Ejaculatory Time Research Articles

Effect of a single dose of letrozole on ejaculation time, semen quality, and testicular hemodynamics in goat bucks subjected to heat stress.

Letrozole (LTZ) is an aromatase inhibitor that limits estrogen (E2) production and increases testosterone (T) levels. This research aimed to examine the impact of a single dose of LTZ on testicular hemodynamics, ejaculation time, and semen quality in goats under heat stress (HS). Therefore, Doppler examination and semen evaluation were performed on twelve mature bucks for two weeks (W-1, W-2) as pre-heat stress control during winter. Then during summer HS bucks were subjected to Doppler examination, semen evaluation, and hormonal analysis (T, E2, and LH) at 0h. Afterward, bucks were assigned into two groups and subcutaneously injected with physiological saline (n = 6; CON) or LTZ (0.25mg/kg BW; n = 6; LTZ). Both groups were subjected to Doppler scanning and hormonal analysis at 2, 4, 24, 48, 72, 96,144, and 168h. Semen evaluation was performed at 48 and 168h. The LTZ group showed increasing (P < 0.05) in semen volume, sperm motility, and viability and decreasing (P < 0.05) in ejaculation time and sperm abnormalities compared to CON group at 48h. Additionally, T concentrations increased (P < 0.01) at 2, 24, and 48h, E2 decreased (P < 0.01) from 2 to 48h, and LH raised (P < 0.01) at 2 and 72h in LTZ group compared to CON one. Doppler indices reduced (P < 0.05) at 96h in LTZ group. semen pH and scrotal circumference were not affected by LTZ. In conclusion, LTZ administration shortened ejaculation time and enhanced semen quality in bucks during HS.

(217) Report of Surgical Treatment Using Allogenic Dermal Graft Penoplasty to Treat Premature Ejaculation

Abstract Introduction Premature ejaculation is the major factor that causes low satisfaction of sexual intercourse. Ejaculation time is determined by various factors including such as psychological, habitual and physical factors, sensitive penile shaft and glans. Objective This study aimed to report the effectiveness and the safety of newly adopted surgical treatment using allogenic dermal graft. Methods We had performed Dermal graft surgery for treating premature ejaculation in 56 men who have short time ejaculatory problems within 5 minutes on average. We adopted a pre-pubic minimal incision and dissected penile shaft and pre-pubic space. Inserted graft materials were Allograft dermis which were fixed at the Buck's fascia. Glans sulcus was dissected from 8 o’clock to 4 o’clock and the thin strip shaped graft was fixed at the dissected space of glans sulcus. Vibratory sense of glans and penile shaft was estimated by biothesiometry and ejaculatory time was surveyed at both preoperative and postoperative status (5month~18month). Results 48 patients answered that their ejaculatory time was considerably delayed. And 7 patients slightly delayed. Among them, 1 man answered that there was no surgical effects despite of slightly being reduced penis sense. Following being asked raising their frequency of sexual intercourse, 1 man with no surgical effect was considerably improved in delaying the ejaculatory time. Among 136 cases, the inflammation on wound site occurred in 2 patients fully recovered in 2 weeks. No other complication occurred. Conclusions The surgical treatment using allogenic dermal graft is very effective in treating premature ejaculation. And this surgical procedure is very safe without no series complication. Disclosure No.

(076) Hyaluronic Acid Injection of Penis for Management of Premature Ejaculation: A Systematic Review with Single-Arm Meta-Analysis

