Ejaculation

射精
  • 文章类型: Journal Article
    克劳斯血球,这是在19世纪50年代发现的,是在生殖器和其他皮肤粘膜组织中发现的特殊感觉结构1-4。自发现以来,克劳斯小体的生理特性和功能仍不清楚。在这里,我们报告了小鼠阴蒂和阴茎的克劳斯小体的解剖和生理特性及其在性行为中的作用。与阴茎相比,我们在阴蒂观察到高密度的克劳斯小体。使用小鼠遗传工具,我们确定了两种不同的体感神经元亚型,它们支配阴蒂和阴茎的克劳斯小体,并投射到脊髓独特的感觉末端区域。体内电生理和钙成像实验表明,两种Krause小体传入类型均为A纤维快速适应低阈值机械感受器,最佳地调整到动态,轻微的触摸和机械振动(40-80赫兹)施加到阴蒂或阴茎。功能上,Krause小体传入末端的选择性光遗传学激活诱发雄性小鼠阴茎勃起和雌性小鼠阴道收缩,而Krause小体的遗传消融会损害男性的内渗和射精,并降低女性的性接受能力。因此,阴蒂和阴茎的克劳斯小体是高度敏感的机械振动探测器,可介导性二态交配行为。
    Krause corpuscles, which were discovered in the 1850s, are specialized sensory structures found within the genitalia and other mucocutaneous tissues1-4. The physiological properties and functions of Krause corpuscles have remained unclear since their discovery. Here we report the anatomical and physiological properties of Krause corpuscles of the mouse clitoris and penis and their roles in sexual behaviour. We observed a high density of Krause corpuscles in the clitoris compared with the penis. Using mouse genetic tools, we identified two distinct somatosensory neuron subtypes that innervate Krause corpuscles of both the clitoris and penis and project to a unique sensory terminal region of the spinal cord. In vivo electrophysiology and calcium imaging experiments showed that both Krause corpuscle afferent types are A-fibre rapid-adapting low-threshold mechanoreceptors, optimally tuned to dynamic, light-touch and mechanical vibrations (40-80 Hz) applied to the clitoris or penis. Functionally, selective optogenetic activation of Krause corpuscle afferent terminals evoked penile erection in male mice and vaginal contraction in female mice, while genetic ablation of Krause corpuscles impaired intromission and ejaculation of males and reduced sexual receptivity of females. Thus, Krause corpuscles of the clitoris and penis are highly sensitive mechanical vibration detectors that mediate sexually dimorphic mating behaviours.
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  • 文章类型: Journal Article
    目的:比较传统的经膀胱机器人辅助单纯前列腺切除术(TV-RASP)和新引入的保留尿道(US)RASP的围手术期和术后结局。
    方法:我们回顾性分析了42例接受TV-RASP(n=22)或US-RASP(n=20)的患者,这些患者由两个三级中心的两名经验丰富的外科医生进行。围手术期结果包括手术时间,估计失血量,住院时间,并评估导管插入时间。使用国际前列腺症状评分(IPSS)评估术后结果,生活质量(QoL),尿流图参数,男性性健康问卷-射精功能障碍-简表(MSHQ-EjD-SF)评分,和维持顺行射精。
    结果:本研究分析了22和20例接受TV-RASP和US-RASP的患者,分别。除了TV-RASP组年龄(70.0岁)比US-RASP组(64.5岁)大(p=0.028),其他基线特征之间无差异.围手术期结果表明,US-RASP组的住院时间和导管插入时间明显短于TV-RASP组(p<0.001)。术后1个月,US-RASP组的IPSS和QoL评分中位数明显优于TV-RASP组(分别为p=0.001和p=0.002)。然而,在第6个月和第12个月,IPSS没有发现显著差异,QoL,最大流量,两组之间的残余尿液。US-RASP组的性活动患者术后保持了MSHQ-EjD功能和打扰评分,而TV-RASP组经历了下降。值得注意的是,US-RASP组75.0%的患者保留顺行射精,而TV-RASP组仅为20.0%(p<0.001)。
    结论:US-RASP在功能结局方面并不逊色于TV-RASP。此外,与TV-RASP相比,US-RASP产生了更快的症状改善和保留的顺行射精。然而,需要更大的前瞻性研究来证实这些发现,并进一步研究US-RASP的长期疗效和安全性.
