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At least 19 recordsLinked to original sources
PubMed1998

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↗
PubMed2002

Optimum usage of prilocaine-lidocaine cream in premature ejaculation.

Premature ejaculation is a common male sexual disorder in which orgasm and ejaculation occur before the desired moment. The primary therapeutic approach to premature ejaculation has been behavioural and pharmacotherapy. In this study, we evaluated the efficacy and optimum usage of lidocaine-prilocaine cream 5% in preventing premature ejaculation. Forty patients were examined in the study group and randomized into four groups, each comprising 10 patients. Patients in group 1 applied lidocaine-prilocaine cream 5% for 20 min, the patients in group 2 applied it for 30 min, and the patients in group 3 applied the cream for 45 min before sexual contact, with all patients covering the penis with a condom. Patients in the fourth group applied a base cream as placebo. In group 1, the pre-ejaculation period increased to 6.71 +/- 2.54 min without any adverse effects. In group 2, although the pre-ejaculation period increased in four patients up to 8.70 +/- 1.70 min, six patients in this group and all patients in group 3 had erection loss because of numbness. In the placebo group, there was no change in their pre-ejaculation period. Therefore, lidocaine-prilocaine cream 5% is effective in premature ejaculation and 20 min of application time before sexual contact is the optimum period.

Administration, Topical↗
PubMed1995

[The effect of an antidepressive agent on premature ejaculation].

Premature ejaculation is a common male sexual dysfunction. Many kinds of medication have been used without great success. The start-stop technique is usually preferred. However, some patients and couples do not want to learn this kind of sexual therapy. One common adverse effect of the new selective serotonin re-uptake inhibitors is delayed ejaculation. This article discusses a patient with a premature ejaculation problem combined with minor depression and anxiety, who was successfully treated with paroxetine.

Adult↗
PubMed1987

[Premature ejaculation].

Premature ejaculation (PE) is important in the sexual relations of couples. After emphasizing that certain PE are of curable etiology (eg. short frenum of prepuce), the different stage of PE are analyzed and classified as a function of the severity, and in consequence the reversibility, of the repercussions of the life of couples. A therapeutic technic is described that is based on the target proposed by Masters and Johnson.

Ejaculation↗
PubMed1997

Somatosensory evoked potentials in patients with primary premature ejaculation.

PURPOSE: Premature ejaculation has been believed to be psychological in the majority of patients. With few exceptions organic conditions are rarely implicated. We investigated the possible role of sensory function in patients with primary premature ejaculation to determine whether there is an etiological basis for this condition. MATERIALS AND METHODS: We performed somatosensory evoked potentials from the penis in 34 patients with primary premature ejaculation and in 30 normally potent men. The latencies and amplitudes of the evoked potentials were measured at the penile shaft (dorsal nerve) and at the glans penis. RESULTS: Mean latency of dorsal nerve and glans penis somatosensory evoked potentials was 1.51 and 6.80 (significant) msec. shorter, respectively, in the patients than in the normal subjects. In the normal subjects the mean latency of glans penis somatosensory evoked potentials was 0.99 msec. longer than that of the dorsal nerve (not significantly different) but in patients the mean latency in the glans penis was 4.30 msec. shorter (p < 0.001). Mean amplitude of glans penis somatosensory evoked potentials was less than that of the dorsal nerve in both groups. However, mean amplitudes of dorsal nerve and glans penis somatosensory evoked potentials were significantly greater in patients than in normal men. CONCLUSIONS: Patients with premature ejaculation have hypersensitivity and hyperexcitability of the glans penis, which may give rise to uncontrolled ejaculation and are believed to be organic implications for premature ejaculation.

Adult↗
PubMed1984

Secondary premature ejaculation.

Secondary premature ejaculation is a definite entity which can be due to a variety of causes--physical, pharmacological and psychological. The sparse literature on this subject is reviewed and a series of 25 cases of diverse and sometimes unusual aetiology reported. The fact that ejaculatory control can be adversely affected by a variety of physical and psychological conditions has implications for theories as to the cause of the much commoner entity of primary premature ejaculation, for which there is still no generally agreed-upon aetiological formulation.

