Erectile dysfunction in patients with first-episode psychosis

Sexual dysfunction is more prevalent in psychotic patients than in the nonpsychotic population. The objective of this study was to identify correlations between serum prolactin levels, testosterone levels and erectile dysfunction in patients with first-episode psychosis (n = 40) compared to age-matched healthy controls (n = 40). All subjects underwent clinical evaluation, international index of erectile function (IIEF5) score assessment and measurement of serum prolactin and total testosterone levels. In first-episode psychotic patients, the IIEF-5 score and total testosterone levels were significantly lower, while serum prolactin levels were higher. We concluded that men with first-episode psychosis are at an increased risk for development of erectile dysfunction, and increased duration of untreated psychosis leads to a higher incidence of erectile dysfunction and hyperprolactinemia.     

Effect of increased prolactin and psychosocial stress on erectile function

Sexual dysfunctions in men are complex disorders that consist of organic and psychogenic components. The most common sexual dysfunction is erectile dysfunction. It is the inability to achieve or maintain an erection for satisfactory sexual performance. This disorder can be caused by high blood pressure, heart disease, vascular problems, psychological and hormonal factors such as problems with testosterone and prolactin levels. In this study, we tested the relationship between erectile dysfunction, hyperprolactinemia and psychosocial stress. Clinical examinations of 60 patients with erectile dysfunction, which also included psychosocial stress, focussed on patient history, comprehensive sexological examination, biochemical analyses of serum prolactin, total testosterone and thyroid-stimulating hormone with psychometric evaluation of erectile function and a checklist of trauma symptoms (TSC-40). The results show significant Spearman correlations of psychometric evaluation of erectile function with prolactin (R = .50) and results of the trauma checklist score (R = .55) and significant Spearman correlations between TSC-40 and prolactin (R = .52). This result indicates a significant relationship between erectile dysfunction, hyperprolactinemia and stress symptoms in men.     

Sexual dysfunction in Klinefelter's syndrome patients

Klinefelter's syndrome (KS) is the most common chromosomal abnormality in men with infertility and hypogonadism. Although its influence on fertility has been extensively investigated, very few studies assessed the sexual function of patients with KS. Our aim was to assess the prevalence of sexual dysfunction in patients with KS and investigate possible aetiological factors for reported findings. Medical records of 53 patients with KS were retrospectively reviewed and compared to 75 age‐matched control subjects who were prospectively recruited. Sexual history was evaluated through utilisation of international index of erectile function‐5 and Arabic index for premature ejaculation questionnaires. Sexual desire was reported subjectively by patients or controls. The incidence of erectile dysfunction and premature ejaculation in patients with KS was 18.9% and 22.6% respectively. Compared to age‐matched controls, patients with KS had significantly lower incidence of PE. However, there was no statistically significant difference between both groups regarding erectile function. Libido was significantly lower in patients with KS than normal controls (54.7% vs. 17.3%, p = 0.001). Klinefelter's syndrome is a condition that has a variable presentation. Despite having a higher likelihood of reduced sexual desire, patients may have normal erectile function comparable to age‐matched individuals. They tend to have a lower incidence of premature ejaculation.     

Sexual Dysfunction after Elective Endovascular or Hand-Assisted Laparoscopic Abdominal Aneurysm Repair

ObjectiveTo evaluate the incidence of sexual dysfunction and retrograde ejaculation after elective endovascular aneurysm repair (EVAR) and hand-assisted laparoscopic surgery (HALS) for abdominal aortic aneurysm (AAA).MethodsA total of 100 patients eligible for elective repair of infrarenal AAAs were randomised in two groups: EVAR and HALS. The quality of sexual function was evaluated using the International Index of Erectile Function (IIEF), a 15-item questionnaire. Patients completed the IIEF preoperatively and at 12 months. The incidence of retrograde ejaculation was also evaluated.ResultsOne- and 12-month mortality rates were zero. Three patients in the EVAR group (6%) and two patients in the HALS group (4%) reported an erectile dysfunction (p = NS). The quality of sexual function at 1 year was similar in both groups: total score of 66 in the EVAR group versus 68 in the HALS group (p = 0.66). Retrograde ejaculation was detected in three cases in the HALS group versus no case in the EVAR group.ConclusionsThe HALS technique could be a minimally invasive alternative for sexually active males unsuitable for EVAR repair.     

