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

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*

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.

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

Recently, four premature ejaculation (PE) subtypes have been distinguished on the basis of the duration of the intravaginal ejaculation latency time (IELT). These four PE subtypes have different etiologies and pathogeneses. Genetic research on PE should consider the existence of these PE subtypes and the accurate measurement of the IELT with a stopwatch. Currently, three methods of genetic research on PE have been used. They differ in the investigated population, tool of measurement, study design, and variables of PE. From animal and human research, it is derived that the central serotonergic system "modulates" ejaculation, whereas the ejaculation (reflex) itself is probably not under direct influence of the serotonergic system, but rather under the influence of other neurotransmitter systems in the spinal cord. For genetic research on PE, it is important to take into account that the (serotonergic) modulation of the IELT is variable among men and may even be absent. This means that serotonergic genetic polymorphisms may only be found in men with PE who respond with an ejaculation delay treatment with a selective serotonin reuptake inhibitor.
Animals ; Ejaculation ; Genetic Research ; Humans ; Male ; Neurotransmitter Agents ; Polymorphism, Genetic ; Premature Ejaculation ; Serotonin ; Spinal Cord

A man should control his ejaculation until a woman has an orgasm if the couple desires to achieve mutual orgasms during sexual intercourse. In male-oriented traditional societies, men have sexual relations without concerns about female sexuality. On the contrary, men's erectile dysfunction and premature ejaculation have been regarded as detrimental to sexual relationships since female sexuality has gained similar importance to male sexuality in the context of gender equality. Thus, many men would like to sustain erections for as long as desired and regulate their ejaculation like the experts in the Tantric sex or Taoism. Sexual techniques or teachings of the ancient Tantric sex or Taoism may sound illogical from a modern medical perspective, but they have something to teach us, such as focusing on foreplay to achieve female orgasm. Several issues on men's erectile capability and ejaculation are discussed in this article, while reviewing a variety of viewpoints on male sexual functioning.
Coitus ; Ejaculation ; Erectile Dysfunction ; Female ; Humans ; Male ; Orgasm ; Premature Ejaculation ; Religious Philosophies ; Sexuality

Premature ejaculation is the most common male sexual dysfunction and defined as persistent or recurrent occurrences of ejaculation before or shortly after penetration. But there has never been any effective oral agents for the patients with premature ejaculation. Recently, fluoxetine, a potent serotonin reuptake inhibitor, being used as antidepressant, has been suggested to be helpful for the patients with premature ejaculation. Twenty three male outpatients with premature ejaculation were randomly divided into fluoxetine (n=12) and placebo (n=11) group. In the fluoxetine group, the dose of fluoxetine was 20 mg/day for the first one week and 40 mg/day for the remaining 5 weeks. Patient and his female partner were interviewed separately before starting medication, three weeks and six weeks after medication. The mean intravaginal ejaculation latency time increased to 187.5 seconds after 3 weeks and 254.2 seconds after 6 weeks front 46.7 seconds before treatment (p<0.05). Only 1 out of 12 patients in the fluoxetine group was able to have thrusts over 30 times before treatment. After 3 weeks of Treatment, 8of 12 patients and after 6 weeks of treatment, 7 patients were able to have thrusts over 30 times. There was no significant improvement of intravaginal ejaculation latency time and number of thrusts in the placebo group. Symptomatic improvement was noticed in 75% with fluoxetine group and 18.2% with placebo group. Side reactions of fluoxetine, fatigue and yawning, were noticed in 41% of the patients, but they did not interfere with their daily activities. These findings suggest that fluoxetine can be safely used as a good pharmacotherapeutic treatment for the patients with premature ejaculation.
Ejaculation ; Fatigue ; Female ; Fluoxetine* ; Humans ; Male ; Outpatients ; Premature Ejaculation* ; Serotonin ; Yawning