Ejaculatory dysfunction is a highly prevalent clinical condition that may be classified along a continuum that ranges from premature ejaculation （PE）, through retarded or delayed ejaculation （DE）, to complete anej...Ejaculatory dysfunction is a highly prevalent clinical condition that may be classified along a continuum that ranges from premature ejaculation （PE）, through retarded or delayed ejaculation （DE）, to complete anejaculation （AE）. Retrograde ejaculation （RE） represents a distinct entity in which ejaculate is expelled either partially or completely into the bladder. While DE and PE are significant sources of sexual dissatisfaction among men and their partners, patients with these disorders retain normal fertility in most cases. Conversely, men with AE and RE are unable to deliver sperm into the female genital tract and are therefore rendered subfertile. Therefore, in reviewing ejaculatory disorders as they relate to fertility, this paper will primarily focus on the diagnosis and management of AE and RE. Physiology, diagnostic strategies, pharmacological treatments, and procedural interventions relevant to AE and RE are discussed.展开更多
Parameters of peripheral blood cell have been shown as the potential predictors of erectile dysfunction(ED).To investigate the clinical significance of hematological parameters for predicting the risk of rapid ejacula...Parameters of peripheral blood cell have been shown as the potential predictors of erectile dysfunction(ED).To investigate the clinical significance of hematological parameters for predicting the risk of rapid ejaculation,we established a rat copulatory model on the basis of ejaculation distribution theory.Blood samples from different ejaculatory groups were collected for peripheral blood cell counts and serum serotonin(5-HT)tests.Meanwhile,the relationship between hematological parameters and ejaculatory behaviors was assessed.Final analysis included 11 rapid ejaculators,10 normal ejaculators,and 10 sluggish ejaculators whose complete data were available.The platelet(PLT)count in rapid ejaculators was significantly lower than that in normal and sluggish ejaculators,whereas the platelet distribution width(PDW)and mean platelet volume(MPV)were significantly greater in rapid ejaculators.Multivariate logistic regression analysis and receiver operating characteristic(ROC)curve analysis showed that the PLT was an independent protective factor for rapid ejaculation.Meanwhile,rapid ejaculators were found to have the lowest serum 5-HT compared to normal and sluggish ejaculators(P<0.001).Furthermore,there was a positive correlation between the PLT and serum 5-HT(r=0.662,P<0.001),indicating that the PLT could indirectly reflect the serum 5-HT concentration.In addition,we assessed the association between the PLT and ejaculatory parameters.There was a negative correlation between ejaculation frequency(EF)and the PLT(r=−0.595,P<0.001),whereas there was a positive correlation between ejaculation latency(EL)and the PLT(r=0.740,P<0.001).This study indicated that the PLT might be a useful and convenient diagnostic marker for predicting the risk of rapid ejaculation.展开更多
A systematic review of randomized controlled trials and cohort studies was conducted to evaluate data for the effects of minimally invasive procedures for treatment of symptomatic benign prostatic hyperplasia （BPH） ...A systematic review of randomized controlled trials and cohort studies was conducted to evaluate data for the effects of minimally invasive procedures for treatment of symptomatic benign prostatic hyperplasia （BPH） on male sexual function. The studies searched were trials that enrolled men with symptomatic BPH who were treated with laser surgeries, transurethral microwave therapy （TUMT）, transurethral needle ablation of the prostate （TUNA）, transurethral ethanol ablation of the prostate （TEAP） and high-intensity frequency ultrasound （HIFU）, in comparison with traditional transurethral resection of the prostate （TURP） or sham operations. A total of 72 studies were identified, of which 33 met the inclusion criteria. Of the 33 studies, 21 were concerned with laser surgeries, six with TUMT, four with TUNA and two with TEAP containing information regarding male sexual function. No study is available regarding the effect of HIFU for BPH on male sexual function. Our analysis shows that minimally invasive surgeries for BPH have comparable effects to those of TURP on male erectile function. Collectively, less than 15.4% or 15.2% of patients will have either decrease or increase, respectively, of erectile function after laser procedures, TUMT and TUNA. As observed with TURP, a high incidence of ejaculatory dysfunction （EjD） is common after treatment of BPH with holmium, potassium-titanyl-phosphate and thulium laser therapies （〉 33.6%）. TUMT, TUNA and neodymium：yttrium aluminum garnet visual laser ablation or interstitial laser coagulation for BPH has less incidence of EjD, but these procedures are considered less effective for BPH treatment when compared with TURP.展开更多
文摘Ejaculatory dysfunction is a highly prevalent clinical condition that may be classified along a continuum that ranges from premature ejaculation （PE）, through retarded or delayed ejaculation （DE）, to complete anejaculation （AE）. Retrograde ejaculation （RE） represents a distinct entity in which ejaculate is expelled either partially or completely into the bladder. While DE and PE are significant sources of sexual dissatisfaction among men and their partners, patients with these disorders retain normal fertility in most cases. Conversely, men with AE and RE are unable to deliver sperm into the female genital tract and are therefore rendered subfertile. Therefore, in reviewing ejaculatory disorders as they relate to fertility, this paper will primarily focus on the diagnosis and management of AE and RE. Physiology, diagnostic strategies, pharmacological treatments, and procedural interventions relevant to AE and RE are discussed.
