1
|
Rowland DL, Tamas S, Hevesi K. Updating, correcting, and calibrating the narrative about premature ejaculation. Sex Med Rev 2024:qeae036. [PMID: 38798049 DOI: 10.1093/sxmrev/qeae036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2024] [Revised: 04/20/2024] [Accepted: 05/06/2024] [Indexed: 05/29/2024]
Abstract
INTRODUCTION The narrative surrounding premature ejaculation (PE) has developed and solidified over the past 25 years. Unfortunately, portions of that narrative are outdated and do not reflect more recent conceptualizations or empirical findings regarding this disorder. OBJECTIVE In this review we sought to identify existing narratives about PE in need of updating and to provide revised narratives based on the recent research literature. METHOD Five PE narratives in need of revision were identified, including: the prevalence of PE, age-related differences in PE prevalence, a validated ejaculation latency (EL) for diagnosing PE, differences between lifelong and acquired PE subtypes, and the application of PE definitions beyond penile-vaginal intercourse. Extensive literature searches provided information supporting both the original narrative and the need for a revised narrative based on both consideration of more recent studies and reinterpretation of studies conducted since the establishment of the original narratives. RESULTS For each selected topic, the prevailing narrative based on the extant literature was first presented, followed by discussion of accumulating evidence that challenges the existing narrative. Each section ends with a suggested revised PE narrative. In 2 instances, the revised narrative required significant corrections (eg, PE prevalence, validated EL for diagnosing PE); in 2 instances, it expanded on the existing narrative (eg, PE subtype differences, inclusion of partnered sexual activities beyond penile-vaginal intercourse); and in 2 other instances, it backed off prior conclusions that have since required rethinking (eg, age-related changes in PE, PE subtype differences). Finally, a brief review of the 3-pronged criteria for PE (EL, ejaculatory control, and bother/distress) is presented and discussed. CONCLUSION This review reiterates the dynamic state of research on PE and demonstrates the need for and value of ongoing research that not only addresses new issues surrounding this dysfunction but also challenges and revises some of the existing narratives about PE.
Collapse
Affiliation(s)
- David L Rowland
- Department of Psychology, Valparaiso University, Valparaiso, IN 46383, United States
| | - Stella Tamas
- Institute of Psychology, Eötvös Loránd University, Budapest 1075, Hungary
| | - Krisztina Hevesi
- Institute of Psychology, Eötvös Loránd University, Budapest 1075, Hungary
| |
Collapse
|
2
|
Niu C, Wen G, Ventus D, Jern P, Nyman TJ, Li Y, Santtila P. High-intensity interval training (HIIT) and slow breathing interventions alleviate premature ejaculation (PE) symptoms. Int J Clin Health Psychol 2024; 24:100457. [PMID: 38623145 PMCID: PMC11017278 DOI: 10.1016/j.ijchp.2024.100457] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2024] [Accepted: 04/02/2024] [Indexed: 04/17/2024] Open
Abstract
Background Physical exercise may alleviate premature ejaculation symptoms, a prevalent male sexual dysfunction linked to a series of negative outcomes for men and their partners. Objective We investigated the effectiveness of high-intensity interval training (HIIT) and slow breathing interventions on premature ejaculation symptoms and their relation to autonomic activity and attention regulation. Method Chinese adult men (N = 76, M = 21.89, SD = 3.32) with premature ejaculation completed one of the two-week interventions in their homes or as participants in a normal breathing control group; they reported their age, height, weight, physical activity level, premature ejaculation symptoms, and attention regulation. In the HIIT group, 26 participants engaged in a 7-minute HIIT each day. In the slow breathing group, 25 participants performed 7-minute slow breathing exercises per day while the 25 participants in the normal breathing group similarly performed normal breathing exercises. All participants measured their heart rate once before and five times (with one-minute intervals) after the intervention. When participants had penile-vaginal sex with their partners, they measured their heart rate once after ejaculation. Results Time × Intervention interaction was significant with lower levels of premature ejaculation symptoms on Days 12, 13, and 14 in the HIIT group (M ± SD = 16.19 ± 3.45, 15.96 ± 3.43, and 15.15 ± 3.62) compared to the normal breathing group (M ± SD = 17.68 ± 3.06, 17.68 ± 3.15, and 17.44 ± 3.25). Higher levels of attention regulation were associated with fewer premature ejaculation symptoms. We also found that a larger increase in heart rate from resting to after sex was associated with fewer premature ejaculation symptoms. Conclusion Compared to the control group, the efficacy of two weeks of HIIT exercise in mitigating PE symptoms suggests its potential as a novel treatment for PE.
Collapse
Affiliation(s)
- Caoyuan Niu
- School of Psychology and Cognitive Science, East China Normal University, Shanghai, People's Republic of China
- Faculty of Arts and Sciences, NYU Shanghai, Shanghai, People's Republic of China
| | - Guangju Wen
- Faculty of Arts and Sciences, NYU Shanghai, Shanghai, People's Republic of China
| | - Daniel Ventus
- Experience Lab, Faculty of Education and Welfare Studies, Åbo Akademi University, Vasa, Finland
| | - Patrick Jern
- Department of Psychology, Faculty of Arts, Psychology and Theology, Åbo Akademi University, Turku, Finland
| | - Thomas J. Nyman
- Faculty of Arts and Sciences, NYU Shanghai, Shanghai, People's Republic of China
| | - Yansong Li
- Reward, Competition, and Social Neuroscience Lab, Department of Psychology, School of Social and Behavioral Sciences, Nanjing University, Nanjing, People's Republic of China
- Department of Radiology, The Affiliated Drum Tower Hospital, Nanjing University Medical School, Nanjing, People's Republic of China
- Institute for Brain Sciences, Nanjing University, Nanjing, People's Republic of China
| | - Pekka Santtila
- School of Psychology and Cognitive Science, East China Normal University, Shanghai, People's Republic of China
- Faculty of Arts and Sciences, NYU Shanghai, Shanghai, People's Republic of China
| |
Collapse
|
3
|
Rowland DL, Kövi Z, Tamas S, Hevesi K. Do Ejaculation Latency and Other Sexual Measures Differ Between Men With Lifelong and Acquired Premature Ejaculation? Urology 2024; 184:112-121. [PMID: 37926381 DOI: 10.1016/j.urology.2023.09.055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2023] [Revised: 08/30/2023] [Accepted: 09/08/2023] [Indexed: 11/07/2023]
Abstract
OBJECTIVE To determine whether men with lifelong vs acquired premature ejaculation (PE) subtypes differ on their estimated ejaculation latencies (EL) and related sexual, relationship, and behavioral parameters. METHODS Of 2679 men who responded to an online multinational survey about sexual health and met inclusion criteria, 540 reported "probable" or "definite" PE, as assessed by the Premature Ejaculation Diagnostic Tool. Lifelong and acquired PE subtypes were compared on multiple measures related to EL, as well as on sets of demographic, diagnostic, relationship, sexual behavioral, and sexual functioning measures during both partnered sex and masturbation. RESULTS Nearly 73% of men with PE in this sample reported the lifelong subtype. No differences emerged in EL measures between subtypes, even when parsed according to age. Specifically, men 37years or under with either definite lifelong or acquired PE reported ELs of 1.9 minutes (SD=1.3). For men over 37, lifelong ELs were 2.0 minutes (SD=1.3), acquired ELs 2.4 minutes (SD=1.4). While the lifelong subgroup was younger and reported lower erectile functioning, these differences occurred only in the probable PE group and not the definite PE group. CONCLUSION Our data do not support different EL criteria for men with acquired vs lifelong PE, as suggested by several professional definitions. Furthermore, differences in age and erectile functioning between the groups, often reported in clinical samples though not in our definite PE group, may be an artifact of the general health/patient characteristics that lead such men to seek medical assistance.
Collapse
Affiliation(s)
- David L Rowland
- Department of Psychology, Valparaiso University, Valparaiso, IN.
| | - Zsuzsanna Kövi
- Institute of Psychology, Károli Gáspár University of the Reformed Church, Budapest, Hungary
| | - Stella Tamas
- Institute of Psychology, Eötvös Loránd University, Budapest, Hungary
| | - Krisztina Hevesi
- Institute of Psychology, Eötvös Loránd University, Budapest, Hungary
| |
Collapse
|
4
|
Niu C, Santtila P. Effects of physical exercise interventions on ejaculation control. Sex Med Rev 2023; 12:106-113. [PMID: 37786366 DOI: 10.1093/sxmrev/qead042] [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: 07/24/2023] [Revised: 08/21/2023] [Accepted: 09/12/2023] [Indexed: 10/04/2023]
Abstract
INTRODUCTION Premature ejaculation is a prevalent male sexual dysfunction that causes significant distress for men and their partners on a global scale. Despite its widespread impact, effective treatment options without undesirable side effects remain limited. OBJECTIVES The present review aimed to provide an overview of experimental studies that analyzed the effects of physical exercise interventions on premature ejaculation. METHODS The inclusion criteria for the review included: Population: Adult men. Intervention: An intervention designed to increase physical exercise was delivered in the study. Comparison: Before versus after intervention with or without a comparison group receiving a drug treatment or an active or no control intervention. Outcomes: Self-reported or clinician-rated premature ejaculation or its symptoms. Study type: Experimental designs. We conducted the search process in 9 databases: APA PsycNET, PubMed, Scopus, SPORTDiscus, JSTOR, ScienceDirect, Web of Science, Embase, and CAB Direct. This review included six intervention studies that included 433 participants (307 men with premature ejaculation) ranging from 18 to 50 years of age. All participants had a stable female sexual partner and had not any other physical or mental problems. RESULTS The synthesized results indicated that yoga, running, and high-intensity interval training alleviate premature ejaculation symptoms in men with premature ejaculation after varying intervention duration times. The effectiveness of physical exercise for premature ejaculation symptoms was similar to that of drug treatments. CONCLUSION Physical exercise can be one of the potential treatment modalities for premature ejaculation. The intensity of physical exercise and the effort of participants during exercise are key factors affecting improvements in ejaculation control. A potential limitation was that the review did not include any literature written in non-English languages.
Collapse
Affiliation(s)
- Caoyuan Niu
- School of Psychology and Cognitive Science, East China Normal University, Shanghai 200062, People's Republic of China
- Faculty of Arts and Sciences, NYU Shanghai, Shanghai 200126, People's Republic of China
| | - Pekka Santtila
- School of Psychology and Cognitive Science, East China Normal University, Shanghai 200062, People's Republic of China
- Faculty of Arts and Sciences, NYU Shanghai, Shanghai 200126, People's Republic of China
| |
Collapse
|
5
|
Mainwaring JM, Lee TK, Wassersug RJ, Wibowo E. Scales for Assessing Male Sexual Function are not Entirely Applicable to Gay and Bisexual Men with Prostate Cancer. Urol Clin North Am 2023; 50:549-561. [PMID: 37775214 DOI: 10.1016/j.ucl.2023.06.015] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/01/2023]
Abstract
Scales designed for assessing male sexual function may not be suitable for men of all sexual orientations. We reviewed frequently used sexual function scales and examined the item content and documentation of validation. These scales predominantly focus on general sexual function and erection. They lack questions on behaviors relevant to men-who-have-sex-with-men (MSM), such as anal sex, masturbation, or sexual activities outside of committed relationships. Additionally, the validation samples rarely mention inclusion of MSM, revealing a clear gap in the clinical evaluation tools available for MSM, who are experiencing sexual dysfunction from prostate cancer treatment side effects.
Collapse
Affiliation(s)
| | | | - Richard J Wassersug
- Department of Cellular and Physiological Sciences, University of British Columbia, Vancouver, Canada
| | - Erik Wibowo
- Department of Anatomy, University of Otago, Dunedin, New Zealand.
| |
Collapse
|
6
|
Description of and Relationships among Potential Variables Supported for the Diagnosis of Delayed Ejaculation. SEXES 2023. [DOI: 10.3390/sexes4010005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023] Open
Abstract
The lack of empirically based diagnostic criteria for delayed ejaculation (DE) not only undermines confidence in the reported prevalence rates for this sexual dysfunction, but it has also resulted in a lack of validated patient reported outcomes (PROs) for assessing this condition. The current study was designed to describe and evaluate six face-valid variables previously shown to discriminate between men with and without DE for their utility as diagnostic measures for DE. A sample of 1285 men (mean age = 37.8, SD = 12.7) free of erectile problems and premature ejaculation completed an online sexual health survey that included potential questions intended for use in the diagnosis of DE. Questionnaire items included ones reflective of previously proposed diagnostic constructs related to DE: ejaculation timing/latency, ejaculation efficacy/control, and negative effects of DE. Results indicated that five of the six proposed items showed moderate intercorrelations, suggesting that each constituted a distinct (i.e., non-redundant) though relevant criterion related to the diagnosis of DE. Based on the level of interrelatedness, the better items representing each construct were included in commonality analysis to assess their unique contributions to the diagnosis of DE. Perceived lack of ejaculatory efficacy/control contributed the largest portion of the variance to the diagnosis of DE (58%), with bother/distress (an index of the negative effects of DE) contributing the second largest portion (25%), and ejaculation timing/latency contributing only a small portion of the variance (6%) to the diagnosis of DE. The relevance of these findings to developing a patient report outcome (PRO) for diagnosing DE that considers both empirically supported questions/items and an appropriate balance of items regarding the three constructs was discussed.
