Mean Intravaginal Ejaculatory Latency Time Research Articles

Systematic review and meta-analysis for the value of thyroid disorder screening in men with ejaculatory dysfunction.

To demonstrate evidence from available clinical studies to clarify the scientific points that have been achieved in relation to thyroid disorders and ejaculatory dysfunction (EjD). Clinical trial articles published in English on Medline. Clinical studies that investigated the association of thyroid disorders with the ejaculatory function of subjects and the trials evaluating the effect of thyroid dysfunction treatment on the ejaculatory function of the subjects were eligible. We searched Medline with "ejaculation" and different combinations of "thyroid," "serum TSH," "serum T3," "serum T4" keywords in PubMed. Standardised mean serum thyroid-stimulating hormone (TSH) levels in premature ejaculation (PE) sufferers differed from non-PE control subjects (P=.05). Hyperthyroidism was associated with increased odds among PE subjects (OR=2.0, P=.03). Delayed ejaculation was seen with increased odds in hypothyroid patients compared with hyperthyroidism patients (OR=57, P=.0001). Serum TSH and mean intra-vaginal ejaculation latency time (IELT) of the subjects showed a correlation both before and after treatment for thyroid disorder. Treatment of thyroid disorders improved the mean IELT measures of the subjects. The overall estimate of the effect of hyperthyroidism treatment on mean IELT was .64 (P=.0001) in the random-effects model. The low quality and quantity of evidence from available studies limited the interpretation of our study findings. The causal relationship between EjD and thyroid disorders remains to be clarified. Sufferers of delayed ejaculation acquired PE subjects, and PE sufferers who have accompanying erectile dysfunction and/or anxiety may benefit from thyroid disorder investigation.

Application of micronised acellular dermal matrix for primary premature ejaculation: A preliminary study.

This study aimed to explore the efficacy of injection of micronised acellular dermal matrix (MADM) particles for treating primary premature ejaculation. This study was a prospective single-arm clinical trial. Thirty patients who met the surgical indications were enrolled. MADM particles, mixed in platelet-rich plasma, were injected into Buck's fascia to spread over the dorsal penile nerve, suppress the influx of nerve impulses and, thus, reduce penis sensitivity. We evaluated the changes according to intravaginal ejaculation latency time using a stopwatch and a premature ejaculation diagnostic tool. Meanwhile, we also recorded sexual partner satisfaction and adverse events. All patients recovered well after surgery with no complications such as infections or allergies. The mean intravaginal ejaculation latency time before surgery was 0.72±0.28min, compared with 2.41±0.54min, 2.64±0.41min, 2.79±0.25min and 2.89±0.35min at, respectively, 4, 8, 16 and 20weeks after surgery. The premature ejaculation diagnostic values and sexual partner satisfaction had significantly improved after treatment. Injection of MADM particles is an effective, safe and simple method for treating premature ejaculation.

The impact of transcutaneous posterior tibial nerve stimulation in patients with premature ejaculation

Objectives: Approximately 30-40% of men worldwide are affected by premature ejaculation. Despite much research on this subject, there is still little information about the cause and treatment of premature ejaculation. The aim of this study was to evaluate the therapeutic aspect of transcutaneous posterior tibial nerve stimulation (PTNS) in patients with premature ejaculation. Methods: The study included 60 PE patients, aged 20-50 years, divided into 2 groups as the treatment group (n = 30) and the control group (n = 30). Transcutaneous PTNS was applied to patients in the treatment group for 30 minutes once a week for 12 weeks. In the control group, a stimulation probe was placed on the posterior tibial nerve without giving any stimulation, to provide a placebo effect. The Arabic Index of Premature Ejaculation (AIPE) scale and Intravaginal Ejaculation Latency Time (IELT) measurements were used before and after the procedure. Results: In both groups, the mean IELT duration and AIPE scale scores were statistically significantly increased after the procedure (p < 0.05). The percentage change in the AIPE scale scores after the procedure was found to be higher in the treatment group than in the control group (p = 0.007). Conclusions: The results of the study showed a statistically significant increase in the duration of the time to ejaculation with PTNS, and a significant improvement was obtained in the post-treatment AIPE scale scores. There is a need for further research to achieve more robust results to contribute to premature ejaculation treatment.

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.

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.

