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Principles of Pathophysiology of Infertility Assessment and Treatment*
Published in Asim Kurjak, Ultrasound and Infertility, 2020
Joseph G. Schenker, Aby Lewin, Menashe Ben-David
The mechanism of normal ejaculation depends on the intact autonomic nervous system, and either chemical (α-adrenergic blocking preparations) or surgical sympathectomy can interfere with normal ejaculation. Sympathetic disturbances of ejaculation may cause a bladder neck dysfunction, which leads to retrograde emission of semen into the urinary bladder. Sexual dysfunction, the disability to achieve or maintain an erection, premature ejaculation, or difficulty in ejaculation may be etiological factors in infertility.
Making sense of symptoms
Published in Ruth Skrine, Blocks and Freedoms in Sexual Life, 2019
Another difficulty with diagnostic labels for sexual symptoms is one of definition. How can we, for example, define premature ejaculation? Caplan2 points out that some people have tried to do so by reference to the length of time that vaginal containment can be enjoyed or the number of thrusts possible. Others have diagnosed it in terms of the partner's response: 'Long enough for the woman to reach orgasm on 50% of occasions'. What nonsense. How can one person's problem be defined in terms of another? Perhaps his partner has never been able to reach vaginal orgasm.
Case 47: I’m impotent
Published in Barry Wright, Subodh Dave, Nisha Dogra, 100 Cases in Psychiatry, 2017
Barry Wright, Subodh Dave, Nisha Dogra
There is no evidence of any physical illness. A referral to a urologist is likely to make him more anxious and is unnecessary at this point. The most likely diagnosis is that this man’s problems are psychological. He is able to sustain a normal erection when he is not with his wife and he clearly has a high level of performance anxiety. This has been reinforced by experiences of premature ejaculation. Research shows that problems such as this can be greatly reduced by reduction in anxiety about performance.
Effectiveness of Physiotherapy Interventions in the Management Male Sexual Dysfunction: A Systematic Review
Published in International Journal of Sexual Health, 2023
Caleb Ademola Omuwa Gbiri, Joy Chukwumhua Akumabor
A total of 912 participants were randomized from the 13 included studies: 472 to the intervention group and 440 to the control group. Seventy-nine participants dropped out during the studies and were excluded from statistical analysis. The age of participants ranged from 19 to 83 years. The underlying causes for participants identifying as having erectile dysfunction included radical prostatectomy, myocardial infarction, hypertension, ischemic heart disease, venous occlusion, arterial insufficiency, and psychogenic causes. Participants with premature ejaculation were identified as having lifelong premature ejaculation. The severity of erectile dysfunction in all the studies was mild to severe. Erectile dysfunction had lasted between 6 and 360 months in most participants in the studies.
An update on the treatment of premature ejaculation: A systematic review
Published in Arab Journal of Urology, 2021
Ramadan Saleh, Ahmad Majzoub, Mohammed Abu El-Hamd
Premature ejaculation is a commonly encountered male sexual dysfunction, with a potential negative impact on the patient and his partner. In the present review, we explored the different therapeutic approaches that are currently available for the treatment of PE including behavioural, pharmacological, and surgical options. Interestingly, the medications currently used in the treatment of PE are sold off-label. Except for the newly licensed dapoxetine, which provides an effective, on-demand treatment regimen with relatively minimal side-effects, it is not clear whether it received final FDA approval for treatment of PE. Therefore, it is important for the clinician to recognise all PE treatment options as each patient may respond differently and experience variable side-effects. Future efforts should be directed towards understanding the exact pathophysiology of PE at different clinical setups and developing additional therapies with higher efficacy and minimal or no adverse effects.
Development and characterisation of levosulpiride-loaded suppositories with improved bioavailability in vivo
Published in Pharmaceutical Development and Technology, 2019
Levosulpiride is a derivative of benzamide group which is potentially used for the treatment of depression and psychiatric problems. It selectively blocks D2 receptors in submucosal and myoenteric plexus (Kim et al. 2016a; Fotaki et al. 2005). Levosulpiride enhances gastric evacuation and digestive signs in patients with functional dyspepsia and diabetic gastroparesis. Moreover, it has been successfully investigated for the treatment of premature ejaculation (Greco et al. 2002; Hussain et al. 2010). Beside all the related efficacy of levosulpiride, its poorly water solubility and low permeability (BCS Class IV drug) is a big challenge in developing various formulations, including oral and injectable formulations, for its therapeutic use (Ibrahim et al. 2013). Furthermore, because of its low pKa, various excipients are required for the development of injectable formulations, which sometimes results in severe pain to the patient leading to discomfort, after injection.