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The sensitivity difference between the glans penis and penile shaft in primary premature ejaculation

Asian Journal of Andrology 2023年第4期25卷 487-491页

作者： Lei Zheng Le-Tian Wei Qi-Zhen Tang Chun-Li Song Wen-Rong Liu Ke-Nan Wang Hui Jiang Tao Jiang Department of Andrology Second Hospital of Dalian Medical UniversityDalian 116000China Department of Urology First Hospital of Dalian Medical UniversityDalian 116000China Department of Neuroelectrophysiology First Hospital of Dalian Medical UniversityDalian 116000China Department of Andrology Peking University First HospitalBeijing 100191China.

The penis is a vital organ of perception that transmits perceived signals to ejaculation-related centers.The penis consists of the glans penis and penile shaft,which differ considerably in both histology and innervation.This paper aims to investigate whether the glans penis or the penile shaft is the main source of sensory signals from the penis and whether penile hypersensitivity affects the whole organ or only part of it.The thresholds,latencies,and amplitudes of somatosensory evoked potentials(SSEPs)were recorded in 290 individuals with primary premature ejaculation using the glans penis and penile shaft as the sensory areas.The thresholds,latencies,and amplitudes of SSEPs from the glans penis and penile shaft in patients were significantly different(all P<0.0001).The latency of the glans penis or penile shaft was shorter than average(indicating hypersensitivity)in 141(48.6%)cases,of which 50(35.5%)cases were sensitive in both the glans penis and penile shaft,14(9.9%)cases were sensitive in the glans penis only,and 77(54.6%)cases were sensitive in the penile shaft only(P<0.0001).There are statistical differences in the signals perceived through the glans penis and the penile shaft.Penile hypersensitivity does not necessarily mean that the whole penis is hypersensitive.We classify penile hypersensitivity into three categories,namely,glans penis,penile shaft,and whole-penis hypersensitivity,and we propose the new concept of penile hypersensitive zone.

关键词： neuroelectrophysiology perceptive zone premature ejaculation sensitivity sensory perception

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Selective serotonin reuptake inhibitors in the treatment of premature ejaculation

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Chinese Medical Journal 2007年第11期120卷 1000-1006页

作者： WANG Wei-fu CHANG Le Suks Minhas David J Ralph Department of Urology People＇s Hospital of Hainan Province Haikou 570311 China Department of Gynaecology People＇s Hospital of Hainan Province Haikou 570311China St Peter＇s Department of Andrology Institute of Urology Middlesex Hospital UCL London UK W1T 3AA

Objective To review and assess the update studies regarding selective serotonin reuptake inhibitors （SSRIs） in the treatment of premature ejaculation （PE） and then provide practical recommendations and possible mechanisms concerning state of the art knowledge for the use of SSRIs in alleviating PE. Data sources Using the Medline, 48 articles published from January 1st, 1996 to August 1st, 2006 concerning the use of SSRIs and their possible mechanisms in alleviating PE were found and reviewed. Study selection PE, rapid ejaculation, early ejaculation and SSRIs were employed as the keywords, and relevant articles about the use of SSRIs and their possible mechanisms in the treatment of PE were selected. Results Many kinds of SSRIs, such as fluoxetine, sertraline, paroxetine and citalopram, have widely been employed to treat PE. However, their effects are moderate and there is no a universal agreement about the kind, dose, protocol and duration. Dapoxetine, as the first prescription treatment of PE, may change this bottle-neck situation. SSRIs are suggested to be used in young men with lifelong PE, and acquired PE when etiological factors are removed but PE still exists. Phosphodiesterase 5 inhibitors （PDE5-ls） are suggested to be employed alone or combined with SSRIs when SSRIs fail to treat PE or sexual dysfunction associated with SSRIs occurs. The protocol of taking drugs on demand based on taking them daily for a suitable period is proposed to be chosen firstly. The possible mechanisms include increasing serotonergic neurotransmission and activating 5-hydroxytryptamine 2C （5-HT2c） receptors, then switching the ejaculatory threshold to a higher level, decreasing the penile sensitivity and their own effect of antidepression. Conclusion The efficacies of the current SSRIs are moderate in the treatment of PE and they have not been approved by the FDA, therefore new SSRI like dapoxetine needs to be further evaluated.

