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The effects of ejaculation on serum prostate-specific antigen (PSA).

To determine the effects of ejaculation on serum PSA, we measured serum levels just before masturbation and 24 hours and 5 days later in a study group (n=25) aged between 23 and 25 years. In the study group, 16 cases showed a decrease (mean 22.37%, range 10-50%) in serum PSA levels 24 hours after ejaculation, while 6 had higher levels (mean 38.33%, range 21-67%) and 3 had no changes. No relation was found between seminal plasma levels or total amounts expelled of this marker and the difference in serum levels due to ejaculation. In the control group free of ejaculation in the same period determinations of serum PSA levels revealed no significant changes between days 0, 1 and 5. As compared with the control group, the changes in the study group were found to be statistically insignificant. These results may indicate that ejaculation has an insignificant effect on serum PSA levels.

Adult↗

Premature ejaculation rates and treatment needs in males aged 20 years and over attending urology outpatient clinic.

AIM: The purpose of this study was the assessment of the rates of premature ejaculation and desires for treatment in male patients 20 years and over attending urology outpatient clinic. METHODS: All subjects included in the study were asked whether they had a complaint of premature ejaculation; if so, whether they had sought a doctor's assistance; if not, why they had not; why they did not mention their complaint during the first visit; whether they desired treatment; and if not, why they did not. RESULTS: A total of 1608 subjects were questioned. Premature ejaculation was present in 333 (20.7%). Premature ejaculation was the primary complaint of 33 of those attending the urology outpatient clinic. The most common reasons for not seeking a doctor's assistance were failure to see the condition as a problem, and embarrassment. Fifty four (16.2%) of these patients did not desire treatment. The most common reason for not desiring treatment was regarding it as unnecessary at present, and old age. CONCLUSION: The questioning of all men aged 20 and over attending urology outpatient clinic concerning premature ejaculation will greatly increase diagnoses and treatments.

Adult↗

Morphine inhibits dopaminergic and cholinergic induced ejaculation in rats.

1. Subcutaneous injection (s.c.) of apomorphine (0.1-0.5 mg/kg) and intraperitoneal administration (i.p.) of quinpirole (0.01-0.25 mg/kg), physostigmine (0.05-0.2 mg/kg) and pilocarpine (0.75-3 mg/kg, i.p.) but not neostigmine (0.1-1 mg/kg) induced ejaculation in rats. 2. The responses of drugs were reduced by morphine (1-6 mg/kg, s.c.) pretreatment. 3. The inhibitory effect of morphine was reversed by naloxone (1.5 mg/kg, s.c.). 4. Naloxone (0.75-3 mg/kg, s.c.) alone induced slight but significant ejaculation. 5. Ejaculatory responses induced by apomorphine and quinpirole but not those by physostigmine and pilocarpine were reduced by sulpiride (100 mg/kg, i.p.) pretreatment. 6. Domperidone (1-30 mg/kg, i.p.) did not change the response induced by apomorphine. 7. Pretreatment of animals with the cholinergic antagonist atropine (10 mg/kg, i.p.) decreased the frequency of ejaculation induced by apomorphine, quinpirole, physostigmine or pilocarpine. 8. It may be concluded that D-2 activation induces ejaculation through influence on cholinergic mechanisms and morphine inhibits the ejaculation induced by activation of both cholinergic and dopaminergic systems via opiate receptor sites.

Animals↗

[Treatment of ejaculation disorders by midodrine (Gutron) per os. Retrospective study of about 16 subjects].

PURPOSE: We evaluate the efficiency and side effects of midodrine in the treatment of sperm transport disturbances. MATERIALS AND METHODS: This retrospective study concerned patients addressed in Andrologia Department between 1995 and 2002 for treatment of sperm transport disturbances by administration of Midodrine per os (from 2.5 to 20 mg). Anterograde and retrogrades ejaculates (in urine sample) were examined. RESULTS: Sixteen patients (middle age of 36 years) were included: 12 neurologic lesions (central or peripheral, with 3 diabetes), four post-surgical (urologic and digestive) ejaculatory incompetence. One patient obtained anterior and retrograde ejaculation, two patients obtained anterior ejaculation and six retrograde ejaculations by midodrine per os. This treatment was inefficient in eight subjects. Side effects were exceptional. DISCUSSION: We obtained anterior or retrograde ejaculation in half of our population. The success was more important in patients with central neurologic injuries, diabetes or post-surgical troubles. In peripheral neurologic injuries, midodrine per os (maximal dose of 20 mg) was ineffective. CONCLUSION: Our study demonstrates the efficiency and good tolerance of midodrine per os for treatment of sperm transport disturbances.