Collapse
|
7
|
Niu C, Ventus D, Jern P, Santtila P. Premature ejaculation among Chinese urban men: prevalence and correlates. Sex Med 2023; 11:qfac015. [PMID: 37007854 PMCID: PMC10065173 DOI: 10.1093/sexmed/qfac015] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2022] [Revised: 11/13/2022] [Accepted: 11/23/2022] [Indexed: 01/15/2023] Open
Abstract
Abstract
Background
Premature ejaculation (PE) is a common male sexual dysfunction worldwide. It leads to substantial distress in men and their partners, constitutes a serious threat to the quality and stability of romantic relationships, and results in a decreased quality of life in a large part of the population.
Aim
We investigated the prevalence of PE and correlated factors in an urban sample of Chinese men.
Methods
In total, 1976 Chinese men aged 18 to 50 years responded to an online questionnaire regarding background information, present and previous sexual experience, frequency of different types of sex, as well as erectile and ejaculatory function.
Outcomes
Participants’ age, assigned sex at birth, sexual identity, relationship status, present and previous sexual experience, frequency of sexual activities, International Index of Erectile Function–5, and Checklist for Early Ejaculation Symptoms were used in the analyses.
Results
Forty-four (2.3%) participants had scores that were indicative or strongly indicative of PE, which was highly correlated with erectile problems. Men with more sexual experience (ie, more sexual partners and longer duration of being sexually active) had fewer ejaculatory problems. More frequent masturbation was associated with ejaculatory problems when controlling for age and education. More frequent partnered sex (ie, penile-vaginal sex) was associated with fewer ejaculatory problems. Ejaculation latency times for different types of sexual activities were positively correlated.
Clinical Translation
The results indicated that ejaculatory problems have complex relationships with sexual experience that clinicians should be aware of.
Strengths and Limitations
This study was the first to investigate PE with the Checklist for Early Ejaculation Symptoms as the measurement tool and the associations between PE and sexual experience, frequency of sexual activities, and sexual function in a large Chinese sample. However, self-reported ejaculation latency times may suffer from problems with validity.
Conclusion
Men’s sexual experience (ie, more sexual partners and longer duration of being sexually active) has an effect on their sexual function, which in turn affects their sexual activity.
Collapse
Affiliation(s)
- Caoyuan Niu
- East China Normal University School of Psychology and Cognitive Science, , Shanghai 200062, People’s Republic of China
- Faculty of Arts and Sciences, NYU Shanghai , Shanghai 200122, People’s Republic of China
| | - Daniel Ventus
- Åbo Akademi University Experience Lab, Faculty of Education and Welfare Studies, , Turku FI-20500 , Finland
| | - Patrick Jern
- Faculty of Arts, Psychology and Theology, Åbo Akademi University , Turku FI-20500 , Finland
| | - Pekka Santtila
- East China Normal University School of Psychology and Cognitive Science, , Shanghai 200062, People’s Republic of China
- Faculty of Arts and Sciences, NYU Shanghai , Shanghai 200122, People’s Republic of China
| |
Collapse
|
8
|
Rowland DL, McNabney SM, Hevesi K. Does Bother/Distress Contribute to the Diagnosis of Premature Ejaculation? Sex Med 2022; 10:100548. [PMID: 35952615 PMCID: PMC9537260 DOI: 10.1016/j.esxm.2022.100548] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2022] [Revised: 06/29/2022] [Accepted: 07/06/2022] [Indexed: 11/25/2022] Open
Abstract
Introduction The role of bother/distress in the diagnosis of premature ejaculation (PE) has received minimal investigation compared with the 2 other diagnostic criteria, ejaculatory control and ejaculatory latency (EL). Aim This study assessed (i) the added variance explained by bother/distress to the diagnostic accuracy of PE and (ii) determined its overall contribution to a PE diagnosis. Methods The 3 diagnostic criteria for PE were assessed in 2,589 men (mean age = 38.2 years, SD = 13.5) in order to determine the contribution of each factor to a dysfunctional diagnosis. A series of regression and discriminant analyses were used to assess the value of bother/distress in explaining ejaculatory control and in predicting accuracy of PE group status. Commonality analysis was used to determine the relative contribution of each of these factors to the diagnosis of PE. Main Outcome Measure The major outcome was the quantified contribution of “bother/distress” to a PE diagnosis. Results Bother/distress accounted for about 3–4% of the variation in ejaculatory control and added only minimally to the prediction accuracy of PE group status (no, probable, definite PE). Commonality analysis indicated that bother/distress comprised about 3.6% of the unique explained variation in the PE diagnosis, compared with ejaculatory control and EL which contributed 54.5% and 26.7%, respectively. Common variance among factors contributed the remaining 15.5% to the PE diagnosis. Clinical Translation Bother/distress contributes least to the determination of a PE diagnosis. Its contribution is largely redundant with the unique and combined contributions of ejaculatory control and EL. Strengths and Limitations Using a well-powered and multivariate analysis, this study parsed out the relative contributions of the 3 diagnostic criteria to a PE diagnosis. The study is limited by its use of estimated EL, a single item assessment of bother/distress, and the lack of differentiation of PE subtypes, lifelong and acquired. Conclusion Bother/distress contributes minimally to the PE diagnosis, yet its assessment may be key to understanding the experiences of the patient/couple and to developing an effective treatment strategy. Rowland DL, McNabney SM, Hevesi K. Does Bother/Distress Contribute to the Diagnosis of Premature Ejaculation?. Sex Med 2022;10:100548.
Collapse
Affiliation(s)
- David L Rowland
- Department of Psychology, Valparaiso University, Valparaiso, IN, USA.
| | - Sean M McNabney
- Department of Psychology, Valparaiso University, Valparaiso, IN, USA; Department of Applied Health Science, School of Public Health, Indiana University, Bloomington, IN, USA
| | - Krisztina Hevesi
- Institute of Psychology, Eötvös Loránd University, Budapest, Hungary
| |
Collapse
|
9
|
The Tenuous Role of Distress in the Diagnosis of Premature Ejaculation: A Narrative Review. Sex Med 2022; 10:100546. [PMID: 35905650 PMCID: PMC9537272 DOI: 10.1016/j.esxm.2022.100546] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2022] [Revised: 06/22/2022] [Accepted: 06/23/2022] [Indexed: 11/20/2022] Open
Abstract
BACKGROUND Unlike the other 2 criteria for diagnosing premature ejaculation (PE), namely lack of ejaculatory control and short ejaculation latency (EL), the role of bother/distress has received only minimal consideration and investigation. AIM The specific aim was to determine both why distress is included in the PE diagnosis and whether such inclusion is advantageous to achieving better diagnostic outcomes. To this end, the review explored the historical and theoretical underpinnings of the inclusion of "bother/ distress" in the diagnosis of PE, with reference to the larger role that distress has played in the diagnosis of mental disorders, in an attempt to understand the utility (or lack thereof) of this construct in making a PE diagnosis. METHODS We reviewed the role of bother/distress across current professional definitions for PE and then expanded this discussion to include the role of distress in other sexual dysfunctions. We then included a brief historical perspective regarding the role that distress has played in the diagnosis of PE. This discussion is followed by a deeper look at 2 nosological systems, namely DSM and ICD, to allow perspective on the inclusion of the bother/distress construct in the diagnosis of mental and behavioral disorders, including the assumptions/arguments put forward to include or exclude bother/distress as an important criterion underlying various professional assumptions. OUTCOME Determination of the value and/or need of including bother/distress as a necessary criterion for the diagnosis of PE. RESULTS Based on the research literature, bother/distress does not appear to be as critical for a PE diagnosis as either the lack of ejaculatory control or short EL. It is the weakest of the differences among men with and without PE, and recent evidence suggests that its inclusion is generally redundant with the severity of the 2 other criteria for PE, ejaculatory control and EL. CLINICAL TRANSLATION Bother/distress appears to serve little purpose in the diagnosis of PE yet its assessment may be important for the treatment strategy and for assessing treatment effectiveness. STRENGTHS AND LIMITATIONS This review did not provide a critical analysis of the literature regarding the role of bother/distress in PE, but rather focused on its potential value in understanding and diagnosing PE. CONCLUSION Although bother/distress appears to add little to the improvement of accuracy for a PE diagnosis, understanding and assessing the man's or couple's experience of distress has important implications for the treatment strategy and focus, as well as for assessing treatment success. Rowland DL, Cooper SE. The Tenuous Role of Distress in the Diagnosis of Premature Ejaculation: A Narrative Review. Sex Med 2022;XX:XXXXXX.
Collapse
|
10
|
Bhat GS, Shastry A. Validation of holding time, a novel tool to assess control over ejaculation in males: A pilot study. Andrologia 2022; 54:e14509. [PMID: 35746895 DOI: 10.1111/and.14509] [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: 04/28/2022] [Revised: 05/30/2022] [Accepted: 06/01/2022] [Indexed: 11/30/2022] Open
Abstract
Premature ejaculation (PE) is considered as a disorder of perceived loss of ejaculatory control. However, we cannot objectively estimate ejaculatory control due to the absence of an objective tool to measure it. Hence, we designed a pilot study to validate holding time (HoT), a novel objective tool, hypothesized by us, to measure ejaculatory control in men. The construct validity of this tool to differentiate premature ejaculators from normal ejaculators was also assessed in our sample. The study sample had 10 healthy, sexually active normal ejaculators, and 10 premature ejaculators, who volunteered to participate in the study conducted from May 2020 to April 2021. The mean HoT in normal ejaculators was 120.2 ± 31.7 s and the same in premature ejaculators was 32.9 ± 12.9 s. Both the normal (r = 0.983) as well as premature ejaculators (r = 0.839) had good test-retest reliability. The construct validity of HoT to diagnose PE was good with 90% sensitivity, 91% specificity, 63.8% positive predictive value, and 98.1% negative predictive value to diagnose PE when compared with diagnosis by a standard tool. It could be concluded that HoT successfully measured ejaculatory control in men and differentiated normal ejaculators from the premature ejaculators in the sample studied.
Collapse
Affiliation(s)
- Gajanan S Bhat
- Department of Urology, Andrology and Sexual Medicine, TSS Shripad Hegde Kadave Institute of Medical Sciences, Sirsi, Karnataka, India
| | - Anuradha Shastry
- Department of Urology and Sexual Medicine, TSS Shripad Hegde Kadave Institute of Medical Sciences, Sirsi, Karnataka, India
| |
Collapse
|
11
|
Wang C, Zhang H, Liu Z, Tu X, Zhang Y. A Modified Procedure to Diagnose Erectile Dysfunction Using the International Index of Erectile Function (IIEF-6) Combined With the Premature Ejaculation Diagnosis Tool (PEDT) via an Internet Survey. Sex Med 2022; 10:100506. [PMID: 35378439 PMCID: PMC9177868 DOI: 10.1016/j.esxm.2022.100506] [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: 11/29/2021] [Revised: 02/15/2022] [Accepted: 02/25/2022] [Indexed: 10/25/2022] Open
|
12
|
Zhang C, Quan Y, Song Y, Bai W, Li Q, Xu T, Zhang X. Efficacy and safety assessment of glandular augmentation with hyaluronic acid for premature ejaculation. Andrologia 2022; 54:e14435. [PMID: 35523761 DOI: 10.1111/and.14435] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2021] [Revised: 02/21/2022] [Accepted: 03/30/2022] [Indexed: 12/13/2022] Open
Abstract
Glandular augmentation (GA) with hyaluronic acid (HA) is a newly developed, minimally invasive therapy for patients with premature ejaculation (PE); however, evidence supporting its efficacy is scarce. To provide a comprehensive profile of GA with HA gel in managing PE, 184 patients with PE who received GA with HA gel therapy from October 2017 to November 2019 were included and followed up for 1 year. The Fan technique was applied. Intravaginal Ejaculation Latency Time (IELT), Chinese Index of Premature Ejaculation-5(CIPE-5) and Visualised Satisfaction Index (VSI) of sexual experience were assessed at initial and 1-, 3-, 6- and 12-month post injection. A total of 71 patients with primary PE (pPE, 38.6%) and 113 patients with acquired PE (aPE, 61.4%) were enrolled. The mean IELT increased to 100.7 ± 43.2 s(p < .05) for pPE patients and 359.2 ± 87.1 s (p < .05) for aPE patients 1-month post injection and remained significantly higher at the end point with acceptable attenuation. The mean CIPE-5 score increased to 17.6 ± 6.4 (p < .05) in the 1st month and remained steady. The VSI scores increased to 6.6 ± 1.0 (p < .05) for patients with pPE and 7.7 ± 1.2 (p < .01) for patients with aPE. Increments in VSI in patients with aPE were significantly higher than those in patients with pPE (p < .01). No severe complications were noted. GA with HA may be an effective and safe method to treat PE. Patients with acquired PE were also more satisfied post treatment.