    OBJECTIVE: To compare the perioperative and postoperative outcomes between traditional trans-vesical robot-assisted simple prostatectomy (TV-RASP) and the newly introduced urethral-sparing (US) RASP.
    METHODS: We retrospectively reviewed 42 patients who underwent TV-RASP (n=22) or US-RASP (n=20) performed by two experienced surgeons at two tertiary centers. Perioperative outcomes including operation time, estimated blood loss, length of hospital stay, and catheterization time were assessed. Postoperative outcomes were evaluated using the International Prostate Symptom Score (IPSS), quality of life (QoL), uroflowmetry parameters, Male Sexual Health Questionnaire-Ejaculation Dysfunction-Short Form (MSHQ-EjD-SF) scores, and maintenance of anterograde ejaculation.
    RESULTS: This study analyzed 22 and 20 patients who underwent TV-RASP and US-RASP, respectively. Except for the TV-RASP group being older (70.0 years) than the US-RASP group (64.5 years) (p=0.028), no differences among other baseline characteristics existed. Perioperative outcomes indicated that hospital stay and catheterization time were significantly shorter in the US-RASP group than in the TV-RASP group (p<0.001). At postoperative month 1, the median IPSS and QoL scores were significantly better in the US-RASP group than in the TV-RASP group (p=0.001 and p=0.002, respectively). However, at months 6 and 12, no significant differences were noted in IPSS, QoL, maximum flow rate, and postvoid residual urine between the two groups. Sexually active patients in the US-RASP group maintained postoperative MSHQ-EjD functional and bother scores, whereas the TV-RASP group experienced a decline. Notably, 75.0% of patients in the US-RASP group preserved antegrade ejaculation, compared to only 20.0% in the TV-RASP group (p<0.001).
    CONCLUSIONS: US-RASP is not inferior to TV-RASP in terms of functional outcomes. In addition, US-RASP yielded more rapid symptom improvements and preserved antegrade ejaculation than TV-RASP. However, larger prospective studies are required to confirm these findings and to further investigate the long-term efficacy and safety of US-RASP.
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  • 文章类型: Meta-Analysis
    本研究旨在研究射精禁欲对精子参数的影响。
    该分析已在PROSPERO(CRD42023472124)中注册。我们使用以下文本术语在PubMed上进行了搜索:((\“精子参数\”或\“精子分析\”[网格])和(\“精子DNA碎片\”或\“DNA碎片\”[网格])和(\“性禁欲\”[网格]或\“禁欲\”),并使用术语在Scopus中进行了高级搜索研究的精子参数是精子体积,精子总运动性,进行性精子运动性,精子浓度,精子形态学,和精子DNA片段化(SDF)。已将两天的禁欲期定义为“短”或“长”禁欲期。
    2013年至2022年发表的13项研究纳入了这项荟萃分析。共有2315名患者,每个队列从6到836不等,参加了这项研究。我们表明,更长的禁欲时间与更高的精子浓度相关(平均差异[MD]:8.19;p<0.01),精子体积(MD:0.96;p<0.01),和更高的SDF(MD:3.46;p<0.01),但进行性精子运动性较低(MD:-1.83;p<0.01)。否则,在比较长的患者中没有观察到统计学上的显著差异。关于总精子运动的禁欲时间较短(MD:-1.83;p=0.06)。Meta回归分析显示,戒断天数与精子浓度(斜率:3.74;p<0.01)和SDF(斜率:0.65;p=0.044)呈正相关。
    根据我们的数据,短暂的射精禁欲与更好的精子质量有关。的确,据报道,在一个短期禁欲队列中,有较高比例的进行性精子运动性和较低水平的SDF.相比之下,长期禁欲组的精子浓度较高。
    https://www.crd.约克。AC.英国/PROSPERO/,标识符CRD42023472124。
    UNASSIGNED: This study aimed to investigate the effects of ejaculatory abstinence on sperm parameters.
    UNASSIGNED: This analysis was registered in PROSPERO (CRD42023472124). We performed a search on PubMed using the following text terms: ((\"sperm parameters\" OR \"sperm analysis\" [Mesh]) AND (\"sperm DNA fragmentation\" OR \"DNA fragmentation\" [Mesh]) AND (\"sexual abstinence\" [Mesh] OR \"abstinence\")) and an advanced search in Scopus using the terms (\"sperm parameters\" OR \"sperm parameters\" OR \"DNA fragmentation\") AND (\"abstinence\"). The sperm parameters that were investigated were sperm volume, total sperm motility, progressive sperm motility, sperm concentration, sperm morphology, and sperm DNA fragmentation (SDF). A two-day cut-off as a \"short\" or \"long\" abstinence period has been defined.