Psychosocial stress,somatoform dissociative symptoms and free testosterone in premature ejaculation

One of the most common sexual dysfunctional diseases in adult males is premature ejaculation. So far, there is no evidence of how premature ejaculation is associated with psychosocial stress. We tested the relationship between neuroendocrine changes in patients with premature ejaculation and indicators of stress experience as a new psychosomatic hypothesis where psychosocial stress may significantly contribute to the aetiology of premature ejaculation. A total of 55 patients with premature ejaculation were included in the study. The control group consisted of 55 healthy men. The diagnosis of premature ejaculation was confirmed by a sexology examination, a history of patients and the values of the premature ejaculation diagnostic tool questionnaire. Comprehensive biochemical serum analysis was focused on the values of total testosterone, free testosterone, luteinising hormone, thyroid-stimulating hormone, dehydroepiandrosterone sulphate, sex hormone-binding globulin and a premature ejaculation diagnostic tool score with trauma symptom checklist and somatoform dissociation questionnaire. The results show significant Spearman correlations of trauma symptom checklist with the premature ejaculation diagnostic tool score (R = 0.84) and free testosterone (R = 0.62) and somatoform dissociation questionnaire with the premature ejaculation diagnostic tool score (R = 0.53) and free testosterone (R = 0.57). Spearman correlations of trauma symptom checklist with somatoform dissociation questionnaire show significant correlation (R = 0.54).     

The decline in sexual function,psychological disorders (anxiety and depression) and life satisfaction in older men: A cross-sectional study in a hospital-based population

This study explored the relationships between the decline in sexual function and psychological burdens and life satisfaction in older men with the aim of providing prospective targets for interventions. From January 2016 to January 2019, we selected 1,326 men aged over 50 years old. We adopted the International Index of Erectile Function-5 (IIEF-5), self-estimated intravaginal ejaculatory latency time (IELT), the premature ejaculation diagnostic tool (PEDT), the General Anxiety Disorder-7 (GAD-7), the Patients Health Questionnaire-9 (PHQ-9), the satisfaction with life scale and the control, autonomy, self-realisation and pleasure scale (CASP-19) to measure premature ejaculation, erectile dysfunction and well-being (including, depression, anxiety, and life quality and satisfaction) respectively. The individuals were divided into two main groups: the decline group and the no-decline group. The incidences of erectile dysfunction (ED), premature ejaculation (PE), anxiety and depression in men who reported a decline in sexuality were 73.83% (330/447), 63.98% (286/447), 75.84% (339/447) and 68.46% (306/447) respectively. Men who showed a decline in sexuality had significantly worse psychological and life satisfaction/quality scores than those in the no-decline group (p < .001 for all). When they had PE or ED simultaneously, these differences widened. Significantly worsened psychological status and life quality/satisfaction scores could be observed in patients who had declined sexual desire and declined frequency of sex (p < .001 for both). Under the impact of the decline in sexual function, the younger participants (age < 60) had significantly worsened negative emotions and life quality and satisfaction. Based on the results of the study, we found that the decline in sexuality was associated with depression and anxiety and worse life satisfaction and quality. Clinicians need to pay more attention to psychological status and life satisfaction and quality for those patients affected by a decline in sexuality.     

Prevalence of premature ejaculation in Turkish men with chronic pelvic pain syndrome

