Portugal
| | - Duarte Vieira e Brito
- Urology Department, Francisco Gentil Portuguese Institute of Oncology, Coimbra, Portugal
| | - Bruno Jorge Pereira
- Urology Department, Cova da Beira University Hospital Centre, Covilhã, Portugal
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Canat L, Degirmentepe RB, Atalay HA, Çakir SS, Alkan I, Çulha MG, Ozbir S, Canat M. Low serum vitamin D is associated with an increased likelihood of acquired premature ejaculation. Int Braz J Urol 2019; 45:621-628. [PMID: 31063279 PMCID: PMC6786110 DOI: 10.1590/s1677-5538.ibju.2018.0887] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2019] [Accepted: 02/24/2019] [Indexed: 12/16/2022] Open
Abstract
Purpose: To investigate the relationship between 25-hydroxyvitamin D (25 (OH) D) levels and acquired premature ejaculation (PE). Materials and Methods: A total of 97 patients with acquired PE and 64 healthy men as a control group selected from volunteers without PE attending our Andrology Outpatient Clinic between November 2016 and April 2017 were included the study. All patients were considered to have acquired PE if they fulfilled the criteria of the second Ad Hoc International Society for Sexual Medicine Committee. Premature ejaculation diagnostic tool questionnaires were used to assessment of PE and all participants were instructed to record intravaginal ejaculatory latency time. Vitamin D levels were evaluated in all participants using high performance liquid chromatography method included in the study. Results: Compared to men without PE, the patients with acquired PE had significantly lower 25 (OH) D levels (12.0 ± 4.5 ng/mL vs. 18.2 ± 7.4 ng/mL, p < 0.001). In the logistic regression analysis, 25 (OH) D was found to be an independent risk factor for acquired PE, with estimated odds ratios (95% CI) of 0.639 (0.460-0.887, p = 0.007) and the area under curve of the ROC curve of 25 (OH) D diagnosing acquired PE was 0.770 (95% CI: 0.695 to 0.844, p < 0.001). The best cut-off value was 16 ng/mL with a sensitivity of 60.9%, specificity of 83.5%, PPV of 70.9%, and NPV of 76.4% to indicate acquired PE. Conclusions: This study demonstrates that lower vitamin D levels are associated with the acquired PE. The result of our study showed that the role of serum vitamin D levels should be investigate in the etiology of acquired PE. Perhaps supplementation of vitamin D in men with acquired PE will ameliorate the sexual health of these patients.
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Affiliation(s)
- Lütfi Canat
- Department of Urology, Okmeydani Training and Research Hospital, Istanbul, Turkey
| | | | - Hasan Anil Atalay
- Department of Urology, Okmeydani Training and Research Hospital, Istanbul, Turkey
| | - Suleyman Sami Çakir
- Department of Urology, Okmeydani Training and Research Hospital, Istanbul, Turkey
| | - Ilter Alkan
- Department of Urology, Okmeydani Training and Research Hospital, Istanbul, Turkey
| | - Mehmet Gokhan Çulha
- Department of Urology, Okmeydani Training and Research Hospital, Istanbul, Turkey
| | - Sait Ozbir
- Department of Urology, Okmeydani Training and Research Hospital, Istanbul, Turkey
| | - Masum Canat
- Department of Endocrinology and Metabolism, Şişli Etfal Training and Research Hospital, Istanbul, Turkey
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Boeri L, Capogrosso P, Ventimiglia E, Schifano N, Montanari E, Montorsi F, Salonia A. Sexual Dysfunction in Men with Prediabetes. Sex Med Rev 2019; 8:622-634. [PMID: 30852183 DOI: 10.1016/j.sxmr.2018.11.008] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2018] [Revised: 11/19/2018] [Accepted: 11/25/2018] [Indexed: 01/03/2023]
Abstract
INTRODUCTION Previous studies have shown a strong association between diabetes mellitus (DM) and the frequency and severity of some aspects of male sexual dysfunction (SD). The same relationship with prediabetes (preDM) has been less well investigated. AIM To systematically review the current literature on the association between preDM and SD, focusing on erectile dysfunction (ED), sex steroid hormone alterations, and premature ejaculation (PE). METHODS The present review was conducted in accordance with the PRISMA declaration standards for systematic reviews. A systematic search for the terms "male sexual dysfunction," "prediabetes," "IFG or IGT," "glycemia," "ED," "ejaculation," and "hypoactive sexual desire disorder" was carried out in the PubMed and Embase databases. MAIN OUTCOME MEASURE Prevalence of SD in men with preDM and severity of ED, PE, and hormone alterations in men with preDM compared with controls. RESULTS 12 studies reporting data on the association between SD and preDM were found in the literature. According to these studies, ED is more prevalent in men with preDM compared with controls, the severity of ED increases progressively as a function of impaired glucose metabolism, testosterone values and preDM are strongly correlated, men with preDM are at increased risk of testosterone deficiency and hypogonadism, men with hypogonadism have a higher prevalence of preDM, and the association between PE and preDM is controversial. CONCLUSION PreDM is a common and underdiagnosed clinical condition that is strongly associated with male SD. A detailed glucose metabolism investigation should be performed in every patient with SD to screen for glucose abnormalities and eventually to implement prevention program to decrease their chances of developing life-changing chronic illnesses. Boeri L, Capogrosso P, Ventimiglia E, et al. Sexual Dysfunction in Men with Prediabetes. Sex Med Rev 2019;8:622-634.
