Résumé
Background: Current drugs used for sexual dysfunction have several limitations, necessitating the search for alternative medicine. Aim and Objective: The study investigated the effect of Citrullus lanatus ethanolic seed extract (CLESE) on the sexual behavior and reproductive hormones of adult male Wistar rats. Material and Methods: Twenty-four adult male Wistar rats were randomized into four groups (n=6). Group 1 received saline (1 ml/kg, p.o.) and served as normal control, groups 2 and 3 were given CLESE (500 and 1000 mg/kg, p.o.) for 14 consecutive days. Group 4 received Sildenafil Citrate (SC) (5 mg/kg, p.o.), which served as positive control drug and this was administered 4 h before sexual behavioral test only on days 7 and 14. Sexual behavioral tests were performed in a Plexiglas copulatory arena. Male sexual behavioral parameters were evaluated following one on one exposure of experimental male rats with oestrusinduced sexual seeking female rats. Thereafter, rats were sacrificed. Results: CLESE enhanced ibido by significantly (p < 0.05) increasing mounting and intromission frequencies relative to normal controls. CLESE also enhanced intromission and ejaculation latencies, but decreased mounting latency and post ejaculatory interval. Serum testosterone and luteinizing hormone were also significantly (p < 0.05) increased. The histological findings showed improved histoarchitechture of the testes and hypothalamic sections. Conclusion: The findings from this study showed that CLESE enhanced sexual behavior via mechanism related to increased serum testosterone and luteinizing hormone and may be useful for men with sexual dysfunction.
Résumé
Premature ejaculation (PE) is the most common male sexual dysfunction, which represents a diagnostic as well as a therapeutic challenge for physicians. However, no universally accepted definition is currently available for PE. As a result, physicians continue to diagnose patients with PE according to major guidelines set by the professional societies. These guidelines either recommend the use of validated questionnaires or patient-reported outcomes. Recent efforts directed toward classifying PE may help provide a better understanding of the prevalence and risk factors of this disorder. While the exact etiology of PE has not been clearly elucidated, several risk factors have been strongly reported in the literature. Clearly, to understand the revised definition of PE, its etiology and pathophysiology is necessary to improve the clinical management of this medical condition and form the basis of future research in this regard. In this review, we highlight the past and current definitions of PE and present an appraisal on the classifications and theories suggested for the etiopathogenesis of PE.
Résumé
Premature ejaculation (PE) is the most common male sexual dysfunction, which represents a diagnostic as well as a therapeutic challenge for physicians. However, no universally accepted definition is currently available for PE. As a result, physicians continue to diagnose patients with PE according to major guidelines set by the professional societies. These guidelines either recommend the use of validated questionnaires or patient-reported outcomes. Recent efforts directed toward classifying PE may help provide a better understanding of the prevalence and risk factors of this disorder. While the exact etiology of PE has not been clearly elucidated, several risk factors have been strongly reported in the literature. Clearly, to understand the revised definition of PE, its etiology and pathophysiology is necessary to improve the clinical management of this medical condition and form the basis of future research in this regard. In this review, we highlight the past and current definitions of PE and present an appraisal on the classifications and theories suggested for the etiopathogenesis of PE.
Sujets)
Humains , Mâle , Éjaculation précoce/physiopathologieRésumé
The premature ejaculation diagnostic tool (PEDT) is a brief diagnostic measure to assess premature ejaculation (PE). However, there is insufficient evidence regarding its validity in the new evidence-based-defined PE. This study was performed to evaluate the validity of PEDT and its association with IIEF-15 in different types of evidence-based-defined PE. From June 2015 to January 2016, a total of 260 men complaining of PE and defined as lifelong PE (LPE)/acquired PE (APE) according to the evidence-based definition from Andrology Clinic of the First Affiliated Hospital of Anhui Medical University, along with 104 male healthy controls without PE from a medical examination center, were enrolled in this study. All individuals completed questionnaires including demographics, medical and sexual history, as well as PEDT and IIEF-15. After statistical analysis, it was found that men with PE reported higher PEDT scores (14.28 ± 3.05) and lower IIEF-15 (41.26 ± 8.20) than men without PE (PEDT: 5.32 ± 3.42, IIEF-15: 52.66 ± 6.86, P < 0.001 for both). It was suggested that a score of ≥9 indicated PE in both LPE and APE by sensitivity and specificity analyses (sensitivity: 0.875, 0.913; specificity: 0.865, 0.865, respectively). In addition, IIEF-15 were higher in men with LPE (42.64 ± 8.11) than APE (39.43 ± 7.84, P < 0.001). After adjusting for age, IIEF-15 was negatively related to PEDT in men with LPE (adjust r =-0.225, P < 0.001) and APE (adjust r =-0.378, P < 0.001). In this study, we concluded that PEDT was valid in the diagnosis of evidenced-based-defined PE. Furthermore, IIEF-15 was negatively related to PEDT in men with different types of PE.
Résumé
A disfunção erétil é uma patologia caracterizada pela inabilidade de desenvolver ou manter uma ereção suficiente para o bom desempenho sexual. Há várias causas para disfunção erétil. As principais são neurogênicas, vasculares, endocrinológicas e alguns remédios. Inibidores da fosfodiesterase-5 são as drogas de escolha para o tratamento. Drogas intracavernosas e próteses penianas podem também ser usadas.
Résumé
PURPOSE: Recently a marked increase in both clinical and research activity in the field of male sexual dysfunction has led to a better evaluation and more treatment options. The clinical distribution and prevalence of male sexual dysfunction is essential to further improve diagnostic as well as therapeutic options. For the evaluation of clinical characteristics of male sexual dysfunction, we performed this study. MATERIALS AND METHODS: Two thousands male patients complaining sexual dysfunction visiting our hospital were reviewed. Chief complaints were classified as impotence, premature ejaculation, penile lesion, ejaculatory disorder, and orgasm disorder. We analyzed prior histories of management, associated diseases and treatment in our hospital. RESULTS: In age distribution, patients in their 40s were most common and 31.2% was under 40 years of age. Of the symptoms complained, erectile dysfunction was 61.8% and premature ejaculation with or without erectile dysfunction was 11.7% or 15.0%, respectively.40.4% had been managed for sexual dysfunction. Of them, 70.3% was managed by nonmedical or oriental means and 29.7% by physicians. 88.8% had associated diseases for sexual dysfunction. Diabetes was observed In 17.3%, cardiovascular disease in 13.8%, systemic disease in 20.8%. 68.8% was treated at our hospital. Of them, 64.7% was treated pharmacologically. CONCLUSIONS: Symptoms of male sexual dysfunction were relatively common in men under 40 years of age comprising nearly one third of the patients complaining sexual dysfunction. Most of the patients had prior histories of management by nonmedical means due to lack of insight. Many patients preferred pharmacologic treatment. Future change In patient's insight will direct the patient to seek care by an urologist.