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Sample records for lifelong premature ejaculation

  1. The pathophysiology of lifelong premature ejaculation

    PubMed Central

    2016-01-01

    For many decades it has been thought that lifelong premature ejaculation (PE) is only characterized by persistent early ejaculations. Despite enormous progress of in vivo animal research, and neurobiological, genetic and pharmacological research in men with lifelong PE, our current understanding of the mechanisms behind early ejaculations is far from complete. The new classification of PE into four PE subtypes has shown that the symptomatology of lifelong PE strongly differs from acquired PE, subjective PE and variable PE. The phenotype of lifelong PE and therefore also the pathophysiology of lifelong PE is much more complex. A substantial number of men with lifelong PE not only have PE, but also premature erection and premature penile detumescence as part of an acute hypertonic or hypererotic state when engaged in an erotic situation or when making love. As both erectio praecox, ejaculatio praecox, detumescentia praecox, and the hypererotic state are part of the phenotype lifelong PE, it is argued that lifelong PE is not only a disturbance of the timing of ejaculation but also a disturbance of the timing of erection, detumescence and arousal. Since 1998, the pathophysiology of lifelong PE was thought to be mainly mediated by the central serotonergic system in line with genetic polymorphisms of specific serotonergic genes. However, by accepting that lifelong PE is characterized by the reversible hypertonic state the hypothesis of mainly serotonergic dysfunction is no longer tenable. Instead, it has been postulated that the pathophysiology of lifelong PE is mediated by a very complex interplay of central and peripheral serotonergic, dopaminergic, oxytocinergic, endocrinological, genetic and probably also epigenetic factors. Progress in research of lifelong PE can only be accomplished when a stopwatch is used to measure the IELT and the cut-off point of 1 minute for the definition of lifelong PE is maintained. Current use of validated questionnaires, neglect of

  2. The pathophysiology of lifelong premature ejaculation.

    PubMed

    Waldinger, Marcel D

    2016-08-01

    For many decades it has been thought that lifelong premature ejaculation (PE) is only characterized by persistent early ejaculations. Despite enormous progress of in vivo animal research, and neurobiological, genetic and pharmacological research in men with lifelong PE, our current understanding of the mechanisms behind early ejaculations is far from complete. The new classification of PE into four PE subtypes has shown that the symptomatology of lifelong PE strongly differs from acquired PE, subjective PE and variable PE. The phenotype of lifelong PE and therefore also the pathophysiology of lifelong PE is much more complex. A substantial number of men with lifelong PE not only have PE, but also premature erection and premature penile detumescence as part of an acute hypertonic or hypererotic state when engaged in an erotic situation or when making love. As both erectio praecox, ejaculatio praecox, detumescentia praecox, and the hypererotic state are part of the phenotype lifelong PE, it is argued that lifelong PE is not only a disturbance of the timing of ejaculation but also a disturbance of the timing of erection, detumescence and arousal. Since 1998, the pathophysiology of lifelong PE was thought to be mainly mediated by the central serotonergic system in line with genetic polymorphisms of specific serotonergic genes. However, by accepting that lifelong PE is characterized by the reversible hypertonic state the hypothesis of mainly serotonergic dysfunction is no longer tenable. Instead, it has been postulated that the pathophysiology of lifelong PE is mediated by a very complex interplay of central and peripheral serotonergic, dopaminergic, oxytocinergic, endocrinological, genetic and probably also epigenetic factors. Progress in research of lifelong PE can only be accomplished when a stopwatch is used to measure the IELT and the cut-off point of 1 minute for the definition of lifelong PE is maintained. Current use of validated questionnaires, neglect of

  3. Lifelong premature ejaculation: definition, serotonergic neurotransmission and drug treatment.

    PubMed

    Waldinger, Marcel D

    2005-06-01

    The ejaculation distribution theory (EDT) postulates a biological continuum of the intravaginal ejaculation latency time (IELT) in men. Such an continuum has recently been found in two epidemiological stopwatch studies. In addition, a continuum of ejaculation latency time has also been demonstrated in laboratory rats. It is suggested that the invariable parts of ejaculation, i.e. premature and retarded ejaculation are highly influenced by genetic and neurobiological factors. In contrast, superimposed on biological roots, ejaculation of men, in the middle part of the continuum, is probably more easily influenced by environmental and psychological factors. A meta-analysis of 35 daily SSRI and clomipramine treatment studies demonstrated a similar efficacy for paroxetine, clomipramine, sertraline and fluoxetine, with paroxetine exerting the strongest effect on ejaculation. Based on fundamental insights into serotonergic neurotransmission, it is suggested that on-demand conventional SSRI treatment will not lead to similarly impressive ejaculation delay as that found after daily conventional SSRI treatment. Future studies with SSRIs with short half-lives, short T(max) and high C(max )should elucidate whether these pharmacokinetic properties are able to affect the pharmacodynamics of 5-HT neurons in such a way that immediate clinically relevant ejaculation delay occurs.

  4. Premature Ejaculation

    MedlinePlus

    ... may help men who have premature ejaculation. Some antidepressants seem to help delay ejaculation, including antidepressants called selective serotonin reuptake inhibitors (SSRIs). These antidepressants ...

  5. The relationship between the second-to-fourth digit ratios and lifelong premature ejaculation: a prospective, comparative study.

    PubMed

    Bolat, D; Kocabas, G U; Kose, T; Degirmenci, T; Aydin, M E; Dincel, C

    2017-02-19

    To investigate the relationship between the fetal androgen exposure and lifelong premature ejaculation by using the ratio of the second (index)-to-fourth (ring) digits (2D : 4D) which is the marker for higher prenatal androgen exposure. Totally 65 patients with lifelong premature ejaculation and 65 control cases without any ejaculatory complaints were enrolled in the study. A detailed medical history was obtained and self-estimated intravaginal ejaculatory latency times were recorded. Ejaculation function was evaluated by Premature Ejaculation Diagnostic Tool. The lengths of the second and fourth digits of both hands were measured and 2D : 4Ds were calculated. The mean 2D : 4D values were 0.964 ± 0.024 vs. 0.978 ± 0.032 (p = 0.004) for the right hand and 0.966 ± 0.023 vs. 0.979 ± 0.032 (p = 0.006) for the left hand in lifelong premature ejaculation and control groups, respectively. Significant correlations were observed between the digit ratios and self-estimated intravaginal ejaculatory latency time (r = 0.258, p = 0.003 for right hand; r = 0.240, p = 0.06 for left hand), and between the digit ratios and total Premature Ejaculation Diagnostic Tool scores (r = -0.263, p = 0.003 for right hand; r = -0.238, p = 0.06 for left hand). Individuals with lower digit ratios have higher risks of shorter intravaginal ejaculatory latency times. These results suggest that increased fetal androgen exposure may be a new risk factor for the development of lifelong premature ejaculation.

  6. Premature ejaculation

    MedlinePlus

    ... he is about to reach orgasm. Stop the stimulation for about 30 seconds and then start it ... man wants to ejaculate. The last time, continue stimulation until the man reaches orgasm. The "squeeze" method: ...

  7. The effects of three phosphodiesterase type 5 inhibitors on ejaculation latency time in lifelong premature ejaculators: a double-blind laboratory setting study.

