Background: Premature ejaculation is one of the most common sexual dysfunction which affects the quality of life in both men and women. Objectives: To assess the effects of a topical anesthetic mixture in the treatment of Premature Ejaculation (PE). Subjects and method: Fifty-six men diagnosed as PE were guided to use a local anesthetic mixture of procaine-xylocain applied to glands on the penis before sexual activity (about 15 minutes prior), the course of treatment lasted 3 months. Results:There was a significant increase in the mean of intravaginal ejaculatory latency time (IEL n from 1.87 to 8.41 mins (p<0. OS) and satisfying scores of both overall sex life and sexual relationship with their partners. General results were divided into 4 degrees: good (30.2%) average (43.4%) no result (15.1%) and negative results (11.3%). Some side effects included retarded ejaculation or anejacualation (9.43%) decrease of glands penis and vagina sensitivity (28.3% and 9.43% respectively). Conclusion: While there is no effective therapy for PE, anesthetic creams might be effective for treatment of the disorder. \r\n', u'\r\n', u'
topical anesthetic mixture ; premature ejaculation

No abstract available.
Humans ; Life Style ; Premature Ejaculation

Premature ejaculation (PE) is the most common male sexual dysfunction, which represents a diagnostic as well as a therapeutic challenge for physicians. However, no universally accepted definition is currently available for PE. As a result, physicians continue to diagnose patients with PE according to major guidelines set by the professional societies. These guidelines either recommend the use of validated questionnaires or patient-reported outcomes. Recent efforts directed toward classifying PE may help provide a better understanding of the prevalence and risk factors of this disorder. While the exact etiology of PE has not been clearly elucidated, several risk factors have been strongly reported in the literature. Clearly, to understand the revised definition of PE, its etiology and pathophysiology is necessary to improve the clinical management of this medical condition and form the basis of future research in this regard. In this review, we highlight the past and current definitions of PE and present an appraisal on the classifications and theories suggested for the etiopathogenesis of PE.
Humans ; Male ; Premature Ejaculation/physiopathology*

PROPOSE: Premature ejaculation (PE) is the most prevalent male ejaculation disorder. The premature ejaculation diagnostic tool (PEDT) was developed to systematically apply the DSM-IV-TR criteria in diagnostic PE. This study was designed to assess the validity of the Korean version of the PEDT as a diagnostic tool for PE. MATERIALS AND METHODS: The Korean version development of the PDET involved two stages: (1) Development of the initial language version through two independent forward translations and one backward translation. Discrepancies between the original English form and the first draft Korean translation were reviewed by the panel. Discrepancies between the original English form and the Korean translation were reviewed by the panel. (2) For psychometric validation and scoring system development, data was collected from men with and without PE based on clinician diagnosis, using DSM-IV-TR criteria. A total of 98 patients with a DSM-IV-TR defined PE and 100 men without PE were enrolled into the study and requested to complete the PEDT, which was translated into Korean. The PE patients were also requested to measure intravaginal ejaculatory latency time (IELT). The 50 men of no-PE group and all PE group were requested to come for a second visit to assess the PEDT's retest reliability. The results were analyzed statistically by SPSS version 12. RESULT: The mean age of the no-PE group and PE group were 43.4+/-9.2 and 51.6+/-9.0, respectively. The geometric mean IELT of the PE group was 115.37+/-78.14s. The number of men reporting IELTs of <1, 1-<2 and >2min were 28 (28.6%), 29 (29.6%) and 41 (41.8%), respectively. The Cronbach's alpha score of the Korean version of PEDT was calculated as 0.93, showing adequate internal consistency. The test-retest correlation coefficients of each item were higher than 0.72 and the correlation coefficients of the total score was 0.88. (P<0.001) Sensitivity and specificity analyses suggested a score of < or =8 indicated no-PE, 9 and 10 probable PE, and > or =11 PE. CONCLUSIONS: The Korean version of PEDT was highly effective in detecting the presence of PE. The result of our study supports its validity as a diagnostic instrument in the clinical setting.
Ejaculation ; Humans ; Male ; Premature Ejaculation ; Psychometrics ; Sensitivity and Specificity ; Translations

This is a systematic review and meta-analysis on the efficacy of ondemand tramadol for the treatment of lifelong premature ejaculation.