Dapoxetine for the management of premature ejaculation

Premature ejaculation is the most prevalent male sexual disorder and is more common in South Asia. Bangladesh is no exception. Premature ejaculation causes dissatisfaction in the relationship, frustration for the patient and partner as well as reason of marital failure. Since 1970s sex therapy was the mode of treatment for premature ejaculation. Now treatment with drugs also seems effective. Now a days dapoxetine is used in Bangladesh for the treatment of premature ejaculation. The aim of the study was to determine the efficacy and tolerability of dapoxetine in patients with premature ejaculation. It was a prospective study conducted in private chamber of Dhaka city during the period of March 2016 to February 2017. A total of 60 patients within 21 to 75 years were enrolled in the study according to criteria of International Society for Sexual Medicine (ISSM). We determined the efficacy of dapoxetine 30 mg/day for 12 weeks. The primary endpoint was intra vaginal ejaculatory latency time (IELT) measured by stopwatch. Safety and tolerability were assessed. All analysis was done on an intention-to-treat basis. The results showed that, dapoxetine significantly prolonged IELT (p&lt;0.001) after 12 weeks. After treatment of 1st, 4th ,8th week mean IELT were 1.71 (SD±0.50) minutes, 2.36 (±0.46) minutes and 2.98 (±0.66) minutes respectively. At the end of 12th week 3.89 (±0.87) minutes was evaluated. Common adverse effects were observed as nausea (11.0%), diarrhoea (3.5%), headache (5.6%), dizziness (5.8%), insomnia (2.1%) and backache (1.8%). So from this study it could be said that, dapoxetine was an effective and generally well tolerated treatment for men with premature ejaculation.&#x0D; Bang J Psychiatry June 2017; 31(1): 15-19

142 Predictors of Intravaginal Ejaculatory Latency Time Among a Cohort of Men Presenting to a Sexual Medicine Clinic

Premature ejaculation (PE) is a common male sexual dysfunction and is associated with significant psychological distress. Intravaginal ejaculatory latency time (IELT) is one objective measure utilized in the diagnosis of PE. The objective of this study was to identify factors associated with IELT in a cohort of men presenting to a male sexual dysfunction clinic. A prospective database is maintained of all men presenting to a sexual dysfunction clinic since January 2014. Patients complete an 89-item intake questionnaire that includes information on erectile dysfunction, Peyronie’s Disease, low testosterone symptoms, orgasmic dysfunction, and ejaculatory dysfunction, with one question asking to estimate IELT. Comparative analyses with t-test and linear regression models were used to compare IELT to other patient demographic and pathophysiologic characteristics. A total of 1,406 men completed the intake questionnaire, with 550 responding to the question on IELT. Mean IELT was 8.4 minutes (standard deviation 10.1 minutes). Factors associated with higher IELT included frequency of intercourse (p<0.0001), erection sustainability (p<0.0001), presence of nocturnal erections (p=0.039), IIEF-5 score (p<0.001), and overall satisfaction with sexual relationship (p=0.02). Factors associated with lower IELT included longer duration of relationship (p<0.01) and current alcohol use (p=0.03).

Which of available selective serotonin reuptake inhibitors (SSRIs) is more effective in treatment of premature ejaculation? A randomized clinical trial.

ABSTRACTPurpose:To compare the efficacy and safety of available selective serotonin reuptake inhibitors (SSRIs) in order to find the most effective drug with the least number of side effects in treatment of premature ejaculation (PE).Materials and Methods:This study was a randomized clinical trial. Four hundred and eighty patients with PE in the 4 groups referred to Imam Reza hospital Tehran, Iran from July 2018 to February 2019 were enrolled in the study. The patients received sertraline 50mg, fluoxetine 20mg, paroxetine 20mg and citalopram 20mg, every 12 hours daily. The intravaginal ejaculatory latency time (IELT) before treatment, fourth and eighth weeks after treatment was recorded by the patient's wife with a stopwatch.Results:Mean IELT before, 4 and 8 weeks after treatment in four groups were: sertraline 69.4±54.3, 353.5±190.4, 376.3±143.5; fluoxetine 75.5±64.3, 255.4±168.2, 314.8±190.4; paroxetine 71.5±69.1, 320.7±198.3, 379.9±154.3; citalopram 90.39±79.3, 279.9±192.1, 282.5±171.1 seconds, respectively. The ejaculation time significantly increased in all groups (p <0.05), but there was no significant difference between the groups (P=0.75). Also, there was no significant difference in drugs side effects between groups (p >0.05). The most common side effects were drowsiness and dyspepsia, which were not severe enough to cause discontinuation of the drug.Conclusions:All available SSRIs were effective and usually had no serious complications. In patients who did not respond to any of these drugs, other SSRI drugs could be used as a salvage therapy.