Chronic pelvic pain syndrome is a common and serious health problem affecting the quality of life in men. Limited studies exist on the relation of this condition to premature ejaculation. We evaluated prevalence rates of premature ejaculation in Turkish male patients with chronic pelvic pain syndrome and compared them with healthy control subjects. Sixty-six men with chronic pelvic pain syndrome were included in the study (group 1). A questionnaire consisting of 2 parts--demographic data and a Turkish version of the National Institutes of Health Chronic Prostatitis Symptom index--was administered to all patients. Premature ejaculation was defined as intravaginal ejaculation latency of less than 2 minutes with the same partner for at least 6 months. All patients were evaluated with physical examinations and routine laboratory tests. If erectile dysfunction was noted from the medical history, penile Doppler ultrasonography also was performed. The results were compared with the results of 30 healthy men without urinary symptoms (group 2). The chi2 test was used for statistical analyses. Of 66 patients with chronic pelvic pain syndrome, 51 had premature ejaculation (77.3%), and in 10 (15.2%) patients, premature ejaculation and erectile dysfunction were found together. Penile Doppler ultrasonography showed no vascular pathology in patients with erectile dysfunction. The rate of premature ejaculation was higher in patients in the study group than it was in patients in the control group, and this difference was statistically significant (P < .05). Both chronic pelvic pain syndrome and premature ejaculation are common disorders, but their ethiopathogeneses are not well understood. In Turkish men with chronic pelvic pain syndrome, the incidence of psychogenic sexual problems was higher than in the normal population.     

Prevalence of sexual dysfunction in Chinese men with chronic prostatitis

OBJECTIVE: To investigate the prevalence and risk factors of sexual dysfunction in Chinese men with chronic prostatitis. PATIENTS AND METHODS: A questionnaire survey was conducted among 2000 men diagnosed as having chronic prostatitis using the National Institutes of Health Chronic Prostatitis Index and analysis of expressed prostatic secretions. The survey was designed to elicit information about age, height, weight, occupation and history of disease and treatment. The erectile capacity of the men was assessed using the five-question version of the International Index of Erectile Function. RESULTS: Of the 2000 men with chronic prostatitis selected, 1786 completed the survey; the overall prevalence of sexual dysfunction in these patients was 49%. The prevalence of premature ejaculation and erectile dysfunction accounted for 26% and 15%, respectively; 7.7% had both premature ejaculation and erectile dysfunction. There was a negative correlation between prevalence and age, and with the duration of chronic prostatitis (both P < 0.001). CONCLUSIONS: The prevalence rate of sexual dysfunction in Chinese men with chronic prostatitis is high and related to age.     

慢性前列腺炎与性功能障碍的调查分析

目的 :调查慢性前列腺炎患者性功能障碍的患病率及其与年龄、病程的关系。　方法 :对 2 0 0 0例患者进行了问卷调查 ,内容包括 :①年龄、身高、体重、职业、病程、治疗情况等 ;②国际前列腺炎症状评分指数表 (NIH CPSI) ;③勃起功能国际指数问卷 5 (IIEF 5 )。　结果 :176 8份调查表有效 (88.4 % )。慢性前列腺炎患者性功能障碍的患病率为 4 9.0 % ,其中 ,早泄占 2 6 .4 % ,勃起功能障碍占 14 .9% ,早泄合并勃起功能障碍占 7.7%。　结论 :慢性前列腺炎患者性功能障碍的患病率较高 ,患病率与患者年龄及病程呈负相关。     

Circumcision does not have effect on premature ejaculation: A systematic review and meta‐analysis

We attempted to evaluate whether circumcision has an effect on premature ejaculation. We searched three databases: PubMed, EMBASE and Google scholar on 1 May 2016 for eligible studies that referred to male sexual function after circumcision. No language restrictions were imposed. The Cochrane Collaboration's RevMan 5.2 software was employed for data analysis, and the fixed or the random‐effect model was selected depending on the heterogeneity. Twelve studies were included in the meta‐analysis, containing a total of 10019 circumcised and 11570 uncircumcised men. All studies were divided into five subgroups by types of study design to evaluate the effect of circumcision on premature ejaculation (PE). Intravaginal ejaculation latency time (IELT), difficulty of orgasm, erectile dysfunction (ED) and pain during intercourse were also assessed because PE was usually discussed along with these subjects. There were no significant differences in PE (odds ratio [OR], 0.90; 95% confidence interval (CI), 0.72‐1.13; p = .37) and orgasm (OR, 1.04; 95% CI, 0.89‐1.21; p = .65) between circumcised and uncircumcised group. However, IELT (OR, 0.72; 95% CI, 0.60‐0.83; p < .00001), ED (OR, 0.42;95% CI, 0.22‐0.78; p = .40) and pain during intercourse (OR, 0.36; 95% CI, 0.17‐0.76; p = .007) favoured circumcised group. Based on these findings, circumcision does not have effect on PE.     