    PubMed

    Gökçe, Ahmet; Halis, Fikret; Demirtas, Abdullah; Ekmekcioglu, Oguz

    2011-04-01

    Study Type--Therapy (RCT) Level of Evidence 1b. What's known on the subject? and What does the study add? Several authors have reported their experience with PDE5 inhibitors alone or in combination with selective serotonin re-uptake inhibitors for treating premature ejaculation. However, to our knowledge, this is the first laboratory design study to evaluate the effects of three PDE5 inhibitors throughout the ejaculation process in men with lifelong premature ejaculation. In this laboratory setting study PDE5 inhibitors seem to prolong ELT but the difference from placebo is significant only in vardenafil. The quality of penile rigidity is better with PDE5 inhibitors in the post-ejaculatory period but the difference is significant only in sildenafil and vardenafil. • To evaluate the effects of three phosphodiesterase type 5 (PDE5) inhibitors on the ejaculation process in men with lifelong premature ejaculation using a double-blind laboratory setting. • Eighty men with lifelong premature ejaculation, 20 in each group, received placebo, vardenafil (10 mg), sildenafil (50 mg) or tadalafil (20 mg) in a double-blind study design. Placebo or PDE5 inhibitor was ingested after at least 2 h fasting and non-smoking. The subjects were placed in a silent room immediately and real-time penile rigidity and tumescence was monitored. • Subjects read some magazines or newspapers without any sexually stimulating material for 1.5 h. At the end of this period audiovisual sexual stimulation began with a video film and after the 8th minute the subject began vibratory stimulation to the frenular area. • At the beginning of ejaculation the patient stopped stimulation. When the patient began and stopped stimulation, the light near the observer turned on and off and the observer calculated the ejaculation period with a chronometer. The elapsed time was the ejaculation latency time (ELT) in seconds. • There was no interaction between subjects and observer during the test. The ELT

  8. An evidence-based unified definition of lifelong and acquired premature ejaculation: report of the second international society for sexual medicine ad hoc committee for the definition of premature ejaculation.

    PubMed

    Serefoglu, Ege Can; McMahon, Chris G; Waldinger, Marcel D; Althof, Stanley E; Shindel, Alan; Adaikan, Ganesh; Becher, Edgardo F; Dean, John; Giuliano, Francois; Hellstrom, Wayne Jg; Giraldi, Annamaria; Glina, Sidney; Incrocci, Luca; Jannini, Emmanuele; McCabe, Marita; Parish, Sharon; Rowland, David; Segraves, R Taylor; Sharlip, Ira; Torres, Luiz Otavio

    2014-06-01

    The International Society for Sexual Medicine (ISSM) Ad Hoc Committee for the Definition of Premature Ejaculation developed the first evidence-based definition for lifelong premature ejaculation (PE) in 2007 and concluded that there were insufficient published objective data at that time to develop a definition for acquired PE. The aim of this article is to review and critique the current literature and develop a contemporary, evidence-based definition for acquired PE and/or a unified definition for both lifelong and acquired PE. In April 2013, the ISSM convened a second Ad Hoc Committee for the Definition of Premature Ejaculation in Bangalore, India. The same evidence-based systematic approach to literature search, retrieval, and evaluation used by the original committee was adopted. The committee unanimously agreed that men with lifelong and acquired PE appear to share the dimensions of short ejaculatory latency, reduced or absent perceived ejaculatory control, and the presence of negative personal consequences. Men with acquired PE are older, have higher incidences of erectile dysfunction, comorbid disease, and cardiovascular risk factors, and have a longer intravaginal ejaculation latency time (IELT) as compared with men with lifelong PE. A self-estimated or stopwatch IELT of 3 minutes was identified as a valid IELT cut-off for diagnosing acquired PE. On this basis, the committee agreed on a unified definition of both acquired and lifelong PE as a male sexual dysfunction characterized by (i) ejaculation that always or nearly always occurs prior to or within about 1 minute of vaginal penetration from the first sexual experience (lifelong PE) or a clinically significant and bothersome reduction in latency time, often to about 3 minutes or less (acquired PE); (ii) the inability to delay ejaculation on all or nearly all vaginal penetrations; and (iii) negative personal consequences, such as distress, bother, frustration, and/or the avoidance of sexual intimacy. The

  9. An Evidence-Based Unified Definition of Lifelong and Acquired Premature Ejaculation: Report of the Second International Society for Sexual Medicine Ad Hoc Committee for the Definition of Premature Ejaculation

    PubMed Central

    Serefoglu, Ege Can; McMahon, Chris G; Waldinger, Marcel D; Althof, Stanley E; Shindel, Alan; Adaikan, Ganesh; Becher, Edgardo F; Dean, John; Giuliano, Francois; Hellstrom, Wayne JG; Giraldi, Annamaria; Glina, Sidney; Incrocci, Luca; Jannini, Emmanuele; McCabe, Marita; Parish, Sharon; Rowland, David; Segraves, R Taylor; Sharlip, Ira; Torres, Luiz Otavio

    2014-01-01

    Introduction The International Society for Sexual Medicine (ISSM) Ad Hoc Committee for the Definition of Premature Ejaculation developed the first evidence-based definition for lifelong premature ejaculation (PE) in 2007 and concluded that there were insufficient published objective data at that time to develop a definition for acquired PE. Aim The aim of this article is to review and critique the current literature and develop a contemporary, evidence-based definition for acquired PE and/or a unified definition for both lifelong and acquired PE. Methods In April 2013, the ISSM convened a second Ad Hoc Committee for the Definition of Premature Ejaculation in Bangalore, India. The same evidence-based systematic approach to literature search, retrieval, and evaluation used by the original committee was adopted. Results The committee unanimously agreed that men with lifelong and acquired PE appear to share the dimensions of short ejaculatory latency, reduced or absent perceived ejaculatory control, and the presence of negative personal consequences. Men with acquired PE are older, have higher incidences of erectile dysfunction, comorbid disease, and cardiovascular risk factors, and have a longer intravaginal ejaculation latency time (IELT) as compared with men with lifelong PE. A self-estimated or stopwatch IELT of 3 minutes was identified as a valid IELT cut-off for diagnosing acquired PE. On this basis, the committee agreed on a unified definition of both acquired and lifelong PE as a male sexual dysfunction characterized by (i) ejaculation that always or nearly always occurs prior to or within about 1 minute of vaginal penetration from the first sexual experience (lifelong PE) or a clinically significant and bothersome reduction in latency time, often to about 3 minutes or less (acquired PE); (ii) the inability to delay ejaculation on all or nearly all vaginal penetrations; and (iii) negative personal consequences, such as distress, bother, frustration, and/or the

  10. The mathematical formula of the intravaginal ejaculation latency time (IELT) distribution of lifelong premature ejaculation differs from the IELT distribution formula of men in the general male population

    PubMed Central

    Janssen, Paddy K.C.