Collapse
Affiliation(s)
- Chunlong Zhang
- Department of Urology, Peking University People's Hospital, Beijing, China
| | - Yuan Quan
- Department of Urology, Peking University People's Hospital, Beijing, China
| | - Yuxuan Song
- Department of Urology, Peking University People's Hospital, Beijing, China
| | - Wenjun Bai
- Department of Urology, Peking University People's Hospital, Beijing, China
| | - Qing Li
- Department of Urology, Peking University People's Hospital, Beijing, China
| | - Tao Xu
- Department of Urology, Peking University People's Hospital, Beijing, China
| | - Xiaowei Zhang
- Department of Urology, Peking University People's Hospital, Beijing, China
| |
Collapse
|
13
|
Rowland DL, Teague LG, Hevesi K. Premature Ejaculation Measures During Partnered Sex and Masturbation: What These Findings Tell Us About the Nature and Rigidity of Premature Ejaculation. JOURNAL OF SEX & MARITAL THERAPY 2022; 48:680-693. [PMID: 35253608 DOI: 10.1080/0092623x.2022.2042442] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Men with premature ejaculation (PE) during partnered sex (as defined by poor ejaculatory control) show significantly reduced PE symptomology during masturbation, but the reasons for this disparity are not clear. This study investigated the other two PE-related diagnostic criteria, namely ejaculatory latency (EL) and bother/distress, in order to explore possible explanations for this disparity between types of sexual activity. Specifically, 1,447 men with either normal or poor ejaculatory control were compared on EL parameters, bother/distress, and sexual satisfaction/pleasure during both partnered sex and masturbation. Results indicated that men with PE reported longer ELs during masturbation than partnered sex, in contrast with men without PE who reported shorter ELs during masturbation. Bother/distress was lower for both groups during masturbation, but bother/distress in men with PE during masturbation was comparable to that of men without PE during partnered sex. Minimal difference in these patterns was found across lifelong and acquired PE subtypes, whereas men with PE with comorbid erectile dysfunction appeared to represent a distinct group. These findings have implications for PE management or treatment as well as for the overall conceptualization of PE as a pathophysiological condition.
Collapse
Affiliation(s)
- David L Rowland
- Department of Psychology, Valparaiso University, Valparaiso, IN, USA
| | - Lijana G Teague
- Department of Psychology, Valparaiso University, Valparaiso, IN, USA
| | - Krisztina Hevesi
- Institute of Psychology, Eötvös Loránd University, Budapest, Hungary
| |
Collapse
|
14
|
Haghighi M, Jahangard L, Meybodi AM, Shayganfard M, Ahmadpanah M, Faryadres M, Dürsteler KM, Brühl AB, Sadeghi-Bahmani D, Brand S. Influence of modafinil on early ejaculation - Results from a double-blind randomized clinical trial. J Psychiatr Res 2022; 146:264-271. [PMID: 34799125 DOI: 10.1016/j.jpsychires.2021.11.015] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/04/2021] [Revised: 10/16/2021] [Accepted: 11/05/2021] [Indexed: 10/19/2022]
Abstract
BACKGROUND For men, early ejaculation is a serious health concern. Here, we tested the influence of modafinil (Profinil®) on early ejaculation. To this end, we performed a double-blind randomized clinical trial among men with early ejaculation. METHODS A total of 46 men with early ejaculation (mean age: 37.35 years) and in stable marital relationships with regular weekly penile-vaginal intercourse were randomly assigned either to the modafinil (100 mg) or to the placebo condition. Compounds were taken about 4-6h before intended penile-vaginal intercourse. At baseline and four weeks later at the end of the study, participants completed a series of self-rating questionnaires covering early ejaculation. Female partners also rated their male partners' early ejaculation profile. RESULTS Dimensions of early ejaculation improved over time, but only so in the modafinil condition, while no improvements were observed in the placebo condition. CONCLUSIONS Among male adults in stable marital relationships with regular weekly penile-vaginal intercourse modafinil improved dimensions of early ejaculation, always compared to placebo. Given the strong effect of modafinil on cognitive-executive processes, it is conceivable, that modafinil acted both via physiological and cognitive-executive pathways.
Collapse
Affiliation(s)
- Mohammad Haghighi
- Behavioral Disorder and Substance Abuses Research Center, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Leila Jahangard
- Behavioral Disorder and Substance Abuses Research Center, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Azadeh Mazahri Meybodi
- Taleghani Hospital Research Development Committee and Department of Psychiatry, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mehran Shayganfard
- Department of Psychiatry, Arak University of Medical Sciences, Arak, Iran
| | - Mohammad Ahmadpanah
- Behavioral Disorder and Substance Abuses Research Center, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Mohammad Faryadres
- Department of Biostatistics and Epidemiology, School of Public Health, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Kenneth M Dürsteler
- Psychiatric Clinics, Division of Substance Use Disorders, University of Basel, 4002, Basel, Switzerland; Center for Addictive Disorders, Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich, 8001, Zurich, Switzerland
| | - Annette Beatrix Brühl
- Center for Affective, Stress and Sleep Disorders (ZASS), Psychiatric University Hospital Basel, 4002, Basel, Switzerland
| | - Dena Sadeghi-Bahmani
- Center for Affective, Stress and Sleep Disorders (ZASS), Psychiatric University Hospital Basel, 4002, Basel, Switzerland; Department of Psychology, Stanford University, Stanford, CA, USA; Sleep Disorders Research Center, Kermanshah University of Medical Sciences, Kermanshah, 67146, Iran
| | - Serge Brand
- Center for Affective, Stress and Sleep Disorders (ZASS), Psychiatric University Hospital Basel, 4002, Basel, Switzerland; Sleep Disorders Research Center, Kermanshah University of Medical Sciences, Kermanshah, 67146, Iran; Substance Abuse Prevention Research Center, Health Institute, Kermanshah University of Medical Sciences, Kermanshah, 67146, Iran; Department of Sport, Exercise and Health, Division of Sport Science and Psychosocial Health, University of Basel, 4052, Basel, Switzerland; School of Medicine, Tehran University of Medical Sciences, Tehran, 25529, Iran.
| |
Collapse
|
15
|
Rowland DL, Althof SE, McMahon CG. The Unfinished Business of Defining Premature Ejaculation: The Need for Targeted Research. Sex Med Rev 2022; 10:323-340. [PMID: 34996746 DOI: 10.1016/j.sxmr.2021.11.003] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2021] [Revised: 11/17/2021] [Accepted: 11/22/2021] [Indexed: 01/23/2023]
Abstract
INTRODUCTION Fifteen years have passed since the International Society of Sexual Medicine first established the 3-pronged criteria for premature ejaculation (PE): a short ejaculation latency, lack of ejaculatory control, and bother/distress. Although the process of establishing valid criteria for any condition or disorder is an ongoing one, a dearth of targeted research on these criteria has hindered professional societies from updating and revising them. OBJECTIVES To review and critique existing criteria used in the diagnosis of PE, to identify specific problems with them, and to recommend studies that will address shortcomings. METHODS Each of the PE criteria was evaluated and compared against standard procedures for establishing validated measures. Following each analysis, targeted research to address the gaps has been recommended. RESULTS Each PE criterion has shortcomings and each can be improved by using standard validation procedures, as noted by the targeted research outcomes. Professional societies can play an important role by encouraging broad participation in research that generates new and relevant data supporting, validating, or challenging the existing criteria. CONCLUSION The concepts underlying the diagnostic criteria for PE have both broad consensus and functional utility. Nevertheless, much of the research investigating PE has uncritically adopted these criteria without concomitantly recognizing their limitations. These limitations prevent determining accurate prevalence rates, interpreting research findings with confidence, and establishing efficacious treatment outcomes. Rowland DL, Althof SE, McMahon CG. The Unfinished Business of Defining Premature Ejaculation: The Need for Targeted Research. Sex Med Rev 2021;XX:XXX-XXX.
Collapse
Affiliation(s)
- David L Rowland
- Department of Psychology, Valparaiso University, Valparaiso, IN, USA.
| | - Stanley E Althof
- Center for Marital and Sexual Health of South Florida, Greenacres, FL, USA and Case Western Reserve School of Medicine, Cleveland, OH, USA
| | - Chris G McMahon
- Australian Centre for Sexual Health, St Leonards, New South Wales, Australia
| |
Collapse
|
16
|
Althof SE, McMahon CG, Rowland DL. Advances and Missteps in Diagnosing Premature Ejaculation: Analysis and Future Directions. J Sex Med 2022; 19:64-73. [PMID: 34895858 DOI: 10.1016/j.jsxm.2021.10.010] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2021] [Revised: 10/13/2021] [Accepted: 10/25/2021] [Indexed: 01/23/2023]
Abstract
BACKGROUND There are several problems with diagnostic criteria for premature ejaculation (PE) that lack objectivity, clarity and precision. They hamper accurate determination of PE prevalence estimates, investigations into the etiology of the dysfunction, impact on partners, development of validated Patient Reported Outcomes, regulatory authority oversight, and which men might benefit from specific treatment interventions. AIM We sought to review, analyze and comment on the evolution of the definitions of PE and offer suggestions for future directions for PE definitions. Our goal is to propose strategies whereby the criterion sets are useful to researchers, clinicians and governmental oversight agencies alike and bring harmony and scientific rigor among the conflicting and confusing definitions. METHODS There are several premature ejaculation definitions published in the peer reviewed medical literature. The PUBMED electronic database from 1970 to 2021 was searched for published definitions. Search terms included the medical subject headings of premature ejaculation, definition and diagnosis. In chronological order, Table 1 lists the various diagnosis and criteria sets for PE. We discuss the process by which constructs, which make up diagnostic criteria sets, are operationalized and validated. RESULTS We review definitions of PE beginning with Masters and Johnson's focus on partner orgasmic attainment and move through the nebulous and subjective criterion sets found in the early Diagnostic and Statistical Manuals and International Classification of Disease series, to the more evidenced-based definitions found in International Society of Sexual Medicine, Diagnostic and Statistical Manuals-5 and the American Urological Association (AUA) definitions. Additionally, we discuss how constructs and criteria sets have been adopted to minimize errors of inclusion and exclusion in defining disease/dysfunction. STRENGTHS AND LIMITATIONS This manuscript offers a careful chronological analysis of the published definitions of PE. This historical lens allows the reader to perceive the shifting science underlying the development of PE definitions. The manuscript is limited regarding our comments on acquired PE as evidenced-based research is incomplete. CONCLUSION Over the past 50 years there has been considerable forward momentum in defining PE based on well conducted scientific studies. We support the American Urological Association's modification in Intravaginal ejaculatory latency time to 2-minutes for lifelong PE, concur with the 11th revision of the International Classification of Diseases recommendation for changing the terminology from premature ejaculation to early ejaculation. We also recommend ongoing validation of definitions, moving away from the current heterosexist definition of PE based on penile-vaginal sex and urge further population based research into acquired PE to develop stronger evidenced-based criterion sets for this subtype.