关键词： premature ejaculation selective serotonin reuptake inhibitions

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Sexual function of premature ejaculation patients assayed with Chinese Index of premature ejaculation

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Asian Journal of Andrology 2004年第2期6卷 121-126页

作者： Yi-MingYuan Zhong-ChengXin HuiJiang Yan-JieGuo Wu-JiangLiu LongTian Ji-ChuanZhu DepartmentofUrology PekingUniversityfirstHospitalBeijing100034China DepartmentofUrology PekingUniversitysecondHospitalBeijing100034China

Aim: To assess the psychometric properties of the Chinese Index of premature ejaculation (CIPE). Methods: The sexual function of 167 patients with and 114 normai controls without premature ejaculation (PE) were evaluated with CIPE. All subjects were married and had regular sexual activity. The CIPE has 10 questions, focusing on libido, erectile function, ejaculatory latency, sexual satisfaction and difficulty in delaying ejaculation, self-confi dence and depression. Each question was responded to on a 5 point Likert-type scale. The individual question score and the total scale score were analyzed between the two groups. Results: There were no significant differences between the age, duration of marriage and educational level (P > 0.05) of patients with and vvithout PE and normai controls. The mean latency of patients with PE and normai controls were 1.6±1.2 and 10.2±9.5 minutes, respectively. Significant differences between patients with (26.7±4.6) PE and normai controls (41.9±4.0) were observed on the total score of CIPE (P ejaculation, anxiety and depression. Receiver Operat ing Characteristic (ROC) curve analysis of CIPE-5 questionnaire indicated that the sensitivity and specificity of CIPE were 97.60 % and 94.74 %, respectively. Employing the total score of CIPE-5, patients with PE could be divided into three groups: mild (>15 point) 19.8 %, moderate (10-14 point) 62.8 % and severe (< 9 point) 16.7 %. Conclusion: The CIPE-5 is a useful method for the evaluation of sexual function of patients with PE and can be used as a clinical endpoint for clinical trials studying the efficacy of pharmacologica] intervention.

关键词： premature ejaculation Chinese index of premature ejaculation latency sex satisfaction diagnosis

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Validity of premature ejaculation diagnostic tool and its association with International Index of Erectile Function-15 in Chinese men with evidence-based-defined premature ejaculation

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Asian Journal of Andrology 2018年第1期20卷 19-23页

作者： Dong-Dong Tang Chao Li Dang-Wei Peng Xian-Sheng Zhang Department of Urology The First Affiliated Hospital of Anhui Medical University Hefei China Reproductive Medicine Center The First Affiliated Hospital of Anhui Medical University Hefei China

The premature ejaculation diagnostic tool （PEDT） is a brief diagnostic measure to assess premature ejaculation （PE）. However, there is insufficient evidence regarding its validity in the new evidence-based-defined PE. This study was performed to evaluate the validity of PEDT and its association with IIEF-15 in different types of evidence-based-defined PE. From June 2015 to January 2016, a total of 260 men complaining of PE and defined as lifelong PE （LPE）/acquired PE （APE） according to the evidence-based definition from Andrology Clinic of the First Affiliated Hospital of Anhui Medical University, along with 104 male healthy controls without PE from a medical examination center, were enrolled in this study. All individuals completed questionnaires including demographics, medical and sexual history, as well as PEDT and IIEF-15. After statistical analysis, it was found that men with PE reported higher PEDT scores （14.28 ± 3.05） and lower IIEF-15 （41.26 ± 8.20） than men without PE （PEDT： 5.32 ± 3.42, IIEF-15：52.66 ± 6.86, P 〈 0.001 for both）. It was suggested that a score of 〉9 indicated PE in both LPE and APE by sensitivity and specificity analyses （sensitivity： 0.875, 0.913; specificity： 0.865, 0.865, respectively）. In addition, IIEF-15 were higher in men with LPE （42.64 ± 8.11） than APE （39.43 ± 7.84, P 〈 0.001）. After adjusting for age, IIEF-15 was negatively related to PEDT in men with LPE （adjust r = -0.225, P 〈 0.001） and APE （adjust r = -0.378, P 〈 0.001）. In this study, we concluded that PEDT was valid in the diagnosis of evidenced-based-defined PE. Furthermore, IIEF-15 was negatively related to PEDT in men with different types of PE.