Adult↗
PubMed1993

Penile sensitivity in men with premature ejaculation and erectile dysfunction.

Previous research indicates that penile sensitivity is typically lower in men with erectile dysfunction than in age-matched controls. On the assumption that sensitivity might be greater in men with short ejaculation latency (premature ejaculation), the present research investigated penile threshold (sensitivity) to vibrotactile stimulation in men with premature ejaculation, erectile dysfunction, or a combination of the two. Premature ejaculators showed thresholds commensurate with controls, while men with erectile dysfunction, or combined erectile dysfunction and premature ejaculation, showed significantly elevated thresholds. Although premature ejaculators did not show penile hypersensitivity, there was a significant correlation in this group between ejaculation latency and threshold. Overall, these findings argue against a primary role for penile sensitivity in ejaculation latency, and suggest that other somatic factors or cognitive factors may play the more critical role in premature ejaculation.

Adult↗
PubMed1987

The psychophysiological nature of premature ejaculation.

The hypothesis that premature ejaculators (PEs) are less able than non-premature ejaculators (NPEs) to evaluate accurately their level of physiologically determined sexual arousal was tested. Twenty-six men (13 PEs and 13 NPEs) viewed a variety of videotaped vignettes, some of which were excerpts from sexually explicit films. Concurrent subjective (self-report) and objective (plethysmograph) ratings of sexual arousal were taken. Data revealed that both the PEs and NPEs were equally accurate in assessing their level of physiological sexual arousal. These results and those from a sexual history questionnaire were used to evaluate several hypotheses regarding the nature and etiology of premature ejaculation.

Adult↗
PubMed1996

Clomipramine and sexual function in men with premature ejaculation and controls.

PURPOSE: We determined whether clomipramine taken as needed increases ejaculation latency in men with premature ejaculation and controls. MATERIALS AND METHODS: The study included 8 patients with primary premature ejaculation, 6 with premature ejaculation and erectile dysfunction, and 8 controls. A prospective, double-blind, placebo controlled, crossover design was used that included 2, 3-week periods with clomipramine and placebo. During treatment phases subjects took either 25 mg. clomipramine or placebo as needed, that is 12 to 24 hours before anticipated sexual activity (coitus or masturbation). Subjects also visited the laboratory during these phases for evaluation of sexual response using visual erotic stimulation with and without vibration to the penis. Daily logs of sexual activities were maintained during treatment phases. RESULTS: Clomipramine significantly increased the latency to ejaculation during sexual activity (coitus or masturbation) from approximately 2 to 8 minutes in men with primary premature ejaculation. There were no significant effects in controls and men with premature ejaculation plus erectile dysfunction. Laboratory assessment indicated that men with primary premature ejaculation were better able to control ejaculatory response with clomipramine therapy. In these men clomipramine also resulted in increased satisfaction with sex life and relationship. Clomipramine inhibited nocturnal penile tumescence in all subjects. CONCLUSIONS: Clomipramine (25 mg. as needed) effectively increases ejaculatory latency in men with primary premature ejaculation, while treatment is not effective in those with premature ejaculation and erectile dysfunction.

Adult↗
PubMed1992

Evaluation and treatment of premature ejaculation: a critical review.

OBJECTIVE: Premature ejaculation is the most prevalent male sexual dysfunction. The present article is a comprehensive review of the literature on premature ejaculation. METHOD: This critical discussion of the literature evaluates the definitional issues, theoretical conceptualizations, assessment strategies, and treatment alternatives for premature ejaculation. RESULTS: The review integrates the most recent findings on the diagnosis and treatment of premature ejaculation updating an earlier review with the addition of more than fifty recent articles and adding sections on treatment generalization and maintenance, medical evaluation, pharmacological intervention, and a discussion of methodological issues in the literature. CONCLUSIONS: The pause-squeeze technique remains the current treatment of choice for the disorder. However, this unitary treatment recommendation disguises a multidimensional disorder which has yet to evolve an operational definition, psychometrically sound assessment procedures, or clearly articulated etiology.