Collapse
Affiliation(s)
- Stanley E Althof
- Case Western Reserve University School of Medicine, Cleveland, OH, USA
- Center for Marital and Sexual Health of South Florida, West Palm Beach, FL, USA
| | - Chris G McMahon
- Australian Centre for Sexual Health, St. Leonards, New South Wales, Australia
| | - David L Rowland
- Department of Psychology, Valparaiso University, Valparaiso, IN, USA
| |
Collapse
|
17
|
Xi Y, Zhang H, Colonnello E, Limoncin E, Jannini EA, Zhang Y. The masturbatory premature ejaculation diagnostic tool (MPEDT): A novel psychometric tool to evaluate premature ejaculation during masturbation. Andrology 2021; 10:333-339. [PMID: 34825515 DOI: 10.1111/andr.13125] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2021] [Revised: 10/19/2021] [Accepted: 11/02/2021] [Indexed: 02/03/2023]
Abstract
BACKGROUND Premature ejaculation (PE) is a highly prevalent male sexual dysfunction. Its current definition, together with the most used diagnostic tools, does not include nonvaginal sexual intercourse such as anal sex, self-masturbation and/or partnered-masturbation, and other forms of sexual stimulation. However, diagnostic psychometry currently available is exclusively evaluating PE in the vaginal coitus. OBJECTIVES To validate a new tool, the masturbatory premature ejaculation diagnostic tool (MPEDT), by assessing the control over ejaculation and its psychological effects during self-masturbation, rather than heterosexual vaginal intercourse. MATERIALS AND METHODS We studied 135 male patients aging from 18 to 40 years seeking medical care for PE in the Infertility and Sexual Medicine Department from June to September 2020. All the participants were asked to fill the premature ejaculation diagnostic tool PEDT and MPEDT questionnaires to estimate the PE symptoms during, respectively, intercourse and self-masturbation. The reliability/validity, the factor analysis of the tool, and the diagnostic sensitivity/specificity of MPEDT were calculated. RESULTS The overall Cronbach alpha was 0.884. In our adjusted model, both root mean square error of approximation (RMSEA) and standardized root mean square residual (SRMR) were lower than 0.08, while goodness of fit index, adjusted goodness of fit index, non-normed fit index (NNFI), and comparative fit index (CFI) were higher than 0.9. The area under the ROC curve (AUC) is 0.943 ± 0.015. The results suggest MPEDT points being ≤5 as "normal," ≥7 as "PE during self-masturbation," and 6 as "suspected PE," with the sensitivity of 91.9% and specificity of 88.1%. DISCUSSION An efficient diagnostic psychometric tool is needed for the individuals who, based on the impaired control over ejaculation during self-masturbation, may also suffer from PE during partnered intercourse. MPEDT is able to evaluate the existence of PE symptoms not necessarily during heterosexual intercourse but rather during self-masturbation, possibly aiding to the diagnosis, as well as planning and follow-up of a prompt therapeutical strategy. CONCLUSION MPEDT could be considered a new, objective, and reliable diagnostic tool for the evaluation of the existence of PE symptoms.
Collapse
Affiliation(s)
- Yu Xi
- Department of Infertility and Sexual Medicine, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Hui Zhang
- Department of Infertility and Sexual Medicine, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Elena Colonnello
- Chair of Endocrinology & Medical Sexology (ENDOSEX), Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy
| | - Erika Limoncin
- Chair of Endocrinology & Medical Sexology (ENDOSEX), Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy
| | - 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, Guangzhou, China
| |
Collapse
|
18
|
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.
Collapse
|
19
|
Haghighi M, Doostizadeh M, Jahangard L, Soltanian A, Faryadres M, Dürsteler KM, Beatrix Brühl A, Sadeghi-Bahmani D, Brand S. Influence of Lisdexamfetamine Dimesylate on Early Ejaculation-Results from a Double-Blind Randomized Clinical Trial. Healthcare (Basel) 2021; 9:859. [PMID: 34356237 PMCID: PMC8303163 DOI: 10.3390/healthcare9070859] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Revised: 06/27/2021] [Accepted: 06/30/2021] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Among male sexual dysfunctions, erectile dysfunction and early ejaculation have the highest prevalence rates. Here, we tested the influence of lisdexamfetamine dimesylate (Vyas®) on early ejaculation. To this end, we performed a double-blind randomized clinical trial among males with early ejaculation. METHODS A total of 46 males with early ejaculation (mean age: 35.23 years) and in stable marital relationships with regular weekly penile-vaginal intercourse were randomly assigned either to the lisdexamfetamine dimesylate condition (30 mg) or to the placebo condition. Compounds were taken about six hours before intended penile-vaginal intercourse. At baseline and four weeks later at the end of the study, participants completed a series of self-rating questionnaires covering early ejaculation. Female partners also rated participants' early ejaculation profile. RESULTS Compared to the placebo condition, dimensions of early ejaculation improved over time in the lisdexamfetamine condition, though improvements were also observed in the placebo condition. CONCLUSIONS Among male adults in stable marital relationships with regular weekly penile-vaginal intercourse, lisdexamfetamine dimesylate improved dimensions of early ejaculation. Given that improvements were also observed in the placebo condition, psychological factors such as increased attention to early ejaculation and favorable expectations of the compound should be considered.
Collapse
Affiliation(s)
- Mohammad Haghighi
- Behavioral Disorders and Substance Abuse Research Center, Hamadan University of Medical Sciences, Hamadan 6516848741, Iran; (M.H.); (M.D.); (L.J.)
| | - Mona Doostizadeh
- Behavioral Disorders and Substance Abuse Research Center, Hamadan University of Medical Sciences, Hamadan 6516848741, Iran; (M.H.); (M.D.); (L.J.)
| | - Leila Jahangard
- Behavioral Disorders and Substance Abuse Research Center, Hamadan University of Medical Sciences, Hamadan 6516848741, Iran; (M.H.); (M.D.); (L.J.)
| | - Alireza Soltanian
- Modeling of Non-Communicable Diseases Research Center, Hamadan University of Medical Sciences, Hamadan 6516848741, Iran;
- Department of Biostatistics and Epidemiology, School of Public Health, Hamadan University of Medical Sciences, Hamadan 6516848741, Iran;
| | - Mohammad Faryadres
- Department of Biostatistics and Epidemiology, School of Public Health, Hamadan University of Medical Sciences, Hamadan 6516848741, Iran;
| | - Kenneth M. Dürsteler
- Psychiatric Clinics, Division of Substance Use Disorders, University of Basel, 4002 Basel, Switzerland;
- Center for Addictive Disorders, Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich, 8001 Zurich, Switzerland
| | - Annette Beatrix Brühl
- Center for Affective, Stress and Sleep Disorders (ZASS), Psychiatric University Hospital Basel, 4002 Basel, Switzerland; (A.B.B.); (D.S.-B.)
| | - Dena Sadeghi-Bahmani
- Center for Affective, Stress and Sleep Disorders (ZASS), Psychiatric University Hospital Basel, 4002 Basel, Switzerland; (A.B.B.); (D.S.-B.)
- Sleep Disorders Research Center, Kermanshah University of Medical Sciences, Kermanshah 67146, Iran
- Department of Physical Therapy, University of Alabama at Birmingham, Birmingham, AL 35294, USA
- Substance Abuse Prevention Research Center, Health Institute, Kermanshah University of Medical Sciences, Kermanshah 67146, Iran
- Department of Psychology, Stanford University, Stanford, CA 94305, USA
| | - Serge Brand
- Center for Affective, Stress and Sleep Disorders (ZASS), Psychiatric University Hospital Basel, 4002 Basel, Switzerland; (A.B.B.); (D.S.-B.)
- Sleep Disorders Research Center, Kermanshah University of Medical Sciences, Kermanshah 67146, Iran
- Department of Physical Therapy, University of Alabama at Birmingham, Birmingham, AL 35294, USA
- Department of Sport, Exercise and Health, Division of Sport Science and Psychosocial Health, University of Basel, 4052 Basel, Switzerland
- School of Medicine, Tehran University of Medical Sciences, Tehran 25529, Iran
| |
Collapse
|
20
|
Banbury S, Moneta G, Chandler C. An exploratory study examining the relationship between sexual self efficacy and premature ejaculation mediated by depression, anxiety and sexual fantasy among a British cohort. SEXUAL AND RELATIONSHIP THERAPY 2021. [DOI: 10.1080/14681994.2021.1932796] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- Samantha Banbury
- Psychology Department, School of Social Sciences, London Metropolitan University, London, UK
| | - Giovanni Moneta
- Psychology Department, School of Social Sciences, London Metropolitan University, London, UK
| | - Chris Chandler
- Psychology Department, School of Social Sciences, London Metropolitan University, London, UK
| |
Collapse
|
21
|
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.
Collapse
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.
| |
Collapse
|
22
|
Yan K, Ju G, Tan Q, Zeng L, Qiu W. Bioequivalence Analysis of 2 Dapoxetine Hydrochloride Formulations in Healthy Chinese Male Volunteers Under Fed and Fasting Conditions: A Randomized, Open-Label, 2-Sequence, 2-Period, 2-Way Crossover Study. Clin Pharmacol Drug Dev 2021; 10:384-392. [PMID: 33385318 DOI: 10.1002/cpdd.866] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2020] [Accepted: 08/02/2020] [Indexed: 11/11/2022]
Abstract
This study assessed whether the reference and test formulations of dapoxetine hydrochloride were bioequivalent under fed and fasting conditions postadministration of a single dose as well as evaluated the safety profile of these 2 formulations. This study was a randomized, single-center, 2-period, open-label, 2-way crossover design study with a washout period of 7 days between each period. The study included 80 subjects, 40 under fed and 40 under fasting conditions. During each study period, the subjects were administered a single oral dose of either the reference or the test formulation, followed by collection of plasma samples 70 hours postdose. High-performance liquid chromatography-tandem mass spectrometry (HPLC-MS/MS) was performed to determine the concentrations of dapoxetine in plasma samples along with the calculation of Cmax , AUC0-t, and AUC0-inf . In addition, adverse events were monitored to determine the safety of these formulations. The geometric mean ratio (90%CI) for the reference and test formulations was 86% to 100%, 89% to 103%, and 89% to 103% under fasting conditions and 92% to 107%, 91% to 100%, and 92% to 101% under fed conditions for Cmax , AUC0-t , and AUC0-inf , respectively. The 90%CIs for the test/reference ratio for AUC and Cmax were within the acceptable limits of bioequivalence, thus demonstrating bioequivalence for these 2 dapoxetine hydrochloride formulations.
Collapse
Affiliation(s)
- Keyu Yan
- School of Pharmacy Lanzhou University, Lanzhou University, Lanzhou, PR China
| | - Gehang Ju
- School of Pharmacy Lanzhou University, Lanzhou University, Lanzhou, PR China
| | - Qiong Tan
- Jiangsu Lianhuan Pharmaceutical Co., Ltd., Jiangsu, PR China
| | - Lijiao Zeng
- Wuhan Hongren Biopharmaceutical Inc., Hubei, PR China
| | - Wen Qiu
- Phase I Clinical Unit, Lanzhou University Second Hospital, Lanzhou, Gansu, PR China
| |
Collapse
|
23
|
Diagnostic Criteria for Premature Ejaculation: Clarifying the Role of “Ejaculatory Control” and “Bother/Distress”. SEXES 2020. [DOI: 10.3390/sexes1010007] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
“Ejaculatory control” and “bother/distress” are key criteria for diagnosing men with premature ejaculation (PE), yet compared with ejaculatory latency (EL), these constructs have received only minimal attention. In addition, they have not been characterized in men having different sexual orientations or subtypes of PE. This study aimed to characterize relationships among ejaculatory control, bother/distress, and EL; to assess differences across men having different sexual orientations, PE status, and PE subtypes (i.e., lifelong vs. acquired); and to determine the importance of ejaculatory control to men’s sexual partners. In total, 1071 men and sexual partners of men rated their ejaculatory control and bother/distress and estimated their EL; these measures were compared across sexual orientation, PE status, PE subtype, and male and female partners of men. Results revealed a monotonic though slightly curvilinear relationship between ejaculatory control and bother/distress. These PE criteria differed significantly between PE and non-PE men, to a lesser extent between gay and straight men, and not at all between men having lifelong vs. acquired PE. Female and male partners of men affirmed the importance of ejaculatory control during partnered sex, indicating lack of control as a potential reason for ending a relationship.