    2016-01-01

    Purpose To find the most accurate mathematical description of the intravaginal ejaculation latency time (IELT) distribution in the general male population. Materials and Methods We compared the fitness of various well-known mathematical distributions with the IELT distribution of two previously published stopwatch studies of the Caucasian general male population and a stopwatch study of Dutch Caucasian men with lifelong premature ejaculation (PE). The accuracy of fitness is expressed by the Goodness of Fit (GOF). The smaller the GOF, the more accurate is the fitness. Results The 3 IELT distributions are gamma distributions, but the IELT distribution of lifelong PE is another gamma distribution than the IELT distribution of men in the general male population. The Lognormal distribution of the gamma distributions most accurately fits the IELT distribution of 965 men in the general population, with a GOF of 0.057. The Gumbel Max distribution most accurately fits the IELT distribution of 110 men with lifelong PE with a GOF of 0.179. There are more men with lifelong PE ejaculating within 30 and 60 seconds than can be extrapolated from the probability density curve of the Lognormal IELT distribution of men in the general population. Conclusions Men with lifelong PE have a distinct IELT distribution, e.g., a Gumbel Max IELT distribution, that can only be retrieved from the general male population Lognormal IELT distribution when thousands of men would participate in a IELT stopwatch study. The mathematical formula of the Lognormal IELT distribution is useful for epidemiological research of the IELT. PMID:26981594

  11. On-demand d-modafinil may be an effective treatment option for lifelong premature ejaculation: a case report.

    PubMed

    Serefoglu, E C

    2016-02-01

    Premature ejaculation (PE) is considered to be the most common form of male sexual dysfunction. Given that acute oral administration of d-isomer of modafinil (d-modafinil) can extend the latency to ejaculation in rats without suppressing sexual behaviour, the effects of on-demand d-modafinil treatment were examined on a 30-year-old male patient with lifelong PE. The patient was instructed to take d-modafinil 100 mg 3 h prior to the sexual relation for four times and was invited for a control visit. The patient was re-evaluated 2 weeks later. He reported that his IELT increased to 15 min. He reported heartburn and insomnia when he used d-modafinil for the first time; however, these symptoms were transient and did not recur after the initial dose. Overall, he reported considerable improvement and noted that he feels much better with the treatment. Based on this limited data, on-demand d-modafinil seems to be an effective treatment for men with lifelong PE. The side effects were transient and mild in the reported case. Further randomised clinical trials are necessary to elucidate the therapeutic concept of this drug in patients with lifelong PE.

  12. Serotonin Transporter Promoter Region (5-HTTLPR) Polymorphism Is Not Associated With Paroxetine-Induced Ejaculation Delay in Dutch Men With Lifelong Premature Ejaculation

    PubMed Central

    Janssen, Paddy K.C.; Zwinderman, Aeilko H.; Olivier, Berend

    2014-01-01

    Purpose To investigate the association between the 5-HT-transporter-gene-linked promoter region (5-HTTLPR) polymorphism and 20-mg paroxetine-induced ejaculation delay in men with lifelong premature ejaculation (LPE). Materials and Methods This was a prospective study of 10 weeks of paroxetine treatment in 54 men with LPE. Intravaginal ejaculation latency time (IELT) was measured by stopwatch. Controls consisted of 92 Caucasian men. All men with LPE were genotyped for the 5-HTTLPR polymorphism. Allele frequencies and genotypes of short (S) and long (L) variants of the polymorphism were compared between patients and controls. Associations between the LL, SL, and SS genotypes and fold increase of mean IELT were investigated. Results Of the 54 patients, 43 (79.6%) responded to 20-mg paroxetine treatment with an ejaculation delay, whereas 11 patients (20.4%) did not respond; 44%, 18%, and 18% of the patients showed a fold increase in mean IELT of 2-10, 10-20, and more than 20, respectively. Of the 54 men, 14 (25.9%) had the LL genotype, 29 (53.7%) had the SL genotype, and 11 (20.4%) had the SS genotype. In the 92 controls, the LL, SL, and SS genotypes were present in 27 (29.3%), 41 (44.6%), and 24 (26.1%), respectively. No statistically significant differences were found in 5-HTTLPR allelic variations or in 5-HTTLPR gene variations. In all men treated with 20 mg paroxetine, analysis of variance of the natural logarithm of fold increase in the IELT showed no statistically significant difference according to genotype (p=0.83). Conclusions The 5-HTTLPR polymorphism is not associated with daily 20-mg paroxetine treatment-induced ejaculation delay in men with LPE. PMID:24578810

  13. An evidence-based unified definition of lifelong and acquired premature ejaculation: report of the second International Society for Sexual Medicine Ad Hoc Committee for the Definition of Premature Ejaculation.

    PubMed

    Serefoglu, Ege Can; McMahon, Chris G; Waldinger, Marcel D; Althof, Stanley E; Shindel, Alan; Adaikan, Ganesh; Becher, Edgardo F; Dean, John; Giuliano, Francois; Hellstrom, Wayne J G; Giraldi, Annamaria; Glina, Sidney; Incrocci, Luca; Jannini, Emmanuele; McCabe, Marita; Parish, Sharon; Rowland, David; Segraves, R Taylor; Sharlip, Ira; Torres, Luiz Otavio

    2014-06-01

    The International Society for Sexual Medicine (ISSM) Ad Hoc Committee for the Definition of Premature Ejaculation developed the first evidence-based definition for lifelong premature ejaculation (PE) in 2007 and concluded that there were insufficient published objective data at that time to develop a definition for acquired PE. The aim of this article is to review and critique the current literature and develop a contemporary, evidence-based definition for acquired PE and/or a unified definition for both lifelong and acquired PE. In April 2013, the ISSM convened a second Ad Hoc Committee for the Definition of Premature Ejaculation in Bangalore, India. The same evidence-based systematic approach to literature search, retrieval, and evaluation used by the original committee was adopted. The committee unanimously agreed that men with lifelong and acquired PE appear to share the dimensions of short ejaculatory latency, reduced or absent perceived ejaculatory control, and the presence of negative personal consequences. Men with acquired PE are older, have higher incidences of erectile dysfunction, comorbid disease, and cardiovascular risk factors, and have a longer intravaginal ejaculation latency time (IELT) as compared with men with lifelong PE. A self-estimated or stopwatch IELT of 3 minutes was identified as a valid IELT cut-off for diagnosing acquired PE. On this basis, the committee agreed on a unified definition of both acquired and lifelong PE as a male sexual dysfunction characterized by (i) ejaculation that always or nearly always occurs prior to or within about 1 minute of vaginal penetration from the first sexual experience (lifelong PE) or a clinically significant and bothersome reduction in latency time, often to about 3 minutes or less (acquired PE); (ii) the inability to delay ejaculation on all or nearly all vaginal penetrations; and (iii) negative personal consequences, such as distress, bother, frustration, and/or the avoidance of sexual intimacy. The

  14. Dapoxetine: in premature ejaculation.

    PubMed

    Hoy, Sheridan M; Scott, Lesley J

    2010-07-30

    Dapoxetine, a selective serotonin reuptake inhibitor, is the first oral pharmacological agent indicated for the treatment of men aged 18-64 years with premature ejaculation. In four randomized, double-blind, placebo-controlled, multicentre studies of 12-24 weeks' duration, oral dapoxetine 30 or 60 mg (administered as needed) was effective in the treatment of men with premature ejaculation, inducing significantly (p < 0.001) greater improvements from baseline than placebo in the primary efficacy endpoint (mean intravaginal ejaculatory latency time [IELT] or mean average IELT [defined as the average of IELT values over the previous 4 weeks], as measured by the female partner utilizing a stopwatch). For the most part, dapoxetine recipients achieved significantly better outcomes than placebo recipients with regard to the secondary endpoints, including the Premature Ejaculation Profile (PEP) domains and the Clinical Global Impression or Patient Global Impression ratings of change in premature ejaculation, across these clinical studies. The beneficial effects of dapoxetine therapy on the perceived control over ejaculation and satisfaction with sexual intercourse PEP domains were sustained in a 9-month noncomparative extension phase of two identical 12-week, double-blind studies. Oral dapoxetine therapy for up to 12 months was generally well tolerated in men with premature ejaculation, with the nature of treatment-emergent adverse events generally similar across the clinical studies and between dapoxetine and placebo.

  15. [Ejaculatory disorders except premature ejaculation, orgasmic disorders].