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Affiliation(s)
- Luca Boeri
- Division of Experimental Oncology/Unit of Urology, Urological Research Institute, IRCCS Ospedale San Raffaele, Milan, Italy; Department of Urology, IRCCS Foundation Ca' Granda Ospedale Maggiore Policlinico, University of Milan, Milan, Italy
| | - Paolo Capogrosso
- Division of Experimental Oncology/Unit of Urology, Urological Research Institute, IRCCS Ospedale San Raffaele, Milan, Italy.
| | - Eugenio Ventimiglia
- Division of Experimental Oncology/Unit of Urology, Urological Research Institute, IRCCS Ospedale San Raffaele, Milan, Italy; University Vita-Salute San Raffaele, Milan, Italy
| | - Nicolò Schifano
- Division of Experimental Oncology/Unit of Urology, Urological Research Institute, IRCCS Ospedale San Raffaele, Milan, Italy; University Vita-Salute San Raffaele, Milan, Italy
| | - Emanuele Montanari
- Department of Urology, IRCCS Foundation Ca' Granda Ospedale Maggiore Policlinico, University of Milan, Milan, Italy
| | - Francesco Montorsi
- Division of Experimental Oncology/Unit of Urology, Urological Research Institute, IRCCS Ospedale San Raffaele, Milan, Italy; University Vita-Salute San Raffaele, Milan, Italy
| | - Andrea Salonia
- Division of Experimental Oncology/Unit of Urology, Urological Research Institute, IRCCS Ospedale San Raffaele, Milan, Italy; University Vita-Salute San Raffaele, Milan, Italy
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Trovão JN, Serefoglu EC. Neurobiology of male sexual dysfunctions in psychiatric disorders: the cases of depression, anxiety, mania and schizophrenia. Int J Impot Res 2018; 30:279-286. [PMID: 30228317 DOI: 10.1038/s41443-018-0077-8] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2018] [Revised: 08/16/2018] [Accepted: 09/03/2018] [Indexed: 01/09/2023]
Abstract
While the pathophysiology of several psychiatric disorders has become modestly elucidated in the last decade, comorbid sexual dysfunctions in such patients are frequently left apart from clinical and research interest. We aimed to address the malfunctioning neurocircuitry underlying sexual dysfunctions in depression, anxiety, schizophrenia and mania. We performed a comprehensive literature review, addressing any combination of the topics of "neurobiology"/"neural", "sexual"/"desire"/"arousal"/"orgasm"/"ejaculation" and "depression"/"anxiety"/"schizophrenia"/"mania"/"bipolar". Altered neurotransmitter levels or connectivity in patients are reported in sexual dysfunctions (either desire, arousal, orgasm and ejaculation) and main psychiatric disorders (depression, anxiety, mania and schizophrenia). Neuronal pathways responsible for the occurrence of sexual dysfunctions in psychiatric disorders can be figured out by overlap of their acknowledged pathophysiology. However, specific research in that group is scant, so future tailored studies are warranted to elucidate actual mechanisms.
