Relevance of seminal plasma nitric oxide levels and the efficacy of SSRI treatment on lifelong premature ejaculation

The aim of this study was to determine the relevance of seminal plasma nitric oxide (NO) levels and the efficacy of selective serotonin reuptake inhibitor (SSRI) treatment on premature ejaculation. A total of 16 men (aged 32.18 ± 3.32) with lifelong premature ejaculation [intravaginal ejaculation latency time (IELT) <1 min] and 11 healthy men (control group) were included in this study. The healthy men formed Group 1, and the patients were randomly categorised into two groups. Group 2 patients received 20 mg day^?1 of paroxetine, and Group 3 patients received 50 mg day^?1 of sertraline for 4 weeks. Baseline and post‐treatment findings were compared among the three groups. Mean baseline seminal NO levels in men with premature ejaculation were significantly higher than in the healthy control group (32.24 ± 5.61 μm  l^?1 versus 19.71 ± 3.50 μm  l^?1, respectively) (P < 0.001). There was no significant difference between the sertraline and paroxetine groups in terms of IIEF scores, IELT scores and NO levels. At the end of the first month, the mean IELT scores of the paroxetine and sertraline groups showed a significant improvement compared with the baseline values (P < 0.001). After treatment with paroxetine and sertraline, NO levels dec‐reased from baseline. Our study indicates that premature ejaculation is significantly related with a higher level of seminal NO. Baseline seminal plasma NO values obtained in patients with premature ejaculation were significantly higher than in the healthy control group. After treatment with SSRIs, decreased seminal NO may retard ejaculation. Further studies are needed to confirm this suggestion and the role of NO in the pathophysiology and treatment of premature ejaculation.     

Relation between blood vitamin B12 levels with premature ejaculation: case–control study

The aim of this study was to investigate whether vitamin B12 levels are associated with premature ejaculation (PE). A total of 109 subjects (56 PE and 53 controls) were included in this study. PE was defined as self‐reported intravaginal ejaculatory latency time (IELT) based on the Diagnostic and Statistical Manual of Mental Disorders IV criteria and those who had had an IELT of <2 min was considered as PE. All participants were evaluated using premature ejaculation diagnostic tool (PEDT), International Index of Erectile Function (IIEF) and Beck Depression Inventory (BDI). The vitamin 12 levels were measured in all subjects. The mean age between the PE and controls was comparable (p = .084). Mean IIEF and BDI scores between the two groups did not statistically differ. The mean IELT values in the PE group were significantly lower than in the control group (p < .0001). PE patients reported significantly lower vitamin B12 levels compared with the controls (213.14 vs. 265.89 ng ml^?1; p < .001). The ROC analysis showed a significant correlation between the diagnosis of PE and lower vitamin B12 levels. This study has demonstrated that lower vitamin B12 levels are associated with the presence of PE. This work also shows a strong correlation between vitamin B12 levels and the PEDT scores as well as the IELT values.     

Use of paroxetine on-demand in premature ejaculation

IntroductionIt has been described varied definitions of premature ejaculation (PE), which has determined different prevalences and rates of success for the different therapies with selective serotonin re-uptake inhibitors. Our goal was evaluate the effectiveness of paroxetine like treatment of premature ejaculation administered ondemand (4-6 hours previous to intercourse) compared to the scheme of daily dose.Patients and methodA prospective study type crossover was designed with 14 patients. Grupo A: 7 patient received paroxetine 20 mg /d by three weeks followed by paroxetine 20 mg 4-6 hours before the intercourse by three weeks. Group B: the other 7 patients received the same scheme but replacing by placebo. Later to three weeks of therapy suspension, crossover was made.ResultsThe intravaginal ejaculatory latency time (IELT) pre-treatment was 0,4 minutes. In the group A the IELT average was of 4,3 minutes in the treatment with daily paroxetine; 5,8 minutes when they received paroxetine on-demanad; 0.9 with daily placebo and 0,6 with placebo on-demand (p < 0.001). For group B the IELT during the daily placebo was 0,8 minutes and with placebo on-demand it was of 1,1 . When they received daily paroxetine the IELT was 3,3 minutes and during the phase of paroxetine on-demand it was increased to 6,1 (p<0.001).ConclusionsThe treatment of premature ejaculation with paroxetine in daily dose and scheme on-demand appears similar like effective options.     