Abstract Introduction Premature ejaculation (PE) is the most prevalent male sexual dysfunction globally. Pharmacological treatments as the primary mainstay for PE therapy have drawbacks in systemic effect and possible recurrence after drug cessation. In the last few years, there has been a progressive use of hyaluronic acid (HA) injection in Andrology, including its use to prolong ejaculation latency time by increasing penile glans sensitivity. However, no meta-analysis on its efficacy and safety exists. Objective The study aimed to conduct a comprehensive systematic review and single-arm meta-analysis to identify the efficacy and safety of HA injection in the penis for treating PE. Methods A systematic search on PubMed, Scopus, and Embase databases were searched from inception to May 31, 2023, according to the Preferred Reporting Items for Systematic Reviews and Meta-analysis statement. Risk of bias of included study were carried out based on Cochrane ROB2 and ROBINS-I tools. Intravaginal ejaculatory latency time (IELT) was considered the primary outcome, whereas satisfaction and complication rate were the secondary outcomes. Pooled rate and mean difference with matching 95% confidence level intervals (CIs) in the random effect model were applied in analysis using STATA 18.0 and RevMan 5.4. To ensure the impact of each study, a leave-one-out sensitivity analysis was performed. Results Of the 60 studies identified, three clinical trials and six observational studies with low and moderate risk of bias met the inclusion criteria. A total of 616 participants were eligible for meta-analysis. The results found that HA injection, with different techniques, can significantly increase IELT by 239.78 (95% CI 147.14 – 332.43), 202.76 (95% CI 121.86 – 283.66), 164.62 (95% CI 112.19 – 217.06), and 189.01 (95% CI 71.74 – 306.28) seconds at 1, 3, 6, and ≥12 months follow-up. Despite significant heterogeneity among the studies, the sensitivity analysis results were unaffected by the removal of any of the articles. As for safety, the most commonly reported complications were pain, ecchymosis, and papule formation with pooled incidence of 19% (95% CI: 15% – 24%), 8% (95% CI: 5% – 13%), and 5% (95% CI: 3% – 8%), respectively. The majority of adverse events were mild, temporary, and self-limited, although a single case of skin necrosis and vascular emboli had been reported. In addition, patients and their partners also reported increased satisfaction after HA injection. Conclusions HA injection in the penile can effectively prolong the ejaculation time by at least a year with tolerable adverse events. Nevertheless, the optimal injection technique, ideal patient candidate, and long-term outcome still need to be determined through additional well-designed trials. Disclosure No.

Prevalence of sexual complaints in subjects aged 20 to 40 consulting at the central hospital of Yaoundé

Background: Male sexual dysfunction is a problem that is becoming more common with the increase in life expectancy. Few data are available in sub-Saharan Africa, and in Cameroon, no study has been documented. The objective was to determine the prevalence of sexual complaints among subjects aged 20 to 40 consulting the Urology Service at the Central Hospital of Yaoundé. Methods: We conducted a descriptive cross-sectional study at the Central Hospital of Yaoundé over a 4-month period from January 1 to April 30, 2019. Men aged 20 to 40, sexually active, and freely consenting to participate were included in our study (66 had sexual complaints and 39 had other complaints). Results :105 patients were included in the study, with 66 reporting sexual complaints and 39 presenting other complaints. The average age of our study population was 31.7 years. Alcohol was found in 60.6% of cases, followed by tobacco at 30.3% for toxicological history. 78.7% of patients were overweight. Digital rectal examination was mostly normal; however, hemorrhoids were the most common finding at 14.2%. Decreased libido was very common in our study population, with a proportion of 41%, followed by erectile dysfunction at 37.1%. 66.3% of patients had a normal ejaculation time of 1 to 20 minutes. 21.2% of patients had premature ejaculation. 80.3% of patients had a Perceived Stress Scale (PSS) score higher than 27. 9.2% of patients had severe erectile dysfunction according to the IIEF5 score. 3.8% of patients had low testosterone levels. 62.2% of patients had never talked to anyone in their circle about sexual problems. 68.1% of patients resorted to self-medication, while 18.1% turned to traditional medicine. Conclusion: Despite the increasing frequency of sexual disorders worldwide, the subject remains taboo in our context, leading to underdiagnosis and undertreatment.

(243) Frenular Delta Excision with Neurectomy of Ventro – Lateral Branches of Penile Dorsal Nerves (Alaa Aglan4 Operation)