Adrenergic alpha-Agonists↗

H-reflex and physiologic measures of ejaculation in men with spinal cord injury.

OBJECTIVE: To investigate the various physiologic parameters characterizing and predicting ejaculation. DESIGN: Single case-control study. SETTING: A referred care center and university setting. PARTICIPANTS: Two men with spinal cord injury (SCI) and 2 control subjects. INTERVENTION: Subjects were asked to self-stimulate with a Ferticare vibrator to induce ejaculation over 5 to 8 independent sessions. MAIN OUTCOME MEASURES: Penile tumescence, blood pressure, heart rate, electromyographic activity of the bulbocavernosus muscles, abdominal muscles, soleus H-reflex, and occurrence of ejaculation. RESULTS: Changes on all measures were observed, with penile tumescence being more stable in control subjects. Blood pressure increased in both groups, whereas tachycardia was observed in controls and bradycardia in subjects with SCI. H-reflex dropped slightly in controls but increased in subjects with SCI. Muscular patterns differed on ejaculatory success or failure. CONCLUSIONS: Physiologic changes on all measures can be observed in men with SCI as a function of ejaculation. Changes include hypertension and bradycardia, characteristic of hyperreflexia, and tachycardia in controls. The neural mechanisms underlying these patterns are discussed. H-reflex showed increased spinal cord excitability in subjects with SCI after ejaculation, which suggests spasticity. The results support investigation of the H-reflex to predict ejaculatory success or failure in men with SCI, along with specific analysis of muscular patterns.

Adult↗

Arguments raised by the recent discovery that insulin and leptin are expressed in and secreted by human ejaculated spermatozoa.

The recent findings demonstrating that insulin and leptin are expressed in and secreted by human ejaculated spermatozoa raise the controversial issue related to mRNA function in male gamete. Capacitated sperm display an increased metabolism and overall energy expenditure presumably to affect the changes in sperm signaling and function during capacitation. However the relationship between the signaling events associated with capacitation and the change in sperm metabolism energy is poorly understood. It emerges from the findings here reported that both leptin and insulin may be crucial in ejaculated spermatozoa to manage their energy status. Immunoistochemical analysis revealed that in uncapacitated sperm insulin was located at the subacrosomial level, in the midpiece and through the tail while leptin was immunodetected at the equatorial segment and at the midpiece. Capacitated sperm display an overall decrease and a more uniform distribution in the signal for both hormones and this is in agreement with their enhanced release in the medium. Both hormones in ejaculated sperm somehow recapitulate the cross-talk between their signalling transductional pathways in somatic cells, resulting in the increase of phosphoinositide 3-kinase (PI3K) activity, AKT S473 and Glycogen synthase kinase 3 (GSK-3)-S9 phosphorylations. During capacitation GSK-3 phosphorylation was abolished suggesting how in capacitating sperm there is a block in glycogen synthesis. This reasonably indicates how during capacitation glycogen reserve is mobilized and this makes the glucose as energy substrate available. For instance insulin dismissed by ejaculated spermatozoa up-regulates Glucose 6-Phosphate Dehydrogenase (G6PDH), the rate-limiting enzyme in the pentose phosphate pathway (PPP), which has be shown to be crucial in the acquisition of fertilizing capability as well as to mediate gamete fusion. Insulin immunoneutralization or blockage of its release, dramatically down regulated G6PDH. Interestingly, in the presence of a disruptor of insulin signaling wortmannin, an inhibitor of PI3K, the intrinsic activity of G6PDH drops. Leptin appears to play similar action to that of insulin on G6PDH in sperm (data in progress). The enhanced activity of this enzyme induced by both hormones produces an increase of NADPH that is essential for fatty acid synthesis from acetyl CoA. These fatty acids have two possible fates: beta-oxidation to produce ATP or reesterification back into triacylglycerol. Inter-relationships of the classes of substrates of free fatty acids (FFA) and glucose utilized for energy, has been long established [Randle, P.J., 1964. The interrelationships of hormones, fatty acid and glucose in the provision of energy. Postgrad. Med. J. 40, 457-463]. The authors observed in ejaculated spermatozoa what it occurs in somatic cells: FFA beta-oxidation tested utilizing the octanoil-CoA as substrate, appears to be stimulated by leptin and down-regulated by the contemporaneous presence of insulin in uncapacitated sperms. FFA beta-oxidation activity dramatically increases when capacitation starts, so it may be assumed the possibility that leptin may work to stimulate such enzymatic activity providing additional metabolic fuel to triggering capacitation process. The autonomous capability of sperm to release insulin and leptin suggests that they through an autocrine short loop may provide the recruitment of energy substrate according to sperm metabolic needs. This occurs independently by the systemic regulation and may represent a protective mechanism which preserves sperm fertilizing capability by any detrimental effects produced by long calorie restriction or by alterations occurring in the energy homeostasis at systemic level.