Is testosterone replacement an effective treatment of secondary premature ejaculation?

There are very few studies that have evaluated premature ejaculation characteristics in regard to subtypes. Additionally, to our knowledge, there are no studies which have explored testosterone replacement therapy in secondary premature ejaculation patients with testosterone deficiency. Therefore, our aims were as follows: (a) to determine the characteristics of patients with premature ejaculation in regard to the four subtypes of premature ejaculation and (b) to determine the efficacy of testosterone replacement therapy in the treatment of testosterone-deficient patients with secondary premature ejaculation. Patients who applied to our clinic from May 2010 to August 2018 with premature ejaculation were included in this study. The mean age of the study group was 36.42 (min-max: 24-52) years. Those with secondary premature ejaculation were found to have significantly lower testosterone concentration compared to the other groups. Shortest mean intravaginal ejaculation latency time and lowest International Index of Erectile Function-5 score were found among those with secondary PE. In regard to treatment results, recipients of testosterone replacement demonstrated a 4.8-fold increase in mean intravaginal ejaculation latency time, while dapoxetine recipients had a 1.8-fold increase. Our findings demonstrate that testosterone replacement may be a promising treatment for those with secondary PE in the presence of testosterone deficiency.

Frequency of etiological factors among patients with acquired premature ejaculation: prospective, observational, single-center study.

Although premature ejaculation (PE) is a common male sexual dysfunction, its pathophysiology has not been fully elucidated. Several medical problems such as erectile dysfunction, depression, anxiety, hormonal disorders and chronic prostatitis may play a role in the etiology of acquired PE. This study aims to evaluate the frequency of these etiologic factors among patients with acquired PE. Between May and July 2016, 53 men with acquired PE were included in the study. Self-estimated intravaginal ejaculation latency time (IELT) of these patients was recorded along with their medical history and physical examination findings. Moreover, 5-item version of the International Index of Erectile Function (IIEF-5), premature ejaculation profile (PEP), anxiety and depression scales (STAI-1, STAI-2, and BECK), and chronic prostatitis symptom index (NIH-CPSI) were administered. Fasting plasma glucose, follicle stimulating hormone (FSH), luteinizing hormone (LH), prolactin, total and free testosterone, total prostate specific antigen, thyroid and thyroid stimulating hormone levels were measured. Urine analysis and 2 cup tests were also studied. Mean age of the patients was 42.41 ± 11.14 (22-60). Mean duration of the PE complaint was 34.18 ± 36.76 (3-144) months. Mean IELT time of the patients was 38.28 ± 30.79 (3-180) s. Of the patients; 69.81%, 62.26%, 56.60%, 45.28%, 30.19%, 24.53%, 16.98%, 15.09%, and 7.55% had depression, chronic prostatitis, erectile dysfunction, anxiety, diabetes mellitus, abnormal FSH or LH, hypoprolactinemia, hyperthyroidism, and high testosterone levels, respectively. The results of our study revealed that anxiety disorders, depression, erectile dysfunction, and chronic prostatitis are common among patients with acquired PE and may play role in the etiology of this problem. There is a need for further researches related to the exact pathophysiology of acquired PE with larger number of patients.

Clinical features of and couple’s attitudes towards premature ejaculation: a multicenter cross-sectional study

Introduction The current study aimed to investigate the clinical features of and couple’s attitudes towards premature ejaculation (PE). Methods Qualified patients were continuously enrolled from 15 medical centers in different regions of China. Patient data were collected from March 1 2017 to July 31 2017. All men were assessed by the Premature Ejaculation Diagnostic Tool (PEDT) and Intravaginal Ejaculation Latency Time (IELT). Besides, sexual desire, force of ejaculation, and the five-item International Index of Erectile Function (IIEF-5) score were recorded. The couple’s attitudes towards PE were evaluated by a self-designed questionnaire. Results In total, 1033 males diagnosed with PE and their sexual partners and 3176 males without PE were enrolled. The mean PEDT and IELT scores of the patients with PE were 14.38 ± 3.68 and 1.59 ± 0.85, respectively. IIEF-5, sexual desire, and force of ejaculation significantly decreased in patients with PE. Among the 1033 couples, 44.3%, 21.39%, and 33.98% of the couples were seeking PE because of the dissatisfaction of the males, the females or both partners, respectively. In terms of the males who were dissatisfied with PE, 49.51% and 17.86% complained of short IELT and inability to control ejaculation. In terms of the females dissatisfied with PE, 41.61%, 19.93%, 21.68%, and 14.51% complained of arousal difficulty, weak sexual desire, failing to have organism and poor relationship, respectively. Conclusions PE has a negative impact on erectile function, sexual desire, and force of ejaculation. Sexual partners play important roles in the medical procedures for addressing PE.

