Ejaculatory Latency Time Research Articles

Randomized, double blind, placebo controlled clinical study to assess efficacy and safety of NRL/MW/201901 in subjects suffering from erectile dysfunction

Sex is an integral part of a well-being. Sexual satisfaction is the most important component of the quality of life. In management of ED overall sexual potential and quality of life needs to be taken care of as a holistic approach to management. The aim of the study was to clinically validate effect of NRL/MW/201901 a polyhedral Nutraceutical product in ED. The clinical efficacy of NRL/MW/201901 in patients suffering from erectile dysfunction was evaluated by assessing Quality of Erection Questionnaire and sexual encounter profile with Intra-vaginal ejaculation latency time, serum testosterone and anthropometric analysis etc. NRL/MW/201901 was effective in increasing erection function, orgasmic function, intercourse satisfaction, overall satisfaction and sexual desire. There is marked increase in number of sexual encounters in NRL/MW/201901 treated group. Serum levels of testosterone were increased after treatment of NRL/MW/201901 than in placebo group. It was evident from the anthropometric analysis of the subjects that there was significant increase in resting metabolism and % skeletal muscle content in NRL/MW/201901 treated group. There were no evident adverse events related to drug. Thus it could be concluded that NRL/MW/201901 is safe and effective in the treatment of mild to moderate erectile dysfunction.

Perceptions, Expectations, Preferences, and Attitudes Toward Premature Ejaculation, Its Diagnosis and Topical Treatment with Fortacin™ Spray: Results from an Expert Panel Discussion.

IntroductionPremature ejaculation (PE) represents the most prevalent male sexual issue. Before beginning treatment, it is essential to discuss the patient’s expectations thoroughly.MethodsHerein, we report the results of an expert panel discussion about perceptions, expectations, preferences, and attitudes towards PE, its diagnosis and treatment. The panel took place in October 2019 and involved 30 Italian urologists experienced in the management of male sexual dysfunction. It aimed at investigating physicians’ points of view about selected aspects of PE management which emerged during the counselling of PE patients over the previous two years. Treatment-related questions were mainly focused on topical treatment with Fortacin™.ResultsOverall, 83.3% of those interviewed declared that most of their patients perceive PE as a bother rather than a disease. The percentage of urologists interviewed perceived that improved subjective control over ejaculation and prolonged intravaginal ejaculatory latency time (IELT) as the main benefit expected by the majority of their patients was 56.5% and 10%, respectively. Eighty percent of urologists reported on-demand regimen as the dosage modality preferred by the majority of their patients and half of them reported the topical route to be the way of administration preferred in most cases. Moreover, 73.3% of urologists reported that adherence to treatment was higher in patients undergoing topical treatment. Finally, 80% of urologists perceived Fortacin to be efficacious in patients with acquired PE and 70% of them perceived its efficacy to be independent from IELT.DiscussionMost patients perceive PE as a bother rather than a disease and mainly advocate an improved control over ejaculation. Fortacin is perceived as efficacious in patients with acquired PE, and independent from IELT.

Impact of Childhood Sexual Assault on Sexual Function in the Czech Male Population.

IntroductionThis study explores the impact of childhood sexual assault (CSA) on men's sexual function. There is limited understanding on the impact of CSA perpetrated against boys on later adult male sexual function, as there is a dearth of research on this topic. It was hypothesized that men reporting a history of CSA were more likely to report sexual function issues than men with no history of CSA.Material and methodsA cross-sectional survey study of 1,004 Czech men aged between 15 and 85 years (M = 42.8 years; Standard deviation = 17.6 years) have been conducted. The participants anonymously answered a questionnaire on multiple aspects of their life and sexuality. This questionnaire included sought data on history of CSA and self-reported intravaginal ejaculation latency time and the 5-item International Index of Erectile Function.Results25 men (2.5%) indicated a history of CSA. 71% of the perpetrators where known by the victims, with a minority declaring the crime to authorities (37.5%). Half of those reporting assault also reported sexual function issues in the present or at some time in their life. Significant correlations were recorded between a history of CSA and erectile dysfunction but not significantly with premature ejaculation.ConclusionsMen who reported a history of CSA are more likely to report sexual function issues than those who do not. The identified association between CSA and sexual function issues in adult life contributes to the small body of literature on the topic. When taking a sexual history, it is recommended to practitioner to include questions about CSA, considering its correlation with erectile dysfunction. An understanding of the relationship between CSA and adult sexual function helps practitioner to improve his patient's well--being and life satisfaction.Kamnerdsiri WA, Fox C, Weiss P, et al. Impact of Childhood Sexual Assault on Sexual Function in the Czech Male Population. J Sex Med 2020;8:446–453.