    PubMed

    Rigot, J-M; Marcelli, F; Giuliano, F

    2013-07-01

    Disorders of ejaculation and orgasm apart from premature ejaculation are pretty uncommon. Medical literature was reviewed and combined with expert opinion of the authors. The semiology of these disorders is essential: aspermia, hypospermia, retrograde ejaculation, delayed or absent ejaculation with or without orgasm. Whether this is a lifelong or acquired condition, it is essential to assess the side-effects of medications i.e. psychotropic drugs, including antidepressant, neuroleptics, tramadol, alphablockers: tamsulosin and silodosin must always be surveyed. The management is often difficult, especially with a parenthood perspective. The management of lifelong disorders must rely on psychosexual therapies. Copyright © 2013 Elsevier Masson SAS. All rights reserved.

  16. Premature ejaculation: A review

    PubMed Central

    Gajjala, Sukumar Reddy; Khalidi, Azheel

    2014-01-01

    Premature ejaculation (PE) is a common male sexual disorder. It is defined by the Diagnostic and statistical manual of mental disorders as “ejaculation occurring, without control, on or shortly after penetration and before the person wishes it, causing marked distress or interpersonal difficulty.[1] Although the timing of intravaginal ejaculatory latency time (IELT) (i.e., time from penetration to ejaculation) is not included in this definition, an IELT of <2 min, or ejaculation occurring before penetration, has been considered consistent with PE.[2] Management involves both the patient and his partner. Therapeutic options should suit both partners and be appropriate to their habit in planning and frequency of intercourse. Follow-up at appropriate intervals to judge efficacy, titrate dosage of pharmacological treatments and ascertain side effects is mandatory. PMID:26396440

  17. Effects of paroxetine on intravaginal ejaculatory latency time in Egyptian patients with lifelong premature ejaculation as a function of serotonin transporter polymorphism.

    PubMed

    Salem, A M; Kamel, I I; Rashed, L A; GamalEl Din, S F

    2017-01-01

    Premature ejaculation (PE) is a common ejaculatory complaint. The estimated rates among Turkish men reached 20%, although the severest type of PE (lifelong PE) usually does not exceed 2.3%. This could be seen in line with two survey studies involving five nations. They revealed that 2.5% of men had an intravaginal ejaculation latency time of <1 min and 6% of <2 min. Rapid ejaculation may be treated pharmacologically with a variety of different medications that act either centrally or locally to delay ejaculation and subsequent orgasm. Antidepressants, particularly members of the selective serotonin reuptake inhibitor class, retard ejaculation significantly. Recently, it was postulated that men with lifelong PE might result from a combination of polymorphisms of the serotonergic transporter and receptors, and other neurotransmitters and/or receptors. Our findings augment the significant effect of paroxetine in delaying ejaculation in the responders (P<0.001). Meanwhile, the findings do not suggest a positive association between such response and serotonin transporter gene promoter polymorphism.

  18. In vitro measurement of ejaculation latency time (ELT) and the effects of vardenafil on ELT on lifelong premature ejaculators: placebo-controlled, double-blind, cross-over laboratory setting.

    PubMed

    Gökçe, Ahmet; Demirtas, Abdullah; Halis, Fikret; Ekmekcioglu, Oguz

    2010-12-01

    The aim of this study is to measure the ejaculation latency time (ELT) and to evaluate the effects of vardenafil on ELT and rigidity parameters of patients with lifelong premature ejaculation (PE) in a laboratory setting. Double-blind, placebo-controlled, cross-over laboratory study was performed with 40 males with lifelong PE. As the subject ingested the placebo or vardenafil, real-time penile tumescence and rigidity monitoring began. Audiovisual sexual stimulation (AVSS) was performed 45 min later. The patient began vibratory stimulation to the frenular area at 8th minute of AVSS till ejaculation. A button has been placed under the cover where the patient presses to operate the vibrator. ELT was calculated in seconds with a chronometer. Following ejaculation, AVSS was stopped. The test was repeated with second medication in 7-15 days. Among 40 patients, the results of 17 could be evaluated. When the patient took placebo and vardenafil, mean ELTs were 62.7 and 189.5 s, respectively. When compared with placebo, vardenafil improved ELT significantly (P = 0.04). After the beginning of AVSS, time to first recorded base or tip rigidities was shorter and time to last recorded tip or base rigidities following ejaculation was longer than placebo; however, these differences were not significant (P > 0.05 for each). This laboratory design might be used to evaluate the effects of drugs on patients with ejaculation disorders. In this laboratory setting study, vardenafil exerted a threefold increase in ejaculation delay outside the vagina in patients with lifelong PE.

  19. Advances in treating premature ejaculation

    PubMed Central

    Şerefoğlu, Ege Can

    2014-01-01

    In spite of its high prevalence and long history, the ambiguity regarding the definition, epidemiology and management of premature ejaculation continues. Topical anesthetic creams and daily or on-demand selective serotonin reuptake inhibitor (SSRI) treatment forms the basis of pharmacotherapy for premature ejaculation today, in spite of low adherence by patients. Psychotherapy may improve the outcomes when combined with these treatment modalities. Tramadol and phosphodiesterase type 5 inhibitors have a limited role in the management of premature ejaculation. Further research is required to develop better options for the treatment of this common sexual disorder. PMID:25184045

  20. Psychosexual therapy for premature ejaculation.

    PubMed

    Althof, Stanley E

    2016-08-01

    Premature ejaculation (PE) is a male sexual dysfunction that creates considerable anguish for the man, his partner and their relationship. PE is not one disorder but includes the four subtypes (lifelong, acquired, natural and subjective) each with unique psychological concerns and issues. Psychological treatment for men and couples with PE addresses sexual skills/techniques but also focuses on issues of self-esteem, performance anxiety and interpersonal conflict. The outcome studies for psychotherapy alone are difficult to interpret and compare because of poor methodological design (lack of control groups, small sample size, poor outcome measures and lack of follow-up). However, the few studies that surmount these methodological hurdles suggest that psychological intervention offers men and couples a promising treatment option. Combination pharmaco- and psychotherapy is the most promising intervention for lifelong and acquired PE and offers superior efficacy to drug alone. This is because men and couples learn sexual skills, address the intrapsychic, interpersonal and cognitive issues that precipitate and maintain the dysfunction.

  1. Psychosexual therapy for premature ejaculation

    PubMed Central

    2016-01-01

    Premature ejaculation (PE) is a male sexual dysfunction that creates considerable anguish for the man, his partner and their relationship. PE is not one disorder but includes the four subtypes (lifelong, acquired, natural and subjective) each with unique psychological concerns and issues. Psychological treatment for men and couples with PE addresses sexual skills/techniques but also focuses on issues of self-esteem, performance anxiety and interpersonal conflict. The outcome studies for psychotherapy alone are difficult to interpret and compare because of poor methodological design (lack of control groups, small sample size, poor outcome measures and lack of follow-up). However, the few studies that surmount these methodological hurdles suggest that psychological intervention offers men and couples a promising treatment option. Combination pharmaco- and psychotherapy is the most promising intervention for lifelong and acquired PE and offers superior efficacy to drug alone. This is because men and couples learn sexual skills, address the intrapsychic, interpersonal and cognitive issues that precipitate and maintain the dysfunction. PMID:27652220

  2. Association of STin2 Variable Number of Tandem Repeat (VNTR) Polymorphism of Serotonin Transporter Gene with Lifelong Premature Ejaculation: A Case-Control Study in Han Chinese Subjects

    PubMed Central

    Huang, Yuanyuan; Zhang, Xiansheng; Gao, Jingjing; Tang, Dongdong; Gao, Pan; Peng, Dangwei; Liang, Chaozhao