RANDOMIZED, PLACEBO-CONTROLLED STUDY TO EVALUATE THE EFFICACY, SAFETY, AND TOLERABILITY OF BENZOCAINE WIPES IN SUBJECTS WITH PREMATURE EJACULATION

AimThis study investigated the efficacy and safety of benzocaine wipes (PREBOOST) applied to the penis prior to intercourse for the treatment of men with premature ejaculation.Materials and methodsThe study utilized the local anesthetic benzocaine, in the form of wipes, for topical application to the glans penis prior to sexual intercourse. The design included three phases: screening and baseline, blinded randomized controlled, and an open-label phase with crossover of the placebo group to open-label active treatment. The two co-primary efficacy measures were the intravaginal ejaculatory latency time (IELT) measured by stopwatch, and the patient-reported outcome measured by the Index of Premature Ejaculation (IPE). Additional efficacy evaluation included a responder analysis using a predetermined 120s improvement in IELT as a responder threshold. Safety evaluation included patient-reported events along with a physical examination. ResultsThe treatment phase showed a statistically significant increase from the baseline, in the treatment group (mean 165s) compared with the placebo group (mean 110s), P<0.007. After the second month of use, the treatment group had a mean IELT of 329.70s (±21.37 SE) in comparison to the placebo group which had a mean IELT of 110.10s (±9.90 SE) (P=0.001). The open-label phase showed further increase in IELT in the treatment group and a statistically significant increase in IELT in the placebo/ crossover group. Using the IPE, the men in the treatment group reported significantly higher sexual satisfaction (P=0.047) and greater improvement in distress (P=0.020) with a trend toward improve-ment in the ejaculatory control domain scores (P=0.093). The responder analysis showed a statisti-cally significant response to the use of benzocaine versus placebo, attesting an IELT increase that was clinically meaningful. Benzocaine wipes were well tolerated by subjects and partners.ConclusionThis randomized, placebo controlled clinical trial with crossover design showed that benzocaine wipes applied topically to the penis prior to sexual intercourse had a statistically significant prolongation of time to ejaculation, a clinically meaningful benefit, in the treatment of premature ejaculation. Furthermore, benzocaine wipes were well tolerated by the subjects and no evidence of transference to their female partners.

Is There Any Association Between Regular Physical Activity and Ejaculation Time?.

Premature ejaculation (PE) is a prevalent disorder in males leading to sequelae such as lack of self-confidence,anxiety, depression and unsatisfactory intercourse for these men and their partners. The aim of this study was to evaluate the relationship between ejaculation and physical activity. Group 1 comprised 112 participants who took regular physical activity and Group 2 comprised 126 participants with a sedentary lifestyle. The participants were 18-45 years old, same ethnic origin, insame location and had regular sexual activity for at least 6 months. A comparison was made by metabolic equivalents (MET), premature ejaculation diagnostic tool (PEDT) and intravaginal ejaculatory latency time (IELT). The mean age of Groups 1 and 2 was 25.34 years (range, 18-41 years) and 28.49 years (range, 19-45 years), respectively (P = .21). The mean PEDT score was 6.18 in Group 1, and 10.02 in Group 2. Significant differences were found between Groups 1 and 2 (P = .001). The mean MET score of Group 1 was 3448.23 METmin/week (3012-4496 MET- min/week) while the MET score of Group 2 was 201.87 MET- min/week (66-744 MET- min/week) (P = .001). The mean IELT of Groups 1 and 2 were 316.42 s (120-1530 s) and 189.32 s (20-450 s), respectively. The mean IELT was significantly higher in Group 1 (P = .001). The study results demonstrated that PE was less frequent in men that perform regular physical activitycompared to those with a sedentary lifestyle. It can be assumed that regular physical activity may be effectual in gaining a sexual life of higher quality. Prospective studies with longitudinal data are needed to further understand the potential relationship between regular physical activity and premature ejaculation.