PS-5-6 A Double-Blind, Placebo-Controlled Parallel Group Study to Evaluate the Effect of a Single Oral Dose of GSK958108 on Ejaculation Latency Time in Male Patients Suffering From Premature Ejaculation

PS-5-6 A Double-Blind, Placebo-Controlled Parallel Group Study to Evaluate the Effect of a Single Oral Dose of GSK958108 on Ejaculation Latency Time in Male Patients Suffering From Premature Ejaculation

P-02-14 Intra-Urethral Alprostadil Gel Usage in Male Sexual Dysfunction Restores Not Only Erectile Performances but Improves Also the Conjunct Premature Ejaculation

To assess the extensive satisfaction of the intra-urethral utilization of Alprostadil gel in men having both erectile dysfunction (ED) and premature ejaculation (PE). A cohort of 67 men with ED and PE (Gr. A), taking Alprostadil gel by intra-urethral way admission, as a frequency of 3-4/week, before each intimate encounter, was assessed at the recruitment (V1) and after 4 follow-up weeks (V2). They were compared to a 50 men control group, taking Sildenafil 100mg/tb. (Gr. B). Instruments: ED = IIEF-5, ≤ 20 points; PE (short Intravaginal Ejaculation Latency Time - IELT) ≤ 3 minutes (ISSM, 2014); Overall Satisfaction (OS) = EF domain from the IIEF. Global Assessment Question (GAQ): % of “yes” (Giuliano et al., 2008). IIEF-5 at V1: Gr. A = 12.72 ± 3.8, Gr. B = 11.96 ± 4.07 vs. V2: Gr. A = 19.56 ± 2.18, Gr. B = 20.21 ± 1.67; P = 0.5; IELT at V1: Gr. A = 2.47 (2 min. and 28 sec.), Gr. B = 2.15 ± (2 min. and 17 sec.) vs. V2: Gr. A = 6.78 (6 min. and 47 sec.) ± 2.33, Gr. B = 3.33 (3 min. and 20 sec.); P < 0.001. OS at V1 Gr. A = 6.81 ± 1.18, Gr. B = 6.62 ± 0.87 vs. V2: Gr. A = 12.33 ± 3.11, Gr. B = 8.22; P < 0.05. GAQ at V1: Gr. A = 14 subjects (20.89%), Gr. B = 12 subjects (24%) vs. V2: Gr. A = 54 subjects (80.6%); Gr. B = 24 subjects (48%); P(V2) < 0.005.

Clinical effect of computed guided pudendal nerve block for patients with premature ejaculation: a pilot study

Background: Premature ejaculation has a complex etiology, and its pathophysiology is still unclear, with penile hypersensitivity being the most accepted hypothesis. The aim was to investigate the efficacy and safety of a computed tomography-guided pudendal nerve block at the level of the sacrospinous ligament and the Alcock’s canal in patients with premature ejaculation refractory to conventional pharmacological treatment.Methods: This is a prospective pilot study involving five patients suffering from premature ejaculation refractory to standard treatment and clinical features of pudendal nerve entrapment. A CT-guided infiltration of ropivacaine and methylprednisone was done at the levels of sacrospinous ligament and Alcock’s canal. Intra-vaginal ejaculatory latency time (IELT) was recorded several times for each patient before and after infiltration. International Index of Erectile Function (IIEF-5), Premature Ejaculation Diagnostic Tool (PEDT) and Sexual Quality of Life–Male version (SQoL-M) questionnaire were also evaluated before and after infiltration.Results: Overall IELT differed significantly before and after treatment (21.94 vs 215.42 s; p = 0.039). IIEF-5, PEDT and SQoL-M also differed significantly before and after treatment. No complications for the CT-guided infiltration were recorded.Conclusion: CT-guided pudendal nerve block at the sacrospinous ligament and the Alcock’s canal was effective in improving premature ejaculation. Therefore, pudendal nerve entrapment may be a curable cause of sensory premature ejaculation.

