This study aimed to investigate perceived ejaculatory function/satisfaction before treatment for lower urinary tract symptoms (LUTS)/benign prostatic hyperplasia (BPH) and to identify associations between specific categories of ejaculatory dysfunctions (EjDs) and LUTS. A total of 1574 treatment-naïve men with LUTS/BPH were included in this study. All patients underwent routine evaluation for LUTS/BPH including the International Index of Erectile Function and a 5-item questionnaire developed to assess ejaculatory volume/force/pain/satisfaction/latency time. Patients who had sexual intercourse over the past 4 weeks were classified as sexually active group. A total of 783 patients were categorized as sexually active group. Decreased ejaculatory volume and force were reported by 53.4% and 55.7% of 783 sexually active men, respectively. There was a strong correlation between ejaculatory volume and force. Ejaculatory pain/discomfort, premature ejaculation (PE), and delayed ejaculation (DE) were reported in 41.0%, 16.3%, and 41.4% of the patients, respectively. Over 40.0% of men without decreased ejaculation volume/force were satisfied with ejaculatory function, whereas approximately 6.0% of men with decreased volume/force were satisfied with ejaculatory function. About 30.0% of men with decreased volume/force had orgasmic dysfunction, while approximately 10.0% of men without decreased volume/force did. Decreased ejaculatory volume or force was associated with LUTS severity after adjusting for other influential factors including testosterone level, erectile function, and prostate size on ultrasonography, but PE or DE or ejaculatory pain/discomfort was not. In conclusion, a considerable portion of men with LUTS/BPH appear to have a variety of EjDs. Ejaculatory volume/force and satisfaction/orgasm do not always appear to be concordant. Ejaculatory volume or force is independently associated with LUTS severity, whereas PE or DE or ejaculatory pain/discomfort is not.
Aged ; Coitus ; Ejaculation ; Humans ; Lower Urinary Tract Symptoms/physiopathology* ; Male ; Middle Aged ; Orgasm ; Pain/etiology* ; Personal Satisfaction ; Premature Ejaculation/physiopathology* ; Prostate/diagnostic imaging* ; Prostatic Hyperplasia/physiopathology* ; Sexual Dysfunction, Physiological/physiopathology* ; Surveys and Questionnaires ; Testosterone/blood*

Charcot-Marie-Tooth Disease/physiopathology* ; Humans ; Male ; Sexual Dysfunction, Physiological/physiopathology* ; Ultrasonography ; Young Adult

OBJECTIVETo observe the clinical effects of needle-pricking therapy, a newly medical and minimally invasive technique, for functional retrograde ejaculation and to explore its mechanism. Methods Thirty-six patients with functional retrograde ejaculation were randomly divided into an observation group(19 cases) and a control group(17 cases) In the observation group,needle-pricking therapy was used at Guanyuan(CV 4) and bilateral sacral plexus nerve,lumbar 1 nerve and greater occipital nerve stimulating points,once a week. In the control group, midodrine tablets were prescribed orally,three times a day. All the treatment was given for 9 weeks. The clinical effects of the two groups were observed, and the levels of luteinizing hormone(LH), testosterone(Tes) and estra4 diol(E2) were compared between the two groups.

RESULTSThe total effective rate of the observation group was, 89. 47%(17/19), which was better than 47.06% (8/17) of the control group(P<0. 05). The LH and Tes were obviously increased and E2 was decreased compared with those before treatment in the observation group(all P< 0. 01). Tes was raised(P<0. 05) and E2 was apparently declined in the control group(P<0. 01). After treatment, the differences of serum LH and Tes were statistically significant between the two groups(both P<0. 01).

CONCLUSIONNeedle-pricking therapy has advantages for functional retrograde ejaculation probably in that stimulating lumbosacral nerves can strengthen the function of pelvic floor muscles and urethral expansion muscle and regulate sexual gland axis.

Acupuncture Points ; Acupuncture Therapy ; Adult ; Ejaculation ; Humans ; Male ; Middle Aged ; Needles ; Sexual Dysfunction, Physiological ; physiopathology ; therapy ; Treatment Outcome

OBJECTIVETo investigate the prevalence of male sexual dysfunction in males with Parkinson's disease and the pathogenesis and related factors of the problem.

METHODSWe evaluated the sexual function of 140 men with Parkinson's disease using Mini-mental State Examination (MMSE), Unified Parkinson's Disease Rating Scale (Part III) (UPDRS III), Hoenhn-Yahr Staging (HYS), Hamilton Depression Scale (HAMD) and Sexual Dysfunction Standard of ICD-10. We calculated the Levodopa equivalent doses (LED) for all the patients.