关键词： erectile dysfunction International Index of Erectile Function-15 male sexual dysfunction premature ejaculation premature ejaculation diagnostic tool

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Prevalence of premature ejaculation in young and middle-aged men in Korea： a multicenter intemet-based survey from the Korean Andrological Society

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Asian Journal of Andrology 2010年第6期12卷 880-889页

作者： Hyun Jun Park Jong Kwan Park Kwangsung Park Sung Won Lee Sae-Woong Kim Dae Yul Yang DU Geon Moon Kweon-Sik Min Ki-Hak Moon Sang-Kuk Yang Jae Seog Hyun Nam Cheol Park Deparment of Urology Pusan National University School of medicine Busan 602739 Korea Deparment of Urology Chonbuk National University Medical School Jeonju 561712 Korea Deparment of Urology Chonnam National University Medical School Gwangju 501746 Korea Deparment of Urology Sungkyunkwan Univer＆ty School of Medicine Seou1135 710 Korea Deparment of Urology Catholic University College of Medicine Seoul 137701 Korea Deparment of Urology Hallym University College of Medicine Seoul 13 7701 Korea Deparment of Urology Korea University College of Medicine Seoul 152703 Korea Deparment of Urology lnje University College of Medicine Busan 614735 Korea Deparment of Urology Yeungnam University College of Medicine Daegu 705717 Korea Deparment of Urology Konkuk University School of Medicine Chungju 380704 Korea Deparment of Urology Gyeongsang National University School of Medicine Jinju 660702 Korea

In this study, we aimed to investigate the prevalence and perception of premature ejaculation （PE） in young and middle-aged Korean men. The study was conducted using an Internet-assisted questionnaire. A total of 2 037 Korean male adults, aged 20 years or older, were randomly sampled based on age and residency. The questionnaire developed by the PE Study Group of the Korean Andrological Society includes four categories （overall sexual function, symptoms, distress and treatment） with a total of 16 questions. For each question, symptoms were evaluated by a scale ranging from 0 to 10. Intravaginal ejaculation latency time was ‘5-10 min＇ in 38.6%, followed by ‘longer than 10 min＇ in 2919%, ‘2-5 min＇ in 23.6%, ‘1-2 min＇ in 5.4% and ‘shorter than 1 min＇ in 2.5%. In our series, 27.5% of respondents reported having PE. Control over ejaculation within a recent 3-month period was 6.2 points on average. Respondent complaints of PE-related stress averaged 7.1 points and stress-related complaints from sexual partners averaged 7.1 points. The effect of PE on sexual life was 6.8 points. Of the respondents determined as having PE, 42.6% responded that they were inclined to receive treatment. Results from this study suggest that the prevalence of PE diagnosed by the respondent on his own was approximately 27.5% in young and middle-aged men in Korea. PE-related stress had a significant effect on the stress, sexual activity and quality of life of the respondent and his sexual partner.

关键词： epidemiology premature ejaculation questionnaire sexual dysfunction

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Relation of size of seminal vesicles on ultrasound to premature ejaculation

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Asian Journal of Andrology 2017年第5期19卷 554-560页

作者： Zhi-Wei Hong Yu-Ming Feng Yi-Feng Ge Jun Jing Xue-Chun Hu Jia-Ming Shen Long-Ping Peng Bing Yao Zhong-Cheng Xin Center for Reproductive Medicine Jinling Hospital Medical School of Nanjing University Nanjing 210002 China Center for Reproductive Medicine Jinling Hospital Southern Medical University Nanjing 210002 China Andrology Center Peking University First Hospital Peking University Beijing 100009 China

Myriad biological factors have been proposed to explain premature ejaculation （PE）. However, data correlating PE with seminal vesicles （SVs） are sparse. The study aimed to evaluate the relationship between the size of SV and PE. The cross-sectional study included 44 outpatients with PE and 44 volunteers without PE, and the size of SV was compared. Self-estimated intravaginal ejaculatory latency time, the premature ejaculation Diagnostic Tool （PEDT）, the International Index of Erectile Function-15, and the National Institutes of Health-Chronic Prostatitis Symptom Index were used for assessment of symptoms. Compared to the control group, the PE group had significantly higher mean anterior-posterior diameter （APD） of SV （P 〈 0.001）. The optimal mean APD of SV cutoff level was 9.25 mm for PE. In the PE group, PEDT was also higher with a mean APD of SV ≥9.25 mm compared with mean APD of SV 〈9.25 mm. PEDT was significantly correlated with the mean APD of SV （r = 0.326, P = 0.031）. The seminal plasma proteins were compared between six PE and six matched control cases by mass spectrometry and it was shown that 102 proteins were at least 1.5-fold up- or down-regulated. Among them, GGT1, LAMC1, and APP were significantly higher in the PE group. These results indicated that men with a larger mean APD of SV might have a higher PEDT score. Transrectal ultrasound of SV should be considered in the evaluation of patients with premature ejaculation. SV might be a potential target for the treatment of patients with PE and ultrasound change in SV.