Combined Modality Therapy↗
PubMed1997

Ejaculation-retarding properties of paroxetine in patients with primary premature ejaculation: a double-blind, randomized, dose-response study.

OBJECTIVE: To compare the influence of a daily dose of 20 or 40 mg of the serotonergic antidepressant drug paroxetine in delaying ejaculation in patients with primary premature ejaculation. PATIENTS AND METHODS: Thirty-four patients with primary premature ejaculation were randomly assigned to receive 20 mg or 40 mg daily of paroxetine for 7 weeks in a double-blind fixed-dose trial after an initial dose of 20 mg/day in the first week. Patients and their female partners were interviewed separately. In the group receiving 20 mg, one of two capsules consisted of placebo and in the group receiving 40 mg, both capsules contained active drug. RESULTS: The trial was completed by 27 men; both groups showed a statistically significant difference from the baseline values of ejaculation latency (P < 0.001) and a clinically relevant improvement in ejaculation time. The increase in the intravaginal ejaculation latency time was not statistically significant different between the groups. The patient's assessments were confirmed independently by their partners. CONCLUSIONS: The daily use of 20 mg paroxetine may be considered as an adequate treatment for primary premature ejaculation. Increasing the dose may lead to a further increase in ejaculation latency.

Adolescent↗
PubMed2001

Prevalence of chronic prostatitis in men with premature ejaculation.

OBJECTIVES: To investigate the prevalence of chronic prostatitis in men with premature ejaculation. The etiology of premature ejaculation is currently considered psychological in nature. However, the possibility that urologic, hormonal, or neurologic factors may contribute to this condition should be considered in its management. METHODS: We evaluated segmented urine specimens before and after prostatic massage and expressed prostatic secretion specimens from 46 patients with premature ejaculation and 30 controls by bacteriologic localization studies. The incidence of premature ejaculation in the subjects with chronic prostatitis was also evaluated. RESULTS: Prostatic inflammation was found in 56.5% and chronic bacterial prostatitis in 47.8% of the subjects with premature ejaculation, respectively. When compared with the controls, these novel findings were statistically significant (P <0.05). CONCLUSIONS: Considering the role of the prostate gland in the mechanism of ejaculation, we suggest a role for chronic prostate inflammation in the pathogenesis of some cases of premature ejaculation. Since chronic prostatitis has been found with a high frequency in men with premature ejaculation, we stress the importance of a careful examination of the prostate before any pharmacologic or psychosexual therapy for premature ejaculation.

Adult↗
PubMed1993

Some clinical and psychometric characteristics of primary and secondary premature ejaculators.

Patients with premature ejaculation (PE) were subdivided into primary (PPE), individuals who had suffered from PE since the beginning of their sexual lives, and secondary (SPE), those who developed the condition after years of satisfactory sexual functioning. PPEs differed from SPEs on a number of clinical and psychometric variables. Clinically SPEs were significantly more likely to manifest a coexisting erectile disorder, reduction in sex drive, and a decrease in arousal during sexual stimulation than SPEs. They were significantly less likely to report high levels of anxiety during coitus. Psychometrically, on the Derogatis Sexual Functioning Inventory, PPEs were significantly more "impaired" than the SPEs as reflected by scores on the Symptoms and Satisfaction scales and the GSSI. They were significantly less impaired on measures of sex drive (e.g., Drive and Fantasy). On the Hamilton Anxiety Rating Scale (HRAS), the PPEs scored as significantly more anxious than the SPEs. The findings suggest that dichotomizing PE into PPE and SPE may be clinically useful, and may have etiologic treatment and prognostic implications.

Adult↗
PubMedDate not supplied

[Premature ejaculation].

The constant failure to control the orgasm and the following ejaculation is called premature ejaculation. After having excluded organic factors the reason for premature ejaculation is always worry. When the reason for this fear is found, a psychotherapeutic treatment can soon be successful.