Safety and efficacy of vardenafil versus sertraline in the treatment of premature ejaculation: a randomised, prospective and crossover study

We investigated safety and efficacy of vardenafil and sertraline in premature ejaculation (PE). Seventy-two men graded their primary PE on a scale of 0–8 (0 = almost never, 8 = almost always). Intravaginal ejaculatory latency time (IELT) was measured. Patients were included if they scored their PE as 4 or greater and their IELTs were less than 1.30 min. After 6 weeks of behavioural psychosexual therapy, 49 patients still had a PE of 4 or greater and an IELT less than 1.30 min and they were randomised: 6 weeks vardenafil (10 mg) or sertraline (50 mg). After a wash-out phase for 1 week, medication was changed in a cross-over design. Initially, all 72 men with PE received behavioural therapy. Twenty-three men were satisfied with treatment and excluded. The remaining 49 men graded their PE as 5.94 ± 1.6 and IELT was 0.59 min and patients were randomised. Four men discontinued the study. Vardenafil improved PE grading: 2.7 ± 2.1 ( P  < 0.01) and IELT increased to 5.01 ± 3.69 ( P  < 0.001). PE grading improved 1.92 ± 1.32, ( P  < 0.01) and IELT 3.12 ± 1.89 ( P  < 0.001) with sertraline. It is concluded that vardenafil and sertraline are useful agents in the pharmacological treatment of PE.     

Combination therapy with selective serotonin reuptake inhibitors and phosphodiesterase‐5 inhibitors in the treatment of premature ejaculation

We aimed to evaluate the effectiveness of paroxetine and tadalafil combination in the treatment of premature ejaculation (PE). A total of 150 primary (lifelong)PE patients were randomly distributed into three groups of 50 patients each. Group 1 received 20 mg paroxetine every day for 1 month, Group 2 received 20 mg tadalafil on demand 2 h before intercourse, and Group 3 received paroxetine and tadalafil on demand 2 h before intercourse. Intravaginal ejaculatory latency times (IELT) scores were evaluated at baseline, at the end of the first month of therapy and 1 month after discontinuation of the treatment, while International Index of Erectile Function (IIEF) questionnaire scores were evaluated both prior to and after the treatment. At the end of the first month of therapy, IELT scores were compared with the basal values and statistically significant changes were detected (60.6 ± 30.2–117.3 ± 67.3, 68.5 ± 21.4–110.2 ± 37.3, 71.56 ± 40.23–175.2 ± 60.2)(P < 0.01). IELT scores after discontinuation of treatment were found to be close to the baseline IELT scores (P > 0.05). IIEF scores were evaluated both prior to and after the treatment, and no statistically significant difference was detected (P > 0.05). It is concluded that utilisation of selective serotonin reuptake inhibitors (SSRI) and phosphodiesterase‐5 inhibitors (PDE5i) combination before intercourse seems to provide significantly longer ejaculatory latency times as compared with SSRI alone for a long time in patients with PE.     

Lifelong premature ejaculation: definition, serotonergic neurotransmission and drug treatment

The ejaculation distribution theory (EDT) postulates a biological continuum of the intravaginal ejaculation latency time (IELT) in men. Such an continuum has recently been found in two epidemiological stopwatch studies. In addition, a continuum of ejaculation latency time has also been demonstrated in laboratory rats. It is suggested that the invariable parts of ejaculation, i.e. premature and retarded ejaculation are highly influenced by genetic and neurobiological factors. In contrast, superimposed on biological roots, ejaculation of men, in the middle part of the continuum, is probably more easily influenced by environmental and psychological factors. A meta-analysis of 35 daily SSRI and clomipramine treatment studies demonstrated a similar efficacy for paroxetine, clomipramine, sertraline and fluoxetine, with paroxetine exerting the strongest effect on ejaculation. Based on fundamental insights into serotonergic neurotransmission, it is suggested that on-demand conventional SSRI treatment will not lead to similarly impressive ejaculation delay as that found after daily conventional SSRI treatment. Future studies with SSRIs with short half-lives, short T_max and high C_max should elucidate whether these pharmacokinetic properties are able to affect the pharmacodynamics of 5-HT neurons in such a way that immediate clinically relevant ejaculation delay occurs.     