关键词： mass spectrometry premature ejaculation seminal vesicles size transrectal ultrasound

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Safety and efficacy of tramadol hydrochloride on treatment of premature ejaculation

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Asian Journal of Andrology 2013年第1期15卷 138-142页

作者： Bayoumy I Eassa Mohamed A EI-Shazly Department of DermatoLogy Venereology and Andrology AI-Azhar University Cairo 11884 Egypt Department of Urology Menoufiya University Cairo 32511 Egypt

premature ejaculation （PE） is the most common sexual disorder. It affects 20%-30% of adult men; the aetiology of this condition has not yet been elucidated. The aim of this study is to evaluate the efficacy, safety, tolerability, undesirable effects and improved satisfaction with sexual intercourse with tramadol hydrochloride at different dosages for the treatment of PE. A total of 300 patients who presented with lifelong （primary） PE were included in this study. The study was performed for 28 weeks, in which placebo （starch tablet） was given for 4 weeks, and active ingredient （tramadol hydrochloride） was administered at different therapeutic dosages for 24 weeks. Patients were divided into three equal groups, each consisting of 100 patients. The first group （A） was given tramadol hydrochloride capsule 25 mg. The second group （B） was given tramadol hydrochloride capsule 50 mg. The third group （C） was given tramadol hydrochloride capsule 100 mg. All of the 300 participants included completed the study voluntarily. The age of the patients varied from 25 to 50 years. After the treatment period, the recorded data were collected for each group and analysed. The results showed a highly significant increase in the mean intravaginal ejaculatory latency time （IELT） in all groups compared to baseline data （P〈0.0001）. We concluded that using tramadol hydrochloride at different doses on demand for the treatment of PE is effective, safe and tolerable, with minimal undesirable effects, and approval for this indication should be souRht.

关键词： early ejaculation erectile dysfunction intravaginal ejaculation latencytime premature climax premature ejaculation PE rapid ejaculation tramadol

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Penile sensory thresholds in subtypes of premature ejaculation： implications of comorbid erectile dysfunction

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Asian Journal of Andrology 2018年第4期20卷 330-335页

作者： Xiang Chen Fei-Xiang Wang Chao HU Nian-Qin Yang Ji-Can Dai Department of Urology Ren Ji Hospital School of Medicine Shanghai Jiao Tong University Shanghai 200001 China Department of Urology Zhongshan Hospital Fudan University Shanghai 200032 China Shanghai Key Laboratory of Forensic Medicine Shanghai Forensic Service Platform Academy of Forensic Science Shangha 200063 China

Penile hypersensitivity plays an important role in premature ejaculation （PE）, but differences in penile sensitivity among subtypes of PE are unknown. Therefore, we compared penile sensory thresholds in PE subtypes of lifelong and acquired PE, PE with and without erectile dysfunction （ED）, PE with an intravaginal ejaculation latency time 〈1 min and 〉1 min, and PE with and without orgasmic pleasure perceptual dysfunction. During August 2014 to January 2016, 136 patients with PE were included. Penile warm, cold, and vibratory thresholds were measured. Data of clinical characteristics, sexual life, premature ejaculation Diagnostic Tool （PEDT） score, and the 5-item version of the International Index of Erectile Function （IIEF-5） score were collected. Vibratory thresholds of the PE with ED group were higher in the right coronal sulcus （median amplitude： 4.92 vs 3.65 μm, P= 0.02） and the right penile shaft （median amplitude： 3.87 vs 3.30 μm, P = 0.03）, while differences in penile sensory thresholds between other subtypes were not significant. The median PEDT score was lower in the PE without ED group （12 vs 14, P 〈 0.001）. The IIEF-5 and PEDT scores were negatively correlated （r = -0.29, P 〈 0.001）. Patients with orgasmic pleasure perceptual dysfunction had a lower median IIEF-5 score （20 vs 21, P = 0.02）. Patients with PE and ED had lower penile sensitivity, and ED was associated with more severe symptoms and weaker orgasmic pleasure perception. In men with PE, management of comorbid ED is necessary. In case of side effects in erectile function, topical anesthetics should be cautiously used in men with PE and ED.