Down-Regulation↗

Treatment of premature ejaculation with sertraline hydrochloride: a single-blind placebo controlled crossover study.

PURPOSE: The efficacy of sertraline hydrochloride for the treatment of premature ejaculation is evaluated. MATERIALS AND METHODS: A total of 37 potent men, 19 to 70 years old (mean age 41), with premature ejaculation were treated with 50 mg. oral sertraline and placebo in a controlled randomized single-blind crossover trial. All men were either married or in a stable relationship. None of the patients received any formal psychosexual therapy. Chronic open label treatment with sertraline was continued in 29 patients who had achieved an increase in ejaculatory latency times over pretreatment levels with active drug in the initial crossover study. In an attempt to identify which patients could maintain the improved ejaculatory control after withdrawal of the active drug, serial drug withdrawal was conducted every 4 weeks with drug initiation after a further 2 weeks if improved ejaculatory control was not maintained. RESULTS: The mean pretreatment ejaculatory latency time was 0.3 minute (range 0 to 1). The mean ejaculatory interval after 4 weeks of treatment was 3.2 minutes (range 1 minute to anejaculation) with sertraline and 0.5 minute (range 0 to 1) with placebo (p <0.001). Intravaginal ejaculation was achieved for the first time in 5 patients with primary premature ejaculation and 2 patients experienced anejaculation. One patient described minor drowsiness and anorexia, and 2 patients described mild, transient gastrointestinal upset. Staged drug withdrawal allowed 20 of the 29 patients (67%) on chronic open label treatment with sertraline to discontinue the drug after a mean interval of 7.3 months with a mean ejaculatory latency time of 4.1 minutes (range 1 to 12). CONCLUSIONS: Sertraline appears to be a useful agent in the pharmacological treatment of premature ejaculation.

1-Naphthylamine↗

Ejaculation and fertility after extended retroperitoneal lymph node dissection for testicular cancer.

We studied ejaculation and fertility in 55 men who had undergone suprahilar extended retroperitoneal lymphadenectomy for nonseminomatous testicular cancer between 1972 and 1980. Antegrade ejaculation had returned spontaneously in 25 patients, with sperm counts of 35 to 190 million per ml., and normal morphology and motility in 20. The other 5 men either refused to provide semen for analysis or had had vasectomies but all had fathered children postoperatively. Ten men in whom antegrade ejaculation had not returned spontaneously were treated wih sympathomimetic drugs. Antegrade ejaculation was induced in 5 patients, 1 of whom fathered a child while taking the drugs. Two other patients who had only small volumes of ejaculate also responded well to sympathomimetic drugs. A therapeutically sound retroperitoneal node dissection can be performed for testicular cancer without impairing fertility permanently in a significant number of patients.

Adolescent↗

Characterization of p-chloroamphetamine-induced penile erection and ejaculation in anesthetized rats.

Methodological shortcomings present in elicitation of male sexual reflexes in anesthetized animals. The present study has demonstrated, however, that intraperitoneal (i.p.) injection of p-chloroamphetamine (PCA), an indirect serotonin (5-HT) agonist, elicited simultaneously both penile erection and ejaculation in anesthetized rats. PCA (2.5-10.0 mg/kg, i.p.) caused an intermittent cluster of genital responses consisting of penile erection, glans erections, and penile cups, which closely resembles the response observed during the ex copula tests in unanesthetized rats. Measurements of intracavernous penile pressure showed that rhythmic changes in penile pressure were produced by PCA, together with glans erections and penile cups. PCA also caused a frequent ejaculations and the weighing of ejaculate accumulated over 0.5 hr was increased in a bell-shaped pattern, and the maximum effect was observed at 5.0 mg/kg. Pretreatment with p-chlorophenylalanine, a serotonin (5-HT)-synthesis inhibitor, significantly inhibited the expression of PCA-induced penile erection and ejaculation, while acute spinal transection at thoracic level did not affect the sexual responses. These results indicate that PCA-induced penile erection and ejaculation in anesthetized rats are mainly produced by the release of 5-HT, which is limited to the lower spinal cord and/or the peripheral sites. Furthermore, the sexual responses can be easily and reliably elicited by administration of PCA, which may be useful for the study of the mechanisms underlying male sexual functions.

