Sympathetic skin response in patients with primary premature ejaculation

Abstract

To evaluate the possible role of the autonomic (sympathetic) nervous system function among the patients with primary premature ejaculation (PPE) and determine whether there is an etiological basis for this condition. We performed sympathetic skin response located in the penis (PSSR) in 52 patients with PPE and 46 normally potent men. The latencies and amplitudes of PSSR were measured. The PSSR waveforms were classified into P type and N type according to the waveform characteristics. The waveform distribution in the PPE patients was not statistically different from that in the control group (P=0.609). Mean latency of the PSSR was significantly shorter in the patients than that in the normally potent men (P<0.001). Mean amplitude of the PSSR was significantly greater in patients than that in the normal men (P<0.001). Patients with PPE have hyperactivity of the sympathetic nervous system, which may be another factor involved in the pathological mechanisms of PPE, and the PSSR is an objective test to evaluate patients with PPE.

The Sympathetic Skin Response Located in the Penis as a Predictor of the Response to Sertraline Treatment in Patients with Primary Premature Ejaculation

“…Additionally, the serum 5‐HT level in PE patients after 8‐week sertraline treatment increased significantly, accompanying with IELT prolonged [40]. More recently, our studies and other reports indicate that the sympathetic overactivity is another factor involved in the pathological mechanisms of PPE [9,10,41]. Therefore, the increased sympathetic input may facilitate the activation of the SGE in response to a minimal amount of external stimulation, and SSRI may delay ejaculation by enhancing the role of the descending inhibitory serotonergic projections from the brainstem to SGE [30], which is in agreement with the above second hypothesis.…”

“…Meanwhile, PPE has been claimed to be caused by somatic disorders and/or neurobiological imbalances, such as penile hypersensitivity, hyperarousability, and genetic predisposition [6]. More recently, our study, in which sympathetic skin response located in the penis (PSSR) tests were used, indicated that hyperactivity of the sympathetic nervous system may be another factor involved in the pathological mechanisms of PPE [9]. The results are in agreement with a recent study reporting the sympathetic overactivity in PPE patients through measuring 24-hour heart rate variability (HRV) in the men with PPE [10].…”

“…PSSR is a noninvasive biological marker of sympathetic system function. Details of PSSR recording method have been reported in our previous study [9]. Briefly, recording ring electrodes were placed around the proximal (negative site) and distal (positive site) region of the penile shaft, with 2 cm distance.…”

“…Thus, we divided the patients into a normal PSSR group and an abnormal PSSR group, based on the latency parameter. In a previous study, we found that the mean latency of PSSR was 1,514.5 ± 168.3 milliseconds in the healthy control group [9]. A value out of this reference range was considered abnormal, and the deviation was regarded as the cutoff value to classify the normal and abnormal outcome measures when it is more than 1.96 standard deviations from the mean of controls [26].…”

Relationship Between Amyloid Precursor Protein in Seminal Plasma and Abnormal Penile Sympathetic Skin Response in Lifelong Premature Ejaculation

“…The latency of the penile sympathetic skin response (PSSR) was significantly shorter and the amplitude of the PSSR was significantly larger in patients with lifelong PE compared with normally potent men. 10 Furthermore, the amplitude of PSSR in patients with lifelong PE was decreased and the latency of PSSR was prolonged after 8-week sertraline treatment. 11 Our previous study showed that patients with PE had higher amyloid precursor protein (APP) levels in seminal plasma compared with the control group.…”