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Affiliation(s)
- José Nuno Trovão
- Department of Psychiatry of Centro Hospitalar Vila Nova de Gaia/Espinho, Porto, Portugal
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Perineal Ultrasound: a Review in the Context of Ejaculatory Dysfunction. Sex Med Rev 2018; 6:419-428. [DOI: 10.1016/j.sxmr.2017.12.005] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2017] [Revised: 12/11/2017] [Accepted: 12/15/2017] [Indexed: 01/23/2023]
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Kempeneers P, Andrianne R, Cuddy M, Blairy S. Sexual Cognitions, Trait Anxiety, Sexual Anxiety, and Distress in Men With Different Subtypes of Premature Ejaculation and in Their Partners. JOURNAL OF SEX & MARITAL THERAPY 2018; 44:319-332. [PMID: 29161211 DOI: 10.1080/0092623x.2017.1405299] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
This study examined trait anxiety and sexual cognitions in 610 men with premature ejaculation (PE) (DSM-IV-TR criteria) and in 107 partners of these men, and compared their scores to normative data. Sexual anxiety, intravaginal ejaculatory latency time, feeling of control over ejaculation, and PE-related distress were also assessed. The scores of 343 participants (56.23%) with clearly identifiable subtypes of PE according to Waldinger's classification system (lifelong, acquired, variable, and subjective subtypes) were compared in these domains. Finally, the predictive value of these factors in determining PE-related distress was explored. The following conclusions can be summarized from the results: (1) Men affected by PE are more distressed by the problem than their partners; (2) there is no evidence that levels of trait anxiety in individuals with PE are dissimilar to those found in the general population; (3) "dysfunctional" sexual cognitions likely play a role in PE, especially with regard to PE-related distress; (4) different subtypes of PE have similar profiles on measures of trait anxiety, sexual anxiety, and sexual cognitions; (5) differences between subtypes are only apparent with regard to feeling of control over ejaculation, with men with lifelong or acquired PE scoring significantly lower than those with a subjective form of the problem.
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Affiliation(s)
- Philippe Kempeneers
- a University of Liege , Department of Psychology , Liege , Belgium
- b Alexians' Hospital , Henri-Chapelle , Belgium
| | | | - Marion Cuddy
- d Talking Therapies Southwark , Maudsley Hospital , London , UK
| | - Sylvie Blairy
- a University of Liege , Department of Psychology , Liege , Belgium
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Khan HL, Bhatti S, Abbas S, Khan YL, Gonzalez RMM, Aslamkhan M, Gonzalez GR, Aydin HH. Longer trinucleotide repeats of androgen receptor are associated with higher testosterone and low oxytocin levels in diabetic premature ejaculatory dysfunction patients. Basic Clin Androl 2018; 28:3. [PMID: 29556396 PMCID: PMC5838858 DOI: 10.1186/s12610-018-0068-0] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2017] [Accepted: 02/01/2018] [Indexed: 12/31/2022] Open
Abstract
Background Despite its worldwide high occurrence, the obscurity regarding the description, epidemiology and management of premature ejaculation remains provocative. It is well established that male premature ejaculatory dysfunction is an increasing problem due to spontaneous ejaculation across a variety of general and clinical subjects. The main goal of this study was to determine the relationships between trinucleotide repeats of the androgen receptor (AR), sex steroids, and pituitary hormones with sexual function in men with type 2 diabetes mellitus (DM) and reported with acquired premature ejaculation (PE). Methods A total of 150 normal and 250 PE + DM subjects were enrolled in this study. Each subject was invited to fill out an elaborative questionnaire to acquire precise selective information regarding BMI, duration of PE + DM, self-reported Intra-Vaginal Ejaculatory Latency Time (IELT), sexual and mental health status by using the premature ejaculation diagnostic tool (PEDT) and Beck Depression Inventory-II (BDI-II). Pearson's correlation analysis was used to analyze the relationship between clinical, hormonal, and genetic variables. Ward's minimum variance cluster analysis and principal component analysis were used for evaluation of dependence between genetic, clinical, and demographic parameters. Results The patients who have the lowest number of (≤21) (CAG)n repeats have higher serum oxytocin levels (114.2 pg/ml; n = 54, 43.2%) than the controls (69.18 pg/ml; n = 22, 17.6%) and the patients with the highest (≥26) number of (CAG)n repeats (62.9 pg/ml; n = 108, 43.2%).On the other hand, patients who have the highest numbers of (CAG)n repeats (≥26) have higher serum testosterone (6.1 ng/ml; n = 108, 43.2% of cohort) lower prolactin (3.01 ng/ml; n = 108, 43.2% of cohort) levels than the controls and patients with the lowest numbers (≤21) of (CAG)n repeats and their TSH (1.53 mIU/L, P < 0.05) levels are lower than those of controls. In the Pearson correlation model, self-estimated IELT demonstrated significantly negative correlation with both (CAG)n and (GCC)n repeats (r = - 0.16, p = 0.0001; r = - 0.19, p = 0.0001) respectively. These repeats have positive correlation with PEDT (r = 0.28, p = 0.0001: r = 0.24, p = 0.0001, whole model) and inversely correlated with BDI-II (r = - 0.25, p = 0.0001). Conclusion This study indicates that androgen receptor polymorphism modulates the endocrine effect on ejaculatory reflex and depends strongly on its "cofactors". Moreover, our results also confirmed an association between long tri-nucleotide repeats of androgen receptor, sex steroids, pituitary, and thyroid hormones in relation to acquired premature ejaculatory dysfunction in diabetic patients. However, endocrine regulation of PE reflex is a complex phenomenon that requires further investigation.