Abstract Introduction Neurectomy is one of the surgical options used for treatment of premature ejaculation, variable degrees of neurectomy could be done, aggressive neurectomy may cause severe demenishion in sensations as occurs in cases of perovic technique for penis elongation or in cases of sliding techniques used in treatment of peyronie`s disease also it increases the risk of erectile dysfunction. In our old trials in phalloplasty and penile implantation we were doing neurectomy routinely with few exceptions, the success rate at that time was 78% and some side effects were reported e.g neuroma, numbness, and recurrence. After application of prediction test (spraying local anesthesia procomail at frenular area (temporary excision) and local injection around the chosen nerve/s) the picture has been changed. as we could predict the expected gained time post-surgery. The classic neurectomy is related to neural supply of glans. once we was doing classic Alaa Aglan operation (cutting bulbospongiosus muscles bilaterally plus frenular delta excision) but we found the muscles congenitally absent so we excised part of frenular delta with neurectomy to neural supply to the same area (i.e. ventro – lateral branches of dorsal nerves) the results were satisfactory to the patient. Many patients were afraid of muscles cutting at our early trials, so this operation was the alternative option, dorsal neurectomy could be done with it according to prediction tests in some cases (usually with implants). Objective Presentation of new operation for treatment of premature ejaculation (Alaa Aglan4). Methods Study was done between 3/12/2011 – 8/2/2017 (5 years following up), 247 patients were operated (after prediction test), partial excision of frenular delta plus neurectomy to ventral branches of RT and LT penile dorsal nerves. Neurectomy was done at middle third of penile shaft before branching. Dissection of proximal part till penis root and retraction of the proximal end and placing it at penis root area (to avoid reunion or recurrence). Results Numbness was reported in 13 patients disappeared within 3 months, neuroma was obvious in 7 patients treated by vitamin B injection in 5 patient’s. Re-excision of 2mm of proximal neural end (under local anesthesia) in 3 patients. No recurrence was reported. The dissection of nerves and covering the proximal end with inverted skin graft or silicone cap as a barrier between the nerves ends to prevent reunion and recurrence was done outside this study, but this technique is simple and easy. Erectile dysfunction was not reported in all patients. after 4 months all patients were satisfied by the ejaculation time. Conclusions Alaa Aglan4 operation is simple, effective, safe and permanent treatment for premature ejaculation guided by prediction test. Disclosure No.

(342) Glans Augmentation and Glans – Bulbospongiousus Reflex

Abstract Introduction The creation of a barrier at the level of glans by the bulking agents blocking accessibility and inhibiting the tactile stimuli to reach the dorsal nerve of penis (branch of pudendal nerve) receptors is the theory behind the effect of hyaluronic acid in the field of premature ejaculation. Clinically there is a doubt about that as filler injection in frenular delta (most sensitive area in penis) and in G-spot at female accelerates time of ejaculation, some cases with history of failed dorsal neurectomy my response to hyaluronic acid injection, filler or fat injection in penis shaft doesn’t improve ejaculation time, in the opposite side implants like Elist`s implant (pneuoma) or other solid inner condoms improves premature ejaculations. The cause is that the hard implant masks pressure on the corona thus inhibits glans – bulbospongiosus reflex which delays the second phase of ejaculation, ring application at coronal sulcus delays ejaculation for the same reason, filler or fat is not solid and doesn’t resist pressure and compressed due to pressure. In glans area compression is not possible due to tight space at glans mucosa. Objective Explanation why glans augmentation by filler delays ejaculation. Methods Seven patients with history of previous glans penis augmentation (hyaluronic acid) with good response (12-14 months ago) instead of re-injection, Alaa Aglan operation was done, cutting of bulbospongiosus muscles bilaterally plus frenular delta excision 4 months post-operative all patients were injected by hyaluronic acid at glans. Results All patients were satisfied by the operation, 3 months post-operative the gained time was calculated for each patient (by himself) then hyaluronic acid injection was done. No change in time was reported in all patients and they reported that it was still the same time gained after surgery despite all patients reported satisfactory results after previous injection one year ago. Conclusions Inhibition of glans – bulbospongiosus reflex is the main cause to delay ejaculation after glans augmentation. Disclosure No.

Study on Sexual Behaviour Parameters of Marwari Stallions during Breeding Season

The ejaculation and mounting times of a stallion, as well as the amount of time it takes for the stallion to respond to an oestrus mare, are all elements that might affect the libido of the horse. In order to gain an understanding of how tropical horses adapt to potentially difficult climatic circumstances in terms of their sexual performance, it is necessary to study their reproductive behaviour. The present investigation was carried out on six healthy Marwari stallions (aged between 50 to 140 months) to evaluate and to analyse their sexual behaviour during the breeding season in the arid region. The study was carried out for a period of three weeks and sexual behaviour parameters were recorded at the time of semen collection. Parameters observed and analysed in the present study include erection time, reaction time, ejaculation time, number of mounts and number of thrusts. Erection time, reaction time and ejaculation time of stallions was 19.02±1.18 sec, 29.11±1.37 sec, 26.86±0.95 sec, respectively. The number of mounts and number of thrusts of stallions was 1.39±0.09 and 10.00±0.17 respectively. The above study describes the normal sexual behaviour parameters of Marwari stallions in the arid region and analysed that non-significant (P&gt;0.05) difference exists among the horses for various sexual behaviour parameters.