Premature ejaculation and stress

Recent findings indicate that men with premature ejaculation report more frequent sexual problems associated with increased anxiety and interpersonal difficulties. Bearing this in mind, the neuroendocrine changes were examined in men with premature ejaculation and compared to other indicators of stressful experiences to see whether there can be any correlation which could indicate how these factors may contribute to the aetiology of premature ejaculation. Our study comprised 60 male outpatients diagnosed as having secondary premature ejaculation. Clinical examinations were focused on biochemical analysis of cortisol and psychometric scoring using a diagnostic tool for premature ejaculation, traumatic stress and somatoform dissociation. The control group consisted of a 60 healthy men. The results showed significant Spearman correlations of the Premature Ejaculation Diagnostic Tool score with Trauma Symptom Checklist score (R = .86), cortisol level (R = .47) and Somatoform Dissociation Questionnaire score (R = .61). In the control group, the results did not reach statistical significance. Spearman correlations of the Premature Ejaculation Diagnostic Tool score with Trauma symptoms checklist score was (R = .21), cortisol (R = .27) and with Somatoform dissociation questionnaire score (R = .25). These results represent the first reported findings documenting the relationship of traumatic stress indicators with the experience of secondary premature ejaculation and cortisol levels.     

男性慢性肾功能不全病人的性功能障碍研究

目的 :研究四川省男性慢性肾功能不全病人性功能障碍的发病情况、表现形式和相关因素。　方法 :多中心合作、临床横断面调查 ,利用性功能电脑测评与诊断系统 (SCASF) ,对四川省 12 4例慢性肾功能不全病人和 12 5例慢性肾脏病肾功能正常病人 (对照组 )的性功能状态进行综合评价 ,同时测定其血常规、肾功能、性激素、性激素结合球蛋白等指标。　结果 :①慢性肾功能不全病人性功能障碍主要表现为性欲减退、勃起功能障碍 (ED)、早泄。②慢性肾功能不全病人性欲减退、ED、早泄、性操作焦虑、性合作缺乏的发生率明显高于对照组 (P <0 .0 5 )。③血液透析和腹膜透析病人各种形式的性功能障碍的发生率和障碍的严重程度没有差异 ;透析组 (血液透析和腹膜透析 )、未替代治疗组、肾移植组比较 ,未替代治疗组性欲减退和性操作焦虑的发生率高于透析组与肾移植组 ;未替代治疗组和透析组ED的发生率高于肾移植组。④多因素分析表明 ,性功能障碍的发生与病人的病程、肌酐清除率、甲状旁腺激素、血浆白蛋白无关。贫血、抑郁和应用 β受体阻滞剂是性欲减退的危险因素。年龄增加是ED的危险因素。应用血管紧张素转换酶抑制剂或血管紧张素受体拮抗剂和应用人基因重组促红细胞生成素 (r HuEpo)可减少ED的发生。　结论 :男性慢性     

SPP、TURP、HoLEP三种前列腺切除术对性功能的影响

目的比较钬激光前列腺切除术（HoLEP）、经尿道前列腺电切术（TURP）和耻骨上前列腺切除术（SPP）三种手术方式对BPH患者性功能的影响。方法随访92例前列腺切除手术的BPH患者，评价：IPSS、性生活情况、勃起功能（阴茎勃起硬度、IIEF-5）和射精情况（射精有无、精液量、有无逆行射精、有无射精痛）。结果（1）三组术后3月IPSS评分均有显著下降（P〈0．01）；（2）三组术后IIEF-5均有不同程度降低，SPP组与术前比较，差异有显著统计学意义（P〈0．01）。校正可能影响IIEF-5的因素后，三组手术IIEF．5评分改变无统计学差异；（3）HoLEP组、TURP组、SPP组勃起功能下降的发生率分别为：38．1％、28．6％、31．0％，HoLEP、SPP组术后勃起硬度下降明显；（4）HoLEP组和SPP组术后逆行射精发生率较术前有显著差异；（5）三种手术对性欲以及射精量的影响均较小；（6）勃起硬度的降低以及逆行射精的发生三种手术间无明显差异。结论HoLEP术后可导致性功能下降，主要表现在勃起功能降低和逆行射精。HoLEP术对性功能的影响与TURP和SPP相似。     

Clomipramine and Sexual Function in Men with Premature Ejaculation and Controls

Purpose

We determined whether clomipramine taken as needed increases ejaculation latency in men with premature ejaculation and controls.