    UNASSIGNED: Thirteen studies published between 2013 and 2022 were included in this meta-analysis. A total of 2,315 patients, ranging from 6 to 836 from each cohort, were enrolled in the study. We showed that longer abstinence time was associated with greater sperm concentration (mean difference [MD]: 8.19; p <0.01), sperm volume (MD: 0.96; p <0.01), and higher SDF (MD: 3.46; p <0.01), but lower progressive sperm motility (MD: -1.83; p <0.01). Otherwise, no statistically significant difference was observed in patients with longer vs. shorter abstinence times regarding total sperm motility (MD: -1.83; p = 0.06). Meta-regression analysis showed that days of abstinence were positively and linearly related to sperm concentration (slope: 3.74; p <0.01) and SDF (slope: 0.65; p = 0.044).
    UNASSIGNED: According to our data, short ejaculatory abstinence is associated with better sperm quality. Indeed, a higher percentage of progressive sperm motility and lower levels of SDF have been reported in a short abstinence cohort. In contrast, the long abstinence group reported a higher sperm concentration.
    UNASSIGNED: https://www.crd.york.ac.uk/PROSPERO/, identifier CRD42023472124.
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  • 文章类型: Journal Article
    在哺乳动物中,一些生理状况与高的脑催产素(OXT)系统活性有关。这些包括雌性的泌乳和雄性和雌性的交配,两者都与降低应激反应和抗焦虑有关。此外,在社交恐惧条件(SFC)的小鼠模型中,增强泌乳小鼠的脑OXT信号,特别是在侧隔(LS),据报道,这是社会恐惧表达减少的基础。这里,我们研究了雄性小鼠交配对焦虑相关行为的影响,社会(和暗示)恐惧表达及其灭绝,OXT神经元的活性由LS和杏仁核中的cFos表达和OXT释放反映。我们进一步关注大脑OXT参与交配诱导的社会恐惧灭绝的过程。我们可以证实雄性小鼠交配的抗焦虑作用,而与射精的发生无关。Further,我们发现,只有成功的交配导致射精(Ej+)促进社会恐惧灭绝,而没有射精的交配(Ej-)没有。相比之下,交配并不影响暗示恐惧的表达。使用细胞活性标记cFos和pErk,我们进一步确定腹侧LS(vLS)是参与射精对社会恐惧灭绝影响的潜在区域.支持,微透析实验揭示了LS内OXT释放的增加,但不是杏仁核,在交配期间。最后,交配前将OXT受体拮抗剂注入LS或交配后注入侧脑室(icv),这表明大脑OXT受体介导的信号传导在交配诱导的社交恐惧消退的促进中具有重要作用。
    In mammals, some physiological conditions are associated with the high brain oxytocin (OXT) system activity. These include lactation in females and mating in males and females, both of which have been linked to reduced stress responsiveness and anxiolysis. Also, in a murine model of social fear conditioning (SFC), enhanced brain OXT signaling in lactating mice, specifically in the lateral septum (LS), was reported to underlie reduced social fear expression. Here, we studied the effects of mating in male mice on anxiety-related behaviour, social (and cued) fear expression and its extinction, and the activity of OXT neurons reflected by cFos expression and OXT release in the LS and amygdala. We further focused on the involvement of brain OXT in the mating-induced facilitation of social fear extinction. We could confirm the anxiolytic effect of mating in male mice irrespective of the occurrence of ejaculation. Further, we found that only successful mating resulting in ejaculation (Ej+) facilitated social fear extinction, whereas mating without ejaculation (Ej-) did not. In contrast, mating did not affect cues fear expression. Using the cellular activity markers cFos and pErk, we further identified the ventral LS (vLS) as a potential region participating in the effect of ejaculation on social fear extinction. In support, microdialysis experiments revealed a rise in OXT release within the LS, but not the amygdala, during mating. Finally, infusion of an OXT receptor antagonist into the LS before mating or into the lateral ventricle (icv) after mating demonstrated a significant role of brain OXT receptor-mediated signaling in the mating-induced facilitation of social fear extinction.