Effect of Melatonin Implantation on Sexual Behavior and some of Semen Quality of Iraqi Buffalo Bulls

This study investigated the effect of melatonin implantation on sexual behavior and some aspects of the semen quality of buffalo bulls. Nine buffalo bulls had divided into three groups (3/group). The first group was the control group (C1). The buffalo bulls were implanted with melatonin hormone in the second (72 mg; C2) and third (90 mg; T3) groups under the skin of the left ear base and repeated one month after the first implantation. Semen was collected for 14 weeks and evaluated weekly. The first amount of time was lower in the C3 group than in the C2 and C1 groups. Semen volume at 2nd ejaculation was higher (P<0.05) in the C3 group than in other groups. Mass activity and motility increased in the C3 group compared to the C2 and C1 groups at different ejaculation times. The melatonin implantation (90 mg) can improve the semen quality of Iraqi bulls which in turn enhancing the reproductive performance, conception rate of female buffalo and increasing the artificial insemination productivity and owner’s income.

Effects on Herd Efficiency of Sexual Experience and Behavioral Characteristics of Saanen X Hair Male Goat Based On Age

Effects on Herd Efficiency of Sexual Experience and Behavioral Characteristics of Saanen X Hair Male Goat Based On Age

Progressive arousal: a new concept and definition for premature ejaculation.

Premature ejaculation (PE) is a nosologic entity with issues in its conceptualization and definition. To understand if the altered sexual response in men with PE is in the orgasm phase, as currently assumed, or the arousal phase with difficulties in modulating, regulating, or decreasing sexual arousal. Men were recruited who looked for help for PE and met the diagnostic criteria according to clinical standards. The participants completed a sociodemographic survey and the Premature Ejaculation Diagnostic Tool. They also performed a masturbation exercise with a maximum of 5 stops, with the intention of prolonging the arousal phase. The time of the exercise was measured from the beginning of genital masturbation to ejaculation. We calculated the total time of the exercise, the median time at each start, and the number of dropouts. We performed a pairwise comparison analysis between starts and made a survival curve representing the percentage of men who remained in the exercise. A total of 481 men with PE participated (mean ± SD; age, 29.25 ± 8.72 years). We found that the expected median survival time until ejaculation was 317.00seconds (95% CI, 288.34-345.65). However, the average time during stimulation decreased as the exercise progressed, and statistically significant differences were observed in their pairwise comparison (P < .001). Also, the chances of ejaculation increased as the exercise progressed, with 62.16% of the participants ejaculating before the end of the exercise. The results indicated increasing sexual arousal, where stops in stimulation were progressively less effective at maintaining ejaculation times at starts. We showed that the arousal phase is altered in PE, not the orgasm phase, and this could finally have implications in the diagnosis and/or treatment of this condition. The analysis of the times at starts and stops in a masturbation exercise in men with PE, had been barely addressed before. In the future, it would be important to verify the effect of stops during sexual intercourse and to incorporate a control group of men without PE. We propose a new conceptualization and definition for PE: progressive arousal disorder is the inability to modulate, regulate, or decrease arousal during any sexual activity, even with brief stops during sexual stimulation, causing unwanted ejaculation.

Low frequency neuromuscular electrical stimulation applied to the bulbospongiosus muscle prolongs the ejaculation latency in a rat model.

Premature ejaculation (PE) is common, but its true pathophysiology is not clear, and treatments are limited. We aimed to investigate the effect of neuromuscular electrical stimulation applied in different modes and frequencies to the bulbospongiosus muscle on ejaculation parameters. In this study, 24 male Wistar albino rats were used. The rats were equally divided into three groups: control, high-frequency burst (HFB) and low-frequency (LF) (n = 8 each). Neuromuscular electrical stimulation was applied to the rats for 30 min. In the HFB group, this stimulation was applied in the burst mode at 80 Hz frequency using 200 microseconds (µs) transition time. In the LF group, manual stimulation was applied using a 2 Hz frequency and 200 µs transition time. Following the intraperitoneal administration of para-chloroamphetamine at a dose of 5 mg/kg, ejaculation time, increase in basal seminal vesicle pressure, seminal vesicle maximum pressure, number and interval time of seminal vesicle contractions and bulbospongiosus muscle electromyography activities were evaluated over 30 min. There was a significant difference between the groups in terms of ejaculation time (p = 0.002). The ejaculation times of the LF, HFB and control groups were 1344.71 ± 105.9, 908 ± 62 and 672 ± 149.7 s, respectively. The post hoc analysis revealed that the ejaculation time of the LF group was significantly longer than that of the HFB and control groups (p = 0.033 and p = 0.001, respectively). The remaining parameters did not differ significantly between the groups. The results showed that low-frequency (2 Hz) electrical stimulation applied to the male rats significantly prolonged the ejaculation time. It is thus considered that applying neuromuscular electrical stimulation before planned sexual activity can prevent the rhythmic contractions necessary for completing the ejaculatory process by maintaining subtetanic continuous contraction and prolonging the ejaculation time in patients with premature ejaculation complaints.