METHODS: A systematic review and meta-analysis with metaregression of trials evaluating the use of tramadol to treat premature ejaculation using intravaginal ejaculation latency time as a measure.Relevant studies were identified using PubMed, Ebscohost,MEDLINE, EMBASE and the Cochrane Collaboration Library.

RESULTS: This analysis included 8 publications. Study of the intravaginal ejaculation latency time (IELT) among 599 patients showed that tramadol was effective in subjects with premature ejaculation as seen by the significant difference in mean IELT of tramadol treated patients versus those receiving placebo (mean difference 2.43 minutes; 95% CI 0.93-3.93; P=0.002). The effect on IELT between tramadol and paroxetine was not statistically significant (mean difference -0.58; 95% CI -5.81 to 4.65; P=0.83).Meta-regression analysis showed that the lower the dose of tramadol,the higher its benefit in the prolongation of IELT, however, there was no significant difference (95% CI regression coefficient -0.0956 to 0.0322). There was a significant difference in adverse effects profile of tramadol versus placebo (risk ratio 2.48; 95% CI 1.55-3.98; overall effect Z= 3.79; P<0.0002) and overall therapeutic effectiveness between tramadol compared to placebo (risk ratio 0.55; 95% CI 0.46-0.67; P<0.00001).

CONCLUSION: On-demand tramadol is an effective treatment for lifelong premature ejaculation. It significantly prolongs the intravaginal ejaculation latency time. The overall adverse events and overall therapeutic effectiveness are significantly greater during treatment with tramadol.

PURPOSE: We evaluated the effect of injectable hyaluronic acid gel(HA) for augmentation of the glans penis and treatment of premature ejaculation. MATERIALS AND METHODS: In 139 patients with premature ejaculation, dorsal neurectomy(Group I; n=25) and glandular augmentation using HA(Group II; n=114) were done. Six months after each procedure, ejaculatory latency, penile vibratory threshold, and patient and partner satisfaction were assessed in both groups. RESULTS: There was no significant difference in preoperative ejaculation time in the two groups, being 89.2+/-40.3 sec in Group I and 96.5+/-52.3 sec in Group II. Postoperatively, ejaculatory latency was significantly increased, to 235.6+/-58.6 sec in Group I and 324.2+/-107.6 sec in Group II(p<0.01). The postoperative vibratory threshold was also significantly increased in both groups(p<0.01). Satisfaction was expressed by both the patient and his partner in 68%(17/25) and 44%(11/25), respectively, in Group I and 79.8%(91/114) and 64.0% (73/114) in Group II. The maximal glandular girth was significantly increased, from 9.2+/-0.6 cm to 11.0+/-0.4 cm, in Group II. CONCLUSIONS: Glandular augmentation with injectable HA gel appears to be very effective for the treatment of premature ejaculation. Glandular augmentation with a bulking agent is anticipated to replace the hazardous, irreversible dorsal neurectomy.
Ejaculation ; Humans ; Hyaluronic Acid* ; Male ; Penis* ; Premature Ejaculation*

The purpose of this study was to determine the prevalence and factors associated with of Premature Ejaculation &Erectile Dysfunctionamong Malaysian men.A cross-sectional study was conducted in urban and rural areas using standardized and validated self-administeredquestionnaires.A total of 319 samples were recruited for PE screening. The overall prevalence of PE was 31.7% with 20.7% and 40.8% for urban and rural arearespectively. Depression, anxiety and frequent masturbation were significantly associated with PE. While For ED, infrequent sexual intercourse was the sole factor significantly associated with ED.PE and ED were highly prevalent in both urban and rural areas; with several significant preventable associated factors.
Premature Ejaculation ; Erectile Dysfunction ; Sexual Dysfunction ; Malaysia