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  • 文章类型: Journal Article
    当雄性竞争时,性选择有利于增加其交配或受精成功的生殖特征(交配前和交配后的性选择)。假设男性在这两种性特征之间面临权衡,因为他们都来自同一资源池。因此,分配到伴侣获取或射精中应该与其他关键生活史特征产生类似的权衡。对这些假设的测试非常罕见。雄性只在交配后射精,因此,射精的成本与交配的成本高度混淆。因此,关于生殖分配的每个组成部分如何影响男性未来的表现,人们知之甚少。这里,我们使用一种新技术进行了一项实验,以区分蚊子(Gambusiaholbrooki)的交配努力和射精的生活史成本。我们比较了被操纵的雄性(没有射精的交配),控制男性(交配和射精),天真的雄性(既不交配也不射精)连续与雌性和2个敌对雄性住在一起。我们评估了他们的成长,躯体维持,交配和战斗行为,8周和16周后的精子性状。过去的交配努力显著降低了男性未来的交配努力和生长,但不是他的精子生产,虽然过去的精子释放显着降低了男性未来的射精量,但不是他的交配努力。免疫反应是受过去交配努力和过去射精影响的唯一特征。这些发现挑战了以下假设:男性生殖分配从共同的资源库中汲取,以在以后的生活中产生类似的生活史成本。相反,我们提供了明确的证据,即在交配前和交配后性选择下分配到性状对随后的男性生殖表现具有不同的性状特异性影响。
    When males compete, sexual selection favors reproductive traits that increase their mating or fertilization success (pre- and postcopulatory sexual selection). It is assumed that males face a trade-off between these 2 types of sexual traits because they both draw from the same pool of resources. Consequently, allocation into mate acquisition or ejaculation should create similar trade-offs with other key life history traits. Tests of these assumptions are exceedingly rare. Males only ejaculate after they mate, and the costs of ejaculation are therefore highly confounded with those of mating effort. Consequently, little is known about how each component of reproductive allocation affects a male\'s future performance. Here, we ran an experiment using a novel technique to distinguish the life history costs of mating effort and ejaculation for mosquitofish (Gambusia holbrooki). We compared manipulated males (mate without ejaculation), control males (mate and ejaculate), and naïve males (neither mate nor ejaculate) continuously housed with a female and 2 rival males. We assessed their growth, somatic maintenance, mating and fighting behavior, and sperm traits after 8 and 16 weeks. Past mating effort significantly lowered a male\'s future mating effort and growth, but not his sperm production, while past sperm release significantly lowered a male\'s future ejaculate quantity, but not his mating effort. Immune response was the only trait impacted by both past mating effort and past ejaculation. These findings challenge the assumption that male reproductive allocation draws from a common pool of resources to generate similar life history costs later in life. Instead, we provide clear evidence that allocation into traits under pre- and postcopulatory sexual selection have different trait-specific effects on subsequent male reproductive performance.
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  • 文章类型: Journal Article
    背景:报告前列腺钬激光剥除术(HoLEP)和正中叶选择性激光剥除术(MLHoLEP)患者的射精和排尿结果。
    方法:对在单中心接受MLHoLEP以保持射精功能的下尿路症状(LUTS)/良性前列腺梗阻(BPO)患者进行回顾性分析。使用国际前列腺评分症状(IPSS)评估泌尿功能,IPSS-生活质量指数(IPSS-QoL)尿流峰值(Qmax)和排尿后残留(PVR)。使用国际勃起功能指数(IIEF-5)评估勃起功能。在术前顺行射精的患者中,每次随访时常规筛查逆行射精.将3个月和12个月时的性功能和泌尿功能与基线值进行比较。
    结果:共有55例患者符合我们的纳入标准。IPSS的重大改进,IPSS-QoL,在3个月和12个月时发现PVR和Qmax,与基线相比(均P<0.05)。八名患者(14.5%)由于持续的LUTS/BPO而需要手术再干预。在3个月(P=0.3)和12个月(P>0.9)时,勃起功能无明显变化。在术前顺行射精的患者中(n=32),术后仅记录了4例从头逆行射精。
    结论:MLHoLEP代表了希望保留射精功能的LUTS/BPO男性的新选择。患者应该意识到,泌尿功能的改善可能不如传统技术,由于持续性LUTS,再干预率较高。
    方法:4级。
    BACKGROUND: To report ejaculatory and urinary results in patients who underwent holmium laser enucleation of the prostate (HoLEP) with selective laser enucleation of the median lobe (MLHoLEP).