基金funded by the Research Foundation of Anhui Provincial Institute of Translational Medicine(No.2023zhyx-C94)the National Natural Science Foundation of China(No.82071637).
文摘Parameters of peripheral blood cell have been shown as the potential predictors of erectile dysfunction(ED).To investigate the clinical significance of hematological parameters for predicting the risk of rapid ejaculation,we established a rat copulatory model on the basis of ejaculation distribution theory.Blood samples from different ejaculatory groups were collected for peripheral blood cell counts and serum serotonin(5-HT)tests.Meanwhile,the relationship between hematological parameters and ejaculatory behaviors was assessed.Final analysis included 11 rapid ejaculators,10 normal ejaculators,and 10 sluggish ejaculators whose complete data were available.The platelet(PLT)count in rapid ejaculators was significantly lower than that in normal and sluggish ejaculators,whereas the platelet distribution width(PDW)and mean platelet volume(MPV)were significantly greater in rapid ejaculators.Multivariate logistic regression analysis and receiver operating characteristic(ROC)curve analysis showed that the PLT was an independent protective factor for rapid ejaculation.Meanwhile,rapid ejaculators were found to have the lowest serum 5-HT compared to normal and sluggish ejaculators(P<0.001).Furthermore,there was a positive correlation between the PLT and serum 5-HT(r=0.662,P<0.001),indicating that the PLT could indirectly reflect the serum 5-HT concentration.In addition,we assessed the association between the PLT and ejaculatory parameters.There was a negative correlation between ejaculation frequency(EF)and the PLT(r=−0.595,P<0.001),whereas there was a positive correlation between ejaculation latency(EL)and the PLT(r=0.740,P<0.001).This study indicated that the PLT might be a useful and convenient diagnostic marker for predicting the risk of rapid ejaculation.
文摘A systematic review of randomized controlled trials and cohort studies was conducted to evaluate data for the effects of minimally invasive procedures for treatment of symptomatic benign prostatic hyperplasia （BPH） on male sexual function. The studies searched were trials that enrolled men with symptomatic BPH who were treated with laser surgeries, transurethral microwave therapy （TUMT）, transurethral needle ablation of the prostate （TUNA）, transurethral ethanol ablation of the prostate （TEAP） and high-intensity frequency ultrasound （HIFU）, in comparison with traditional transurethral resection of the prostate （TURP） or sham operations. A total of 72 studies were identified, of which 33 met the inclusion criteria. Of the 33 studies, 21 were concerned with laser surgeries, six with TUMT, four with TUNA and two with TEAP containing information regarding male sexual function. No study is available regarding the effect of HIFU for BPH on male sexual function. Our analysis shows that minimally invasive surgeries for BPH have comparable effects to those of TURP on male erectile function. Collectively, less than 15.4% or 15.2% of patients will have either decrease or increase, respectively, of erectile function after laser procedures, TUMT and TUNA. As observed with TURP, a high incidence of ejaculatory dysfunction （EjD） is common after treatment of BPH with holmium, potassium-titanyl-phosphate and thulium laser therapies （〉 33.6%）. TUMT, TUNA and neodymium：yttrium aluminum garnet visual laser ablation or interstitial laser coagulation for BPH has less incidence of EjD, but these procedures are considered less effective for BPH treatment when compared with TURP.