口服帕罗西汀治疗早泄的随机对照研究

目的:验证帕罗西汀对早泄的治疗效果。方法:将符合纳入标准的80例早泄患者随机分为试验组和对照组,每组40例。所有患者进入为期4周的基线水平观察期,记录治疗前的阴道内射精潜伏时间(IELT)和性交满意度分值。试验组每天口服帕罗西汀20 mg,对照组口服安慰剂。治疗30 d后记录每个患者治疗后的IELT值和性交满意度分值。结果:试验组治疗后平均IELT与治疗前比较明显延长(5.75±1.24 min vs 0.89±0.21min,P<0.01),性交满意度与治疗前比较明显提高(6.4±1.2分vs 2.7±0.9分,P<0.01)。对照组治疗后平均IELT和性交满意度与治疗前比较均无显著性差异(1.06±0.28 min vs 0.97±0.18 min,3.6±1.3分vs 3.1±1.1分,P>0.05)。结论:早泄患者每天口服帕罗西汀20 mg,30 d后IELT和性交满意度均有明显改善。     

帕罗西汀与达帕西汀的对比，治疗早泄的新的选择性5-羟色胺再摄取抑制剂

达帕西汀氢氯化物是一种选择性5-羟色胺再摄取抑制剂,也是第一种被批准可以按需服用治疗早泄的药物。本文目的为研究按需服用达帕西汀（30mg和H60mg）和每日服用帕罗西汀（20mg）对早泄的疗效。研究募集了150名患者进行了长达1个月的研究。患者被分成3组,每组50人。第一组按需服用达帕西汀30mg。第二组按需服用达帕西汀60mg。第三组每日服用帕罗西汀20mg。治疗结束后,我们的结果检测值相对于基准阴道内射精潜伏期（IELT）延长了。与基准IELT相比,帕罗西汀组、30mg达帕西汀组和60mg达帕西汀组的治疗后IELT分别延长了117％（P〈0．01）,117％（P〈0．01）和170％（P〈0．01）。30mg达帕西汀组和帕罗西汀组的IELT增幅相同（P〉0．05）,而60mg达帕西汀组的IELT增幅明显高于30mg达帕西汀组（P〈0．05和帕罗西汀组P〈0．01）。性交前1～3小时服用达帕西汀60mg是针对早泄的非常有效的治疗方法。然而,与当前普遍使用的帕罗西汀相比,达帕西汀30mg疗效并不显著。     

Impact of physical activity on patient self‐reported outcomes of lifelong premature ejaculation patients: Results of a prospective,randomised, sham‐controlled trial

Previous studies have investigated whether physical activity increases serotonin hormone levels. Serotonin receptor dysfunction is one of the frequently accused factors of premature ejaculation (PE). Nevertheless, no studies up to date have demonstrated that the association between physical activity and premature ejaculation. We aimed to investigate the relationship between physical activity and PE and determine whether moderate physical activity might delay ejaculation time or be an alternative treatment for PE. A total of 105 patients diagnosed with PE were enrolled in this study. Of the patients, 35 were treated with dapoxetine, (30 mg) on demand (Group 1), 35 performed moderate physical activities (Group 2), and 35 performed minimal physical activity (Group 3‐sham). Demographic characteristics, metabolic equivalents (MET), premature ejaculation diagnostic tool (PEDT) and intravaginal ejaculatory latency time (IELT) were recorded. There were no significant differences among three groups in terms of age, BMI, MET, PEDT or IELT before treatment. At the end of the study, there was significant decrease in PEDT scores, and increase in IELT in groups 1 and 2 as compared to Group 3. In conclusion, a moderate physical activity longer than 30 min at least 5 times a week leads to ejaculation delay, and appears as an alternative to dapoxetine on demand for the treatment of PE.     