Collapse
|
24
|
Ur Rehman MF, Imran Zaidi A, Ul Haq T, Rafique S, Ali F. Comparison of the Efficacy of Tramadol and Paroxetine in the Management of Premature Ejaculation. Cureus 2020; 12:e10725. [PMID: 33145131 PMCID: PMC7599037 DOI: 10.7759/cureus.10725] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Objective The goal of this study was to compare the efficacy of tramadol and paroxetine in the treatment of primary premature ejaculation (PE). Study design This study was a randomized controlled trial performed in the outpatient department of Nishtar Hospital, Multan, from January 2017 to January 2018. Methodology One hundred six patients were diagnosed with PE and included in the study. The patients were categorized into two groups receiving either tramadol or paroxetine through a lottery randomization method. The main variables were baseline PE, baseline satisfaction after intercourse, baseline intravaginal ejaculatory latency time (IELT), ejaculation control, difficulty in ejaculation, and after-treatment satisfaction with sexual intercourse and IELT. We used IBM SPSS Statistics for Windows, Version 23.0 (Armonk, NY: IBM Corp.) for data analysis, and p≤0.05 was considered statistically significant. Results Ejaculation control, difficulty in ejaculation, and distress due to ejaculation in patients in the tramadol group was noted as 24.5%, 7.5%, and 7.5%, respectively. Ejaculation control, difficulty in ejaculation, and distress due to ejaculation in the paroxetine group was noted as 49.1%, 17%, and 24.5%, respectively. The differences were statistically significant within the groups at baseline and after treatment of PE (p<0.001). Conclusion Tramadol is an effective and useful drug as compared to paroxetine for the treatment of PE. Tramadol can be used as an alternative to other medications for the treatment of lifelong PE.
Collapse
Affiliation(s)
| | | | - Tanveer Ul Haq
- Urology, Multan Institute of Kidney Diseases, Multan, PAK
| | - Shoaib Rafique
- Urology, Multan Institute of Kidney Diseases, Multan, PAK
| | - Farman Ali
- Internal Medicine, District Headquarter Hospital, Khanewal, PAK
| |
Collapse
|
25
|
Evaluating the Perceived Importance of Male Ejaculatory Function. Urology 2020; 147:162-166. [PMID: 32991911 DOI: 10.1016/j.urology.2020.09.020] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2020] [Revised: 08/16/2020] [Accepted: 09/04/2020] [Indexed: 11/21/2022]
Abstract
OBJECTIVE To assess the perceived importance of male ejaculatory function (EjF) from the perspective of adult men and their sexual partners. METHODS In a large survey study, men were asked about the importance of their own EjF. Sexual partners of men were asked about the general importance their partner's EjF, and whether they would support a partner's decision to pursue BPH treatment despite ejaculatory dysfunction. RESULTS One hundred and two men completed the survey section regarding their own EjF, and 100 participants completed the survey section assessing the importance of their male partner's EjF. While 55% of men agreed or strongly agreed that "ejaculation is an important part of an enjoyable sexual experience," only 30% of partners similarly agreed or strongly agreed (P = .005). A greater percentage of men (12%) agreed or strongly agreed that they "preferred large semen volume" compared to sexual partners of men (3%), however this was not significant. Sixty eight percent of sexual partners would agree or strongly agree to support their male partner's decision to pursue BPH treatment despite potential ejaculatory dysfunction. CONCLUSION The perceived importance of EjF differs between men and their sexual partners, as men believe ejaculation to be a more important component of an enjoyable sexual experience than their partners.
Collapse
|
26
|
Liu H, Zhang M, Huang M, Cai H, Zhang Y, Liu G, Deng C. Comparative efficacy and safety of drug treatment for premature ejaculation: A systemic review and Bayesian network meta-analysis. Andrologia 2020; 52:e13806. [PMID: 32892379 DOI: 10.1111/and.13806] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2020] [Revised: 07/17/2020] [Accepted: 07/26/2020] [Indexed: 11/29/2022] Open
Abstract
To assess the comparative efficacy and safety of drug treatments for premature ejaculation. A systemic review and Bayesian network meta-analysis were executed on randomised controlled trials of drug interventions for premature ejaculation. Intravaginal ejaculation latency time and related adverse effects were outcome measures. A total of 44 RCTs with 11,008 patients were included in our NMA. In therapy <8 weeks, the ranking of drug efficacy was topical creams >selective serotonin reuptake inhibitor (SSRI)+ phosphodiesterase 5 inhibitor (PDE5i) > PDE5i > sertraline > clomipramine > paroxetine > dapoxetine 60 milligram (mg) > dapoxetine 30 mg > fluoxetine>citalopram > duloxetine>placebo. In therapy ≥ 8 weeks, the ranking of drug efficacy was SSRI + PDE5i > topical creams > paroxetine > tramadol > PDE5i > fluoxetine > dapoxetine 60 mg > dapoxetine 30 mg > clomipramine>citalopram > placebo. For total adverse events, clomipramine, dapoxetine 30 mg, dapoxetine 60 mg, paroxetine, PDE5i, SSRI + PDE5i and tramadol had a higher risk than placebo. In conclusion, in ≥8 weeks of therapy, the drug combination of SSRI + PDE5i was the most effective PE therapy. In <8 weeks of therapy, the efficacy of local anaesthetics was best. All drug treatments were ranked better than placebo. In general, drugs with better effects had more obvious side effects.
Collapse
Affiliation(s)
- Hanchao Liu
- Department of Andrology, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Mingxiao Zhang
- Department of Urology, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Mingchuan Huang
- Department of Transplantation, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Hongcai Cai
- Department of Andrology, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Yadong Zhang
- Department of Andrology, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Guihua Liu
- Reproductive Medicine Center, the Sixth Affiliate Hospital of Sun Yat-sen University, Guangzhou, China
| | - Chunhua Deng
- Department of Andrology, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| |
Collapse
|
27
|
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.
Collapse
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
| |
Collapse
|
28
|
El-Hamd MA, Saleh R, Majzoub A. Premature ejaculation: an update on definition and pathophysiology. Asian J Androl 2020; 21:425-432. [PMID: 30860082 PMCID: PMC6732885 DOI: 10.4103/aja.aja_122_18] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
Premature ejaculation (PE) is the most common male sexual dysfunction, which represents a diagnostic as well as a therapeutic challenge for physicians. However, no universally accepted definition is currently available for PE. As a result, physicians continue to diagnose patients with PE according to major guidelines set by the professional societies. These guidelines either recommend the use of validated questionnaires or patient-reported outcomes. Recent efforts directed toward classifying PE may help provide a better understanding of the prevalence and risk factors of this disorder. While the exact etiology of PE has not been clearly elucidated, several risk factors have been strongly reported in the literature. Clearly, to understand the revised definition of PE, its etiology and pathophysiology is necessary to improve the clinical management of this medical condition and form the basis of future research in this regard. In this review, we highlight the past and current definitions of PE and present an appraisal on the classifications and theories suggested for the etiopathogenesis of PE.
Collapse
Affiliation(s)
- Mohammed Abu El-Hamd
- Department of Dermatology, Venereology and Andrology, Faculty of Medicine, Sohag University, Sohag 82749, Egypt
| | - Ramadan Saleh
- Department of Dermatology, Venereology and Andrology, Faculty of Medicine, Sohag University, Sohag 82749, Egypt
| | - Ahmad Majzoub
- Department of Urology, Hamad Medical Corporation and Weill Cornell Medicine-Qatar, Doha 00974, Qatar
| |
Collapse
|
29
|
Ventus D, Gunst A, Arver S, Dhejne C, Öberg KG, Zamore-Söderström E, Kärnä A, Jern P. Vibrator-Assisted Start-Stop Exercises Improve Premature Ejaculation Symptoms: A Randomized Controlled Trial. ARCHIVES OF SEXUAL BEHAVIOR 2020; 49:1559-1573. [PMID: 31741252 PMCID: PMC7300103 DOI: 10.1007/s10508-019-01520-0] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/06/2018] [Revised: 06/18/2019] [Accepted: 07/13/2019] [Indexed: 05/04/2023]
Abstract
Premature ejaculation (PE) is associated with decreased quality of life, lower confidence and self-esteem, and higher levels of depression, anxiety, and interpersonal difficulties. Here we investigated the effectiveness of vibrator-assisted start-stop exercises for treatment of PE, and whether the treatment effect could be enhanced by an additional psychobehavioral intervention. Fifty participants with a mean age of 41.7 years were included and randomized into two treatment groups and a waiting list control group. Participants were instructed to perform start-stop exercises while stimulating the penis with a purpose-made vibrator, 3 times a week for 6 weeks. Additionally, participants in one of the treatment groups received additional psychoeducation and performed mindfulness meditation-based body scan exercises three times a week. Data were gathered through online questionnaires before and after treatment, as well as 3 and 6 months after treatment. The interventions reduced PE symptoms with large effect sizes (partial η2 = .20 across the three groups, d [95% CI] = 1.05 [.27, 1.82] and 1.07 [.32, 1.82] for treatment groups compared to waiting list control group). The additional psychobehavioral intervention did not further reduce PE symptoms, but did decrease PE-associated negative symptoms such as levels of sexual distress, anxiety, and depression. No side effects were reported. Vibrator-assisted start-stop exercises can be offered as an adequate treatment option for PE.
Collapse
Affiliation(s)
- Daniel Ventus
- Department of Psychology, Åbo Akademi University, Fabriksgatan 2, 20500, Turku, Finland.
- Anova, Karolinska University Hospital, Stockholm, Sweden.
| | - Annika Gunst
- Department of Psychology, University of Turku, Turku, Finland
- Anova, Karolinska University Hospital, Stockholm, Sweden
| | - Stefan Arver
- Anova, Karolinska University Hospital, Stockholm, Sweden
- Department of Medicine, Huddinge, Karolinska Institutet, Stockholm, Sweden
| | - Cecilia Dhejne
- Anova, Karolinska University Hospital, Stockholm, Sweden
- Department of Medicine, Huddinge, Karolinska Institutet, Stockholm, Sweden
| | - Katarina G Öberg
- Anova, Karolinska University Hospital, Stockholm, Sweden
- Department of Medicine, Huddinge, Karolinska Institutet, Stockholm, Sweden
| | | | | | - Patrick Jern
- Department of Psychology, Åbo Akademi University, Fabriksgatan 2, 20500, Turku, Finland
- Department of Psychology, University of Turku, Turku, Finland
| |
Collapse
|
30
|
Wei S, Wu C, Yu B, Ma M, Qin F, Yuan J. Advantages and limitations of current premature ejaculation assessment and diagnostic methods: a review. Transl Androl Urol 2020; 9:743-757. [PMID: 32420180 PMCID: PMC7215025 DOI: 10.21037/tau.2019.12.08] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
Premature ejaculation (PE) is the most common male sexual dysfunction worldwide. Characteristic symptoms of PE are unexpected, rapid, complete ejaculation, which negatively impacts the sexual act for both sexual partners. Despite the existence of a definitive PE classification system and various diagnostic tools, diagnosing PE is still challenging due to the limitations associated with the assessment of this condition. Hence, it is necessary to review the diagnostic methods and processes of the physical examination that are currently performed in the medical setting. It is also important to analyze any controversial results of each main PE assessment method and propose novel diagnostic and assessment methods. To date, it is important to verify the accuracy of the PE evaluation method due to the ambiguity of previous definitions and proven invalidity of current examining techniques. Clinical diagnosis is based mainly on the patient history, patient-reported outcome scores, and diagnostic tools. Introduction of intravaginal ejaculatory latency time, penile biothesiometry, and the electrophysiological test provided objective means of evaluating PE. Due to the controversial and inconclusive findings in PE psychogenic and neurogenic etiology, utilizing a single parameter to describe and qualify PE using the aforementioned diagnostic methods provides valuable, but insufficient information for PE diagnosis. There is still a lack of a feasible and plausible means of objective measurement to evaluate the ejaculatory latency and control over ejaculation. Consequently, a comprehensive penile stimulation that simulates sexual intercourse could be useful to record intensity and duration parameters before the ejaculatory threshold, providing a more accurate method of describing and diagnosing PE versus a single chronological observation.
Collapse
Affiliation(s)
- Shanzun Wei
- The Andrology Laboratory, West China Hospital, Sichuan University, Chengdu 610041, China.,Department of Urology, West China Hospital, Sichuan University, Chengdu 610041, China
| | - Changjing Wu
- The Andrology Laboratory, West China Hospital, Sichuan University, Chengdu 610041, China
| | - Botao Yu
- The Andrology Laboratory, West China Hospital, Sichuan University, Chengdu 610041, China.,Department of Urology, West China Hospital, Sichuan University, Chengdu 610041, China
| | - Ming Ma
- The Andrology Laboratory, West China Hospital, Sichuan University, Chengdu 610041, China.,Department of Urology, West China Hospital, Sichuan University, Chengdu 610041, China
| | - Feng Qin
- The Andrology Laboratory, West China Hospital, Sichuan University, Chengdu 610041, China
| | - Jiuhong Yuan
- The Andrology Laboratory, West China Hospital, Sichuan University, Chengdu 610041, China.,Department of Urology, West China Hospital, Sichuan University, Chengdu 610041, China
| |
Collapse
|
31
|
Jern P, Sola IM, Ventus D. Do women's Relationship Satisfaction and Sexual Functioning Vary as a Function of Their Male Partners' Premature Ejaculation Symptoms? JOURNAL OF SEX & MARITAL THERAPY 2020; 46:630-638. [PMID: 32410522 DOI: 10.1080/0092623x.2020.1766612] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
The present study investigated how women's sexual functioning and relationship satisfaction are associated with their partner's premature ejaculation (PE) symptoms, and whether prevalence rates of PE differ when women report on their male partners compared to male self-report. The sample comprised of responses from 1,779 Finnish women (mean age 33.3 years) and a control group of 1,024 Finnish men. Women who reported that their male partners had symptoms of PE were less satisfied with their relationships, and reported lower levels of arousal, orgasm, satisfaction, lubrication, and pain, but not desire. Effect sizes of these associations were small. Men and women report similar base rates of PE, suggesting that on a population level prevalence estimates are remarkably similar irrespective of whether men report on PE symptoms themselves, or women report on their partners.
