Premature Ejaculation patients and their partners: arriving at a clinical profile for a real optimization of the treatment.

Abstract

The aim of the study is to extrapolate clinical features of Premature Ejaculation (PE) patients and female partners of men affected with PE, in order to get a profile that can be of assistance for physicians within the dynamics of a couple, one of which is a PE patient. An observational, non-interventional, cross-sectional epidemiological study entitled IPER (Italian Premature Ejaculation Research) was conducted and included two different cohorts of subjects that were randomly sampled from a patient dataset of selected General Practitioners: 1. IPER-M sub-cohort (1.104 subjects) was made of male subjects in which they were then distinguished patients with or without PE based on the score of the PEDT questionnaire; IPER-F sub-cohort (1.109 subjects) was made of female subjects from an independent sample of women (therefore not the partners of the IPER-M males) in which they then distinguished those partners of a male subject with PE or not. In addition to an identical general questionnaire to explore demographic aspects and habits, each subcohort was then evaluated using validated questionnaires. No differences were noted between PE+/PE- patients in terms of alcohol consumption, smoking habits, physical activity nor stress condition in everyday life, employment, socio-economic class and marital status. While the prevalence of PE proportionally increased with age, excluding the 50-59 and 70-80 years decades, in the IPER-M group an overall statistically significant difference for the mean age between the PE+ and PE- groups (p = 0.002) was detected, but without reaching any difference amongst the different age classes in the IPER-F group. The PE+ patients reported a significantly lower frequency rate of sexual intercourse, worse QoL (p = 0.006 and p < 0.0001, respectively), and increased anxiety status (p < 0.0001 for both subgroups). This study shows that, rather than talking with a patient affected by PE it would be advisable to introduce the concept of couple counseling with the person patient and his partner, because it is only through classification of both partners as one couple and a full understanding of their mutual sexual experience that PE treatment can be optimized and its results measured accurately.

Impact of extracorporeal shockwave therapy for erectile dysfunction and Peyronie's disease on reproductive and hormonal testicular function

“…[21][22][23][24] In recent years, ESWT has proven to be an effective treatment in selected patients with ED and PD, to improve erectile function and relieve penile pain, respectively. [4][5][6] ESWT is generally described as a safe andrological procedure characterized by mild and transient side effects. 4,5,7 However, the still limited knowledge of the biological effects of shock waves, 2,3 the description of testicular damage following ESWL, 25,26 and espe-cially some recent pre-clinical studies showing the negative impact of low-intensity ESWT (Li-ESWT) on testicular function 8,27 have raised several concerns about the possible testicular effects of ESWT in ED or PD setting because of tissue contiguity between penis and testes.…”

“…6 However, standardized treatment protocols and optimal parameter settings for performing ESWT have not yet been defined. 4,5 Although ESWT in andrology is generally well tolerated, with rare, mild, and self-limiting side effects (e.g., pain, erythema), 4,5,7 some concerns may arise from the anatomical proximity of the testes to the penis, which can theoretically be exposed to shock waves. Impairment of spermatogenesis and worsening of seminal parameters have recently been described in adult rats undergoing ESWT on the penile surface; however, there are currently no human studies available evaluating the effects of ESWT for andrological purposes on testicular function.…”

Male Sexual Dysfunction and Infertility in Spinal Cord Injury Patients: State-of-the-Art and Future Perspectives

“…In this population, after SCI, several sexual consequences can occur, such as (ED and ejaculatory dysfunction), fertility problems (such as impaired spermatogenesis, abnormalities in sperm viability, motility, and morphology), and systemic disorders, such as genitourinary infection and endocrine imbalances [ 7 , 8 , 9 , 10 , 11 , 12 ]. ED represents the major concern in both complete and incomplete SCI patients, especially when associated with chronic disease [ 13 , 14 , 15 , 16 ]. Furthermore, the level and completeness of the SCI influence sexual functioning following the SCI [ 17 ].…”

Toxicity of Antioxidant Supplements in Patients with Male Factor Infertility: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

“…Infertility, defined as the inability of a couple to achieve a pregnancy after one year of regular unprotected intercourse, affects 10 to 15% of couples [ 1 ]. It has been reported that a male factor is present in about 20–70% of infertile couples [ 1 , 2 , 3 ]. Oxidative stress (OS), defined as an imbalance in the levels of reactive oxygen species (ROS) and antioxidants, has been reported as one of the main causes of male infertility [ 4 ].…”