Effect of Wubi Shanyao Pills on sexual dysfunction in rats with adenine-induced kidney-Yang deficiency

The aim of this paper was to study the effect of Wubi Shanyao Pills on sexual dysfunction in rats with kidney-Yang deficiency and to investigate its possible mechanism. Adenine(100 mg·kg~(-1)) was administered to male SD rats for 8 weeks to establish kidney-Yang deficiency model, and at the same time, Wubi Shanyao Pills(2, 1, 0.5 g·kg~(-1)) were administered to rats for 8 weeks. The syndrome manifestation of kidney-Yang deficiency was observed in rats and the scores of symptoms were evaluated. Sexual behavior indexes(incubation period and times of capture, straddle and ejaculation) were measured by mating experiment. The levels of serum testosterone(T), estradiol(E_2), follicle stimulating hormone(FSH), luteinizing hormone(LH), and gonadotropin releasing hormone(GnRH) were measured by radioimmunoassay. The wet weights of testis and seminal vesicle were measured. The content of fructose in seminal plasma was detected by UV spectrophotometry. The pathological changes of testis and epididymis were observed by HE staining. The expression levels of transforming growth factor(TGF-β1) and cytochrome P450 aromatase(CYP19) in testis were detected by immunohistochemistry and Western blot. The results showed that Wubi Shanyao Pills could significantly reduce the score of kidney-Yang deficiency syndrome, improve the symptoms of kidney-Yang deficiency syndrome, shorten capture, straddle and ejaculation latency, increase capture and straddle times, increase serum T, LH, FSH, E_2 and GnRH levels, increase the wet weight of testis and seminal vesicle and fructose content in seminal plasma, improve the pathological structure of testis and epididymis, and inhibit the expression of TGF-β1 and increase CYP19 in testis of the model rats. Therefore, Wubi Shanyao Pills can significantly improve sexual dysfunction in rats with kidney-Yang deficiency, and its mechanism may be related to regulating the low function of hypothalamus pituitary gonad(HPG) axis and improving the disorder of sex hormone secretion. In addition, it may be also related to inhibiting the expression of testicular TGF-β1, increasing the expression of CYP19 protein, and then regulating the amount of T converted to E_2.

Phosphodiesterase-5 Inhibitors for Premature Ejaculation: Systematic Review and Meta-Analysis of Placebo-Controlled Trials.

The purpose of this analysis is to assess the efficacy and safety of phosphodiesterase-5 inhibitors (PDE5Is) for the treatment of premature ejaculation (PE). A comprehensive search was performed to ascertain from trials about PDE5Is for the treatment of PE and compare the results, including intravaginal ejaculatory latency time (IVELT), score of sexual satisfaction scale, and side effects, between the group treated with PDE5Is and that treated with placebo. Seven studies involving a total of 471 patients were included in this meta-analysis. This analysis showed that patients who were treated with PDE5Is had significantly increased IVELT (mean difference [MD] 2.60; 95% CI [1.85, 3.36]; p < .00001) and score of sexual satisfaction scale (MD 2.04; 95% CI [0.78, 3.30]; p = .002) compared with the group on placebo. More patients had side effects while taking PDE5Is, such as headache, dizziness, flushing, and nasal congestion. PDE5Is were significantly more effective than placebo in the treatment of PE. Side effects were more common among patients who were treated with PDE5Is.

Characteristics of men who are bothered by rapid ejaculation: results from clinical intake surveys.

The objective of this study is to identify factors associated with bother with rapid ejaculation in a cohort of men presenting to a sexual dysfunction clinic, independent of a diagnosis of PE. A prospective institutional database has been maintained on patients completing an 89-item intake questionnaire querying various areas of sexual dysfunction. Regarding ejaculatory dysfunction, patients are asked "Do you feel bothered, annoyed, and/or frustrated by ejaculating too quickly?" Statistical modeling was performed to identify associations. A total of 1359 men completed the intake survey, and 694 responded to the question on bother with rapid ejaculation. Overall, 42.9% (298/694) of respondents reported bother with rapid ejaculation. Men reporting bother were more likely to report lower intravaginal ejaculatory latency (IELT) time (4.2 vs 12.2 min, p < 0.0001), problems with depression (32% vs 21%, p = 0.001), negative impact on relationship (73% vs 51%, p < 0.0001), and negative impact on partner's sexual satisfaction (26% vs 15%, p < 0.001). These results highlight the importance of asking all men presenting with sexual health concerns about their bother with rapid ejaculation for complete assessment of sexual and mental wellbeing.