Collapse
Affiliation(s)
- Patrick Jern
- Department of Psychology, Åbo Akademi University, Turku, Finland
| | - Ida-Maria Sola
- Department of Psychology, Åbo Akademi University, Turku, Finland
| | - Daniel Ventus
- Department of Psychology, Åbo Akademi University, Turku, Finland
| |
Collapse
|
32
|
Sihotang RC, Alvonico T, Taher A, Birowo P, Rasyid N, Atmoko W. Premature ejaculation in patients with lower urinary tract symptoms: a systematic review. Int J Impot Res 2020; 33:516-524. [PMID: 32393845 DOI: 10.1038/s41443-020-0298-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2019] [Revised: 04/18/2020] [Accepted: 04/23/2020] [Indexed: 11/09/2022]
Abstract
Lower urinary tract symptoms (LUTS) refer to a group of symptoms related to bladder, prostate, and urethra. LUTS are common in men and the severity increases with age. LUTS are frequently associated with sexual dysfunction, such as premature ejaculation (PE), standing as the most common sexual dysfunction in men. Both LUTS and PE cause distress and dissatisfaction for the patient and his partner. This systematic review aims to determine the relationship between LUTS and PE in men. Two reviewers independently conduct a literature search in five online databases (PubMed, Scopus, Proquest, ClinicalKey, and ScienceDirect). In addition, reviewers also reviewed the reference list of chosen articles to identify additional relevant studies. Twelve articles were included in this systematic review that consists of one cohort study and 11 cross-sectional studies. The total scores of each identified study ranged from "poor" to "good." The prevalence of PE in LUTS ranged from 12 to 77%. Most of the studies showed a significant relationship between LUTS and PE. PE is more common in older age with the peak prevalence in age of 60-69 years old. There is a possible association between PE and LUTS. Further research using cohort or case-control study design on this topic is needed.
Collapse
Affiliation(s)
- Retta Catherina Sihotang
- Faculty of Medicine, Universitas Indonesia, No. 6, Salemba Raya Road, DKI Jakarta, 10430, Indonesia.
| | - Timotius Alvonico
- Faculty of Medicine, Universitas Indonesia, No. 6, Salemba Raya Road, DKI Jakarta, 10430, Indonesia
| | - Akmal Taher
- Department of Urology, Cipto Mangunkusumo National Hospital, Diponegoro Road, DKI Jakarta, 10430, Indonesia
| | - Ponco Birowo
- Department of Urology, Cipto Mangunkusumo National Hospital, Diponegoro Road, DKI Jakarta, 10430, Indonesia
| | - Nur Rasyid
- Department of Urology, Cipto Mangunkusumo National Hospital, Diponegoro Road, DKI Jakarta, 10430, Indonesia
| | - Widi Atmoko
- Department of Urology, Cipto Mangunkusumo National Hospital, Diponegoro Road, DKI Jakarta, 10430, Indonesia
| |
Collapse
|
33
|
Sexual Dysfunction and Psychopathological Variables Among Tramadol Abusers: An Egyptian Perspective. ADDICTIVE DISORDERS & THEIR TREATMENT 2020. [DOI: 10.1097/adt.0000000000000205] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
|
34
|
Liu SZ, Feng DC, Liu ZH, Liang JY, Ren ZJ, Zhou C, Wu K, Zhang FX, Zhang F, Lu YP, Wang XD. Development of nanotechnology in andrology. Transl Androl Urol 2020; 9:702-708. [PMID: 32420177 PMCID: PMC7214986 DOI: 10.21037/tau.2020.01.18] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
Since first introduced in 1980s, nanotechnology has always been the eye-catching point as its providing us with new approaches to explore the microscopic world. Many nanotechnology-associated novel technologies have been brought into clinical use in the past decades and uncountable patients benefited from them, which convinces us of a bright prospect of nanotechnology in the field of medicine. In this review, literatures concerning nanotechnology applications in andrology were retrieved and we made a comprehensive discussion on drug delivery, gene therapy and stem cell therapy use in andrology, which calls for the engagement of nanotechnology.
Collapse
Affiliation(s)
- Sheng-Zhuo Liu
- Department of Urology/Institute of Urology, West China Hospital, Sichuan University, Chengdu 610041, China
| | - De-Chao Feng
- Department of Urology/Institute of Urology, West China Hospital, Sichuan University, Chengdu 610041, China
| | - Zhi-Hong Liu
- Department of Urology/Institute of Urology, West China Hospital, Sichuan University, Chengdu 610041, China
| | - Jia-Yu Liang
- Department of Urology/Institute of Urology, West China Hospital, Sichuan University, Chengdu 610041, China
| | - Zheng-Ju Ren
- Department of Urology/Institute of Urology, West China Hospital, Sichuan University, Chengdu 610041, China
| | - Chuan Zhou
- Department of Urology/Institute of Urology, West China Hospital, Sichuan University, Chengdu 610041, China
| | - Kan Wu
- Department of Urology/Institute of Urology, West China Hospital, Sichuan University, Chengdu 610041, China
| | - Fu-Xun Zhang
- Department of Urology/Institute of Urology, West China Hospital, Sichuan University, Chengdu 610041, China
| | - Fan Zhang
- Department of Urology/Institute of Urology, West China Hospital, Sichuan University, Chengdu 610041, China
| | - Yi-Ping Lu
- Department of Urology/Institute of Urology, West China Hospital, Sichuan University, Chengdu 610041, China
| | - Xian-Ding Wang
- Department of Urology/Institute of Urology, West China Hospital, Sichuan University, Chengdu 610041, China
| |
Collapse
|
35
|
Hui J, Wang L, Liu R, Yang C, Zhang H, He S, Chen Z, Wei A. A bibliometric analysis of international publication trends in premature ejaculation research (2008-2018). Int J Impot Res 2020; 33:86-95. [PMID: 31896831 DOI: 10.1038/s41443-019-0224-x] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2019] [Revised: 10/22/2019] [Accepted: 12/17/2019] [Indexed: 01/13/2023]
Abstract
The incidence of premature ejaculation (PE) has been on the rise over the years. Thus, significant research efforts have been directed toward understanding the pathogenesis and hence treatment of PE. Here, we performed a comprehensive analysis of the worldwide trends in research outputs in the field of PE. This study investigated the universal findings of previous PE studies and the trending issues surrounding the condition. We employed the Web of Science Core Collection for data collection. The Excel (2016) and CiteSpace IV were used for information analysis. The information was categorized using journal names, institutions, research frontiers, citation reports, regions/countries, and authors. A sum of 886 publications concerning PE between 2008 and 2018 were identified as of July 6, 2019. The highest number of publications was identified in the Journal of Sexual Medicine published. The United States of America (USA) had the highest number of publications and H-index value. The highest co-citations were from Waldinger MD. The most common keyword was 'drug treatment'. A steady pattern was observed for PE publications done between the period of 2008-2018. Thus, the USA is at the forefront of research on PE research. The interesting advanced research frontiers were drug treatment, circumcision, and sertraline.
Collapse
Affiliation(s)
- Jialiang Hui
- Department of Urology, Nanfang Hospital, Southern Medical University, Guangzhou, 510515, China
| | - Li Wang
- Department of Urology, Nanfang Hospital, Southern Medical University, Guangzhou, 510515, China
| | - Ruiyu Liu
- Department of Urology, Nanfang Hospital, Southern Medical University, Guangzhou, 510515, China
| | - Changmou Yang
- Department of Urology, Nanfang Hospital, Southern Medical University, Guangzhou, 510515, China
| | - Haibo Zhang
- Department of Urology, Nanfang Hospital, Southern Medical University, Guangzhou, 510515, China
| | - Shuhua He
- Department of Urology, Nanfang Hospital, Southern Medical University, Guangzhou, 510515, China
| | - Zerong Chen
- Department of Urology, Nanfang Hospital, Southern Medical University, Guangzhou, 510515, China.
| | - Anyang Wei
- Department of Urology, Nanfang Hospital, Southern Medical University, Guangzhou, 510515, China.
| |
Collapse
|
36
|
Jenkins LC, Gonzalez J, Tal R, Guhring P, Parker M, Mulhall JP. Compliance With Fluoxetine Use in Men With Primary Premature Ejaculation. J Sex Med 2019; 16:1895-1899. [PMID: 31735615 DOI: 10.1016/j.jsxm.2019.09.017] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2019] [Revised: 09/16/2019] [Accepted: 09/24/2019] [Indexed: 01/23/2023]
Abstract
BACKGROUND Premature ejaculation (PE) is a common sexual dysfunction for which selective serotonin reuptake inhibitors (SSRIs) have been used effectively for treatment. However, compliance with therapy and predictors of long-term SSRI use in the treatment of PE are not well known. AIM To analyze our experience with drop-out rates with fluoxetine in the primary PE population and to identify predictors of continued use of this agent. METHODS Men with primary PE constituted who used fluoxetine and had at least 12 months follow-up constituted the study population. Subjects underwent a comprehensive interview to ascertain self-reported (non-stopwatch) intravaginal ejaculatory latency time (IELT), self-rated control over ejaculation, and personal and patient-reported partner distress due to PE. Patients were treated with fluoxetine 20 mg daily, with the possibility of dose titration up or down based on efficacy and side effects. OUTCOMES The PE parameters of interest included self-reported IELT, self-rated control over ejaculation, personal and partner distress due to PE, and medication adherence. RESULTS 130 men were included in the study. Dropout rates at 6 and 12 months were 56% and 72%. Self-rated "poor" ejaculatory control decreased from 98%-41% (P < .01), high personal distress from 47%-11% (P < .01), and high partner distress rates from 72%-27% (P < .01). Predictors of continued use at 12 months included high partner distress, being unpartnered, and having a post-treatment IELT ≥5 minutes (P < .01). Overall side effects included headache (5%), dizziness (4%), nausea (5%), nervousness (5%), and sleepiness (8%); however, moderate to severe side effects reported included nausea (2%), sleepiness (2%), headache (2%), and dizziness (2%). CLINICAL IMPLICATIONS Compliance with SSRIs is a well-described problem in the depression literature, but data are sparse regarding continued use of SSRIs in the treatment of PE. STRENGTHS AND LIMITATIONS We report on 12-month compliance with SSRIs for the treatment of PE. Our early compliance rates were more encouraging than what has been reported in the past. However, IELT was self-reported and not measured objectively, and we did not use validated patient-reported outcomes but rather self-reported ejaculatory control and distress levels, which have limitations. CONCLUSIONS Fluoxetine is an effective agent for the treatment of PE with significant improvement realized in IELT, ejaculatory control, and distress levels for both men and their partners. Despite its efficacy, continued use of fluoxetine beyond 6 months is poor. Jenkins LC, Gonzalez J, Tal R, et al. Compliance with Fluoxetine Use in Men with Primary Premature Ejaculation. J Sex Med 2020;16:1895-1899.
