Management of premature ejaculation -- a comparison of treatment outcome in patients with and without erectile dysfunction

This study evaluated the problem of premature ejaculation (PE) in patients treated for erectile dysfunction. The aim was to compare the efficacy of selective serotonin reuptake inhibitors (SSRIs) in the management of primary PE and PE associated with sildenefil treatment. Eighty-seven patients with PE seen over a period of 17 months were recruited into this prospective study. They were categorized into two groups: primary PE (GPI) and PE in sildenefil-treated patients (GPII). All patients recruited into GPII had erectile dysfunction (ED) that was successfully treated with sildenefil citrate for at least a year. Both groups of patients were given sertraline 50 mg 4 h before expected time of sex. The minimum follow-up was 6 months. The ejaculation latency before and after treatment of the two groups were compared. The sexual satisfaction scores of the patients in the two groups were also sought and analysed. Twenty-eight percent of patients with ED who were successfully treated with sildenefil developed PE. Subjects in group GPI were younger and have less comorbid factors than those in group GPII. There was no significant difference in the mean ejaculation latency for both groups (46 vs. 34.6 sec for GPI and GPII, respectively). However, there was highly significant difference in the ejaculation latency between the two groups after treatment with sertraline for 6 months (247.2 vs. 111.6 sec for GPI and GPII, respectively). There was also significant difference in the sexual satisfaction score for group GPI post-treatment, but not for GPII. No significant side-effect of sertraline was reported from patients in both groups. Successful treatment of ED could not assure sexual satisfaction. At least a quarter of sildenefil treated ED patients might develop PE which would continue to frustrate these patients sexually. While selective serotonin re-uptake inhibitors (SSRIs) was effective in the management of primary PE, they were not as effective in patients with sildenefil corrected ED.     

Impact of erectile function and age in men with lower urinary tract symptoms on ejaculatory dysfunction and premature ejaculation

Lower urinary tract symptoms (LUTSs) and ED are clearly correlated, but to date no correlation with ejaculatory dysfunction (EjD) has been identified. Therefore, this study evaluated the impact of erectile function in men with LUTS on EjD and premature ejaculation (PE). Erectile function, PE and EjD of 239 men (mean age, 53.0 ± 10.65 years), International Prostate Symptom Score (IPSS), International Index of Erection Function (IIEF), intravaginal ejaculatory latency time (IELT) and the seven-item Male Sexual Health questionnaire (MSHQ)-EjD were used to compare with the degree of LUTS. Ages were divided into five groups (<40, 40-49, 50-59, 60-69 and >70 years). The IPSS categorized patients into three symptom groups: mild, 1-7; moderate, 8-19; and severe, >19. ED was classified into five categories based on IIEF-EF scores: severe (0-6), moderate (7-12), mild-to-moderate (13-18), mild (19-24) and normal (25-30). The correlations among age, IIEF-EF, IELT and the MSHQ-EjD domain were studied through regression and cross-tabulation analyses. The results revealed that aging significantly affected each item of the MSHQ-EjD (P<0.05). The IIEF-EF domain was also correlated with each question on the MSHQ-EjD (P<0.05). PE (IELT <1 min) increased in incidence as patients got older but was not linked to IIEF-EF (P>0.05). These results indicate that EjD is closely related to age and erectile function, and that PE is closely related to age, although PE is not related to erectile function.     

Sexual dysfunction in partners of men with premature ejaculation

Research in partners of men with erectile dysfunction suggests that a woman's sexual difficulties can be contingent on her partner's sexual dysfunction. However, little research has been conducted in partners of men with other sexual dysfunctions, such as premature ejaculation (PE). We evaluated 139 partners of men diagnosed with having PE and 89 age-matched women whose partners did not have any sexual dysfunction. Results showed that 77.7% of PE partners had at least one sexual dysfunction, compared to 42.7% of the control group. Further research needs to be undertaken to investigate the temporal relationship between sexual dysfunctions in both partners.     

银屑病与勃起功能障碍的研究进展

银屑病是一种与多个系统密切相关的慢性炎症性疾病。近年来流行病学研究显示,银屑病与勃起功能障碍(ED)的发生密切相关,可能是引起ED的一个独立因素。银屑病引起ED可能与血管内皮损伤、氧化应激、精神抑郁等有关。探讨银屑病患者ED的发生情况及发病机制,有助于提高银屑病患者对发生ED的早期认识,预防ED的发生、发展,对改善银屑病患者的生活质量具有重要意义。     

Clinical evaluation of lumbar disc hernia in the teenagers

Lumbar disc herniation is a rare occurrence in teenagers. There are several questions as to its pathogenesis, relationship to trauma, and clinical manifestations compared with those in adults. In the present paper, we described nine cases of teen-age lumbar disc herniation, which accounts for about 3.3% of all the operated lumbar disc herniations in our clinic. In the discussion, 687 cases of teen-age lumbar disc herniation were analyzed from the world literature. The clinical signs and symptoms in teenagers showed no distinct difference from those in adults. Laségue's sign was found in nearly all the patients. Although direct or indirect trauma to the lumbar region may play an important role in causing disc herniation in teenagers, a more important factor seems to be the degeneration of the disc material, which begins in children earlier than usually suspected. Although surgical therapy has been advocated by many authors, it must be followed up for a long term before the efficacy of such treatment for teenagers can be confidently ascertained.     

