O ejaculador precoce por ele mesmo: um estudo piloto / The premature ejaculator by himself: a pilot study

Objetivo: Avaliar autopercepção de portadores de ejaculação precoce (EP), repercussão da disfunção sobre desempenho e satisfação sexual do casal e benefícios esperados com o tratamento.Métodos: Foi desenvolvido instrumento para acessar os objetivos do estudo. Ejaculadores precoces maiores de 18 anos foram recrutados, até completar amostra. Testes qui-quadrado e exato de Fisher verificaram associações entre EP e variáveis categóricas. Teste ?t de Student? comparou médias das variáveis contínuas. Valores de p£0,05 foram considerados estatisticamente significantes.Resultados: A amostra foi constituída por 32 indivíduos, 53,1% com EP ao longo da vida (EPL) e 46,9% EP adquirida (EPA), para os quais a EP se caracteriza por: falta de controle (100,0% dos EPL 70,6% dos EPA), breve tempo intravaginal (66,7% e 52,9%) e preocupação em satisfazer a parceira (33,3% e 64,7%). Impactam a vida do paciente: falta de controle da ejaculação para 100,0% dos EPL e 94,2% dos EPA (p=0,53) pouco tempo de penetração 93,4% e 88,2% (p=0,63) sofrimento pessoal 86,7% e 94,1% (p = 0,45) insatisfação pessoal com o intercurso 86,7% e 76,5% (p=0,76) insatisfação da parceira 86,7% e 88,2% (p=0,99). Medicamento associado a psicoterapia foi o tratamento preferencial para 40,0% (EPL) e 35,3% (EPA). Mais controle ejaculatório, tempo dentro da vagina e satisfação da parceira são as principais expectativas quanto ao tratamento.Conclusão: Para portadores de EPL, controle e tempo intravaginal são as características mais importantes de EP, enquanto aqueles com EPA valorizam controle e satisfação da parceira. Os dois grupos preferem tratamento combinado (medicação e psicoterapia), ainda que essa preferência não seja consenso.

Sexual satisfaction among patients with erectile dysfunction treated with counseling, sildenafil, or both.

INTRODUCTION: Sexual satisfaction is linked to life satisfaction, and erectile dysfunction (ED) may lead to an impaired quality of life (QOL). AIM: Our goal was to evaluate the QOL among Brazilian patients with ED, before and after three kinds of treatment. METHODS: Men aged 25-55 years, with a diagnosis of psychogenic or mixed ED, according to the Classification of Mental and Behavioral Disorders of the International Classification of Diseases, 10th edition, and the Standard Practice in Sexual Medicine, were randomly assigned to three treatment groups: counseling, sildenafil, and sildenafil plus counseling. At baseline each group had 40 patients. Sildenafil was provided in 50 mg that could be adjusted to 100 mg. The patients could initially take one to two tablets per week and the entire treatment lasted for 3 months. Counseling was provided in group sessions that took place once a week. They were evaluated at baseline and after 3 months of treatment with the Male Sexual Quotient (MSQ) and the Sexual Health Inventory for Men (SHIM). MAIN OUTCOME MEASURES: The correlation between the patients' MSQ score and scores on the SHIM. RESULTS: One hundred seventeen patients were enrolled. The three groups were similar according to age, marital status, mean time of ED, and ED severity and etiology. At baseline, MSQ and SHIM total scores were not different among the three groups. MSQ scores increased from 41.2 +/- 15.3, 38.7 +/- 18.0, and 46.8 +/- 17.0 to 48.5 +/- 15.3, 63.8 +/- 21.6, and 70.0 +/- 17.3 after counseling, sildenafil, and sildenafil plus counseling, respectively (P < 0.05). SHIM scores also increased significantly (9.6 +/- 4.1, 9.7 +/- 4.1, and 10.2 +/- 3.9 to 12.1 +/- 3.9, 16.7 +/- 5.6, and 17.7 +/- 4.5 after counseling, sildenafil, and sildenafil plus counseling, respectively) (P < 0.05). There were no serious adverse events related to sildenafil, and no patient was withdrawn from the study because of an adverse event. CONCLUSIONS: The three treatments were significantly efficient, and the best treatment was sildenafil associated with counseling.