Materials and Methods

The study included 8 patients with primary premature ejaculation, 6 with premature ejaculation and erectile dysfunction, and 8 controls. A prospective, double-blind, placebo controlled, crossover design was used that included 2, 3-week periods with clomipramine and placebo. During treatment phases subjects took either 25 mg. clomipramine or placebo as needed, that is 12 to 24 hours before anticipated sexual activity (coitus or masturbation). Subjects also visited the laboratory during these phases for evaluation of sexual response using visual erotic stimulation with and without vibration to the penis. Daily logs of sexual activities were maintained during treatment phases.

Results

Clomipramine significantly increased the latency to ejaculation during sexual activity (coitus or masturbation) from approximately 2 to 8 minutes in men with primary premature ejaculation. There were no significant effects in controls and men with premature ejaculation plus erectile dysfunction. Laboratory assessment indicated that men with primary premature ejaculation were better able to control ejaculatory response with clomipramine therapy. In these men clomipramine also resulted in increased satisfaction with sex life and relationship. Clomipramine inhibited nocturnal penile tumescence in all subjects.

Conclusions

Clomipramine (25 mg. as needed) effectively increases ejaculatory latency in men with primary premature ejaculation, while treatment is not effective in those with premature ejaculation and erectile dysfunction.     

The relationship between serum irisin levels and erectile dysfunction in diabetic men (irisin and erectile dysfunction in diabetic patients)

Irisin is an exercise-induced myokine that alleviates endothelial dysfunction and reduces insulin resistance in type 2 diabetes mellitus. We conducted this cross-sectional prospective study to determine the association of serum irisin levels and erectile dysfunction in type 2 diabetic patients. We compared 34 diabetic patients with erectile dysfunction with 30 diabetic patients without erectile dysfunction. In our study, serum irisin levels were found to be statistically significantly higher in diabetic patients without erectile dysfunction compared to those with erectile dysfunction (p = .016) and according to correlation analysis, irisin levels had a significantly negative correlation with the serum HbA1C value (r = −.294, p = .018). Based on the results of our study, we think that this molecule can be used in the diagnosis or treatment of erectile dysfunction in diabetic patients, if these findings are supported by larger studies.     

Prevalence of sexual dysfunction in men with chronic prostatitis/chronic pelvic pain syndrome: a meta-analysis

Purpose

This study aims to estimate the prevalence of sexual dysfunction in men with chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) by conducting a meta-analysis.

Methods

Relevant publications were searched using PubMed, Embase, CBM, China National Knowledge Infrastructure, VIP and Wanfang databases up to August 2015. Studies that reported the prevalence of erectile dysfunction, premature ejaculation and total sexual dysfunction in men with CP/CPPS were included.

Results

A total of 24 studies involving 11,189 men were included. Overall prevalence of sexual dysfunction in men with CP/CPPS was 0.62 (95 % CI 0.48–0.75), while the prevalence of erectile dysfunction and premature ejaculation was 0.29 (95 % CI 0.24–0.33) and 0.40 (95 % CI 0.30–0.50), respectively. From 1999 to 2010, the prevalence of sexual dysfunction, erectile dysfunction and premature ejaculation was 0.65 (95 % CI 0.45–0.83), 0.27 (95 % CI 0.22–0.33) and 0.41 (95 % CI 0.27–0.55), respectively. From 2011 to 2014, the prevalence of sexual dysfunction, erectile dysfunction and premature ejaculation was 0.50 (95 % CI 0.22–0.75), 0.35 (95 % CI 0.29– 0.40) and 0.39 (95 % CI 0.37–0.41), respectively.