AB082. Association study of STin2 VNTR polymorphism of serotonin transporter gene with lifelong premature ejaculation: a case-control study in Han Chinese subjects

BackgroundSTin2 VNTR polymorphism was a variable number of tandem repeats in the intron 2 of serotonin transporter gene. We aimed to explore the relationship between STin2 VNTR polymorphism and lifelong premature ejaculation (LPE).MethodsA total of 115 outpatients who complained of ejaculating prematurely and who were diagnosed as LPE, and 101 controls without PE complaint were recruited. Allelic variations of STin2 VNTR were genotyped using PCR-based technology. We evaluated the associations between STin2 VNTR allelic and genotypic frequencies and LPE, as well as the intravaginal ejaculation latency time (IELT) of different STin2 VNTR genotypes among LPE patients.ResultsThe patients and controls did not differ significantly in terms of any characteristic except age. A significantly higher frequency of STin2.12/12 genotype was found among LPE patients versus controls (P=0.026). Frequency of patients carrying at least one copy of the 10-repeat allele was significantly lower compared to the control group (28.3% vs. 41.8%, OR =0.55; 95% CI: 0.31–0.97, P=0.040). In LPE group, the mean IELT showed significant difference in STin2.12/12 genotype when compared to those with STin2.12/10 and STin2.10/10 genotypes. The fold-increase of the mean IELT in 10-repeat allele carriers showed a 50% longer compared to STin2.12 allele homozygous.ConclusionsOur results indicated the presence of STin2.10 allele is a protective factor for LPE. Men carrying the higher expression genotype STin2.12/12 have shorter IELT than those 10-repeat allele carriers.

184 On-demand use of Tramadol, Sildenafil, Paroxetine and Local Anaesthetics for the Management of Premature Ejaculation: A Randomized Placebo-controlled Clinical Trial

To compare the clinical efficacy of the on-demand use of four drugs in the management of patients with premature ejaculation (PE), as the off-label use of selective serotonin-reuptake inhibitors and topical penile anaesthetics is frequently indicated for the management of patients with PE, and tramadol HCl and sildenafil citrate were also tried for managing this disorder, but with recommendations based on weak evidence. This was a single-centre, single-blind, placebo-controlled clinical trial conducted on 150 patients who had PE for >1 year. Patients were randomized equally into five groups. On-demand tramadol, sildenafil, paroxetine, local lidocaine gel or placebo was given for patients in groups 1–5, respectively. During the month before treatment, the intravaginal ejaculation latency time (IELT) and sexual satisfaction scores (on a 0–5-point scale) were measured and compared to the mean IELT and sexual satisfaction scores recorded during 4 weeks of on-demand drug administration, with monitoring of any possible side-effects.

Pelvic muscle floor rehabilitation as a therapeutic option in lifelong premature ejaculation: long-term outcomes.

The aim of the study was to evaluate the long-term outcomes of pelvic floor muscle (PFM) rehabilitation in males with lifelong premature ejaculation (PE), using intravaginal ejaculatory latency time (IELT) and the self-report Premature Ejaculation Diagnostic Tool (PEDT) as primary outcomes. A total of 154 participants were retrospectively reviewed in this study, with 122 completing the training protocol. At baseline, all participants had an IELT ≤60 s and PEDT score >11. Participants completed a 12-week program of PFM rehabilitation, including physio-kinesiotherapy treatment, electrostimulation, and biofeedback, with three sessions per week, with 20 min for each component completed at each session. The effectiveness of intervention was evaluated by comparing the change in the geometric mean of IELT and PEDT values, from baseline, at 3, 6, and 12 months during the intervention, and at 24 and 36 months postintervention, using a paired sample 2-tailed t-test, including the associated 95% confidence intervals. Of the 122 participants who completed PFM rehabilitation, 111 gained control of their ejaculation reflex, with a mean IELT of 161.6 s and PEDT score of 2.3 at the 12-week endpoint of the intervention, representing an increase from baseline of 40.4 s and 17.0 scores, respectively, for IELT and PEDT (P < 0.0001). Of the 95 participants who completed the 36-month follow-up, 64% and 56% maintained satisfactory ejaculation control at 24 and 36 months postintervention, respectively.

Premature ejaculation: Pharmacotherapy vs group psychotherapy alone or in combination.