Collapse
Affiliation(s)
- Lawrence C Jenkins
- Sexual & Reproductive Medicine Program, Urology Service, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Joshua Gonzalez
- Sexual & Reproductive Medicine Program, Urology Service, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Raanan Tal
- Sexual & Reproductive Medicine Program, Urology Service, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Patricia Guhring
- Sexual & Reproductive Medicine Program, Urology Service, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Marilyn Parker
- Sexual & Reproductive Medicine Program, Urology Service, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - John P Mulhall
- Sexual & Reproductive Medicine Program, Urology Service, Memorial Sloan Kettering Cancer Center, New York, NY, USA.
| |
Collapse
|
37
|
Balci M, Atan A, Senel C, Guzel O, Aslan Y, Lokman U, Kayali M, Bilgin O. Comparison of the treatment efficacies of paroxetine, fluoxetine and dapoxetine in low socioeconomic status patients with lifelong premature ejaculation. Cent European J Urol 2019; 72:185-190. [PMID: 31482028 PMCID: PMC6715088 DOI: 10.5173/ceju.2019.1855] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2019] [Revised: 05/31/2019] [Accepted: 05/31/2019] [Indexed: 11/22/2022] Open
Abstract
Introduction To assess the treatment efficacies of paroxetine, fluoxetine and dapoxetine in patients with lifelong premature ejaculation (PE). Material and methods One hundred and seventy male patients with lifelong PE were included in our study. Premature ejaculation profile (PEP) and Intravaginal ejaculation latency times (IELT) were recorded. Paroxetine 20 mg/d was given in Group 1 (n = 64), fluoxetine 20 mg/d was given in Group 2 (n = 47) and dapoxetine 30 mg on demand (at least two times/week) was given in Group 3 (n = 59) patients. After 1 month of treatment, the patients' IELT, PEP and patient reported clinical global impression of change (CGIC) were completed. Results The mean age was 36 ±9.2 years. There was no difference between the groups' age, PEP and IELT before treatment (p >0.05). PEP and IELT improved in all three groups (p <0.001). The changes in the 1st and 3rd questions of PEP was significantly higher in group 1 than in the other groups (pPEP-1 = 0.042, pPEP-3 = 0.001). The changes in the 2nd and 4th questions of PEP were similar between groups (pPEP-2 = 0.444, pPEP-4 = 0.442). In group 1 and 3 IELT changes were better than group 2 (pIIEL1-3 = 0.297, pIIEL1-2 = 0.017, pIIEL2-3 = 0.100). There was no difference between CGIC scores (p = 0.087). The treatment was terminated by 8 patients in Group 1 and 9 patients in Group 2 because of side effects. Conclusions While paroxetine treatment seemed to be better than the other medications, dapoxetine 30 mg treatment has less side effects than the two others and its' on demand usage makes it more prominent than the others.
Collapse
Affiliation(s)
- Melih Balci
- University of Health Sciences, Ankara Numune Research and Training Hospital, Department of Urology, Ankara, Turkey
| | - Ali Atan
- Gazi University School of Medicine Department of Urology, Ankara, Turkey
| | - Cagdas Senel
- University of Health Sciences, Ankara Numune Research and Training Hospital, Department of Urology, Ankara, Turkey
| | - Ozer Guzel
- University of Health Sciences, Ankara Numune Research and Training Hospital, Department of Urology, Ankara, Turkey
| | - Yilmaz Aslan
- University of Health Sciences, Ankara Numune Research and Training Hospital, Department of Urology, Ankara, Turkey
| | - Utku Lokman
- TOBB University of Economics and Technology School of Medicine, Department of Urology, Ankara, Turkey
| | - Mustafa Kayali
- University of Health Sciences, Ankara Numune Research and Training Hospital, Department of Urology, Ankara, Turkey
| | - Ovunc Bilgin
- University of Health Sciences, Ankara Numune Research and Training Hospital, Department of Urology, Ankara, Turkey
| |
Collapse
|
38
|
Men with subjective premature ejaculation have a similar lognormal IELT distribution as men in the general male population and differ mathematically from males with lifelong premature ejaculation after an IELT of 1.5 minutes (Part 2). Int J Impot Res 2019; 31:341-347. [DOI: 10.1038/s41443-019-0172-5] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2019] [Revised: 04/30/2019] [Accepted: 06/07/2019] [Indexed: 11/08/2022]
|
39
|
M. S, S. A, Bhat GS. Premature Ejaculation: Do We Need to Address the Issue Differently? JOURNAL OF PSYCHOSEXUAL HEALTH 2019. [DOI: 10.1177/2631831819856740] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Introduction: Premature ejaculation is a complex condition with controversial management modalities. We decided to assess the treatment-seeking behavior of affected couples, which is an indirect indicator of the efficacy of the present management modalities of premature ejaculation. Materials and Methods: Couples, who reported premature ejaculation at our outpatient clinics between January 2015 and December 2016, were enrolled in the study. Patients with acquired causes for premature ejaculation were excluded. Both the partners were administered premature ejaculation diagnostic tool (PEDT) questionnaire separately at the time of initiation of the study and after 1 month. They were asked to report intravaginal ejaculatory latency time (IELT) and their treatment-seeking behavior at these time intervals. The couples were counselled regarding their diagnosis and offered treatment with dapoxetine 30 mg as and when required. Results: A total of 117 couples with an average married life of 5.4 years were enrolled for the study. Among these, 68 had premature ejaculation (PE), 30 had probable PE and 19 had no PE as estimated on PEDT. Post treatment, 55% of couples with PE, 47% of couples with probable PE and 55% of couples without PE wanted to continue treatment seeking despite improvement. Female partners had the desire to seek treatment despite the male partner reporting otherwise. Conclusion: The treatment seeking behavior of the affected couple indicates the inefficacy of the present management modalities of PE. As specialized health care providers, we need to address these concerns to provide a comprehensive solution to their problems.
Collapse
Affiliation(s)
- Shivalingaiah M.
- Department of Urology, Institute of Nephro Urology, Bengaluru, Karnataka, India
| | - Anuradha S.
- Department of Urology, Andrology and Sexual Medicine, TSS Shripad Hegde Kadave Institute of Medical Sciences, Sirsi, Karnataka, India
| | - Gajanan S. Bhat
- Department of Urology, Andrology and Sexual Medicine, TSS Shripad Hegde Kadave Institute of Medical Sciences, Sirsi, Karnataka, India
| |
Collapse
|
40
|
Erdogan A, Demirbas M, Oner S, Aydos MM, Sambel M, Yilmaz C. Comparison of the levels of the serotonin metabolite, 5-hydroxyindole acetic acid, in cerebrospinal fluid from patients with and without premature ejaculation. Rev Int Androl 2019; 17:41-45. [PMID: 31029436 DOI: 10.1016/j.androl.2018.01.001] [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: 06/29/2017] [Revised: 01/03/2018] [Accepted: 01/09/2018] [Indexed: 01/18/2023]
Abstract
INTRODUCTION Premature ejaculation (PE) is a significant problem as it can cause a loss of sexual self-confidence and a significant deterioration in quality of life. The frequency of PE varies between 9% and 27%. In the current study, we aimed to compare the levels of the serotonin metabolite 5HIAA (5 hydroxyindole acetic acid) in the cerebrospinal fluid (CSF) of patients with and without PE according to IELT (intravaginal ejaculation latency time) in order to investigate the relationship of PE with CSF 5HIAA levels. MATERIALS AND METHODS A total of 60 male patients were included in the study who were planning to undergo surgery under spinal anesthesia, 30 in the patient (PE) group (all of the included patients had an IELT of <1min) and 30 in the control group (patients had an IELT of >1min). Levels of CSF 5HIAA were measured. RESULTS There was a significant negative correlation between IELT and the 5HIAA variables in all patients (r=-0.322, p=0.012). Although the average 5HIAA levels (nmol/L) were higher in the patient group (86.80±28.33) than in the control group (76.44±35.91), this difference was not significant (p=0.22). DISCUSSION Results of the current study bring new and different perspectives to the explanation of PE pathophysiology. There is a need for more specific and genetic studies to determine the best treatment for this common disorder.
Collapse
Affiliation(s)
- Abdullah Erdogan
- Bursa Yuksek Ihtisas Education and Training Hospital, Urology Department, Turkey.
| | - Murat Demirbas
- Bursa Yuksek Ihtisas Education and Training Hospital, Urology Department, Turkey
| | - Sedat Oner
- Bursa Yuksek Ihtisas Education and Training Hospital, Urology Department, Turkey
| | - Mustafa Murat Aydos
- Bursa Yuksek Ihtisas Education and Training Hospital, Urology Department, Turkey
| | - Murat Sambel
- Bursa Yuksek Ihtisas Education and Training Hospital, Urology Department, Turkey
| | - Canan Yilmaz
- Bursa Yuksek Ihtisas Education and Training Hospital, Anesthesiology Department, Turkey
| |
Collapse
|
41
|
Rowland DL, Dabbs CR, Medina MC. Sex Differences in Attributions to Positive and Negative Sexual Scenarios in Men and Women With and Without Sexual Problems: Reconsidering Stereotypes. ARCHIVES OF SEXUAL BEHAVIOR 2019; 48:855-866. [PMID: 29980902 DOI: 10.1007/s10508-018-1270-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/19/2018] [Revised: 03/05/2018] [Accepted: 06/28/2018] [Indexed: 06/08/2023]
Abstract
People with sexual problems are more likely to attribute negative sexual experiences to themselves, in contrast to sexually functional individuals who attribute negative sexual experiences to external factors such as the circumstance or partner. We investigated attribution patterns in 820 men and 753 women, some of whom reported an orgasmic problem, to assess differences between the sexes and those with and without an orgasmic difficulty. Specifically, using an Internet-based approach, we compared attribution responses to four sexual scenarios, one representing a positive sexual experience and three representing negative sexual experiences. Women were more likely to attribute positive outcomes to their partner than men. Women were also more likely to attribute negative outcomes to themselves than men, but they more readily blamed their partner and circumstances for negative outcomes than men as well. Those with orgasmic problems were less willing to take credit for positive outcomes and more willing to accept blame for negative outcomes. Interaction effects between sex and orgasmic problems further highlighted differences between men's and women's attribution patterns. These results are interpreted in the context of traditional notions that men's attributions tend to be more self-serving and women's attributions more self-derogatory.
Collapse
Affiliation(s)
- David L Rowland
- Department of Psychology, Valparaiso University, 1001 Campus Drive, Valparaiso, IN, 46383, USA.
| | - Christopher R Dabbs
- Department of Psychology, Valparaiso University, 1001 Campus Drive, Valparaiso, IN, 46383, USA
| | - Mia C Medina
- Department of Psychology, Valparaiso University, 1001 Campus Drive, Valparaiso, IN, 46383, USA
| |
Collapse
|
42
|
Lee GW, Cho HH, Jeon SH, Choi MJ, Kim D, Kim HS, Song JE, Khang G. Improved Rapid Action of Dapoxetine Hydrochloride & L-arginine Solid Dispersion Using Film Formulation. Macromol Res 2019. [DOI: 10.1007/s13233-019-7047-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
|
43
|
Hendrickx L, Gijs L, Enzlin P. Who's Distressed by Sexual Difficulties? Exploring Associations Between Personal, Perceived Partner, and Relational Distress and Sexual Difficulties in Heterosexual Men and Women. JOURNAL OF SEX RESEARCH 2019; 56:300-313. [PMID: 30028210 DOI: 10.1080/00224499.2018.1493570] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
While not all sexual difficulties cause distress, research and clinical experience suggest that, apart from personal distress, partner and relational sexual distress are also often an important reason to seek professional help. The current study explored the associations between personal, perceived partner, and relational distress that men and women experience as a result of sexual difficulties. Data from heterosexual Flemish individuals ages 16 to 74 who were in a relationship (13,800 men and 13,242 women, mean age of 43.69, SD = 14.94) were collected via an online survey. Presence and severity of sexual difficulties and associated personal, perceived partner, and relational sexual distress were assessed. Among men and women with desire difficulties, either the three types of sexual distress were almost equally common or partner distress was most common. Arousal, orgasm, and sexual pain difficulties were most often associated with personal distress, particularly in men. Both men and women, however, most commonly reported that they experienced all three types of distress. These results are discussed in relation to Western gender-specific sexual scripts. Clinical implications and the importance of couples therapy and suggestions for clinically useful diagnostic criteria are presented.
Collapse
Affiliation(s)
- Lies Hendrickx
- a Institute for Family and Sexuality Studies, Department of Neurosciences , KU Leuven
| | - Luk Gijs
- a Institute for Family and Sexuality Studies, Department of Neurosciences , KU Leuven
| | - Paul Enzlin
- a Institute for Family and Sexuality Studies, Department of Neurosciences , KU Leuven
- b Center for Clinical Sexology and Sex Therapy , University Psychiatric Centre, KU Leuven
| |
Collapse
|
44
|
Fu M, Peng X, Hu Y. Effect of premature ejaculation desensitisation therapy combined with dapoxetine hydrochloride on the treatment of primary premature ejaculation. Andrologia 2019; 51:e13135. [PMID: 30788869 DOI: 10.1111/and.13135] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2018] [Revised: 07/19/2018] [Accepted: 07/31/2018] [Indexed: 11/28/2022] Open
Abstract
To evaluate the overall treatment benefits of premature ejaculation desensitisation therapy combined with 30 mg dapoxetine hydrochloride treatment on patients with primary premature ejaculation (PPE). Ninety-nine PPE patients were randomly divided into two groups at the ratio of 2:1. Sixty-six PPE patients received premature ejaculation desensitisation therapy accomplished by Weili Automatic Semen Collection-Penis Erection Detection and Analysis workstation (WLJY-2008) combined with 30 mg dapoxetine hydrochloride treatment (DTCD group), and another 33 patients received 30 mg dapoxetine hydrochloride-only treatment (DO group). Intravaginal ejaculation latency time (IELT) and premature ejaculation profile (PEP) were recorded before and during the treatment, and clinical global impression of change (CGIC) in PPE was recorded at the fourth week and the end of the treatment and the items. In both groups were significantly improved (p < 0.0001) in IELT, PEP and CGIC for premature ejaculation compared with baseline, and DTCD treatment showed a more significant improvement on PPE patients in the items compared with DO treatment (p < 0.05). Thus, premature ejaculation desensitisation combined with dapoxetine therapy may be a better choice for improving premature ejaculation with PPE.