RESULTSSexual dysfunction was found in 58 (41.43%) of the patients with Parkinson's disease. There were no significant differences in age, education, age of onset, course of disease and scores on UPDRS III, HYS and LED between the sexual dysfunction and normal sexual function groups. The HAMD score was 14.95 +/- 9.12 in the sexual dysfunction group, significantly higher than 10.96 +/- 9.82 in the normal sexual function group (P < 0.05), and it was positively correlated with the inci- dence of male sexual dysfunction (P < 0.05).

CONCLUSIONSexual dysfunction is a common symptom in males with Parkinson's disease, and is correlated with the high HAMD score of Parkinson's disease patients.

Adult ; Aged ; Aged, 80 and over ; Humans ; Male ; Middle Aged ; Parkinson Disease ; physiopathology ; Psychiatric Status Rating Scales ; Sexual Dysfunction, Physiological ; etiology

Diabetes mellitus is a common problem, and female sexual dysfunction is one of its complications in diabetic women. Recent studies show that the major risk factors of sexual dysfunction in diabetic women are diabetes-induced vascular disease, neuropathy, endocrine abnormalities and psychological problems and so on. This article outlines the advances in the recent studies of female sexual dysfunction in diabetic women.
Diabetes Mellitus ; physiopathology ; psychology ; Diabetic Angiopathies ; physiopathology ; psychology ; Diabetic Neuropathies ; physiopathology ; psychology ; Female ; Humans ; Sexual Dysfunction, Physiological ; etiology ; Sexual Dysfunctions, Psychological ; etiology

OBJECTIVETo investigate the correlation of sexual dysfunction with psychological abnormalities by analyzing the sexual function and mental state of the patients with redundant prepuce or phimosis.

METHODSThis study included 216 randomly selected patients with redundant prepuce or phimosis and 85 normal male controls. We conducted investigations among the subjects using a questionnaire on the general data of the patients, Chinese Index of Sexual Function for Premature Ejaculation (CIPE), International Index of Erectile Function (IIEF), and Symptom Checklist 90 (SCL-90). Then we assessed the status of premature ejaculation (PE) and erectile dysfunction (ED), calculated the incidence of psychological abnormalities, such as depression and anxiety, and analyzed the correlation of PE and ED with the mental state of the patients.

RESULTSThe PE and ED patients scored significantly higher than normal controls on SCL-90, somatization, compulsion, depression, anxiety and other factors (P < 0.05). CIPE scores were correlated with the scores on SCL-90, somatization, compulsion, interpersonal sensitivity, depression, anxiety and other factors, while ED-related scores showed no correlation with the scores on SCL-90 and other factors.

CONCLUSIONPatients with redundant prepuce or phimosis have poor mental health, and there is an interaction between PE and the mental state of the patient.

Adolescent ; Adult ; Case-Control Studies ; Erectile Dysfunction ; etiology ; Humans ; Male ; Middle Aged ; Phimosis ; physiopathology ; psychology ; Sexual Behavior ; Sexual Dysfunction, Physiological ; physiopathology ; psychology

OBJECTIVETo investigate the number, course and distribution of normal dorsal penile nerves and their clinical significance for selective neurectomy of the dorsal penile nerve in the treatment of primary premature ejaculation.

METHODSWe dissected 38 cadaveric adult penises and recorded the number, course and distribution of the dorsal penile nerves. A total of 314 cases of primary premature ejaculation underwent selective neurectomy of the dorsal penile nerve. The patients ranged between 20 and 45 years in age and from 1 to 22 years in disease course.

RESULTSThe dorsal penile nerves were distributed in parallel bilaterally in all the cadaveric penises and branched into the ventral side in 4 of them. The total number of dorsal penile nerves was (3.6 +/- 1.2) in the 38 cadaveric penises, 7 in 1 case, 6 in 1 case, 5 in 6 cases, 4 in 9 cases, 3 in 14 cases and 2 in 7 cases, while that of the 314 patients with primary premature ejaculation was (7.0 +/- 1.9), 5 in 64 cases, 6 in 56 cases, 7 in 52 cases, 8 in 40 cases, 9 in 33 cases, 10 in 28 cases, 11 in 25 cases, 12 in 11 cases and 13 in 5 cases. Selective neurectomy of the dorsal penile nerve achieved an intravaginal ejaculation latency of (4.31 +/- 1.87) minutes and sexual satisfaction rate of (61 +/- 17) %, significantly different from those before the operation ([1.24 +/- 0.32] min, [23 +/- 6] %; all P < 0.01).

CONCLUSIONThe abnormal increase of dorsal penile nerves possibly lies at the bottom of the pathogenesis of primary premature ejaculation. Selective neurectomy of the dorsal penile nerve is safe and effective for the treatment of primary premature ejaculation.