Analysis of association between the 5‐HTTLPR and STin2 polymorphisms in the serotonin‐transporter gene and clinical response to a selective serotonin reuptake inhibitor (sertraline) in patients with premature ejaculation

Study Type – Therapy (cohort)
Level of Evidence 2b

OBJECTIVE

To test the hypothesis that polymorphism within the gene‐linked polymorphic region (5‐HTTLPR) and second intron of SLC6A4 gene (STin2) is associated with selective serotonin‐reuptake inhibitors (SSRIs) response in subjects with premature ejaculation (PE).

PATIENTS AND METHODS

In all, 246 men with PE were recruited in this study. They were asked to take sertraline 50 mg daily for 2 weeks, and thereafter 100 mg daily, for a 12‐week treatment period. Pretreatment evaluation included history and physical examination, intravaginal ejaculatory latency time (IELT), and International Index of Erectile Function (IIEF). The efficacy of treatment was assessed using responses to IIEF, and geometric mean IELT evaluation. 5‐HTTLPR was genotyped using polymerase chain reaction techniques. A repeated‐measures analysis of variance of geometric mean IELT was done to test a genotype effect on treatment outcome with SSRI (sertraline).

RESULTS

Of 227 participants who completed the study, 175 (77.1%) responded to sertraline (IELT >1 min). Overall the patients had a 3.7‐fold (95% confidence interval, CI, 1.72–5.46) increase of the geometric mean IELT (P = 0.001). The results showed that responses were significantly better for the L_A/L_A genotype of the 5‐HTTLPR polymorphism than for S‐allele carriers (P = 0.001). The STin2 12/12 genotype was found more often in those responding to sertraline than in those not responding (P = 0.001). The probability of patients responding sufficiently to sertraline with an L_A/L_A genotype was highest (odds ratio 4.66, 95% CI, 2.48–6.14).

CONCLUSIONS

These findings indicate that the genotype of 5‐HTT contributes in unique ways to the variation in the outcome of PE treatment with SSRIs.     

Effect of premature ejaculation desensitisation therapy combined with dapoxetine hydrochloride on the treatment of primary premature ejaculation

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.     

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

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.     

The pharmacological treatment of premature ejaculation

Premature ejaculation (PE) is a common sexual dysfunction in men that is characterized by a short time to ejaculation, and a lack of control over ejaculation, and is associated with distress for men and their partners. Lack of knowledge about the aetiology of PE and lack of approved treatments might contribute to its under-diagnosis and under-treatment. The organic factors involved in PE are not well understood but serotonin (5-hydroxytryptamine, 5-HT) is important at the level of the central nervous system in the complex regulatory mechanisms involved in ejaculation. Selective serotonin reuptake inhibitor (SSRI) antidepressants (paroxetine, fluoxetine and sertraline) and the tricyclic antidepressant clomipramine increase ejaculatory control and delay ejaculation in men with PE, suggesting that pharmacological intervention might be useful for PE. These agents are intended for chronic dosing for treating psychiatric disorders because of their pharmacokinetic profile and pharmacodynamic activity, which might result in limitations when used for treating PE. Indeed, these properties might limit the utility of these drugs, whether administered on-demand or chronically, for the episodic treatment requirements of PE. Elevated synaptic 5-HT levels achieved with acute SSRI treatment might be self-limiting because of activation of presynaptic 5-HT(1A) autoreceptors, and chronic 5-HT(1A) autoreceptor desensitization might contribute to an increase in side-effects and withdrawal symptoms. Short-acting SSRIs such as dapoxetine, currently under development for the on-demand treatment of PE, might circumvent these limitations and offer better ejaculatory control and sexual satisfaction for men with PE. Phosphodiesterase-5 inhibitors have also been evaluated for treating PE, as have topical anaesthetics and the narcotic analgesic tramadol.     