    2016-01-01

    Background The STin2 VNTR polymorphism has a variable number of tandem repeats in intron 2 of the serotonin transporter gene. We aimed to explore the relationship between STin2 VNTR polymorphism and lifelong premature ejaculation (LPE). Material/Methods We recruited a total of 115 outpatients who complained of ejaculating prematurely and who were diagnosed as LPE, and 101 controls without PE complaint. Allelic variations of STin2 VNTR were genotyped using PCR-based technology. We evaluated the associations between STin2 VNTR allelic and genotypic frequencies and LPE, as well as the intravaginal ejaculation latency time (IELT) of different STin2 VNTR genotypes among LPE patients. Results The patients and controls did not differ significantly in terms of any characteristic except age. A significantly higher frequency of STin2.12/12 genotype was found among LPE patients versus controls (P=0.026). Frequency of patients carrying at least 1 copy of the 10-repeat allele was significantly lower compared to the control group (28.3% vs. 41.8%, OR=0.55; 95%CI=0.31–0.97, P=0.040). In the LPE group, the mean IELT showed significant difference in STin2.12/12 genotype when compared to those with STin2.12/10 and STin2.10/10 genotypes. The mean IELT in10-repeat allele carriers was 50% longer compared to homozygous carriers of the STin2.12 allele. Conclusions Our results indicate the presence of STin2.10 allele is a protective factor for LPE. Men carrying the higher expression genotype STin2. 12/12 have shorter IELT than 10-repeat allele carriers. PMID:27713390

  3. Association of STin2 VNTR Polymorphism of Serotonin Transporter Gene with Lifelong Premature Ejaculation: A Case-Control Study in Han Chinese Subjects.

    PubMed

    Huang, Yuanyuan; Zhang, Xiansheng; Gao, Jingjing; Tang, Dongdong; Gao, Pan; Peng, Dangwei; Liang, Chaozhao

    2016-10-07

    BACKGROUND The STin2 VNTR polymorphism has a variable number of tandem repeats in intron 2 of the serotonin transporter gene. We aimed to explore the relationship between STin2 VNTR polymorphism and lifelong premature ejaculation (LPE). MATERIAL AND METHODS We recruited a total of 115 outpatients who complained of ejaculating prematurely and who were diagnosed as LPE, and 101 controls without PE complaint. Allelic variations of STin2 VNTR were genotyped using PCR-based technology. We evaluated the associations between STin2 VNTR allelic and genotypic frequencies and LPE, as well as the intravaginal ejaculation latency time (IELT) of different STin2 VNTR genotypes among LPE patients. RESULTS The patients and controls did not differ significantly in terms of any characteristic except age. A significantly higher frequency of STin2.12/12 genotype was found among LPE patients versus controls (P=0.026). Frequency of patients carrying at least 1 copy of the 10-repeat allele was significantly lower compared to the control group (28.3% vs. 41.8%, OR=0.55; 95%CI=0.31-0.97, P=0.040). In the LPE group, the mean IELT showed significant difference in STin2.12/12 genotype when compared to those with STin2.12/10 and STin2.10/10 genotypes. The mean IELT in10-repeat allele carriers was 50% longer compared to homozygous carriers of the STin2.12 allele. CONCLUSIONS Our results indicate the presence of STin2.10 allele is a protective factor for LPE. Men carrying the higher expression genotype STin2. 12/12 have shorter IELT than 10-repeat allele carriers.

  4. Study of the link between dopamine transporter gene polymorphisms and response to paroxetin and escitalopram in patients with lifelong premature ejaculation.

    PubMed

    Eltonsi, T K; Tawfik, T M; Rashed, L A; GamalEl Din, S F; Mahmoud, M A

    2017-09-14

    We evaluated the role of dopamine (DA) transporter gene polymorphism in lifelong premature ejaculation (LPE) and its role in determining the response to paroxetine and escitalopram. Eighty consecutive patients and controls were recruited. Sixty of them suffered from LPE. They were divided into two equal groups. One group received paroxetine 20 mg daily for 3 months and the other one received ecistalopram 20 mg daily for 3 months. Their wives were instructed to measure the intra-vaginal ejaculation latency time using stopwatch. Five milliliters of blood was withdrawn from patients and controls for PCR analysis. The present study revealed that the mean ages of the patients and controls were 41.42 and 36.4 years, respectively. The majority of the patients were of (10R/10R) genotypes of the DA transporter gene polymorphism, whereas the controls were of (6R/6R) genotypes and this revealed statistically significant result (P-value=0.001). Both paroxitine and escitalopram significantly delayed ejaculation in the responders (P-values=0.001 and 0.001, respectively). The study revealed significant association between such response and DA transporter gene polymorphism (P-values of fold increase and log FI were 0.019 and 0.010, respectively). To the best of our knowledge, this is the first report to demonstrate a highly significant association between such response and DA transporter gene polymorphism in patients with LPE.International Journal of Impotence Research advance online publication, 14 September 2017; doi:10.1038/ijir.2017.29.

  5. The pathophysiology of acquired premature ejaculation.

    PubMed

    McMahon, Chris G; Jannini, Emmanuele A; Serefoglu, Ege C; Hellstrom, Wayne J G

    2016-08-01

    The second Ad Hoc International Society for Sexual Medicine (ISSM) Committee for the Definition of Premature Ejaculation defined acquired premature ejaculation (PE) as a male sexual dysfunction characterized by a the development of a clinically significant and bothersome reduction in ejaculation latency time in men with previous normal ejaculatory experiences, often to about 3 minutes or less, the inability to delay ejaculation on all or nearly all vaginal penetrations, and the presence of negative personal consequences, such as distress, bother, frustration and/or the avoidance of sexual intimacy. The literature contains a diverse range of biological and psychological etiological theories. Acquired PE is commonly due to sexual performance anxiety, psychological or relationship problems, erectile dysfunction (ED), and occasionally prostatitis and hyperthyroidism, consistent with the predominant organic etiology of acquired PE, men with this complaint are usually older, have a higher mean BMI and a greater incidence of comorbid disease including hypertension, sexual desire disorder, diabetes mellitus, chronic prostatitis, and ED compared to lifelong, variable and subjective PE.

  6. The pathophysiology of acquired premature ejaculation

    PubMed Central

    Jannini, Emmanuele A.; Serefoglu, Ege C.; Hellstrom, Wayne J. G.

    2016-01-01

    The second Ad Hoc International Society for Sexual Medicine (ISSM) Committee for the Definition of Premature Ejaculation defined acquired premature ejaculation (PE) as a male sexual dysfunction characterized by a the development of a clinically significant and bothersome reduction in ejaculation latency time in men with previous normal ejaculatory experiences, often to about 3 minutes or less, the inability to delay ejaculation on all or nearly all vaginal penetrations, and the presence of negative personal consequences, such as distress, bother, frustration and/or the avoidance of sexual intimacy. The literature contains a diverse range of biological and psychological etiological theories. Acquired PE is commonly due to sexual performance anxiety, psychological or relationship problems, erectile dysfunction (ED), and occasionally prostatitis and hyperthyroidism, consistent with the predominant organic etiology of acquired PE, men with this complaint are usually older, have a higher mean BMI and a greater incidence of comorbid disease including hypertension, sexual desire disorder, diabetes mellitus, chronic prostatitis, and ED compared to lifelong, variable and subjective PE. PMID:27652216

  7. The drug treatment of premature ejaculation

    PubMed Central

    2016-01-01

    The management recommendation for both acquired premature ejaculation (APE) and lifelong PE (LPE) are similar, such as a behavioral/psychotherapy, a pharmacotherapy and a combination of these treatments. For the drug treatment for PE, gold standard is selective serotonin reuptake inhibitors (SSRIs) including dapoxetine or paroxetine. The drug treatment for PE is still developing and some new promising therapeutic options have been proposed. Topical anesthetics, tramadol, and alpha-1 blockers will be the next strategies of the drug treatment for PE in the future. PMID:27652221

  8. The drug treatment of premature ejaculation.

    PubMed

    Hisasue, Shin-Ichi

    2016-08-01

    The management recommendation for both acquired premature ejaculation (APE) and lifelong PE (LPE) are similar, such as a behavioral/psychotherapy, a pharmacotherapy and a combination of these treatments. For the drug treatment for PE, gold standard is selective serotonin reuptake inhibitors (SSRIs) including dapoxetine or paroxetine. The drug treatment for PE is still developing and some new promising therapeutic options have been proposed. Topical anesthetics, tramadol, and alpha-1 blockers will be the next strategies of the drug treatment for PE in the future.