Adult ; Denervation ; methods ; Ejaculation ; Humans ; Male ; Middle Aged ; Neuroanatomy ; Penis ; innervation ; Peripheral Nerves ; anatomy & histology ; surgery ; Sexual Dysfunction, Physiological ; physiopathology ; surgery ; Treatment Outcome ; Young Adult

We evaluated the genotypes of the serotonin transporter gene (5-HTT) in patients with premature ejaculation (PE) to determine the role of genetic factors in the etiopathogenesis of PE and possibly to identify the patient subgroups. A total of 70 PE patients and 70 controls were included in this study. All men were heterosexual, had no other disorders and were either married or in a stable relationship. PE was defined as ejaculation that occurred within 1 min of vaginal intromission. Genomic DNA from patients and controls was analyzed using polymerase chain reaction, and allelic variations of the promoter region of the serotonin transporter gene (5-HTTLPR) were determined. The 5-HTTLPR (serotonin transporter promoter gene) genotypes in PE patients vs. controls were distributed as follows: L/L 16% vs. 17%, L/S 30% vs. 53% and S/S 54% vs. 28%. We examined the haplotype analysis for three polymorphisms of the 5-HTTLPR gene: LL, LS and SS. The appropriateness of the allele frequencies in the 5-HTTLPR gene was analyzed by the Hardy-Weinberg equilibrium using the chi2-test. The short (S) allele of the 5-HTTLPR gene was significantly more frequent in PE patients than in controls (P<0.05). We suggest that the 5-HTTLPR gene plays a role in the pathophysiology of all primary PE cases. Further studies are needed to evaluate the relationship between 5-HTTLPR gene polymorphism and patient subgroup (such as primary and secondary PE) responses to selective serotonin reuptake inhibitors as well as ethnic differences.
Adult ; Ejaculation ; Genotype ; Humans ; Male ; Middle Aged ; Polymorphism, Genetic ; Serotonin Plasma Membrane Transport Proteins ; genetics ; Sexual Dysfunction, Physiological ; genetics ; physiopathology ; Turkey ; Young Adult

OBJECTIVETo evaluate male sexual function in a series of rectal cancer patients randomized to laparoscopic(LS) or open surgery(OS).

METHODSBetween June 2006 and October 2007, a total of 119 patients with rectal cancer were randomly assigned to laparoscopic(n=60) or open (n=59) resection group. All the patients were treated by D(3) lymphadenectomy combined with pelvic autonomic nerve preservation(PANP) technique. Sexual function was assessed by International Index of Erectile Function(IIEF) before surgery and on 3, 6 and 12 months after operation.

RESULTSSexual dysfunction rate of LS and OS at 3rd month after operation were 23.3% and 32.3% respectively, and 18.3% vs 27.1% after 6 months, and 11.6% vs 16.9% after 12 months. There were no significant difference between LS and OS in sexual dysfunction rate after surgery.

CONCLUSIONSLaparoscopic D(3) lymphadenectomy combined with PANP is not associated with higher sexual dysfunction rate, and the sexual function after laparoscopic surgery is satisfactory.

Adult ; Aged ; Autonomic Pathways ; surgery ; Follow-Up Studies ; Humans ; Laparoscopy ; methods ; Lymph Node Excision ; Male ; Middle Aged ; Neoplasm Staging ; Pelvis ; innervation ; Rectal Neoplasms ; physiopathology ; surgery ; Sexual Dysfunction, Physiological ; etiology

OBJECTIVETo observe the clinical effect of a combined therapy in the treatment of simple premature ejaculation.

METHODSA total number of 110 patients with simple premature ejaculation were divided into a control group (n = 50), given oral hydrochloric acid sertraline only, and a combined therapy group (n = 60), treated by oral administration of hydrochloric acid sertraline, local inunction of a traditional Chinese medicine and guidance in sexual psychology and knowledge. At the end of a 4-week treatment and 4 weeks after the drug withdrawal, the therapeutic effects were evaluated by ejaculation latency and satisfaction with sexual life.

RESULTSThe total effectiveness rates at the end of the 4-week treatment were 91.6% and 76% in the combined therapy and the control groups, while those 4 weeks after the drug withdrawal were 68.3% and 42% respectively, both with significant differences in between (P < 0.05 and P < 0.01).

CONCLUSIONThe combined therapy has a satisfactory clinical effect and stability in the treatment of simple premature ejaculation.

Adult ; Antidepressive Agents ; chemistry ; therapeutic use ; Combined Modality Therapy ; Ejaculation ; Humans ; Hydrochloric Acid ; chemistry ; Male ; Medicine, Chinese Traditional ; methods ; Middle Aged ; Psychotherapy ; methods ; Sertraline ; chemistry ; therapeutic use ; Sexual Dysfunction, Physiological ; physiopathology ; psychology ; therapy ; Treatment Outcome ; Young Adult