Correlations and stratification analysis between premature ejaculation and psychological disorders

We studied the associations and correlations between premature ejaculation (PE) and psychological disorders, such as anxiety and depression, in new perspectives with an aim of improving PE patients' treatment outcomes. Between December 2017 and December 2018, we selected 1,010 men aged over 18 years old. Self‐estimated IELT, the premature ejaculation diagnostic tool, the International Index of Erectile Function‐5, the General Anxiety Disorder‐7 and the Patients Health Questionnaire‐9 were used to measure latency time, premature ejaculation, erectile dysfunction, anxiety and depression respectively. Premature ejaculation patients were categorised into two types: lifelong PE (LPE) and acquired PE (APE). Among the 958 men evaluated, the prevalence of anxiety and depression in PE group was 82.07% (444/541) and 74.68% (404/541) respectively. Premature ejaculation patients after adjustment for age, negative association of IIEF‐5 and positive relation of PEDT score with GAD‐7/PHQ‐9 were observed (p < 0.01 for all). These associations in men with LPE were stronger than APE. Stratification of the duration of PE showed that the longer the duration is, the more the prevalence of anxiety and depression will be. Age stratification showed that under the impact of PE, young men tend to have severe psychological problems.     

Relevance of methodological design for the interpretation of efficacy of drug treatment of premature ejaculation: a systematic review and meta-analysis

The aim of this systematic review and meta-analysis is to evaluate whether the design and methodology of drug-treatment studies of premature ejaculation affect the efficacy outcome differently. Therefore, methodological, design and efficacy data from 79 studies (3034 males), published between 1943 and 2003, are reviewed. A meta-analysis is performed on 43 selective serotonin reuptake inhibitors (SSRIs) and clomipramine studies (1514 males), published between 1973 and 2003; these studies were pooled to provide a summary variance-weighted effect size. The antidepressant-induced percentage increase of the intravaginal ejaculation latency time (IELT) was calculated and examined against various methodological items. A significant difference in efficacy between SSRIs was observed. Using daily treatment, paroxetine appeared more effective than the other SSRIs. Retrospective use of a questionnaire, subjective reports, single-blind and open study designs generate far greater variability of ejaculation time both at baseline and during active drug treatment than real time assessment by stopwatch. In conclusion, at daily treatment, the overall efficacy of paroxetine, clomipramine, sertraline and fluoxetine is comparable, but paroxetine exerts the strongest ejaculation delay. Only eight (18.5%) studies on antidepressant treatment fulfilled all criteria used in evidence-based medicine, for example, randomised, double-blind studies with prospective real time (stopwatch) assessment of the IELT at each intercourse. Single-blind studies, open designs, retrospective reporting, or the use of a questionnaire to assess ejaculation time should be avoided.     

早泄诊断和治疗

早泄(premature ejaculation,PE)是临床上最常见的主诉之一,其共同特征为:射精潜伏期缩短、延迟或控制射精的能力下降、并引起患者痛苦/烦恼。目前尚无一致公认的PE定义。不同定义之间争论的焦点是如何设定射精潜伏期(intravaginal ejaculatory latency time,IELT)。新的分类方法将PE分为:原发性、继发性、自然变异性和早泄样射精障碍。不同类型PE发生的病理生理和病因学不同,决定了治疗方案的差异。     

Possible role of serum testosterone,gonadotropins and prolactin in patients with premature ejaculation

Premature ejaculation (PE) is the most common male sexual dysfunction. This study aimed to investigate the role of serum testosterone, gonadotropins and prolactin in patients with PE. In a prospective a case‐controlled study, it was conducted on 90 male patients with PE and 90 male healthy participants as controls. Patients were evaluated by Premature Ejaculation Diagnostic Tool (PEDT) and intravaginal ejaculatory latency time (IELT). Patients with mean IELT values ≤60 s and PEDT total scores ≥11 were considered to have PE. Serum levels of total testosterone (TT), free testosterone (FT), follicle‐stimulating hormone (FSH), luteinising hormone (LH) and prolactin (PL) were investigated in patients with PE and controls. There was no statistically significant difference between patients with PE and controls regarding the serum levels of TT, FT, FSH, LH and PL (p value ?.05). There was no significant correlation between the sex hormones levels (TT, FT, FSH, LH and PL) and (age, body mass index (BMI), IELTS and total PEDT scores of the patients; p value ?.05). This study concluded that there was no disturbance in serum levels of testosterone, gonadotropins and prolactin in patients with PE and controls. These hormones could not relate to pathogenesis of PE.     