MP75-05 EFFECT OF SEXUAL BEHAVIOR ON PROSTATE-SPECIFIC ANTIGEN LEVELS IN MIDDLE-AGED MEN SCREENED FOR PROSTATE CANCER

INTRODUCTION AND OBJECTIVE: Factors such as prostatitis or benign prostate hyperplasia are known to increase PSA levels. Previous studies have found higher PSA levels after ejaculation, however, knowledge about whether various aspects of sexual behavior lead also to higher PSA levels is lacking. Therefore, the aim of this study was to investigate the effect of sexual behavior on prostate-specific antigen (PSA) levels in middle-aged men screened for prostate cancer. METHODS: PSA levels of 13,607 45-year-old men were analyzed from the ongoing PROBASE trial between 04/2014 and 04//2018. Multiple linear regression was performed on log-transformed PSA levels to determine the effect of various aspects of sexual behavior on PSA levels. RESULTS: Age at first sexual intercourse, number of lifetime sexual partners, self-perceived intravaginal ejaculatory latency time (IELT), anal intercourse, and sexual identity were not associated with alterations in PSA levels. Partnered sexual activity (2-3 times/week: 10% and ≥4 times/week: 13%) and solo-masturbation (2-3 times/week: 5% and ≥4 times/week: 12%) were associated with higher PSA levels, respectively. Due to the additive effect in the multiple model for log-PSA levels, effects could be multiplied. The combination of being sexually active ≥4 times/week and masturbating ≥4 times/week simultaneously was associated with a higher PSA level of 27%. CONCLUSIONS: Higher frequency of masturbation and sexual activity are associated with higher PSA levels in middle-aged men and, consequently, these men are at increased risk of unnecessary biopsies. Therefore, when their first PSA test passes slightly the biopsy threshold, they should abstain from ejaculation for 48 hours prior to the confirmation PSA test. In contrast, factors such as anal intercourse, sexual identity or number of lifetime sexual partners are not associated with alterations in PSA levels and should be ignored when interpreting a PSA level. These patients should rather be reassured to undergo a prostate biopsy in case of an elevated PSA level. Source of Funding: German Cancer Aid

PD28-08 NUMBER OF INTRAVAGINAL THRUSTS BEFORE EJACULATION (NITBE): A CONVENIENT AND RELIABLE TOOL FOR PREMATURE EJACULATION ASSESSMENT

You have accessJournal of UrologySexual Function/Dysfunction: Evaluation I (PD28)1 Apr 2020PD28-08 NUMBER OF INTRAVAGINAL THRUSTS BEFORE EJACULATION (NITBE): A CONVENIENT AND RELIABLE TOOL FOR PREMATURE EJACULATION ASSESSMENT Dong Fang*, Yiming Yuan, Jing Peng, and Zhichao Zhang Dong Fang*Dong Fang* More articles by this author , Yiming YuanYiming Yuan More articles by this author , Jing PengJing Peng More articles by this author , and Zhichao ZhangZhichao Zhang More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000000892.08AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Intravaginal ejaculatory latency time (IELT) is important in the evaluation of premature ejaculation (PE). However, the stopwatch-measured IELT (SW-IELT) is inconvenient in clinics while the self-estimate IELT (E-IELT) is inaccurate. This study is to evaluate the number of intravaginal thrusts before ejaculation (NITBE) in the assessment of PE. METHODS: A prospective study which included PE patients (204 couples) and comparatives (106 couples) was performed from Sep 2015 to Mar 2016. SW-IELT, E-IELT and NITBE were collected and evaluated. RESULTS: Baseline characteristics were similar between two groups. The median SW-IELT was 47.6s vs 187.2s between PE patients and comparatives (p<0.001), and the median NITBE was 41.8 vs 152.4 (p<0.001). It’s interesting that the average time of one thrust was similar (1.1±0.2 s/time vs 1.2±0.2 s/time, p>0.05) between the two groups. As for E-IELT, although patients with PE also exhibited much worse results (94.4s vs 447.5s, p<0.001), there’s significant difference between E-IELT and SW-IELT (p<0.001) and NITBE was more correlated with SW-IELT with a person correlation of 0.989. By ROC curve, 75 times would be the best cut-off value with sensitivity of 81.1% and specificity of 88.2%. CONCLUSIONS: NITBE could be used as a convenient and reliable tool for PE assessment. Source of Funding: None © 2020 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 203Issue Supplement 4April 2020Page: e615-e615 Advertisement Copyright & Permissions© 2020 by American Urological Association Education and Research, Inc.MetricsAuthor Information Dong Fang* More articles by this author Yiming Yuan More articles by this author Jing Peng More articles by this author Zhichao Zhang More articles by this author Expand All Advertisement PDF downloadLoading ...