Conclusion

The prevalence of sexual dysfunction in men with CP/CPPS was high, even though overall sexual dysfunction demonstrated a slightly decreasing trend. Furthermore, erectile dysfunction prevalence rate had an increasing trend in recent years. More prospective studies are needed to evaluate sexual dysfunction improvement with better management of CP/CPPS.

     

Sexual dysfunction in type III chronic prostatitis (CP) and chronic pelvic pain syndrome (CPPS) observed in Turkish patients

Aim  

Chronic prostatitis (CP) and chronic pelvic pain syndrome (CPPS) is a common disabling condition that is primarily associated with pain in the urogenital region and disturbances in urinary and sexual function. Chronic pelvic pain symptoms are the most common presentation, especially perineal, lower abdominal, testicular, penile as well as ejaculatory pain. Other genitourinary tract complaints include voiding disorders and sexual dysfunction. We aimed in the study at examining the prevalence rates of premature ejaculation and erectile dysfunction in patients with chronic pelvic pain syndrome and comparing these rates with those of healthy control subjects.     

不同术式治疗前列腺增生症对性功能影响的观察

目的 比较3种不同术式治疗良性前列腺增生症(BPH)术后对性功能的影响。方法 对40例经尿道前列腺电切术(TURP)和60例耻骨上前列腺切除术(SPPC)与40例改良保留尿道前列腺切除术(MMPC)患者进行9个月的追踪观察，总结其术后勃起功能障碍(ED)及逆行射精发生率。结果 TURP组术后ED发生率增加了35％(14／40)，逆行射精的发生率为50％；SPPC组和MMPC组术后ED的发生率分别增加了为33．33％(20／60)、7．5％(3/40)，逆行射精的发生率分别为62．5％和16％。结论 在治疗前列腺增生症3种术式中，术后性功能损害MMPC组优于TURP组和SPPC组，逆行射精发生率MMPC组也优于其他术式。     

Impact of varicocelectomy on urine dopamine value in patients with premature ejaculation and varicocele

Dopamine is an important regulator of male sexual function and behaviour. Decreased levels of this substance have been observed in blood and seminal plasma of infertile men. Hence, this study was carried out to determine the impact of varicocelectomy on 24‐hr urine dopamine values in patients with both premature ejaculation (PE) and varicocele. In this prospective study, 55 consecutive patients with premature ejaculation and grade 2 or 3 varicocele were enrolled. The urine dopamine level was measured in a 24‐hr sample by HPLC method in a single laboratory centre. Two samples were gathered from each patient, one before and the other 1 month after varicocelectomy. The mean initial and final 24‐hr urine dopamine levels were 259.6 ± 86.3 and 602.9 ± 88.4 micrograms, respectively, showing statistically significant increase (p = .0001), while there was no statistically significant difference between urine volume and creatinine. However, the change in intravaginal ejaculation latency time value was not statistically significant at this short time visit. According to our findings, varicocelectomy results in a significant increase in 24‐hr urine dopamine levels in patients with premature ejaculation and varicocele. However, the effect of this change on premature ejaculation in the long term has yet to be determined.     

Erectile dysfunction, premature ejaculation and hypogonadism and men’s quality of life: an Asian perspective

A large percentage of men are still sexually active as they age. Hence, sexual problems potentially impair men’s quality of life even in later years. Erectile dysfunction, premature ejaculation and hypogonadism are among the common sexual health problems faced by men. Published data from Asian countries demonstrate that erectile dysfunction is associated with poor quality of life in the mental and vitality domains, with increased physical co-morbidity, such as diabetes, heart diseases, prostate hyperplasia, and hyperlipidemia, and with psychological ill-health e.g. depression. A great proportion of men are also bothered by their erectile dysfunction. Although the data on premature ejaculation and hypogonadism in Asian countries are limited, there is evidence to suggest that premature ejaculation is associated with perceived low general health status, increased depression, increased anxiety, and poor mental health and vitality scores. The data also suggests that hypogonadism is associated with a number of domains in quality of life scores and depression. In conclusion, in Asian countries, erectile dysfunction, premature ejaculation and hypogonadism should be actively identified and treated to improve men’s quality of life.