On-demand treatment of premature ejaculation with clomipramine and paroxetine: a randomized, double-blind fixed-dose study with stopwatch assessment

OBJECTIVE: To investigate the degree of ejaculation delay induced by on-demand treatment with 20 mg paroxetine and 25 mg clomipramine and to assess the type and severity of non-sexual side-effects of treatment at the day of and the day after treatment with these drugs. METHOD: A randomized, double-blind, fixed-dose, on-demand study in 30 men with lifelong premature ejaculation was performed. During a 1-month baseline period and a 4-week drug treatment period patients assessed the intravaginal ejaculation latency time (IELT) at home with a stopwatch. Only men with an IELT <1 min were randomly assigned to drug treatment. Patients assessed the drug coitus interval time (DCIT) and used the UKU side effect scale questionnaire at baseline, the day of and the day after intercourse. RESULTS: On-demand treatment with 25 mg clomipramine, with a mean DCIT of 5.14 h, led to a 4.05 (95%CI: 3.26-5.02) fold-increase of the IELT. On-demand treatment with 20 mg paroxetine, with a mean DCIT of 5.39 h, led to a 1.41 (95%CI: 1.22-1.63) fold-increase of the IELT. Both drugs had a high incidence of non-sexual side effects at the coitus day and the next day. At the day of coitus paroxetine led to significant sleepiness and yawning compared to clomipramine. At the day after coitus clomipramine induced significant nausea compared to paroxetine. CONCLUSION: On-demand treatment with 25 mg clomipramine led to a clinical relevant ejaculation delay. In contrast, 20 mg paroxetine had no clinical relevant ejaculation delay in men with lifelong premature ejaculation with an IELT of less than 1 minute. Both drugs exert mostly mild yet annoying non-sexual side effects both at the coitus day and the next day.     

氟西汀治疗早泄的效果观察

目的 :评价氟西汀对早泄的治疗效果及停药后效果维持状况。方法 :将 6 8例早泄患者随机分为A组 :2 4例 ,每天口服氟西汀 2 0mg至研究结束 ;B组 :2 4例 ,每天口服氟西汀 2 0mg至 12周 ,然后改口服安慰剂至研究结束 ;C组 :2 0例 ,每天口服安慰剂至研究结束。分别测定治疗前 4周、治疗后 1周、12周、14～ 16周平均射精潜伏时间。结果 :3组治疗前平均射精潜伏时间差异无统计学意义 (P >0 .0 5 )。A组与B组平均射精潜伏时间经氟西汀治疗前后比较及与C组比较均有明显延长 ,差异有统计学意义 (P <0 .0 1) ;但B组在改服安慰剂后14～ 16周的平均射精潜伏时间与治疗前及对照组相比无统计学意义 (P >0 .0 5 )。结论 :氟西汀能显著延长射精潜伏时间 ,但停药后其疗效并不能维持。     

Relationship between atherogenic indices and acquired premature ejaculation

The aim of this study is to evaluate blood lipid parameters and level of atherogenic indices in acquired premature ejaculation (PE) patients. Between 2020 January and June 2020, 96 patients diagnosed with PE in our clinic and 84 control patients who applied to the urology outpatient clinic for other urological reasons were included in the study. Detailed medical and sexual histories of the patients were taken, and physical examination findings were recorded. In addition, 5-question premature ejaculation diagnostic tool (PEDT) was applied to patients and estimated intravaginal ejaculation latency times (IELT) were recorded. The mean values of lipid parameters; Risk Index of Castelli-1 (CRI-1 (Total cholesterol/ HDL)), CRI-2 (LDL/ HDL), Atherogenic Index of Plasma (AIP (log10 (triglyceride/ HDL)) and Atherogenic Coefficient (AC (HDL/ non-HDL)) were calculated. The average PEDT score was 7.68 + 5.05 (2–22), and the IELT arithmetic mean was 150.39 + 121.53 (5–900) seconds. In the APE group, triglyceride and AIP values were found to be higher than the control group (triglyceride: 188.75 + 76.39 versus 157.20 + 87.45; p = .049; AIP: 0.46 + 0.33 versus 0.35 + 0.35; p = .040). A fair positive correlation was found between PEDT scores and AIP values (r = .355, p < .001). AIP was found to be related to APE, and it was also found to be related to symptom severity.