effectiveness of tramadol in treatment of premature ejaculation on-demand basis

Premature ejaculation [PE] is a worldwide problem. Selective serotonin reuptake inhibitors [SSRIs] are widely used "off label" as pharmacotherapeutic agents in the treatment of PE. Assess the efficacy of Tramadol for on-demand treatment of PE. During the period December 2008 through November 2009, 60 married men visited the surgical specialties hospital urology outpatient and consultancy clinics complaining of premature ejaculation were enrolled in this study. Intravaginal ejaculation latency time [IVELT] was used as an objective tool to assess the efficacy of the investigated treatment. Single-blind, placebo-controlled therapeutic trial was conducted on 60 patients with lifelong PE. PE was defined as IVELT of <2 minutes in at least 80% of intercourse episodes. The patients cohort was randomised into 2 equal sized groups. The intervention group [n=30] used 50 mg tablet of Tramadol hydrochloride, while the control group [n=30] used a placebo tablet for 8 weeks. Drugs were taken 1-2 hours before sexual activity, and sexual intercourse was required at least once per week. IVELT was timed by a stopwatch at each intercourse. The mean IVELT after tramadol and placebo significantly increased from 73.1 and 67.9 seconds to approximately 442.1 and 113.3 seconds, respectively [P < 0.001]. Sexual satisfaction was used to assess the cut-off values of IVELT in defining the minimal and best clinical response to treatment. There was no withdrawal symptoms recorded following the use of tramadol or placebo, but more adverse events were associated with tramadol treatment. Tramadol seems to provide significantly better results in terms of IVELT and intercourse satisfaction versus placebo. Further studies are required to draw final conclusions on the efficacy of this drug in premature ejaculation.

Role of testicular biopsy in the evaluation of azoospermic men

A total of 67 infertile men with azoospermia were studied over 5 years period [February 1997-March 2002]. Their mean age was 33 years and mean duration of infertility was 6 years. They underwent bilateral testicular biopsy under general anaesthesia and the specimens were categorizwd according to histopathological patterns. These included normal spermatgenesis 12 [17.9%]; hypospermatogenesis 4 [5.9%]; spermatogenic arrest 39 [58.2%]; sertoli cell only 7 [10.4%]; and complete tubular hyalinization 5 [7.4%]. This study highlights the role of testicular biopsy as a reliable and useful technique for the investigation of patients with azoospermia

Haematospermia etiology and clinical significance

A prospective study was carried out on 31 patients with hematospermia at Al-Rasheed Military hospital between October 1999 and October 2001. All patients were clinically assessed and subjected to urinalysis and seminal fluid analysis. Other investigations were done according to individual cases. More than 90% of the patients had no prior genitourinary symptoms or significant factors in their history. The etiology of hemtospermia was determined and found to be of inflammatory origin in most men especially the young. In 3 of the 31 patients hematuria occurred with hematospermia and was associated with significant lower urinary tract abnormalities such as bladder tumor, however in none of these a relationship appeared between hematospermia and the disease process. From this study we can conclude that hematospermia is of no importance, does not progress, tend to disappear in the coarse of time 7 rarely is associated with any significant urologic pathology