Collapse
Affiliation(s)
- Min Fu
- Andrology Department, First Hospital of Qinhuangdao, Qinhuangdao, Hebei, China
| | - Xiaohui Peng
- Andrology Department, First Hospital of Qinhuangdao, Qinhuangdao, Hebei, China
| | - Yue Hu
- Andrology Department, First Hospital of Qinhuangdao, Qinhuangdao, Hebei, China
| |
Collapse
|
45
|
Dai H, Li H, Wang J, Bao B, Yan Y, Wang B, Sun S. Effectiveness comparisons of acupuncture for premature ejaculation: Protocol for a network meta-analysis. Medicine (Baltimore) 2019; 98:e14147. [PMID: 30702567 PMCID: PMC6380762 DOI: 10.1097/md.0000000000014147] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/23/2023] Open
Abstract
BACKGROUND As one of the common male sexual dysfunction diseases, the treatment effect of premature ejaculation is often difficult to guarantee. In China, there are many randomized clinical trials that confirm that acupuncture has a good therapeutic effect on premature ejaculation. The aim of this study was to compare the efficacy and safety of acupuncture for premature ejaculation from intravaginal ejaculation latency (IELT), premature ejaculation diagnostic tool (PEDT), Arab premature ejaculation index (AIPE), and premature ejaculation index (IPE). METHODS We will use PubMed, EMBASE, Nursing and Related Health Literature Cumulative Index, Joint and Supplemental Drug Database, Cochrane Center Controlled Trials Registry (CENTRAL), China Biomedical Literature Database (CBM) and China Knowledge Infrastructure (CNKI), The Chinese Science and Technology Periodical Database (VIP), and Wanfang Database conduct systematic searches until October 31, 2018. At the same time, manually search for gray documents, including unpublished meeting articles. The primary outcome included intravaginal ejaculation latency (IELT). Secondary outcomes were premature ejaculation diagnostic tools (PEDT), Arab premature ejaculation index (AIPE), and premature ejaculation index (IPE). The quality and evidence that the risk of inclusion of the BiB tool will be assessed will be assessed on a scale. RESULTS This study will generate a comprehensive review of current evidence of acupuncture for premature ejaculation. CONCLUSION The study will provide updated evidence to evaluate the efficacy and safety of acupuncture for premature ejaculation. ETHICS AND COMMUNICATION Because this research is based on a meta-analysis of published research, ethical recognition and patient consent are unnecessary. AGREEMENT REGISTRATION NUMBER PROSPERO CRD42018111661.
Collapse
Affiliation(s)
- Hengheng Dai
- Graduate School of Beijing University of Chinese Medicine
- Department of Andrology, Dongzhimen Hospital, Beijing University of Chinese Medicine
| | - Haisong Li
- Department of Andrology, Dongzhimen Hospital, Beijing University of Chinese Medicine
| | - Jisheng Wang
- Graduate School of Beijing University of Chinese Medicine
- Department of Andrology, Dongzhimen Hospital, Beijing University of Chinese Medicine
| | - Binghao Bao
- Graduate School of Beijing University of Chinese Medicine
- Department of Andrology, Dongzhimen Hospital, Beijing University of Chinese Medicine
| | - Yubing Yan
- Graduate School of Beijing University of Chinese Medicine
| | - Bin Wang
- Department of Andrology, Dongzhimen Hospital, Beijing University of Chinese Medicine
| | - Song Sun
- Chinese Medicine Hospital, Changping District, Beijing, China
| |
Collapse
|
46
|
Liu T, Jia C, Peng YF, Zhong W, Fang X. Correlation between premature ejaculation and psychological disorders in 270 Chinese outpatients. Psychiatry Res 2019; 272:69-72. [PMID: 30579184 DOI: 10.1016/j.psychres.2018.12.038] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/16/2018] [Revised: 11/01/2018] [Accepted: 12/06/2018] [Indexed: 11/29/2022]
Abstract
Clinical patients with premature ejaculation(PE) often present with poor psychological state. This study investigated whether there is a difference in the psychological state of PE and non-PE in outpatients, and whether there is a correlation between ejaculatory latency and psychological disorders. We studied demographics informations and psychological indicators for PE patients and control group, including the Self-Rating Anxiety Scale(SAS) and Self-Rating Depression Scale(SDS), Pittsburgh Sleep Quality Index (PSQI) and recorded the ejaculatory latency. We analyzed the relationship between PE and psychological disorders by the Pearson correlation and multifactorial logistic regression. There were significant differences in SAS(p < 0.01) and SDS(p < 0.05) scores between the PE and non-PE groups. However, Pearson correlation analysis showed that there was no correlation between ejaculatory latency and SDS. Multifactorial logistic regression analysis showed that anxiety(p < 0.05) and sleep quality(p < 0.05) were closely related to the attack of PE. The incidence of anxiety and depression in PE patients is high, anxiety is a risk factor of PE. Clinicians should pay close attention to the psychological state and sleep quality of patients with PE.
Collapse
Affiliation(s)
- Tao Liu
- Department of Sexual Medicine, Affiliated Yijishan Hospital of Wannan Medical College.
| | - Chao Jia
- Department of Sexual Medicine, Affiliated Yijishan Hospital of Wannan Medical College
| | - Yi-Feng Peng
- Department of Sexual Medicine, Affiliated Yijishan Hospital of Wannan Medical College
| | - Wan Zhong
- Department of Sexual Medicine, Affiliated Yijishan Hospital of Wannan Medical College
| | - Xiang Fang
- Department of Sexual Medicine, Affiliated Yijishan Hospital of Wannan Medical College
| |
Collapse
|
47
|
Efficacy and safety of dapoxetine/sildenafil combination tablets in the treatment of men with premature ejaculation and concomitant erectile dysfunction-DAP-SPEED Study. Int J Impot Res 2019; 31:92-96. [PMID: 30705437 DOI: 10.1038/s41443-019-0122-2] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2018] [Revised: 12/29/2018] [Accepted: 01/10/2019] [Indexed: 12/31/2022]
Abstract
Premature ejaculation (PE) and erectile dysfunction (ED) are the most prevalent sexual disorders in men. ED is commonly reported among patients with PE. Although recent guidelines recommend to treat ED first in men with both PE and ED, this recommendation is not based on evidence and there are limited data about the efficacy and safety of dapoxetine/sildenafil combination therapy for these patients. The aim of this study is to evaluate the clinical efficacy and safety of the dapoxetine/sildenafil combination (Dapoxil® 30/50 mg film-coated tablet) in the treatment of patients with PE and concomitant ED. In a single-center, single-arm, open-label clinical study conducted between October 2016 and September 2017, 74 patients with lifelong or acquired PE and ED were included. All patients were instructed to record their intravaginal ejaculatory latency time (IELT) with a stopwatch for 4 weeks. After the screening, they were requested to complete Premature Ejaculation Diagnostic Tool (PEDT), Premature Ejaculation Profile (PEP), and International Index of Erectile Function-Erectile Function (IIEF-EF) questionnaires before the treatment. The patients received on demand Dapoxil® 1-3 h before sexual intercourse for the next 4 weeks (2 days a week and no more than once a day). The patients were also assessed with global impression of change (GIC) question for the treatment satisfaction and the side effects were recorded. The study was completed with 53 patients (53/74, 71.62%). Mean age of the patients was 45.32 ± 10.05 years. At the end of the 4-week treatment period, the geometric mean IELT of the patients significantly increased (from 22.72 ± 15.16 to 68.25 ± 82.33 s; p < 0.001). Similarly, significant improvements were observed in the mean PEP index score (0.86 ± 0.72 vs. 2.36 ± 1.13; p < 0.001) and mean IIEF-EF domain score (13.17 ± 3.33 vs. 24.60 ± 3.96; p < 0.001). According to the GIC results, 81.13% of the patients were satisfied with the treatment. Non-serious adverse events occurred in 10 patients (18.87%) and 4 (7.55%) of these patients dropped out of the treatment. The most common adverse events were headache, palpitation, and flushing. The dapoxetine/sildenafil combination therapy significantly improves the IELT values and patient reported outcome measures of PE patients who also suffer from ED. Although several side effects were reported, these were mild and transient.
Collapse
|
48
|
Waldinger MD, Schweitzer DH. Method and design of drug treatment research of subjective premature ejaculation in men differs from that of lifelong premature ejaculation in males: proposal for a new objective measure (part 1). Int J Impot Res 2019; 31:328-333. [PMID: 30647430 DOI: 10.1038/s41443-018-0107-6] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2018] [Accepted: 12/07/2018] [Indexed: 11/09/2022]
Abstract
As lifelong premature ejaculation (PE) and subjective PE are two different PE subtypes, the measurement of their characteristic features requires different objective measures. In this article, we address the differences between lifelong PE and subjective PE, in terms of the extent of variation of sexual performance and propose a new objective measure for research of subjective PE. By considering lifelong PE as a mainly "male" sex disorder and subjective PE as a mainly "man" sex disorder, we show that stopwatch-mediated intravaginal ejaculation latency time (IELT) measurement is most adequate for research of lifelong PE, but inadequate for research of subjective PE. Subjective PE needs another objective measure to capture its key characteristics. Arguments are provided to show that the characteristics of subjective PE are different from the key features of lifelong PE. The core issue in lifelong PE is the very short IELT with a very small variation in sexual performance. Subjective PE is characterized by a higher variation of sexual performance. Stopwatch-mediated IELT measurement is essential in case of small variation of sexual performance. In contrast, measurement of various parameters of penile intravaginal thrusting is suggested to be more appropriate in case of high variation of sexual performance observed in subjective PE. In conclusion, research of lifelong PE should be performed by stopwatch measurement of the IELT whereas research of subjective PE should be performed by movement tracker devices, designed to be bound to the males body and/or inserted into the women's vagina with robust software to measure intravaginal thrusting variation performance. Future studies are warranted to provide scientific data to support this hypothesis.
Collapse
Affiliation(s)
- Marcel D Waldinger
- Department of Pharmacology and Physiology, Drexel University College of Medicine, Philadelphia, PA, USA. .,Department of Andrology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, Guangdong, China. .,Private Practice in Psychiatry and Neurosexology, Amstelveen, The Netherlands.
| | - Dave H Schweitzer
- Department of Internal Medicine and Endocrinology, Reinier the Graaf Gasthuis, Delft, The Netherlands
| |
Collapse
|
49
|
Natarajan P, Khan SD. Ejaculatory Dysfunction. Sex Med 2019. [DOI: 10.1007/978-981-13-1226-7_4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
|
50
|
Péloquin K, Byers ES, Callaci M, Tremblay N. Sexual Portrait of Couples Seeking Relationship Therapy. JOURNAL OF MARITAL AND FAMILY THERAPY 2019; 45:120-133. [PMID: 29577354 DOI: 10.1111/jmft.12328] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/16/2023]
Abstract
This study sought to provide information about the sexual well-being of 298 mixed-sex couples seeking relationship therapy and determined the extent to which problems with sexual functioning and dyadic adjustment of both partners are associated with sexual satisfaction. Partners completed measures of dyadic adjustment, sexual satisfaction, and sexual functioning. Thirty percent of couples reported a clinically significant sexual problem. Compared to their male partners, the women were more likely to report a sexual problem as well as lower dyadic adjustment, sexual satisfaction, and overall sexual functioning. Path analysis indicated that relationship adjustment uniquely predicted individuals' own sexual satisfaction; problems in sexual functioning uniquely predicted own and partner sexual satisfaction. Findings underscore the need to address sexual problems in relationship therapy.
Collapse
Affiliation(s)
| | | | | | - Nadine Tremblay
- Clinique de consultation conjugale et familiale Poitras-Wright, Côté
| |
Collapse
|