    METHODS: Patients with lower urinary tract symptoms (LUTS)/benign prostatic obstruction (BPO) who underwent MLHoLEP to preserve ejaculatory function in a single center were retrospectively identified. Urinary function was assessed using International Prostate Score Symptom (IPSS), IPSS-Quality of Life index (IPSS-QoL), peak urinary flow (Qmax) and postvoid residual (PVR). Erectile function was assessed using International Index of Erectile Function (IIEF-5). In patients with preoperative antegrade ejaculation, retrograde ejaculation was routinely screened at each follow-up visit. Sexual and urinary functions at 3 and 12 months were compared with baseline values.
    RESULTS: A total of 55 patients met our inclusion criteria. A significant improvement in the IPSS, IPSS-QoL, PVR and Qmax was found at 3 and 12 months, compared with baseline (all P<0.05). Eight patients (14.5%) required surgical reintervention due to persistant LUTS/BPO. No significant changes in the erectile function were found at 3 (P=0.3) and 12 months (P>0.9). In patients with preoperative antegrade ejaculation (n=32), only four cases of de novo retrograde ejaculation were recorded postoperatively.
    CONCLUSIONS: MLHoLEP represents a new alternative for men with LUTS/BPO who wish to preserve their ejaculatory function. Patients should be aware that improvement in urinary function may be inferior to the traditional technique, with a higher reintervention rate due to persistent LUTS.
    METHODS: Grade 4.
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  • 文章类型: Journal Article
    目的:评估人离体精囊(HISV)中6-硝基多巴胺(6-ND)的基础释放,并表征其作用和起源。
    方法:将从接受前列腺切除术的患者中获得的左HISV悬浮在3-mL器官浴中,其中包含温热(37°C)和充气(95%O2:5%CO2)的Krebs-Henseleit溶液(KHS)和抗坏血酸。2毫升上清液的等分试样用于通过LC-MS/MS定量儿茶酚胺。对于功能研究,获得了对儿茶酚胺的浓度响应曲线,并计算pEC50和Emax值。还通过免疫组织化学和荧光原位杂交测定(FISH)进行酪氨酸羟化酶和S100蛋白的检测。
    结果:6-ND的基础释放高于其他儿茶酚胺(6-ND为14.76±14.54、4.99±6.92、3.72±4.35和5.13±5.76nM,去甲肾上腺素,肾上腺素,还有多巴胺,分别)。与其他儿茶酚胺相比,6-ND的基础释放不受钠电流(Nav)通道抑制剂河豚毒素(1μM;10.4±8.9和10.4±7.9nM,河豚毒素之前和之后,分别)。所有儿茶酚胺均产生浓度依赖性HISV收缩(6-ND的pEC50为4.1±0.2、4.9±0.3、5.0±0.3和3.9±0.8,去甲肾上腺素,肾上腺素,还有多巴胺,分别),但6-ND的效力比去甲肾上腺素和肾上腺素低10倍。然而,用非常低的浓度的6-ND(10-8M,30分钟)对去甲肾上腺素的浓度-反应曲线产生了显着的向左移动。免疫组织化学和FISH测定鉴定了HISV条带的组织上皮中的酪氨酸羟化酶。
    结论:上皮衍生的6-ND是从人分离的精囊中释放的主要儿茶酚胺,通过增强去甲肾上腺素诱导的收缩来调节平滑肌收缩性。
    OBJECTIVE: To evaluate the basal release of 6-nitrodopamine (6-ND) from human isolated seminal vesicles (HISV) and to characterize its action and origin.
    METHODS: Left HISV obtained from patients undergoing prostatectomy surgery was suspended in a 3-mL organ bath containing warmed (37 °C) and gassed (95%O2:5%CO2) Krebs-Henseleit\'s solution (KHS) with ascorbic acid. An aliquot of 2 mL of the supernatant was used to quantify catecholamines by LC-MS/MS. For functional studies, concentration-responses curves to catecholamines were obtained, and pEC50 and Emax values were calculated. Detection of tyrosine hydroxylase and S100 protein were also carried out by both immunohistochemistry and fluorescence in-situ hybridization assays (FISH).