Animals↗

Descending pathways modulating the spinal circuitry for ejaculation: effects of chronic spinal cord injury.

Sexual dysfunction is a common complication in men with chronic spinal cord injury. In particular, ejaculation is severely compromised or absent and the resulting infertility issues are important to this group of predominantly young men. To investigate the neural circuits and descending spinal pathways involved in ejaculation, animal models have been developed in normal and spinal cord-injured preparations. Primarily through studies in rats, spinal ejaculatory circuits have been described including (i) autonomic circuits at the thoracolumbar and lumbosacral levels mediating the emission phase of ejaculation, (ii) somatic circuits at the lumbosacral level controlling the expulsion phase of ejaculation through sequential and rhythmic contraction of perineal striated muscles (e.g. bulbospongiosus), and (iii) a proposed ejaculatory pattern generator in the lumbar cord. Midthoracic incomplete chronic spinal cord injury has revealed the dependency of spinal ejaculatory circuits on bilateral spinal pathways from the brainstem via modulation of pudendal motor neuron reflexes and pudendal nerve autonomic fibers. Accordingly, sensory input from the dorsal nerve of the penis, required to trigger the ejaculatory response in animals and humans, is no longer inhibited from the lateral paragigantocellularis nucleus in the ventrolateral medulla. This inhibitory effect, likely presynaptic through a serotonergic pathway, is thought to be necessary to provide the rhythmic, bursting, and sequential contractions of the perineal muscles during ejaculation. Chronic lateral hemisection injury, which severs half of the descending lateral funiculus-located pathways, results in new functional connections of the pudendal reflex inhibitory and pudendal sympathetic activation pathways across the midline, above and below the lesion, respectively. Clinical correlations in spinal cord-injured men have demonstrated the validity of the rodent animal for the study of ejaculatory dysfunction after chronic injury.

Animals↗

Comparison of the ICSI outcome of ejaculated sperm with normal, abnormal parameters and testicular sperm.

OBJECTIVE(S): To compare fertilization rates, quality of embryos, pregnancy rates (PRs) and outcome of pregnancies in intracytoplasmic sperm injection (ICSI) using sperm from ejaculates of normal and abnormal semen and testicular sperm of non-obstructive azoospermia. STUDY DESIGN: Four hundred fifty-four patients who underwent 454 ICSI cycles were evaluated retrospectively. Patients were divided into three groups according to the quality and source of sperm. Patients in group 1 underwent 133 cycles of ICSI using ejaculated normal semen, group 2 underwent 235 cycles using ejaculated abnormal semen, and group 3 underwent 86 cycles using testicular sperm. RESULTS: The parameters were compared among the groups with respect to cycles induced by long (n = 160) and short (n = 294) protocol. In group 3, the fertilization and PRs were significantly lower than in all other groups (51.3 and 10.6% in the long protocol cycles, 53.3 and 5.1% in the short protocol cycles, respectively). There was no significant difference in the outcome of pregnancies in respect to abortion rates between different groups. CONCLUSION(S): The fertilizing ability of sperm in ICSI is highest with ejaculated sperm and lowest with sperm extracted by testicular biopsy. Also, the clinical PRs are significantly lower in ICSI with sperm from testicular biopsy. However, the outcomes of pregnancies are not affected by using surgically retrieved sperm from ejaculated semen.

Adult↗

Cumulative pregnancy rate following IVF and intracytoplasmatic sperm injection with ejaculated and testicular spermatozoa.