Advantages and limitations of current premature ejaculation assessment and diagnostic methods: a review.

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.

PD28-10 PREVALENCE AND RISK FACTORS OF DELAYED EJACULATION AT AN OUTPATIENT UROLOGY CLINIC

INTRODUCTION AND OBJECTIVE:Delayed ejaculation (DE), defined as a delay in intravaginal ejaculation latency time, is an understudied conditioned with an estimated prevalence of 5%. However, literat...

Changing Aspects of Male Sexual Functions Accompanying Treatment of Benign Prostatic Hyperplasia With Silodosin 8 mg Per Day

BackgroundAlpha-adrenergic antagonist treatment for benign prostatic hyperplasia (BPH) and drug-related sexual side effects are frequent in aging men. AimTo investigate functional changes in erectile and ejaculatory aspects of male sexuality under Silodosin 8 mg per day treatment for BPH. MethodsSexually active patients diagnosed with BPH and who initiated Silodosin treatment were the subjects of the study. The International Prostate Symptom Score, premature ejaculation patient profile (PEP-male) questionnaire, Sexual Health Inventory for Men (SHIM) questionnaire, and estimated intravaginal ejaculation latency time (IELT) values of the participants were used to evaluate sexual functions. Data evaluation was performed in 8 urology clinics retrospectively. OutcomesParticipant ratings for SHIM, PEP, and estimated IELT were the primary outcome measures in the study. ResultsAmong 187 recruited patients, data of 98 patients, who completed the trial period in the study, were eligible. The median age of the eligible participants who completed the trial period for 3 months was 59.5 years (range 45–82). 16 patients of 187 (8%) reported a desire for drug withdrawal for anejaculation during the recruitment period. 46 (46.9%) and 49 (50%) patients reported anejaculation in the first and third month of the treatment, respectively. De novo erectile dysfunction was noticed in 15 patients (15.3%). There was a significant increase in the estimated IELT of subjects in both the first (P = .01) and third (P = .002) month. SHIM-1 (P = .008), SHIM-total (P = .009), and PEP scores (P = .008) were also improved in the third month of the treatment. Neither baseline patient characteristics nor changes in the International Prostate Symptom Score after treatment predicted final outcomes with multivariable analysis. The subgroup analysis of participants who reported “anejaculation” also revealed better outcomes compared with participants ejaculating naturally in the third month as per SHIM ratings. Clinical ImplicationsDespite several male patients having dry orgasms due to Silodosin-induced anejaculation, the majority experienced improved erectile function. Strengths & LimitationsThe present study demonstrated pioneering results while investigating both erectile and ejaculatory dimensions of the male sexual function during Silodosin treatment for BPH. However, lack of partner evaluation, low follow-up rates, and lack of knowledge about reasons why subjects are lost to follow-up after drug initiation have limited our interpretation. ConclusionMost patients using Silodosin 8 mg per day for BPH treatment experienced improvement in their erectile function, estimated IELT, and premature ejaculation profile in the third month of the treatment. Underlying mechanisms and reasons for individual differences necessitate further investigation.Cihan A, Kazaz İO, Yıldırım Ö, et al. Changing Aspects of Male Sexual Functions Accompanying Treatment of Benign Prostatic Hyperplasia With Silodosin 8 mg Per Day. J Sex Med 2020;17:1094–1100.

The relationship between premature ejaculation and anogenital distance.

Premature ejaculation is a common male sexual disease in andrology practice. The goal of essay is to investigate the relation of anogenital distance that predicts prenatal testosterone exposure with premature ejaculation. Between January and May 2019, 150 men were participated in the study. The patients were evaluated with anamnesis and physical examination; age, smoking, alcohol consumption, intravaginal ejaculation latency time, body mass index, premature ejaculation diagnostic tool, distance from anal point to scrotum and distance from anal point to penis were recorded. According to premature ejaculation diagnostic tool score, the patients were classified as premature ejaculation group (score ≥11) and control group (score <11). The mean of the male age was 30.73±4.40years. The mean intravaginal ejaculation latency time score was 3.42±2.71min. Two groups were compared using the distance from anal point to scrotum distance from anal point to penis. In the premature ejaculation group, the distances were found lower (77.46±2.31 and 54.78±2.56mm) than the control group (81.32±3.11 and 58.16±3.48mm). There were statistical differences between two groups (p<.001). It was concluded that it is likely to have a negative relationship between anogenital distance and premature ejaculation diagnostic tool score.