Bilateral orchiectomy deteriorates the structure and function of seminal vesicles in a rat model.

The effects of hormone levels on ejaculation are known. In addition to thyroid hormone levels, testosterone levels are also associated with ejaculation, but no consensus has been reached on this issue. Thus, we investigated the effect of decreased testosterone levels due to bilateral orchiectomy on the chemical stimulation-induced ejaculation phases in rats. Twenty-one male Wistar rats were randomized into the orchiectomy, sham, and control groups, with seven rats in each group. Bilateral orchiectomy was performed. The ejaculation parameters were evaluated 5 days after the sham and bilateral orchiectomy operations and the waiting period in the control group. The seminal vesicle (SV) phasic contraction number and increase in basal pressure amplitude were significantly lower in the orchiectomy group (6.9 ± 3.3 and 0.6 ± 0.3 mmHg) than in the sham and control groups (11.2 ± 1.7 and 1.0 ± 0.4 mmHg, and 14.5 ± 6.6 and 1.1 ± 0.2 mmHg, respectively; p = 0.016 and p = 0.03, respectively). The interval between the SV contractions was significantly longer in the orchiectomy group (166.2 ± 104.3 s) than in the sham and control groups (76.0 ± 15.5 s and 63.1 ± 31.1 s, respectively; p = 0.014 (between groups), orchiectomy vs sham p = 0.040 and orchiectomy vs control p = 0.018). The SV weights of the rats were significantly lower in the orchiectomy group (0.14 ± 0.01 g) than in the sham and control groups (0.37 ± 0.05 g and 0.48 ± 0.03 g respectively; p < 0.0001 (between groups), orchiectomy vs sham p < 0.0001 and orchiectomy vs control p < 0.0001). The groups showed no significant differences in ejaculation time, SV basal pressure, SV maximum amplitude, and bulbospongiosus muscle contraction electromyographic activity. Our results partially clarified the relationship between decreased testosterone levels and ejaculation. Decreased testosterone levels caused statistically significant changes in SV functions and affected the ejaculation emission phase.

Sexual Behavior and Semen Production of Kacang Buck Fed with Kelor (Moringa Oleifera Lamm) Leaf Powder as Feed Concentrate Substitution

This research aimed to evaluate the effect of Kelor (Moringa oleifera Lamm) leaf powder substitution as feed concentrate on the sexual behaviors and semen production of Kacang bucks. This research was conducted in a randomized factorial design with 2 factors, which were Kelor leaf powder substitution levels (0; 10; 20 and 30% in concentrate) and feeding periods (0; 60; 70; 80 and 90 days) with 4 replications for each combination of treatment. All data were analysed with variance analysis and followed by Duncan’s multiple range test to determine significant differences. The results showed that substitution level of Kelor leaf powder had a highly significant effect (P&lt;0.01) to reaction time (libido), false mounting, and ejaculation time. Furthermore, a significant effect (P&lt;0.05) was also shown to influence the erection quality but had a non-significant effect (P&gt;0.05) on clamping and thrusting force, as well as semen production. The feeding periods had a highly significant effect (P&lt;0.01) to reaction time (libido), ejaculation time, clamping force, erection quality, semen production and also showed a significant effect (P&lt;0.05) on false mounting and thrusting force. The interaction of treatments in this research showed a highly significant effect (P&lt;0.01) on ejaculation time, and a significant effect (P&lt;0.05) to clamping and thrusting force, as well as erection quality but did not affect (P&gt;0.05) the reaction time (libido), false mounting and semen. It can be concluded that 20% Kelor leaf powders substitution level on feed concentrate could improve the sexual behavior and semen productions of Kacang bucks.&#x0D; Keywords: sexual behavior, semen production, kacang buck, kelor, feed concentrates substitution.

An innovative approach to lifelong delayed ejaculation: does attachment style play a role?