  9. Impact of physical activity on patient self-reported outcomes of lifelong premature ejaculation patients: Results of a prospective, randomised, sham-controlled trial.

    PubMed

    Kilinc, M F; Aydogmus, Y; Yildiz, Y; Doluoglu, O G

    2017-03-06

    Previous studies have investigated whether physical activity increases serotonin hormone levels. Serotonin receptor dysfunction is one of the frequently accused factors of premature ejaculation (PE). Nevertheless, no studies up to date have demonstrated that the association between physical activity and premature ejaculation. We aimed to investigate the relationship between physical activity and PE and determine whether moderate physical activity might delay ejaculation time or be an alternative treatment for PE. A total of 105 patients diagnosed with PE were enrolled in this study. Of the patients, 35 were treated with dapoxetine, (30 mg) on demand (Group 1), 35 performed moderate physical activities (Group 2), and 35 performed minimal physical activity (Group 3-sham). Demographic characteristics, metabolic equivalents (MET), premature ejaculation diagnostic tool (PEDT) and intravaginal ejaculatory latency time (IELT) were recorded. There were no significant differences among three groups in terms of age, BMI, MET, PEDT or IELT before treatment. At the end of the study, there was significant decrease in PEDT scores, and increase in IELT in groups 1 and 2 as compared to Group 3. In conclusion, a moderate physical activity longer than 30 min at least 5 times a week leads to ejaculation delay, and appears as an alternative to dapoxetine on demand for the treatment of PE.

  10. [Premature ejaculation: pills or sexology?].

    PubMed

    Wisard, M; Audette, N

    2008-03-26

    Premature ejaculation (PE) is a frequent male sexual complaint that affects 20 to 30% of men. The exact aetiology is unknown: psychological/behavioristic and biogenic etiologies have been proposed. The introduction of selective serotonin reuptake inhibitors (SSRI) was revolutionary in the medical treatment of PE. However precautions should be taken because of potential adverse side effects. There is no clear consensus as to whether SSRI may represent an eventual cure of PE or will be required for life. The sexocorporal approach is an other treatment of PE, but convincing scientific treatment data are also lacking.

  11. Current therapies for premature ejaculation.

    PubMed

    Gur, Serap; Kadowitz, Philip J; Sikka, Suresh C

    2016-07-01

    Premature ejaculation (PE) subjectively affects 20-30% of men globally. Until recently, understanding of PE was hampered by the absence of a widely accepted definition, paucity of evidence-based clinical studies, and the absence of an appropriate animal model. Here, we elaborate on the current definition of PE, its pathogenesis, currently available therapies, and future treatment prospects. Most treatments for PE are 'off-label' and include selective serotonin reuptake inhibitors (SSRIs), topical anesthetics, tramadol, and phosphodiesterase type 5 (PDE5) inhibitors. Such knowledge of the benefit and limitations of each treatment will help to direct future drug design and formulations.

  12. Emerging and investigational drugs for premature ejaculation

    PubMed Central

    2016-01-01

    Over the past 20−30 years, the premature ejaculation (PE) treatment paradigm, previously limited to behavioural psychotherapy, has expanded to include drug treatment. Pharmacotherapy for PE predominantly targets the multiple neurotransmitters and receptors involved in the control of ejaculation which include serotonin, dopamine, oxytocin, norepinephrine, gamma amino-butyric acid (GABA) and nitric oxide (NO). The objective of this article is to review emerging PE interventions contemporary data on the treatment of PE was reviewed and critiqued using the principles of evidence-based medicine. Multiple well-controlled evidence-based studies have demonstrated the efficacy and safety of selective serotonin reuptake inhibitors (SSRIs) in delaying ejaculation, confirming their role as first-line agents for the medical treatment of lifelong and acquired PE. Daily dosing of SSRIs is likely to be associated with superior fold increases in IELT compared to on-demand SSRIs. On-demand SSRIs are less effective but may fulfill the treatment goals of many patients. Integrated pharmacotherapy and CBT may achieve superior treatment outcomes in some patients. PDE-5 inhibitors alone or in combination with SSRIs should be limited to men with acquired PE secondary to co-morbid ED. New on-demand rapid acting SSRIs, oxytocin receptor antagonists, or single agents that target multiple receptors may form the foundation of more effective future on-demand medication. Current evidence confirms the efficacy and safety of dapoxetine, off-label SSRI drugs, tramadol and topical anaesthetics drugs. Treatment with α1-adrenoceptor antagonists cannot be recommended until the results of large well-designed RCTs are published in major international peer-reviewed medical journals. As our understanding of the neurochemical control of ejaculation improves, new therapeutic targets and candidate molecules will be identified which may increase our pharmacotherapeutic armamentarium. PMID:27652222

  13. Emerging and investigational drugs for premature ejaculation.

    PubMed

    McMahon, Chris G

    2016-08-01

    Over the past 20-30 years, the premature ejaculation (PE) treatment paradigm, previously limited to behavioural psychotherapy, has expanded to include drug treatment. Pharmacotherapy for PE predominantly targets the multiple neurotransmitters and receptors involved in the control of ejaculation which include serotonin, dopamine, oxytocin, norepinephrine, gamma amino-butyric acid (GABA) and nitric oxide (NO). The objective of this article is to review emerging PE interventions contemporary data on the treatment of PE was reviewed and critiqued using the principles of evidence-based medicine. Multiple well-controlled evidence-based studies have demonstrated the efficacy and safety of selective serotonin reuptake inhibitors (SSRIs) in delaying ejaculation, confirming their role as first-line agents for the medical treatment of lifelong and acquired PE. Daily dosing of SSRIs is likely to be associated with superior fold increases in IELT compared to on-demand SSRIs. On-demand SSRIs are less effective but may fulfill the treatment goals of many patients. Integrated pharmacotherapy and CBT may achieve superior treatment outcomes in some patients. PDE-5 inhibitors alone or in combination with SSRIs should be limited to men with acquired PE secondary to co-morbid ED. New on-demand rapid acting SSRIs, oxytocin receptor antagonists, or single agents that target multiple receptors may form the foundation of more effective future on-demand medication. Current evidence confirms the efficacy and safety of dapoxetine, off-label SSRI drugs, tramadol and topical anaesthetics drugs. Treatment with α1-adrenoceptor antagonists cannot be recommended until the results of large well-designed RCTs are published in major international peer-reviewed medical journals. As our understanding of the neurochemical control of ejaculation improves, new therapeutic targets and candidate molecules will be identified which may increase our pharmacotherapeutic armamentarium.