PURPOSE: The measurement of penile sensitivity is a noninvasive and economical screening method to detect various neurologic disorders including premature ejaculation. We measured the normal range of penile sensitivity using a conventional analogue vibrometer and a new type of digital vibrometer and compared the clinical utility of the two instruments. MATERIALS AND METHODS: The vibration threshold of 50 males who had normal erectile function and ejaculation was measured 3 times with both an analogue and a digital vibrometer. The sites of measurement included the plantar side of the 2nd finger, a distal site on the calf, the penile shaft, and glans. The confidence interval was analyzed by the Kernel density estimation method. RESULTS: The ranges measured by the digital vibrometer were narrower than those measured by the analogue instrument. The normal ranges in the 90% confidence interval by the digital vibrometer were 1.03~.16, 2.49~10.13, 1.54~3.41, 1.61~3.53, 1.91~3.80, 1.55~4.03 Hz/mv in finger tip, calf, right penile shaft, left penile shaft, right glans penis, and left glans penis, respectively. The normal ranges in the 95% confidence interval by digital vibrometer were 1.07~2.15, 3.23~9.50, 1.58~3.33, 1.65~3.48, 1.93~3.38, 1.83~3.73 Hz/mv in finger tip, calf, right penile shaft, left penile shaft, right glans penis, and left glans penis, respectively. The results from the digital vibrometer were more consistent than those by the analogue vibrometer. CONCLUSIONS: The digital vibrometer, MMD-1000A(R) can substitute for the analogue type and has the advantages of greater convenience and more precise measurement of penile sensitivity.
Ejaculation ; Fingers ; Humans ; Male ; Mass Screening ; Nervous System Diseases ; Penis ; Premature Ejaculation ; Reference Values ; Vibration

Twenty-nine premature ejaculation patients entered this study using audiovisual stimulation penogram(AVS-Penogram) to evaluate their dynamic blood flows in the penis. The patients, ages twenty seven through fifty-two(average 34 years), complained of short time-to-coital ejaculation less than 90 seconds. We performed Bulbocavernous Reflex Latency(BCRL) and Pudendal Nerve Somatosensory Evoked Potential (DNSEP) test in nineteen of them. According to the results of audiovisual stimulation penogram the patients were classified into two group: fifteen patients had type I (normal) finding and fourteen patients had type X a(unstable erection due to severe fluctuation in blood flow) Finding. Five patients(33%) of fifteen patients with type I (normal) penogram and eleven patients(78%) of fourteen patients with unstable type II n penogram complained of concomitant erectile failure(p<0.06). The age, time-to-coital ejaculation and the results of expressed prostatic secretion(EPS) were not statistically different between above two groups. Furthermore, all cases in whom BCRL and DNSEP was performed had normal results in both tests. This study indicates that premature ejaculation can occur combined with organic erectile failure seeing that the patients show an unstable hemodynamics, and that in such case premature ejaculation has to be treated with underlying organic causes of impotence.
Ejaculation ; Erectile Dysfunction ; Evoked Potentials, Somatosensory ; Hemodynamics ; Humans ; Male ; Penis ; Premature Ejaculation* ; Pudendal Nerve ; Reflex

We performed penile biothesiometry for determining the penile sensitivity on 56 normal men and 120 patients with primary premature ejaculation (PE) to realize the organic reasons of premature ejaculation. The mean vibration perception threshold at the glans penis and penile shaft was 0.222+/-0.133, 0.124+/-0.046 Microns in normal control, 0.058+/-0.026, 0.055+/-0.023 Microns in patients with PE respectively. The mean vibration perception threshold at the glans penis and penile shaft in patients group showed significantly lower than that of normal controls (P<0.001). The mean vibration perception threshold at the glans penis was higher than that of the penile shaft in normal control, but the mean vibration threshold at the glans penis was as much low as the penile shaft in patients with PE (p<0.001). The vibration perception threshold at the glans penis and penile shaft was increasing with aging in normal men, but in patients with PE, consistently lower values were noted with no increasing tendency with age (p<0.001). The mean vibration perception threshold at the index finger and scrotum was 0.041+/-0.023, 0.334+/-0.184 Microns in normal controls, and 0.039+/-0.023, 0.294+/-0.213 Microns in patients with PE respectively. There were no significant differences between two groups (p>0.05). In conclusion, patients with primary premature ejaculation have a penile hypersensitivity regardless of aging. Penile hypersensitivity may give rise to uncontrolled ejaculation, which is thought to be an organic implication of premature ejaculation."
Aging ; Ejaculation ; Fingers ; Humans ; Hypersensitivity ; Male ; Penis ; Premature Ejaculation* ; Scrotum ; Vibration*