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 50years 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.

Association Between Lifelong Premature Ejaculation and Polymorphism of Tryptophan Hydroxylase 2 Gene in the Han Population.

IntroductionPremature ejaculation (PE) is widely regarded as one of the most common sexual dysfunctions in men. The neurobiogenesis of PE is complex and involves the serotoninergic (5-HT) system.AimIn this study, we investigated whether polymorphisms in the tryptophan hydroxylase 2 (TPH2) gene were associated with lifelong PE (LPE).MethodsA total of 121 men diagnosed with LPE were recruited from our outpatient clinics and 94 healthy controls from the health examination center. Intravaginal ejaculation latency time (IELT) was measured using a stopwatch. The PE diagnostic tool (PEDT) data were collected at the same time. All subjects with LPE and healthy controls were genotyped for polymorphisms in the TPH2 gene. Allele and genotype frequencies of single-nucleotide polymorphisms (SNPs) were compared between the patients and controls.Main Outcome MeasureThe main outcome measures are IELT and PEDT to diagnose LPE. The association of LPE with TPH2 gene polymorphisms in these areas was investigated.ResultsThe IELT, PEDT scores, and education levels in the LPE group were significantly different from those in the control group. Statistically significant differences were found in the SNPs of SNV019 and rs4290270. The frequencies of the G allele and G/A genotype of SNV019 were significantly higher in the patients with LPE than in the controls (P = .045 and .037, respectively). The A allele and A/A genotype of rs4290270 were more frequent in the patients with LPE than in the controls (P = .037 and .049, respectively). In the dominant model of inheritance, the SNV019 polymorphism in the patients with LPE was significantly different from that in the controls (odds ratio [95% confidence interval] = 2.936 [1.066–8.084], P = .037). In men with LPE, there was no statistically significant association between genotype and median IELT.ConclusionThe SNPs SNV019 and rs4290270 of the TPH2 gene seemed to be associated with LPE in the Han population. Men with the A allele of SNV019 or the T allele of rs4290270 may be less likely to suffer from LPE.Fu X, Zhang X, Jiang T, et al. Association Between Lifelong Premature Ejaculation and Polymorphism of Tryptophan Hydroxylase 2 Gene in the Han Population. Sex Med 2020;8:223–229.

Association of NE, leptin, and 5-HT with electrophysiological parameters in patients with primary premature ejaculation.

To investigate the possible role of serum norepinephrine (NE), leptin, and 5-hydroxytryptamine (5-HT) and their correlations with sympathetic skin response located in the penis (PSSR) in primary premature ejaculation (PPE). We compared the serum level of NE, leptin, and 5-HT, intravaginal ejaculatory latency time (IELT) and the premature ejaculation diagnostic tool (PEDT) scores between 57 PPE patients and 42 healthy control men as controls, who were recruited between September 2016 and January 2019. Additionally, the amplitude and latency of PSSR were measured and compared between the two groups. Compared with healthy men, both leptin and NE increased significantly in PPE patients (P=.003, P=.005), while serum 5-HT remarkably decreased (P=.002). Serum leptin, NE, and 5-HT were significantly correlated with the diagnosis of PPE, PSSR amplitude, and latency. Moreover, compared with single serum indicator, NE/5-HT and leptin/5-HT had a stronger correlation with both PSSR amplitude (r=.8377, P<.001; r=.9323, P<.001, respectively) and latency (r=-.8058, P<.001; r=-.8901, P<.001, respectively). Significant differences in leptin, NE, and 5-HT are observed between PPE patients and the controls, which supports the hypothesis of hyperactive sympathetic nerve system (SNS) in PPE. Additionally, leptin/5-HT ratio may serve as an ideal indicator for reflecting SNS activity and predicting treatment response in PPE patients in the future.

Objective and Subjective Measures of Premature Ejaculation: How Closely Do They Correspond and How Well Are the Subjective Measures Recalled?