  14. The epidemiology of premature ejaculation

    PubMed Central

    Saitz, Theodore Robert

    2016-01-01

    Vast advances have occurred over the past decade with regards to understanding the epidemiology, pathophysiology and management of premature ejaculation (PE); however, we still have much to learn about this common sexual problem. As a standardized evidence-based definition of PE has only recently been established, the reported prevalence rates of PE prior to this definition have been difficult to interpret. As a result, a large range of conflicting prevalence rates have been reported. In addition to the lack of a standardized definition and operational criteria, the method of recruitment for study participation and method of data collection have obviously contributed to the broad range of reported prevalence rates. The new criteria and classification of PE will allow for continued research into the diverse phenomenology, etiology and pathogenesis of the disease to be conducted. While the absolute pathophysiology and true prevalence of PE remains unclear, developing a better understanding of the true prevalence of the disease will allow for the completion of more accurate analysis and treatment of the disease. PMID:27652213

  15. The epidemiology of premature ejaculation.

    PubMed

    Saitz, Theodore Robert; Serefoglu, Ege Can

    2016-08-01

    Vast advances have occurred over the past decade with regards to understanding the epidemiology, pathophysiology and management of premature ejaculation (PE); however, we still have much to learn about this common sexual problem. As a standardized evidence-based definition of PE has only recently been established, the reported prevalence rates of PE prior to this definition have been difficult to interpret. As a result, a large range of conflicting prevalence rates have been reported. In addition to the lack of a standardized definition and operational criteria, the method of recruitment for study participation and method of data collection have obviously contributed to the broad range of reported prevalence rates. The new criteria and classification of PE will allow for continued research into the diverse phenomenology, etiology and pathogenesis of the disease to be conducted. While the absolute pathophysiology and true prevalence of PE remains unclear, developing a better understanding of the true prevalence of the disease will allow for the completion of more accurate analysis and treatment of the disease.

  16. [Sexological intervention on premature ejaculation].

    PubMed

    San Martín Blanco, C

    2014-07-01

    Strategies, recommendations and techniques proposed by sex therapy for intervention on premature ejaculation, have represented for nearly four decades the most effective model of intervention in this sexual dysfunction, which currently is complemented by the efficacy of dapoxetine drug treatment. Clinical experience and recent studies support that combined intervention offers the best therapeutic results. In addition in sex therapy, etiologic diagnosis is obtained from the analysis of the interrelationship of the couple. Diagnostic and therapeutic intervention has to be always centered in the relationship, so the techniques and resources must be applied with the expectation of being implemented in the sexual interaction. It will therefore be the relationship that receive treatment, even if medication is used for one of the members of the couple. On the other hand, this model of intervention can be implemented by a professional with training, although not necessarily a specialist. Copyright © 2014 Elsevier España, S.L.U. y Sociedad Española de Medicina Rural y Generalista (SEMERGEN). All rights reserved.

  17. Biallelic and Triallelic 5-Hydroxytyramine Transporter Gene-Linked Polymorphic Region (5-HTTLPR) Polymorphisms and Their Relationship with Lifelong Premature Ejaculation: A Case-Control Study in a Chinese Population

    PubMed Central

    Huang, Yuanyuan; Zhang, Xiansheng; Gao, Jingjing; Tang, Dongdong; Gao, Pan; Li, Chao; Liu, Weiqun; Liang, Chaozhao

    2016-01-01

    Background This study aimed to explore the relationship between premature ejaculation (PE) and the serotonin transporter gene-linked polymorphic region (5-HTTLPR) with respect to the biallelic and triallelic classifications. Material/Methods A total of 115 outpatients who complained of ejaculating prematurely and who were diagnosed as having lifelong premature ejaculation (LPE) and 101 controls without PE complaint were recruited. All subjects completed a detailed questionnaire and were genotyped for 5-HTTLPR polymorphism using PCR-based technology. We evaluated the associations between 5-HTTLPR allelic and genotypic frequencies and their association with LPE, as well as the intravaginal ejaculation latency time (IELT) of different 5-HTTLPR genotypes among LPE patients. Results The patients and controls did not differ significantly in terms of any characteristic except age. The results showed no significant difference regarding biallelic 5-HTTLPR. According to the triallelic classification, no significant difference was found when comparing the genotypic distribution (P=0.091). However, the distribution of the S, LG, and LA alleles in the cases was significantly different from the controls (P=0.018). We found a significantly lower frequency of LA allele and higher frequency of LG allele in patients. Based on another classification by expression, we found a significantly lower frequency of the L’L’ genotype (OR=0.37; 95%CI=0.15–0.91, P=0.025) in patients with LPE. No significant association was detected between IELT of LPE and different genotypes. Conclusions Contrary to the general classification based on S/L alleles, triallelic 5-HTTLPR was associated with LPE. Triallelic 5-HTTLPR may be a promising field for genetic research in PE to avoid false-negative results in future studies. PMID:27311544

  18. Biallelic and Triallelic 5-Hydroxytyramine Transporter Gene-Linked Polymorphic Region (5- HTTLPR) Polymorphisms and Their Relationship with Lifelong Premature Ejaculation: A Case-Control Study in a Chinese Population.

    PubMed

    Huang, Yuanyuan; Zhang, Xiansheng; Gao, Jingjing; Tang, Dongdong; Gao, Pan; Li, Chao; Liu, Weiqun; Liang, Chaozhao

    2016-06-17

    BACKGROUND This study aimed to explore the relationship between premature ejaculation (PE) and the serotonin transporter gene-linked polymorphic region (5-HTTLPR) with respect to the biallelic and triallelic classifications. MATERIAL AND METHODS A total of 115 outpatients who complained of ejaculating prematurely and who were diagnosed as having lifelong premature ejaculation (LPE) and 101 controls without PE complaint were recruited. All subjects completed a detailed questionnaire and were genotyped for 5-HTTLPR polymorphism using PCR-based technology. We evaluated the associations between 5-HTTLPR allelic and genotypic frequencies and their association with LPE, as well as the intravaginal ejaculation latency time (IELT) of different 5-HTTLPR genotypes among LPE patients. RESULTS The patients and controls did not differ significantly in terms of any characteristic except age. The results showed no significant difference regarding biallelic 5-HTTLPR. According to the triallelic classification, no significant difference was found when comparing the genotypic distribution (P=0.091). However, the distribution of the S, LG, and LA alleles in the cases was significantly different from the controls (P=0.018). We found a significantly lower frequency of LA allele and higher frequency of LG allele in patients. Based on another classification by expression, we found a significantly lower frequency of the L'L' genotype (OR=0.37; 95%CI=0.15-0.91, P=0.025) in patients with LPE. No significant association was detected between IELT of LPE and different genotypes. CONCLUSIONS Contrary to the general classification based on S/L alleles, triallelic 5-HTTLPR was associated with LPE. Triallelic 5-HTTLPR may be a promising field for genetic research in PE to avoid false-negative results in future studies.

  19. [A confrontation between premature ejaculation and difficult ejaculation].

    PubMed

    Del Noce, Giorgio; Abraham, Georges

    2010-03-24

    In all current classification of ejaculatory incompetence, premature ejaculation and male anorgasmia are always considered as two opposite clinical disturbances. Nevertheless, any attempt to investigate some possible similarities in their respective pathogenesis could considerably improve not only our understanding of these disorders, but also our therapeutic effectiveness.