    RESULTS: Basal release of 6-ND was higher than the other catecholamines (14.76 ± 14.54, 4.99 ± 6.92, 3.72 ± 4.35 and 5.13 ± 5.76 nM for 6-ND, noradrenaline, adrenaline, and dopamine, respectively). In contrast to the other catecholamines, the basal release of 6-ND was not affected by the sodium current (Nav) channel inhibitor tetrodotoxin (1 μM; 10.4 ± 8.9 and 10.4 ± 7.9 nM, before and after tetrodotoxin, respectively). All the catecholamines produced concentration-dependent HISV contractions (pEC50 4.1 ± 0.2, 4.9 ± 0.3, 5.0 ± 0.3, and 3.9 ± 0.8 for 6-ND, noradrenaline, adrenaline, and dopamine, respectively), but 6-ND was 10-times less potent than noradrenaline and adrenaline. However, preincubation with very low concentration of 6-ND (10-8 M, 30 min) produced significant leftward shifts of the concentration-response curves to noradrenaline. Immunohistochemical and FISH assays identified tyrosine hydroxylase in tissue epithelium of HISV strips.
    CONCLUSIONS: Epithelium-derived 6-ND is the major catecholamine released from human isolated seminal vesicles and that modulates smooth muscle contractility by potentiating noradrenaline-induced contractions.
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  • DOI:
    文章类型: English Abstract
    良性前列腺增生(BPH)是中老年男性常见病。它的一线治疗是药物。但是随着疾病的进展或药物的副作用,手术治疗将成为更好的选择。然而,经尿道前列腺切除术,标准程序,基于各种激光平台或等离子技术的前列腺摘除或切除术在术后随访中导致逆行射精的发生率很高。在过去,逆行射精通常被认为是良性前列腺增生手术的费用。近年来,随着手术技术的不断提高和新技术的出现,逆行射精已引起临床医生的重视。本文主要介绍良性前列腺增生术后逆行射精的发生机制及降低术后逆行射精发生率的方法。这些方法主要包括各种改良手术,以及新颖的微创技术,如前列腺栓塞和前列腺尿道提升。
    Benign prostatic hyperplasia (BPH) is a common disease in middle-aged and elderly men. It\'s first-line therapy is drugs. But with the progression of the disease or side effects of drugs, surgical treatment will become a better choice. However, either transurethral resection of the prostate, the standard procedure, or enucleation or resection of the prostate based on various laser platforms or plasma technologies cause a high incidence of retrograde ejaculation in their postoperative follow-up. In the past, retrograde ejaculation was usually regarded as the cost of benign prostatic hyperplasia surgery. In recent years, with the continuous improvement of surgical skills and the emergence of new techniques, retrograde ejaculation has aroused the attention of clinicians. This article mainly introduces the mechanism of retrograde ejaculation after benign prostatic hyperplasia surgery and the methods to reduce the incidence of retrograde ejaculation after surgery. These methods mainly include various modified surgery, as well as novel minimally invasive techniques such as prostate embolization and prostatic urethral lift.
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  • DOI:
    文章类型: English Abstract
    目的:本研究旨在评估在阴茎生物振动阈值测试下精确定位后,将5%利多卡因乳膏应用于龟头敏感区域治疗原发性早泄的有效性和安全性。
    方法:本研究纳入80例门诊诊断为原发性早泄的患者。随机分为两组。第1组(n=40)按需给予1ml5%利多卡因乳膏。他们被指示将利多卡因乳膏以圆形图案均匀地应用于龟头阴茎,而不精确地应用于龟头阴茎的敏感区域。治疗共4周。第2组(n=40)进行了阴茎生物振动阈值测试,以检测阈值较低的基因座。指示他们将1ml的5%利多卡因乳膏应用于龟头上的敏感部位4周。在计划的性交前20分钟,将利多卡因乳膏局部或均匀地应用于龟头。通过治疗前后阴道内射精潜伏期(IELTs)评价治疗前后的疗效和副作用,结合阿拉伯语早泄指数和IIEF-5评分。
    结果:治疗后,两组IELTs均较治疗前明显改善(P<0.05);精确涂片组阿拉伯早泄指数和IIEF-5评分均高于均匀涂片组(P<0.05)。
    结论:这项研究推断,与使用表面麻醉药的传统方法相比,根据阴茎和龟头振动的阈值应用利多卡因具有积极作用,不良事件报告更少,值得临床推广。
    OBJECTIVE: This study aimed to evaluate the efficacy and safety of applying 5% lidocaine cream to the sensitive area of the glans penis after its precise localization under the penile biological vibration threshold test for the treatment of primary premature ejaculation.