To examine whether there is a correlation between attachment styles, which is a developmental psychology theory, and lifelong DE. The research was planned as prospective, multi-centric and cross-sectional study. Thirty patients who were consecutively admitted to the urology outpatient clinic and diagnosed with lifelong DE and 30 age-matched healthy controls were included in the study. All participants gave a detailed medical history and underwent a complete physical examination, and their laboratory and endocrine (prolactin and testosterone) results were evaluated. Additionally, all patients had to fill out socio-demographic information form, the Experiences in Close Relationships-Revised (ECR-R) Questionnaire, Arizona Sexual Experiences Scale (ASEX), Beck Anxiety Inventory (BAI), and Beck Depression Inventory (BDI). The mean age of the DE patients was 33.5 ± 7.5years. In the DE group, insecure attachment (both anxious and avoidant attachment), anxiety and depression scores were found to be significantly higher (p < 0.001, effect size medium or large) than the control group. Ejaculation times (both for vaginal intercourse and masturbation) were correlated with both insecure (anxious and avoidant) attachment types, as well as their anxiety and depression scores (p < 0.001). The ASEX satisfaction, ejaculation and total scores were found to be higher in DE patients (higher scores indicating greater sexual dysfunction) than in the control group. The large and significant relationships found between lifelong DE and attachment insecurities point to childhood developmental processes. The findings may help us better understand lifelong DE. There is a need for further extensive research on this subject.

Premature ejaculation surgical treatment

ABSTRACT Introduction Premature ejaculation (PE) occurs when a man experiences orgasm and expels semen soon after sexual activity and with minimal penile stimulation . it has also been called early ejaculation rapid ejaculation, rapid climax premature climax, and (historically) ejaculation praecox there is no uniform cut-off defining Premature, but a consensus of experts at the international Society for Sexual Medicine endorsed a definition including ejaculation which always or nearly always occurs Prior to or within about one minute [1] the international classification of Diseases (lcd-10) applies a cut-off of 15 seconds from the beginning of sexual intercourse [2] Materials and Methods The study took place at Hamad Specialized hospital and Alaa Clinic hospital between April 2011 and April 2016, 60 patients were included in this study, inclusion criteria was married heterosexual patients and age varies between 17 and 87 years old Surgical technique: All the patients received spinal anesthesia before Peno – scrotal incision and dissection of bulbspongiosus muscle bilaterally and cutting it completely,(Figures 1-7)then closure in layers followed by identification of frenulur delta (frenulur rough surface area) and excision of frenulur delta (elliptical). Suturing and dressing at the end of operation. In the patient with penile abscess and frenulur skin loss we apply split thickness graft. Intravaginal Ejaculation Latency Time (IELT) is calculated equal to the mean of 3 times done by the same way of sex practice for each individual pre and post-operative; evaluation of cases was done after 1,2,3,6 months then yearly. Results 58 patients improved dramatically after the 1st intercourse (3weeks after surgery) time of ejaculation continued to increase till the 3rd month after surgery then the time is constant. (Tables 1-3) All cases with time less than 2 Minutes (except 2) showed gradual increase in time during the first three months, most of them jumped to 4 – 5 minutes after 3weaks (1st intercourse) then 6 minutes after 2 months and 8 minutes after 3 months without change after that. 3 patients showed improvement directly, 1st patient was 2 minutes and changed to 20 minutes 2nd patient was 3 minutes and changed to 30 minutes (with 5years constant value in both patients) Two patients did not respond to surgery, in 1st patient time was about 20 second but they were not respond to Antidepressant and drugs that treat premature ejaculation and time was not exceed 20 second with drugs but after surgery time increase in 1st patient up to 7.40 minutes and second patient increased from 30 second up to 8.5 minutes with the effect of operation and drug together (clomipramine 50mg) Two patients complained from anejaculation up to around 90 minutes leading to interruption of intercourse. The condition improved after 40 days of operation and time increased from 10,12 minutes to 30, 35 minutes respectively. Conclusion Surgical technique to treat and improve ejaculation time, muscle cutting could be done The combined effect of cutting of bulbospongiosus and frenular delta excision is the best Disclosure Work supported by industry: no.