BackgroundClinical trials evaluating new treatments for premature ejaculation (PE) should ideally include both objective end points and patient reported outcomes (PROs), but there is no consensus currently over the optimal measures or combination of outcomes. In addition, many PROs use a 1-month recall period, despite concerns about potential recall bias. AimsData from a clinical trial of men with lifelong PE were used to examine the consistency of 2 core items of the Premature Ejaculation Profile (PEP), a widely used PRO for assessing subjective aspects of PE. The specific aim was to assess the level of agreement between the original 1-month recall version compared with a new event-based version of the scale in men meeting current definitions of lifelong PE. A further aim was to investigate the convergent validity between an objective end point of intravaginal ejaculatory latency time (IELT), subjective PEP responses, and a patient's Clinical Global Impression of Change (CGIC) measure. MethodsFor assessment of consistency of PEP responses (short-term [ie, sexual event driven] vs 1-month recall), descriptive statistics, correlation coefficients (Pearson and Spearman), and Bland-Altman plots are presented for each time interval. For assessment of convergent validity, descriptive statistics and correlation coefficients (Pearson and Spearman) are presented for each assessment with geometric mean IELT values. Results are also depicted graphically. Geometric mean IELT over the last 4 weeks of treatment and change from baseline (absolute and fold change) were estimated via a general linear model for each category of change in PEP and CGIC, adjusting for baseline IELT. OutcomesPEP items administered via 1-month recall and short-term event-driven responses gave virtually identical results. There was a strong correlation (very good convergent validity) between IELT and responses to PEP and the CGIC. Clinical translationMen with lifelong PE can accurately recall their level of sexual functioning over the previous month. The PEP and CGIC are appropriate instruments to measure the subjective response of men with PE to new treatments. Strengths and limitationsOur analyses address gaps in previously published research on PE assessment methodology. Men with acquired PE, men without partners, and men in homosexual relationships were not studied. ConclusionsIn a clinical trial setting, PEP and CGIC are appropriate end points and are likely the optimal combination of PROs for use with IELT to enable a global assessment of patient response to new PE treatments.Althof S, Rosen R, Harty B, et al. Objective and Subjective Measures of Premature Ejaculation: How Closely Do They Correspond and How Well Are the Subjective Measures Recalled? J Sex Med 2020;17:634–644.

Altered Functional Connectivity of Hypothalamus in Lifelong Premature Ejaculation Patients.

As one of the most prevalent sexual dysfunctions in men, lifelong premature ejaculation (PE) often leads to patient distress. The hypothalamus is implicated in the ejaculatory control of healthy males. However, we do not know whether the hypothalamus-related intrinsic connectivity is altered in lifelong PE patients. To investigate abnormal intrinsic connectivity of the hypothalamus in lifelong PE patients compared with healthy controls (HCs). Prospective pilot study using cross-sectional data of patients and HCs. Forty-seven lifelong PE patients and 30 HCs were included in this study. 3.0T MRI scanner for T1 -weighted imaging using spoiled gradient recalled echo sequence and functional imaging using a single-shot gradient recalled echo sequence. Preprocessing of MRI data and hypothalamus-seeded functional connectivity (FC) computation were performed using DPABI4.1. The two-sample t-test within SPM12 was adopted to examine possible alterations of intrinsic connectivity of hypothalamus in lifelong PE patients compared with HCs including anxiety and depression scores as covariates (false discovery rate-corrected, P < 0.05). The correlation analysis was then used to assess possible associations between the imaging findings and clinical features in the patient group (Bonferroni-corrected, P < 0.05). Compared with HCs, lifelong PE patients had decreased hypothalamus-seeded FC in the left orbitofrontal cortex, bilateral insula, superior temporal cortex, superior temporal pole, middle temporal cortex, left fusiform, right parahippocampal gyrus, and right cerebellum. The intravaginal ejaculatory latency time positively correlated with the mean z-score from the hypothalamus-insula (r = 0.45) and hypothalamus-cerebellum (r = 0.48) intrinsic connectivity, separately. We have shown that hypothalamus-seeded FC alterations and the correlations between the aforementioned abnormal FC alterations and intravaginal ejaculatory latency time. The current findings may promote the understanding of the hypothalamus-related neural mechanisms involved in the abnormal ejaculatory information processing in lifelong PE patients. 1 TECHNICAL EFFICACY STAGE: 3 J. Magn. Reson. Imaging 2020;52:778-784.