Abbreviations & AcronymsObjectives: To examine the relationship between premature ejaculation and plasma melatonin levels, and assess the efficacy of selective serotonin reuptake inhibitors in treating premature ejaculation. Methods: A total of 60 men with lifelong premature ejaculation and 40 healthy male controls were included in the present study. For each participant, a medical history was obtained, a physical examination was carried out, and intravaginal ejaculation latency time and melatonin levels were measured. Premature ejaculation patients were randomly categorized into three treatment groups: group 1 received fluoxetine (20 mg/day), group 2 received paroxetine (20 mg/day) and group 3 received sertraline (50 mg/day). Results: The mean baseline plasma melatonin levels in men with premature ejaculation were significantly lower than in the healthy controls (5.34 vs 14.84 pg/mL). After 4 weeks of treatment, the mean intravaginal ejaculation latency time scores for all of the premature ejaculation treatment groups showed a significant improvement from the baseline values. The plasma melatonin levels were also significantly increased (P < 0.05) from baseline (5.34 pg/mL) to 9.50 pg/mL, 10.24 pg/mL or 13.30 pg/mL for groups 1, 2 and 3, respectively. Conclusions: Our findings show that premature ejaculation is associated with decreased plasma melatonin levels. After treatment with selective serotonin reuptake inhibitors, an increased plasma melatonin level can retard ejaculation, presumably by both central and peripheral mechanisms. This is the first study to evaluate the possible role of serotoninergic interactions on the melatoninergic system in premature ejaculation.

Early removal of urinary catheters after elective cesarean section is associated with reduced mobilization time and hospital stay.

In asymptomatic men with mild increases of prostate specific antigen histological evidence of prostatic inflammation is common. The leukocyte count in post-prostatic massage urine appears to be useful for screening of this condition before biopsy. Our data suggest that 10 leukocytes per high power field in post-prostatic massage urine, the usually applied cutoff, may be too high for the definition of prostatic inflammation.

The aim of this study was to determine the relevance of seminal plasma nitric oxide (NO) levels and the efficacy of selective serotonin reuptake inhibitor (SSRI) treatment on premature ejaculation. A total of 16 men (aged 32.18 ± 3.32) with lifelong premature ejaculation [intravaginal ejaculation latency time (IELT) <1 min] and 11 healthy men (control group) were included in this study. The healthy men formed Group 1, and the patients were randomly categorised into two groups. Group 2 patients received 20 mg day(-1) of paroxetine, and Group 3 patients received 50 mg day(-1) of sertraline for 4 weeks. Baseline and post-treatment findings were compared among the three groups. Mean baseline seminal NO levels in men with premature ejaculation were significantly higher than in the healthy control group (32.24 ± 5.61 μm l(-1) versus 19.71 ± 3.50 μm l(-1) , respectively) (P < 0.001). There was no significant difference between the sertraline and paroxetine groups in terms of IIEF scores, IELT scores and NO levels. At the end of the first month, the mean IELT scores of the paroxetine and sertraline groups showed a significant improvement compared with the baseline values (P < 0.001). After treatment with paroxetine and sertraline, NO levels dec-reased from baseline. Our study indicates that premature ejaculation is significantly related with a higher level of seminal NO. Baseline seminal plasma NO values obtained in patients with premature ejaculation were significantly higher than in the healthy control group. After treatment with SSRIs, decreased seminal NO may retard ejaculation. Further studies are needed to confirm this suggestion and the role of NO in the pathophysiology and treatment of premature ejaculation.

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Erectile dysfunction is defined as the inability to achieve penile erection necessary for sexual intercourse or to sustain erection sufficiently. Although the treatment options for erectile dysfunction are limited, the most common surgical treatment is penile prosthesis implantation. In addition, penile revascularization of the penis is very effective in the treatment of erectile dysfunction due to different vasculogenic reasons, especially pudendal artery occlusion, after perineal trauma. Modified Furlow Fisher technique including anastomosis of the inferior epigastric artery to the penile dorsal vein is a successful treatment option among the revascularization techniques. Despite invasive preliminary evaluations such as duplex Doppler ultrasound, dynamic cavernosometry, selective internal pudendal arteriography, and the long and difficult surgical procedure, it is highly effective in particularly selected young patients.

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Purpose To evaluate the possible effect of constipation on the acute urinary retention (AUR) after transrectal ultrasound-guided prostate biopsy (TRUS PB). Materials and Methods A total of 1,167 patients with prostate-specific antigen (PSA) >4 ng/mL and/or abnormal digital rectal examination underwent a standard 12 core transrectal ultrasound-guided prostate needle biopsy in our hospital and the findings were examined prospectively. Chronic constipation (CC) was defined according to the Rome IV criteria. All cases were well evaluated with respect to clinical-histopathological factors; International Prostate Symptom Score (IPSS), prostate volume, post-void residue, age, body mass index, histopathological inflammation, and AUR. Results The mean age of patients was 64.63±8.31 years, the PSA level was 11.60±16.83 ng/mL, and the prostate volume was 54.66±25.44 mL. In 265 cases (22.7%), CC anamnesis was present and AUR developed in 28 (2.4%) of the cases. In the multivariate analysis for the risk of developing urinary retention, prostate volume, pre-operative IPSS, and presence of CC requiring manual maneuvers to facilitate defecation were found to be risk factors (p=0.023, 0.010, and 0.001, respectively). Conclusions Our findings demonstrated that CC may be a critical factor in the prediction of AUR formation following TRUS PB.