    METHODS: Eighty patients diagnosed with primary premature ejaculation in an outpatient setting were included in this study. They were randomly scored into two groups. Group 1 (n = 40) was given 1 ml of 5% lidocaine cream on demand. They were instructed to apply the lidocaine cream evenly in a circular pattern to the glans penis without precise application to the sensitive area of the glans penis. The treatment lasted for a total of 4 weeks. Group 2 (n = 40) had a penile biological vibration threshold test performed to detect loci with a lower threshold. They were instructed to apply 1 ml of 5% lidocaine cream to the sensitive loci on the glans penis for 4 weeks. Lidocaine cream was applied topically or uniformly to the glans penis 20 minutes before planned intercourse in both groups .The efficacy and side effects before and after treatment were evaluated by the intravaginal ejaculation latency (IELTs) before and after treatment, combined with the Arabic Index of Premature Ejaculation and IIEF-5 score.
    RESULTS: After treatment, IELTs in both groups were significantly improved compared with those before treatment(P<0.05);The Arab premature ejaculation index and IIEF-5 score of the precise smear group are higher than those of the uniform smear group(P<0.05).
    CONCLUSIONS: This study infers that applying lidocaine according to the threshold of penile and glans vibration has a positive effect and fewer adverse event reports compared with the traditional method of using surface anesthetics, which is worthy of clinical promotion.
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  • DOI:
    文章类型: English Abstract
    目的:探讨达泊西汀联合经皮神经肌肉电刺激(TNES)治疗原发性早泄的临床疗效。
    方法:选择符合原发性早泄诊断标准的60例患者作为研究对象,随机分为达泊西汀组(对照组)和达泊西汀联合经皮神经肌肉电刺激组(观察组),每组30例,疗程4周。阴道内射精潜伏期(IELT),早泄诊断工具(PEDT)的评分,位于阴茎(PSSR)的交感神经皮肤反应,患者健康问卷(PHQ-9),记录两组患者治疗前后的广泛性焦虑障碍问卷(GAD-7)。治疗前后,分析两组观察指标的差异及两组有效率的比较。
    结果:观察组和对照组IELT和PSSR潜伏期延长,PEDT评分降低,差异有统计学意义(P<0.01)。与对照组相比,观察组在延长IELT和PSSR潜伏期、降低PEDT评分方面差异有统计学意义(P<0.05)。观察组和对照组的有效率分别为90%和63.33%。分别,差异有统计学意义(P<0.05)。两组患者的抑郁、焦虑改善水平比较,差异无统计学意义(P>0.05)。
    结论:达泊西汀联合TNES治疗原发性早泄的临床疗效优于单用达泊西汀。可作为临床治疗原发性早泄的有效选择。
    OBJECTIVE: To investigate the clinical efficacy of dapoxetine combined with transcutaneous neuromuscular electrical stimulation (TNES) in the treatment of primary premature ejaculation.
    METHODS: A total of 60 patients who met the diagnostic criteria for primary premature ejaculation were selected as study subjects and randomly divided into a dapoxetine group (control group) and a dapoxetine combined with percutaneous neuromuscular electrical stimulation group (observation group).30 patients in each group were treated for 4 weeks. Intravaginal ejaculatory latency time (IELT), the score of Premature Ejaculation Diagnostic Tool (PEDT), sympathetic skin response located in the penis (PSSR), Patient Health Questionnaire (PHQ-9), and Generalized Anxiety Disorder Questionnaire (GAD-7) before and after treatment were recorded in the two groups. Before and after treatment, the difference in observed indexes in the two groups and the comparison of effective rates between the two groups were analyzed.
    RESULTS: The latency of IELT and PSSR was prolonged and the PEDT score was decreased in both the observation group and the control group, the difference was statistically significant (P<0.01). Compared with the control group, the observation group had statistically significant differences in extending IELT and PSSR latency and reducing PEDT score (P<0.05). The effective rates of the observation group and control group were 90% and 63.33%, respectively, and the difference was statistically significant (P<0.05). There was no significant difference in the improvement of depression and anxiety levels between the two groups (P> 0.05).
    CONCLUSIONS: Dapoxetine combined with TNES has a better clinical effect than dapoxetine alone in the treatment of primary premature ejaculation, and can be used as an effective option for clinical treatment of primary premature ejaculation.
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