非编码RNAs与勃起功能障碍关系研究进展

勃起功能障碍(ED)是一种与年龄、心理、躯体疾病、生活方式等众多因素相关的疾病,严重降低了患者的生活质量。以往认为一部分由基因转录而来但不翻译成蛋白的非编码RNAs(ncRNAs)是基因表达过程中的"废物",但近年来发现它们在基因表达过程中起着至关重要的调节作用,ncRNAs对基因表达产物调节可影响阴茎的勃起功能,本文对ncRNAs与ED关系的研究进展进行了综述。     

内皮微粒与勃起功能障碍关系的研究进展

细胞膜微粒是细胞激活、受损和/或凋亡时从质膜上脱落的亚微米囊泡。在正常的机体中,它有多种细胞来源(血小板、白细胞、内皮细胞等),但是在病理条件下其数量就会发生改变。内皮微粒是一种内皮细胞源的包膜微粒,新近研究发现它不仅是一种内皮功能紊乱的标记,同时还可能作为一种新的诊疗勃起功能障碍的重要生物标记。     

Prostatic profile,premature ejaculation,erectile function and andropause in an at-risk Mexican population

Objective  To determine the frequency of prostatic symptomatology, premature ejaculation (PE), erectile function, symptoms in the older adult/andropause assessment and to determine the risk factors involved. Materials and methods  The study was conducted by the Mexican Society of Urology and was carried out from June to October 2006. Epidemiological information was obtained through the completion of four validated questionnaires by patients receiving non-institutional urology treatment. The large database was statistically analyzed using a logistic regression model. Results  A total of 1,779 men with an average age of 56.6 years were included in the study. The average prostate-specific antigen value in the sample was 1.73 (n = 1,316). Prostatic symptomatology in accordance with the international prostate symptom score was 7.96 points. A total of 41.9% of participants reported experiencing PE. The average time to reach ejaculation was 10.97 min. Of the participating individuals, 39.5% were diagnosed with andropause. Prostatic symptomatology was associated with risk factors of age and prostatitis, P < 0.01. Premature ejaculation and erectile dysfunction were associated with age, P < 0.01. Vasomotor problems in the older adult were identified with an association tendency towards alcoholism and excess weight, P < 0.063, but without statistical significance. Sexual problems in the older adult were associated with diabetes mellitus, P < 0.01. Andropause was associated with traumatic problems in general.     

他达拉非治疗ED的概述

勃起功能障碍(ED)是男科常见病、多发病,PDE5抑制剂能竞争性抑制PDE5而抑制cGMP的水解,提高阴茎海绵体平滑肌细胞内cGMP浓度,达到治疗ED的效果。他达拉非可使阴茎海绵体内cGMP水平提高,从而导致勃起。他达拉非可有效改善各种病因和各种程度ED患者的勃起功能;其具有以下特点:有效时间长,安全性高,易于被患者及性伴侣接受,增强性自信、性自尊,性体验更加自然。使患者从生理、心理上最大程度的得到治疗,有效提高性生活质量。因此他达拉非在ED患者的治疗中值得推广。     

A study on tension signs in lumbar disc hernia

Summary The laminae were removed from the lower lumbar spines of five cadavers within four hours of death. A short length of rubber tube was inserted between the nerve roots and the lumbar disc and the tension monitored using semiconductor pressure transducers. The angulatory stresses exerted on the lumbar nerve roots during tension sign tests were found to correspond to clinical experience.

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Résumé Les lames des dernières vertèbres lombaires ont été réséquées sur cinq cadavres dans les quatre heures suivant la mort. Un court tube de caoutchouc a été inséré entre les racines nerveuses et le disque lombaire; la tension a été ensuite enregistrée grâce à des capteurs de pression transistorisés. Les stress angulaires exercés sur les racines lombaires lors de la recherche des signes de tension correspondent aux résultats fournis par l'expérience clinique.

     

BPH与勃起功能障碍关系的研究进展

目前研究已证实勃起功能障碍(ED)和良性前列腺增生(BPH)之间除了有高龄等共同危险因素外,在流行病学上也具有相关关系。虽然目前的研究尚不能得出直接的因果关系,但包括一氧化氮生物利用度改变,自主神经系统和α1受体功能亢进,RhoA/Rhod激酶通路异常及代谢综合征等多种因素在ED和BPH的发病中均起到重要作用。因此对BPH患者进行评估治疗时,应同时筛查性功能指标,判断是否同时合并有ED。多项临床研究发现他达拉非等PDE5抑制剂在ED合并BPH相关下尿路症状的治疗中效果良好,这为进一步研究ED合并BPH的治疗和预防奠定了基础。