Levosulpiride for premature ejaculation: A systematic review and meta-analysis

ABSTRACT Introduction PE is diagnosed in the men that have from the first intercourse persistently occurring ejaculation in ≤1 minute of intercourse (lifelong PE) or significantly reduced ejaculation time (≤3 minutes) later in life (acquired PE), failed to delay ejaculation almost all the time of sexual intercourse, and have developed negative personal and mental conditions (e.g., bother, frustration, distress) and eventually sexual avoidance. Upon stimulation, the glans penis relays sensory information to ejaculatory centers (medial preoptic area, paraventricular nucleus, and periaqueductal grey) in the brain, which integrate the peripheral events of the seminal emission, ejaculation, and orgasm. The nucleus paragigantocellularis then modulates the efferent output of dopamine (DA) that inhibits the release of serotonin and ultimately cause ejaculation through D2 receptors. D2 receptor agonists decrease latency time and ejaculatory threshold and increase the frequency of ejaculation in rats. Furthermore, the damage to dopaminergic neurons increased the latency time of ejaculation. Selective serotonin reuptake inhibitors could be an effective treatment of PE, but they impose adverse side effects. Another approach to PE treatment is the inhibition of DA and/or D2 receptors. Levosulpiride (N-[[(2S)-1-ethylpyrrolidin-2-yl]methyl] 2-methoxy-5-sulfamoylbenzamide) is an antagonist of D2 receptors on the dopaminergic neurons of the central and peripheral nervous system. It has shown therapeutic effects primarily in psychiatric (depression, vertigo and schizophrenia) and motor disorders of the upper gastrointestinal tract (gastroesophageal reflux disease, irritable bowel syndrome, dyspepsia and emesis), but also PE. Some previous studies have reported improvements in intravaginal ejaculation latency time (IELT) in men with PE when they were treated with levosulpiride. However, a few studies have reported no significant improvement after levosulpiride treatment. Objectives This review aims to report the efficacy of levosulpiride in the treatment of PE and improvement of IELT. Methods The present study is a systematic review and meta-analysis. PubMed, Science Direct, and Google Scholar were searched for this review. Randomized control trials (RCTs) comparing levosulpiride with a placebo or other medicine were selected. Results A total of 97 articles were retrieved from the database search, of which only 4 RCTs containing 203 men met the selection criteria. All 4 RCTs were included in the systematic review while only 2 were included in the meta-analysis. A high selection and detection bias was found in both of these studies. The meta-analysis also showed the odds of improving IELT in PE patients using levosulpiride to be significantly higher (p &amp;lt; 0.05) compared to those who used a placebo (OR: 100.81, 95% confidence interval (CI) [13.12-774.90], I2 = 0%). The odds of improving IELT for &amp;gt; 5 min (500% improvement) were also significantly higher (p &amp;lt; 0.05) compared to the placebo groups (OR: 38.88, 95% CI [5.12-295.29], I2 = 0%). Furthermore, the odds of improving IELT for &amp;gt; 1 min but &amp;lt; 5 min were also significantly higher (p &amp;lt; 0.05) than the placebo groups (OR: 32.84, 95% CI [4.15-259.75], I2 = 0%). Conclusion Levosulpiride improved IELT, but even so, limited studies are available on this topic. Additional research is thus required to support the present review's findings. Disclosure Work supported by industry: no.

Sperm Characteristics in Microminipigs.

The microminipig is a relatively new type of mini pig; microminipigs weigh about 10 kg at 6 months of age and are expected to be of use in drug discovery research and safety tests. Herein, we analyzed the characteristics of ejaculated sperm from microminipigs. Sperm parameters such as microstructure and sensitivity to cold shock were investigated using optical or scanning electron microscopy. Ejaculate volumes and total numbers of sperm were lower than in standard pig strains, but were proportional to body weight. Ejaculation time, pH of the ejaculate, sperm motility and morphology, and sensitivity to cold shock were similar to those of standard pig strains. Herein, we provide the first characterization of the ejaculates of microminipigs and demonstrate that this type of pig will be useful not only in medical research, but also in investigations into sperm preservation in different pig breeds.

Use of Infrared Thermography during Ejaculation Process and Its Link with Semen Quality and Freezability in Dogs.