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Affiliation(s)
- Haroon Latif Khan
- Lahore Institute of fertility and Endocrinology, Hameed Latif Hospital, 14 - Abu Bakar Block, New Garden Town, Lahore, Pakistan
| | - Shahzad Bhatti
- Lahore Institute of fertility and Endocrinology, Hameed Latif Hospital, 14 - Abu Bakar Block, New Garden Town, Lahore, Pakistan.,2Department of Human Genetics and Molecular biology, University of Health Sciences, Lahore, -54600 Pakistan.,3Institute of Molecular Biology and Biotechnology, The University of Lahore, Lahore, 54600 Pakistan.,4Department of Medical Education, Rashid Latif Medical College, Lahore, Pakistan
| | - Sana Abbas
- Lahore Institute of fertility and Endocrinology, Hameed Latif Hospital, 14 - Abu Bakar Block, New Garden Town, Lahore, Pakistan
| | - Yousaf Latif Khan
- Lahore Institute of fertility and Endocrinology, Hameed Latif Hospital, 14 - Abu Bakar Block, New Garden Town, Lahore, Pakistan
| | - Rosa Maria Marquez Gonzalez
- Centro de investigacion Biomedica de Occidente, IMSS, Uiversidad de Guadalajara, Jalisco Maxico, Guadalajara, Mexico
| | - Muhammad Aslamkhan
- 2Department of Human Genetics and Molecular biology, University of Health Sciences, Lahore, -54600 Pakistan
| | - Gerardo Rodriguez Gonzalez
- 6Universidad De Guadalajara CIBO, IMSS, Sierra Mojada 800 Independencia, 44340 Guadalajara, Jalisco Maxicom Mexico
| | - Hikmet Hakan Aydin
- 7Department of Medical Biochemistry, Ege University School of Medicine, Bornova, Izmir Turkey
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Where do we come from and where are we going in the treatment of premature ejaculation? Actas Urol Esp 2018; 42:137-139. [PMID: 28919100 DOI: 10.1016/j.acuro.2017.07.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2017] [Accepted: 07/25/2017] [Indexed: 11/22/2022]
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Sato Y, Otani T, Amano T, Araki T, Kondou N, Matsukawa M, Tobe M, Haga K, Uchida K, Honma I. Silodosin versus naftopidil in the treatment of premature ejaculation: A prospective multicenter trial. Int J Urol 2017. [PMID: 28627033 DOI: 10.1111/iju.13392] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
OBJECTIVES To determine the efficacy of two α1-adrenoceptor antagonists with different affinities for α1-adrenoceptor subtypes, silodosin and naftopidil, in the treatment of premature ejaculation. METHODS This was a prospective, open-label, multicenter trial. A total of 26 patients with untreated acquired premature ejaculation were enrolled. Premature ejaculation was defined based on the International Society for Sexual Medicine recommendation. Patients self-administered on demand silodosin 4 mg or naftopidil 25 mg 1 h before intercourse, alternating drugs at least three times each. Clinical global impression change for premature ejaculation, premature ejaculation profile, and intravaginal ejaculation latency time were evaluated at baseline and during treatment. RESULTS Due to clinical global impression change, 24 patients (92%) and 12 patients (46%) reported improvement in their own premature ejaculation problems under silodosin and nafitopidil administration, respectively. Silodosin treatment produced a significantly higher improvement rate compared with naftopidil (P = 0.0002). Objectively, silodosin significantly prolonged intravaginal ejaculation latency time compared with baseline and naftopidil (P < 0.01). Mean intravaginal ejaculation latency times were 1.9, 4.1, and 7.6 min at baseline, control and with silodosin, respectively. The rate of reduced semen volume during silodosin treatment was higher than during naftopidil treatment. There were no adverse systemic effects in either group. CONCLUSIONS Silodosin, a highly selective α1A-adrenoceptor antagonist, produces greater improvements in premature ejaculation profiles and related symptoms along with intravaginal ejaculation latency time in acquired premature ejaculation patients with or without erectile dysfunction. This result supports the clinical use of silodosin as an alternative treatment for premature ejaculation.