The purpose of this study was to calculate the cumulative pregnancy rates of IVF cycles with ICSI using ejaculated or testicular spermatozoa. A computerized database for the IVF cycles with ICSI performed between January 1996 and December 1998 was utilized. Cycles with spermatozoa obtained after electro-ejaculation were excluded. A multifactorial analysis was performed to define the impact of different factors on the success rate of IVF and ICSI. During a 36-month period, 229 pregnancies were achieved by 643 couples using ejaculated spermatozoa, and 83 pregnancies by 167 couples who required testicular spermatozoa. The pregnancy rates (PR) per cycle, including all treatment cycles with ejaculated spermatozoa, remained similar during the first five consecutive cycles achieving a cumulative PR of 80.44%. The cumulative pregnancy rates for cycles with testicular spermatozoa showed a consistent rise during four consecutive treatments and reached 61.84%. The regression analysis of pregnancy rate showed that it was significantly positively correlated with oocyte fertilization rate (P = 0.02), and negatively correlated with maternal age (P = 0.03). Thus, according to the present results, couples with infertility who require IVF with ICSI should be offered at least five consecutive attempts if ejaculated spermatozoa are used, and at least four cycles whenever testicular spermatozoa are used.

Ejaculation↗

Combined use of proacrosin immunocytochemistry and autosomal DNA in situ hybridisation for evaluation of human ejaculated germ cells.

The recently reported human pregnancies and births after fertilising oocytes with round spermatids recovered from the ejaculate of men with non-obstructive azoospermia have underscored the need for a more accurate evaluation of the nuclear and cytoplasmic maturation status of ejaculated germ cells. In this study we describe our first experience with a method combining the immunocytochemical visualisation of proacrosin with autosomal DNA fluorescence in situ hybridisation (FISH) to assess ejaculated germ cells from patients with a spermiogenesis defect. The proacrosin immunoreactivity, analysed with the use of the monoclonal antibody 4D4, has been detected in cells of round spermatid size presenting a haploid FISH figure as well as in larger cells whose ploidy corresponds to primary and secondary spermatocytes. These observations are in agreement with previously published results obtained, with the use of the same antibody, by immunocytochemical analysis of histological sections of testicular tissue. All the cells of round spermatid size possessing proacrosin immunoreactivity were found to be haploid by FISH. On the other hand, some of the haploid cells of round spermatid size did not possess proacrosin immunoreactivity. The structural pattern of proacrosin immunoreactivity was highly variable both in spermatids and in younger spermatogenic cells. These data show that cell size is the main criterion to be used for the identification of ejaculated round spermatids, whereas the presence of the developing acrosome represents only an auxiliary criterion. The scoring of acrosomal development in ejaculated spermatids may be useful as part of pre-treatment diagnosis before the inclusion of infertile couples in a spermatid conception programme.

Acrosin↗

The effect of single-dose oxytocin application on time to ejaculation and seminal parameters in men.

PURPOSE: To report the effect of a single dose of oxytocin on ejaculation time and seminal parameters. METHODS: The prospective randomized clinical study was performed at a private assisted reproduction technology center and included 103 consecutive healthy men (semen donors or husbands of IVF patients). Oxytocin (16 IU) were administered intranasally to 49 subjects, randomly assigned to the study group just before masturbation to ejaculation. The time needed for ejaculation as well as the semen parameters was recorded according to the WHO standards, and compared to the control group of 54 subjects with no prior oxytocin treatment. RESULTS: No significant difference was noted between the two groups concerning ejaculation time and semen parameters. CONCLUSIONS: Although the administration of oxytocin stimulates sexual behavior and performance in mammalian species, our data indicate that oxytocin has no detectable effect on ejaculation time and seminal parameters after intranasal application in normal, healthy men.

Administration, Intranasal↗

Quality of semen after repeated ejaculation treatment in spinal cord injury men.

The study was designed to document the effects of regular drainage after penile vibrator stimulation on the quality of semen in SCI men. Twenty three tetraplegics and 9 paraplegics, 18 to 40 years of age and with neurological levels ranging from C4 to L1, were examined between 1 and 23 years after injury (median 2 years). None had ejaculated after the injury. Penile vibrator stimulation was tried in patients with cervical or thoracic lesions who showed reflex hip flexion on scratching the soles of the feet, 29 out of 32, and rectal electrostimulation in the remaining 3 low lesions with no reflex function in lumbar and sacral segments. The stimulation yielded semen in 29 (91%) of the men; 22 had antegrade and 7 retrograde ejaculation. Sixteen of the 22 patients with antegrade ejaculation entered a home programme of vibrator stimulation prescribed once weekly. Four to 6 months of stimulation resulted in a rise of semen volume and of fructose and acid phosphatase levels in the seminal plasma, suggesting improved function of the seminal vesicles and the prostate. The percentage of motile sperms was low both before and after the treatment period. Despite this, the total count of motile sperms per ejaculate was already high in the patient's first ejaculates compared to the laboratory normal standard, and further clearly increased after the stimulation period. A standardised functional test measuring sperm penetration capacity showed strong evidence of long term stimulation effect. It is suggested that the test is used in the assessment of fertility potential in SCI men.