Premature Ejaculation (PE), the commonest sexual dysfunction in males, is generally treated with local anesthetic and SSRI (Dapoxetine). The aim of our study was investigate Group Psychotherapy as an alternative treatment for PE and compare the efficacy of pharmacological treatment and psychotherapy, either alone or in combination, in terms of response and improved Quality of Life (QoL). From a male outpatient population screened for PE, those who received a diagnosis of PE were proposed for the study, enrolled and divided into 3 groups (A, B and C). Each group was treated with Dapoxetine, Group Psychotherapy alone and Dapoxetine and Group Psychotherapy, respectively. Out of 1237 male outpatients, 353 received a diagnosis of Premature Ejaculation. Of them, 279 were enrolled in the study and randomized into 3 groups (A, B and C). Only 157 patients were evaluable. Before and after treatments all participants completed two questionnaires to evaluate PE status and anxiety and referred their IELT. GROUP A: The mean post-treatment Premature Ejaculation Diagnostic Tool (PEDT) score decreased from 12.95 to 8.26, while the mean Intra-vaginal Ejaculation Latency Time (IELT) increased from 50.77 sec to 203 sec. (p &lt; 0.05); GROUP B: Reduction in the mean PEDT from 13.44 to 5.11 and an increased IELT from 48.33 to 431.11 sec (p &lt; 0.001); GROUP C: The mean post-treatment PEDT score decreased from 12.29 to 5.57, while the mean IELT increased from 46.86 to 412.14 sec (p &lt; 0.001). All groups recorded an improvement in anxiety. According to our results Group Psychotherapy is an alternative method of treatment for PE. Group Psychotherapy plays a significant role in the treatment of PE, determining a better improvement of symptoms than Dapoxetine alone even if not statistically significant.

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 ≤60s 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.

The prevalence of an excessive prepuce and the effects of distal circumcision on premature ejaculation

ObjectiveTo investigate the prevalence of an excessive prepuce in patients with premature ejaculation (PE) and to evaluate the effectiveness of distal circumcision in reducing the penile hypersensitivity, which is thought to be a cause of PE. Patients and methodsMen were considered to have an excessive prepuce if the foreskin exceeded the external urethral meatus by ≥1cm in the flaccid state. The diagnosis of PE was based on the Premature Ejaculation Diagnostic Tool (PEDT) questionnaire score and on the intravaginal ejaculatory latency time (IELT). These features were evaluated at baseline and at 6months after circumcision. ResultsLifelong PE was diagnosed in 352 patients of whom 208 (59.1%) had an excessive prepuce. We offered those with an excessive prepuce a circumcision, as a potential definitive treatment for their PE, and 27 (13%) men accepted. At 6months after circumcision, there was an increase in the mean (SD) IELT from 40.4 (16.5) to 254 (66.8)s (P<0.001) and the mean (SD) PEDT score decreased from 17 (2) to 6.6 (1.9) (P<0.001). Overall, 26 of the 27 (96%) patients that had a circumcision reported an IELT increase. ConclusionsAn excessive prepuce is very common in patients affected by PE. Although accepted by only 13% of our patients, distal circumcision was shown to be a very effective surgical treatment for definitive treatment of PE. We therefore recommend assessing patients complaining of lifelong PE for an excessive prepuce and if they have an excessive prepuce to suggest that they undergo distal circumcision.

Association of STin2 VNTR Polymorphism of Serotonin Transporter Gene with Lifelong Premature Ejaculation: A Case-Control Study in Han Chinese Subjects.

BackgroundThe STin2 VNTR polymorphism has a variable number of tandem repeats in intron 2 of the serotonin transporter gene. We aimed to explore the relationship between STin2 VNTR polymorphism and lifelong premature ejaculation (LPE).Material/MethodsWe recruited a total of 115 outpatients who complained of ejaculating prematurely and who were diagnosed as LPE, and 101 controls without PE complaint. Allelic variations of STin2 VNTR were genotyped using PCR-based technology. We evaluated the associations between STin2 VNTR allelic and genotypic frequencies and LPE, as well as the intravaginal ejaculation latency time (IELT) of different STin2 VNTR genotypes among LPE patients.ResultsThe patients and controls did not differ significantly in terms of any characteristic except age. A significantly higher frequency of STin2.12/12 genotype was found among LPE patients versus controls (P=0.026). Frequency of patients carrying at least 1 copy of the 10-repeat allele was significantly lower compared to the control group (28.3% vs. 41.8%, OR=0.55; 95%CI=0.31–0.97, P=0.040). In the LPE group, the mean IELT showed significant difference in STin2.12/12 genotype when compared to those with STin2.12/10 and STin2.10/10 genotypes. The mean IELT in10-repeat allele carriers was 50% longer compared to homozygous carriers of the STin2.12 allele.ConclusionsOur results indicate the presence of STin2.10 allele is a protective factor for LPE. Men carrying the higher expression genotype STin2. 12/12 have shorter IELT than 10-repeat allele carriers.