Ejaculation↗
PubMedDate not supplied

Clomipramine in the treatment of rapid (premature) ejaculation.

Twenty-three premature ejaculators (PEs) and 11 control subjects were administered 25 mg of clomipramine in a double-blind, placebo-controlled, crossover design study. During 2-week trials, subjects took either the drug or the placebo 4 to 6 hours prior to sexual activity. Daily diary data revealed that, for both groups, orgasmic latency was significantly increased when taking the clomipramine. For the PEs, the average increase in orgasmic latency during intercourse was from less than 1 minute to more than 3.5 minutes. Subjects also participated in two laboratory sessions while on the drug and placebo. During these lab sessions they were exposed to erotic videos with and without the addition of vibrotactile stimulation to the penis. Results from the laboratory data support those from the diaries. Specifically, PEs were significantly less likely to reach orgasm during the lab sessions while on the clomipramine than while on the placebo. Further, they reported a significantly greater sense of control over their orgasm while on the drug. The results of this study, along with previous research, strongly support the value of low doses of clomipramine in the treatment of premature ejaculation, specifically when taken on an as-needed basis as little as 4 hours prior to sexual activity. It is important to note, however, that the beneficial effects of the drug were not uniform across clinical subjects. In this study, those PEs with the shortest orgasmic latencies while on the placebo were the least likely to substantially improve while on the drug. Additional research is necessary to determine whether changes in the timing and dosage of the clomipramine administration can extend the benefits of the drug to those with the shortest latencies.

Adult↗
PubMed1997

The treatment of comorbid premature ejaculation and panic disorder with fluoxetine.

Premature ejaculation is a common sexual disturbance among men. Both open-label and double-blind studies have demonstrated the effectiveness of serotonergic medications for this disorder. These studies support the hypothesis that the serotonergic system has an important role in the modulation of sexual response, especially attainment of orgasm. Serotonergic dysfunction also has been linked to the pathogenesis of panic disorder. Several studies have demonstrated the efficacy of serotonergic drugs in this disorder. The purpose of the present study was to examine the efficacy of fluoxetine, a serotonin selective reuptake inhibitor for the treatment of comorbid premature ejaculation and panic disorder, in 10 men in an open-label design. The patients were given 20 mg of fluoxetine for 8 weeks of the study. Parameters pertaining to sexual function and measures of anxiety were examined. Improvement of premature ejaculation was noted as of week 2 of the study, whereas measures of panic and sexual satisfaction became statistically significant only as of week 4. Further studies with larger samples and longer periods of follow-up are needed in order to determine the usefulness of fluoxetine for the treatment of comorbid premature ejaculation and panic disorder.

Adult↗
PubMed1997

Erectile dysfunction in premature ejaculation.

Between October 1993 and December 1995, 45 patients with premature ejaculation were included in this study. The patients were divided into two groups etiologically, as having primary or secondary ejaculation. After a complete laboratory evaluation all patients underwent papaverine tests color Doppler ultrasonography pharmacocavernosometry-cavernosography and consequently organic etiology were investigated. Venous leakage was found in 5 (22,7%), arterial or mix insufficiency in 2 (9%) of the patients with primary premature ejaculation. In secondary premature ejaculation group, venous leakage was encountered in 9 patients (39,1%), arterial insufficiency in 2 patients (8,6%). In conclusion, investigation of organic etiology for the patients with premature ejaculation, particularly with secondary premature ejaculation, seems to be beneficial for correct diagnosis.

Adult↗
PubMed1975

Premature ejaculation: some thoughts about its pathogenesis.

Premature ejaculation has always been assumed to be a male sexual dysfunction whose pathogenesis involved either male physiologic or psychologic considerations. A small series of unselected cases is presented that suggests that premature ejaculation may also result from hidden femal arousal difficulties. The clinical material illustrates that the newer penile stimulation therapies for premature ejaculation are not required for every couple with this complaint.

Adult↗