关键词： classification erectile dysfunction penile sensitivity penis premature ejaculation sensory thresholds

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A new potential risk factor in patients with erectile dysfunction and premature ejaculation： folate deficiency

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Asian Journal of Andrology 2014年第6期16卷 902-906页

作者： Wen-Jie Yan Nan Yu Tai-Lang Yin Yu-]ie Zou Jing Yang Reproductive Medical Center Renmin Hospital of Wuhan University Wuhan China.

We investigated serum folic acid （FA） levels in patients with erectile dysfunction （ED） and/or premature ejaculation （PE）. Fasting serum samples were obtained from 42 patients with ED, 36 with PE, 25 ED patients with PE, and 30 healthy men; the mean intravaginal ejaculation latency time （IELT） was measured during a 4 weeks baseline period. Levels of sex hormones （follicle-stimulating hormone, luteinizing hormone, total testosterone）, homocysteine （Hcys）, and FA were measured using chemiluminescent immunoassays. The sexual functions of PE patients and normal control men were evaluated using the Chinese Index of premature ejaculation （CIPE）. The abridged Intemational Index of Erectile Function-5 （IIEF-5） questionnaire was used to gauge erectile quality for ED patients and for normal controls. Serum FA concentrations were lower in ED （7.61 ~ 3.97 ng ml-1）, PE （9.37 ＋ 3.40 ng ml-1）, and ED/PE （8.84 ＋ 4.28 ng m1-1） patients than in healthy men （12.23 ~ 5.76 ng ml-z, P〈 0.05）. No significant differences in sex hormone levels were found between patients with sexual dysfunction and healthy controls （P 〉 0.05）. There were positive correlations between serum FA concentrations and ClPE scores （r= 0.530, P〈 0.01）, IIEF-5 scores （r= 0.589, P〈 0.01）, and IELT （r= 0.445, P〈 0.01）; negative correlations with Hcys concentrations （r= -0.487, P〈 0.01） were found in all participants. These findings showed a strong relationship between serum FA levels and sexual dysfunction, possibly due to an effect of FA on the metabolism of nitric oxide, Hcys, and 5-hydroxytryptamine.

关键词： 5-hydroxytryptamine erectile dysfunction folic acid homocysteine nitric oxide premature ejaculation

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No effect of abstinence time on nerve electrophysiological test in premature ejaculation patients

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Asian Journal of Andrology 2018年第4期20卷 391-395页

作者： Bai-Bing Yang Jia-Dong Xia Zhi-Wei Hong Zheng Zhang You-Feng Han Yun Chen Yu-Tian Dai Department of Andrology Drum Tower Hospital Medical School of Nanjing University Nanjing 210000 China Department of Urology The First Affiliated Hospital of Nanjing Medical University Nanjing 210000 China Department of Urology Fujian Provincial Hospital Fuzhou 350000 China

The nerve electrophysiological tests may differentiate the treatment of primary premature ejaculation （PPE） in our previous studies. However, no study verifies if the results will be affected by abstinence time. From January to December in 2016, fifty PPE patients ejaculated within 2 min and 28 control subjects were enrolled. The nerve electrophysiological tests, including dorsal nerve somatosensory evoked potential （DNSEP）, glans penis somatosensory evoked potential （GPSEP）, and penile sympathetic skin response （PSSR）, were recorded before and immediately after ejaculation. The abstinence day was not correlated with the latencies of SEPs or PSSR neither in PE group （P = 0.170, 0.064, and 0.122, respectively） nor in control group （P = 0.996, 0.475, and 0.904, respectively）. No statistically differences were found in the latencies of SEPs and PSSR before and after ejaculation in PE patients （P = 0.439, 0.537, and 0.576, respectively） or control subjects （P = 0. 102, 0. 198, and 0.363, respectively）. Thus, abstinence time does not interfere with the nerve electrophysiological test, which is stable in determining the nerve function of PPE patients.

关键词： abstinence time penile sympathetic skin response postejaculation refractory time premature ejaculation somatosensoryevoked potential

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