Simple SummaryScientific attention to infrared technology has grown over the last decade. Remote and non-invasive monitoring techniques are of great importance in discovering ejaculation response and future trends because of their role in vascular flux regulation. However, detailed information about its use in andrology has yet to be fully explained. Therefore, we aimed to reveal information about the amount of sperm to be obtained by observing stress levels with non-invasive eye temperature measurement, and the relationship between various reproductive temperature patterns and parameters of the animal’s various physiological conditions such as age, body condition, total ejaculation time and testicular volume.This study aimed to describe the thermal variation of external reproductive tracts during ejaculation in relation to sperm quality in dogs. Forty-six adult fertile dogs were monitored using a thermal camera before, during and after the semen collection, taking into account penile and scrotal temperatures as reproductive thermal patterns while eye and perianal temperatures were recorded as complementary thermal patterns of behavioral response. The parameters were classified depending on age (≤4 years and >4 years), body weight (BW) (≤75 kg and >75 kg), sperm concentration (CON) (≤300 million and >300 million), total testicular volume (TTV) (≤600 cm3 and >600 cm3) and total ejaculation time (TET) (≤800 s and >800 s) of the animals from which semen was collected successfully. Heavier males (p < 0.05) that have more consistent testicles (p < 0.01) as well as quicker ejaculate responders (p < 0.001) and lower scrotal temperature had better semen (Δ motility) freezability. The lower eye temperature prior to the ejaculation (p < 0.01), lower scrotal temperature following ejaculation (p < 0.01), and conversely, higher penile temperature during the ejaculation (p < 0.001) had a higher sperm concentration. Furthermore, the sperm freezability was negatively correlated with total ejaculation time (r = −0.39, p < 0.05) and sperm abnormalities were lower in the ejaculate of dogs having a higher temperature of the scrotum, bulbus and penis. In conclusion, infrared monitoring throughout semen collection in dogs can provide information on behavioral reactions during human manipulation, as well as semen quality and testicular functionality.

The effect of a penile fracture on ejaculatory and erectile functions: A cross-sectional study

Background/Aim: There is not enough data in the literature about ejaculatory and erectile functions after a penile fracture. We aimed to report the post-fracture ejaculatory and erectile function change and their relationship with the psychological condition of the patient. Methods: We retrospectively evaluated 27 patients with a penile fracture who were treated surgically. Pre-fracture and post-fracture ejaculatory and erectile functions were evaluated with Intravaginal Ejaculation Latency Time (IELT) and International Index of Erectile Function (IIEF) questionnaires. The psychological conditions of the patients after the fracture were evaluated with the Beck depression score. Results: The mean IELT was increased after penile fracture (P=0.007). The post-fracture and pre-fracture IIEF scores were similar (P=0.062). There was a positive correlation between Beck depression score and post-fracture IELT (r=0.498; P=0.008). Conclusions: According to our results, ejaculation time was longer after penile fractures. It may be related to neurogenic damage due to trauma or the post-fracture psychological condition. However, larger studies with long-term outcomes may reveal the relationship more thoroughly.

Clinical use of hyaluronic acid in andrology: A review.

BackgroundHyaluronic acid is a glycosaminoglycan widely used in the fields of orthopedics, ophthalmology, and aesthetic medicine due to its significant ability to reduce the synthesis of pro‐inflammatory proteins and its activity against oxidative stress, a feature of many degenerative illnesses.ObjectivesThe objective of the present review is to provide a comprehensive narrative review of the most recent literature on the use of hyaluronic acid in andrology in order to facilitate the use of this therapeutic device in the common clinical practice of many physicians. Specific conditions covered in the review are Peyronie's disease, premature ejaculation, and penile enlargement.Materials and methodsA broad and comprehensive literature search included Medline, EMBASE, and the Cochrane Libraries, with no time restriction up to December 2020 and restricted to English language publications. Unpublished studies were not included. The study was registered as “The role of hyaluronic acid in andrology: A systematic review and meta‐analysis” in PROSPERO with the ID CRD42021223416.Discussion and conclusionHyaluronic acid is a valid choice for the treatment of Peyronie's disease in terms of the resolution of the acute phase of the disease and of contributing to stabilizing the disease as a bridge to potential surgery. Data, furthermore, suggest that hyaluronic acid is frequently associated with an overall clinical improvement, allowing the patient to resume normal sexual activity.With regard to premature ejaculation, data suggests hyaluronic acid‐based treatments were effective in prolonging intra‐vaginal ejaculation time. Furthermore, hyaluronic acid was found to be safe and well‐tolerated, with main adverse events limited to local discomfort, ecchymosis, papule formation, and glans numbness, all of which were reported to resolve spontaneously.Last, with regard to penile enlargement, the overall perception of experts is that hyaluronic acid may be an extremely well‐tolerated compound with potential for application in specific areas of male sexual health that are often neglected as compared to more common, and relatively simpler to treat, conditions.