Adolescent↗

Penile sensitivity in men with premature ejaculation.

Premature ejaculation is the most prevalent form of male sexual dysfunction, but its cause has not been well established. Recent studies have indicated that in men with premature ejaculation, penile sensitivity is increased. To investigate whether penile hypersensitivity is a cause of premature ejaculation, we prospectively evaluated the penile sensitivity of 18 patients with a lifelong history of premature ejaculation from the first coital experience and 15 controls, both in the flaccid and erect state. We used an SMV-5 vibrometer (Suzuki-Matsuoka, Teknologue, Tokyo, Japan), which automatically controls stimulatory strength; its precision and reproducibility are thus higher than analogue-type biothesiometers. At the styloid process of the ulna and medial maleolus of the tibia, there was no significant statistical difference in vibratory threshold between the two groups (P > 0.05). Also we did not find significant statistical differences in sensitivity of the glans penis, dorsum of the penile shaft, or frenulum of the penis between the two groups, in either the flaccid or erect state (P > 0.05). According to our results, penile hypersensitivity, as measured by an SMV-5 vibrometer, does not appear to be a major factor contributing to premature ejaculation.

Adult↗

Assessment of as needed use of pharmacotherapy and the pause-squeeze technique in premature ejaculation.

The objective was to compare the efficacy and safety of the as needed use of clomipramine, sertraline, paroxetine, sildenafil and the pause-squeeze technique in treatment of primary premature ejaculation. A prospective double blind randomized crossover study involving 31 patients was performed. Treatment phases comprised five 4-week consecutive treatment periods, each separated by a two-week washout period. Patients were randomly assigned to receive each of the 4 drugs and use pause-squeeze on an as needed basis. Drugs were administered 3 to 5 hours before anticipated coitus. Anxiety score and ejaculation latency time were measured before treatment, after each treatment, and during washout periods. Sexual satisfaction score was measured after each treatment. The median ejaculation latency time was significantly increased from the pretreatment median of 1 minute to 4 minutes, 3 minutes, 4 minutes, 15 minutes and 3 minutes during treatment with clomipramine, sertraline, paroxetine, sildenafil and pause-squeeze technique, respectively (all P 0.0001). Sildenafil was superior to other modalities in terms of ejaculation latency and satisfaction (P = 0.0001). The three antidepressants were comparable to each other in terms of efficacy (P > 0.05). Paroxetine was superior to the pause-squeeze technique in terms of efficacy (P < 0.05). In conclusion, sildenafil appears to be superior to other modalities and a valid alternative in treatment of premature ejaculation. The 3 antidepressants were equivalent to each other in terms of efficacy and safety. Paroxetine was superior to pause-squeeze technique in terms of efficacy.

Adult↗

The efficacy of citalopram in the treatment of premature ejaculation: a placebo-controlled study.

BACKGROUND: Despite the limited number of available study comparing of their efficacy, selective serotonin re-uptake inhibitors (SSRI) have been thought to have beneficial effects for the patients with premature ejaculation. In the present study, we decided to examine the efficacy of citalopram, an SSRI, in the treatment of premature ejaculation. METHOD: The study was consisted of 26 married patients diagnosed with premature ejaculation according to Diagnostic and Statistical Manual of Mental Disorders Third Revised Version (DSM-III-R). The patients were randomly assigned to two groups, citalopram (group I) and placebo (group II), each consisting of 13 patients. The effects of drug on the ejaculatory function were assessed by the intravaginal ejaculation latency time. Additionally, all patients were screened by using Clinical Global Impression-Improvement Scale (CGI-I) and Yonsei Sexual Function Inventory-II (YSFI-II). RESULTS: The increase in the intravaginal ejaculation latency time in the citalopram group was statistically significant than that of placebo group. In addition, with respect to the subscales of the YSFI-II scale, similar overall significant improvements were seen in the patients given citalopram compared to those given placebo. Of group I patients, five (38.5%) were considered as 'very much improved' and four (30.8%) 'much improved' by CGI-I and only one of group II patients (7.7%) showed 'much improved'. CONCLUSION: The patients treated with citalopram showed significantly greater improvement compared to the patients receiving placebo.

Adult↗