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Affiliation(s)
- Yoshikazu Sato
- Department of Urology, Sanjukai Hospital, Sapporo, Hokkaido, Japan
| | - Toshikazu Otani
- Department of Urology, Chubu Rosai Hospital, Nagoya, Aichi, Japan
| | - Toshiyasu Amano
- Department of Urology, Nagano Red Cross Hospital, Nagano, Japan
| | - Tohru Araki
- Department of Urology, Araki Urologic Clinic, Kurashiki, Okayama, Japan
| | - Nobuyuki Kondou
- Department of Urology, Kyoritsu Hospital, Nagoya, Aichi, Japan
| | - Masanori Matsukawa
- Department of Urology, Takikawa Municipal Hospital, Takikawa, Hokkaido, Japan
| | - Musashi Tobe
- Department of Urology, Sanjukai Hospital, Sapporo, Hokkaido, Japan
| | - Kazunori Haga
- Department of Urology, Sanjukai Hospital, Sapporo, Hokkaido, Japan
| | - Kousuke Uchida
- Department of Urology, Sanjukai Hospital, Sapporo, Hokkaido, Japan
| | - Ichiya Honma
- Department of Urology, Sanjukai Hospital, Sapporo, Hokkaido, Japan
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The relationship between acquired premature ejaculation and metabolic syndrome: a prospective, comparative study. Int J Impot Res 2017; 29:105-109. [PMID: 28179637 DOI: 10.1038/ijir.2017.3] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2016] [Revised: 11/07/2016] [Accepted: 01/04/2017] [Indexed: 02/08/2023]
Abstract
The aim of this study was to investigate the relationship between metabolic syndrome (MetS) and acquired premature ejaculation (PE). A total of 100 patients with acquired PE and 100 control cases were enrolled in the study. After obtaining a detailed medical history, anthropometric (weight, height and waist circumference) and blood pressure measurements were performed. Ejaculation and erection functions were evaluated by Premature Ejaculation Diagnostic Tool (PEDT) and International Index of Erectile Function-5 (IIEF-5), respectively. Self-estimated intravaginal ejaculatory latency time (IELT) of the participants was recorded. Fasting blood samples were taken for biochemical and hormonal work-up. The median PEDT scores were 16 (9-22) and 4.5 (2-8) in acquired PE and control groups, respectively (P<0.001). The mean estimated IELT values in PE patients and controls were 36.1±46.5 versus 488.2±313.8 s (P<0.001). MetS was diagnosed in 51 patients (51%) in the PE group and 24 (24%) participants in the control group (P<0.001). A significant negative correlation was observed between the components of MetS and estimated IELT, except for diastolic blood pressure. Moreover, there was a significant positive correlation between the all components of MetS and total PEDT score, except for fasting blood glucose and high-density lipoprotein cholesterol (HDL) levels. Logistic regression analysis revealed that, except blood pressure and HDL levels, MetS components were significant risk factors for PE after adjusting for age and total testosterone. In conclusion, MetS is associated with acquired PE.
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Bhat GS, Shastry A. Use of a stopwatch to measure ejaculatory latency may not be accurate among Indian patients. Indian J Urol 2017; 33:300-303. [PMID: 29021654 PMCID: PMC5635671 DOI: 10.4103/iju.iju_56_17] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
INTRODUCTION Although the use of a stopwatch is recommended to record intravaginal ejaculatory latency time (IELT) for premature ejaculation, there is no Indian literature which assesses the reliability of this method among our patients. Hence, we assessed the accuracy of stopwatch-measured IELT and compared it with other methods such as number of thrusts and self-assessed IELT in an Indian context. METHODS Between January 2015 and December 2015, couples with premature ejaculation (PE) confirmed with the Premature Ejaculation Diagnostic Tool were enrolled in this study. They were asked to report self-assessed IELT for the first 2 weeks, number of thrusts before ejaculation following vaginal penetration for the next 2 weeks, and stopwatch-clocked IELT for the last 2 weeks. At each 2-week interval, the couples answered erectile/ejaculatory performance anxiety index questionnaire (EPAI). The data were analyzed at the end of 6 weeks. RESULTS A total of 42 couples with an average married life of 5.53 years were included in the study. Average stopwatch-clocked IELT was almost 1 min more than the self-reported IELT, which was statistically significant. The average number of thrusts reported was 6.31. Anxiety on the EPAI scale was maximum while using stopwatch to measure IELT. CONCLUSION Use of stopwatch to clock the IELT does not appear to represent true IELT in Indian patients. Self-assessed IELT correlated more accurately with symptoms of PE.
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Affiliation(s)
- Gajanan Shripad Bhat
- Department of Urology, General Hospital, Honavar, Uttara Kannada, Karnataka, India
| | - Anuradha Shastry
- Department of Urology, T.S.S Shripad Hegde Kadave Institute of Medical Sciences, Sirsi, Uttara Kannada, Karnataka, India
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