  20. Rhodiola rosea, folic acid, zinc and biotin (EndEP®) is able to improve ejaculatory control in patients affected by lifelong premature ejaculation: Results from a phase I-II study

    PubMed Central

    Cai, Tommaso; Verze, Paolo; Massenio, Paolo; Tiscione, Daniele; Malossini, Gianni; Cormio, Luigi; Carrieri, Giuseppe; Mirone, Vincenzo

    2016-01-01

    The therapeutic armamentarium currently available for the treatment of premature ejaculation (PE) is not highly satisfactory. However, phytotherapeutics appear to be an interesting option for PE management. The present study aimed to evaluate the tolerability and efficacy of a phytotherapeutic combination of Rhodiola rosea, folic acid, biotin and zinc (EndEP®) in the treatment of patients affected by lifelong PE. All patients affected by lifelong PE who were attending three Urological Institutions from July to December 2014 were enrolled in this prospective, multicentre, phase I–II study. All patients were assigned to receive oral tablets of EndEP® (one tablet per day) for 90 days. Clinical and instrumental analyses were carried out at enrolment and at the end of the study. International Prostatic Symptom Score (IPSS), International Index of Erectile Function (IIEF)-15, Premature Ejaculation Diagnostic Tool (PEDT) and Short Form (SF)-36 questionnaires were used. The intravaginal ejaculation latency time (IELT) for each event was also evaluated using the stop-watch technique. The main outcome measure was the difference from baseline in PEDT questionnaire and mean IELT at the end of the follow-up period. In total, 91 patients (mean age, 32.3±5.6 years) were analysed. The baseline questionnaires mean scores were 1.1±1.6, 26.1±2.9, 15.3±3.4 and 98.2±0.5, for IPSS, IIEF-15, PEDT and SF-36, respectively. The mean IELT at baseline was 73.6±46.9s. At the follow-up examination (90 days after the start of treatment), no statistically significant differences were identified in terms of IPSS (1.4±1.5) or IIEF-15 (26.3±3.1) compared with the pre-treatment values (P=0.19 and P=0.64, respectively). A statistically significant difference was detected between the mean IELT at enrolment and after treatment (73.6±46.9 vs. 102.3±60.0; P<0.001) and SF-36 questionnaire (98.2±0.5 vs. 99.4±0.1; P<0.001). Fifty-five patients reported improvement in the control of

  1. Rhodiola rosea, folic acid, zinc and biotin (EndEP(®)) is able to improve ejaculatory control in patients affected by lifelong premature ejaculation: Results from a phase I-II study.

    PubMed

    Cai, Tommaso; Verze, Paolo; Massenio, Paolo; Tiscione, Daniele; Malossini, Gianni; Cormio, Luigi; Carrieri, Giuseppe; Mirone, Vincenzo

    2016-10-01

    The therapeutic armamentarium currently available for the treatment of premature ejaculation (PE) is not highly satisfactory. However, phytotherapeutics appear to be an interesting option for PE management. The present study aimed to evaluate the tolerability and efficacy of a phytotherapeutic combination of Rhodiola rosea, folic acid, biotin and zinc (EndEP(®)) in the treatment of patients affected by lifelong PE. All patients affected by lifelong PE who were attending three Urological Institutions from July to December 2014 were enrolled in this prospective, multicentre, phase I-II study. All patients were assigned to receive oral tablets of EndEP(®) (one tablet per day) for 90 days. Clinical and instrumental analyses were carried out at enrolment and at the end of the study. International Prostatic Symptom Score (IPSS), International Index of Erectile Function (IIEF)-15, Premature Ejaculation Diagnostic Tool (PEDT) and Short Form (SF)-36 questionnaires were used. The intravaginal ejaculation latency time (IELT) for each event was also evaluated using the stop-watch technique. The main outcome measure was the difference from baseline in PEDT questionnaire and mean IELT at the end of the follow-up period. In total, 91 patients (mean age, 32.3±5.6 years) were analysed. The baseline questionnaires mean scores were 1.1±1.6, 26.1±2.9, 15.3±3.4 and 98.2±0.5, for IPSS, IIEF-15, PEDT and SF-36, respectively. The mean IELT at baseline was 73.6±46.9s. At the follow-up examination (90 days after the start of treatment), no statistically significant differences were identified in terms of IPSS (1.4±1.5) or IIEF-15 (26.3±3.1) compared with the pre-treatment values (P=0.19 and P=0.64, respectively). A statistically significant difference was detected between the mean IELT at enrolment and after treatment (73.6±46.9 vs. 102.3±60.0; P<0.001) and SF-36 questionnaire (98.2±0.5 vs. 99.4±0.1; P<0.001). Fifty-five patients reported improvement in the control of

  2. Animal models of premature and retarded ejaculation.

    PubMed

    Waldinger, Marcel D; Olivier, Berend

    2005-06-01

    Most of our current understanding of the neurobiology of sexual behavior and ejaculatory function has been derived from animal studies using rats with normal sexual behaviour. However, none of these proposed models adequately represents human ejaculatory disorders. Based on the "ejaculation distribution theory", which postulates that the intravaginal ejaculation latency time in men is represented by a biological continuum, we have developed an animal model for the research of premature and delayed ejaculation. In this model, a large number of male Wistar rats are investigated during 4-6 weekly sexual behavioural tests. Based on the number of ejaculations during 30 min tests, rapid and sluggish ejaculating rats are distinguished, each representing approximately 10% at both ends of a Gaussian distribution. Together with other parameters, such as ejaculation latency time, these rats at either side of the spectrum resemble men with premature and delayed ejaculation, respectively. Comparable to the human situation, in a normal population of rats, endophenotypes exist with regard to basal sexual (ejaculatory) performance.

  3. Lidocaine/prilocaine spray for premature ejaculation.

    PubMed

    2017-04-01

    Although premature ejaculation is the most common ejaculation problem, it is poorly understood and currently has no standard definition.(1) Typically, it involves reduced time to ejaculation, inability to control or delay ejaculation and associated distress.(1-5) Treatments that have been assessed include psychosexual counselling, antidepressants (e.g. selective serotonin reuptake inhibitors), phosphodiesterase type-5 inhibitors, tramadol and topical anaesthetic agents (e.g. lidocaine/prilocaine cream). A new formulation (cutaneous spray) of lidocaine/prilocaine (Fortacin-Plethora Solutions Ltd.) was launched in the UK in November 2016 for the treatment of primary premature ejaculation.(6,7) Here, we consider the evidence for lidocaine/prilocaine spray and whether it has a role in the treatment of premature ejaculation. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

  4. Temperament and Character Differences in Patients with Premature Ejaculation

    PubMed Central

    ALTUNOLUK, Bülent; BAğCIOĞLU, Erman; EFE, Erkan; BAHÇECİ, Bülent; SÖYLEMEZ, Haluk

    2013-01-01

    Introduction The debate on the etiology of premature ejaculation is still ongoing although there was huge amount of biological and psychological theories. We aimed to investigate the personality structure of patients with premature ejaculation via temperament and character inventory. Methods Forty patients with premature ejaculation and a matched number of healthy people were included. Participants were asked to fill out a questionnaire booklet with separate sections for general demographic information and the temperament and character inventory. Results Total novelty seeking scores and subscale 1 (exploration-excitability) scores in premature ejaculation patients were significantly higher than in control groups (p<0.05). Total harm avoidance scores and harm avoidance subscale 2 (fear of uncertainty) scores in premature ejaculation patients was found significantly lower than in control group (p<0.05). Beck depression score was significantly higher in patients with premature ejaculation than in control groups. Discussion Men with premature ejaculation are more impulsive (excitant), more tempered, more excitable and less prone to harmful behavior. Current findings tend to reinforce premature ejaculation based upon combination of neurobiological and psychological reasons.

  5. Premature ejaculation: A clinical review for the general physician.

    PubMed

    Chung, Eric; Gilbert, Brent; Perera, Marlon; Roberts, Matthew J

    2015-10-01

    Premature ejaculation is one of the most common sexual dysfunctions in men. Recent epidemiological studies suggest its prevalence in Australia may range from 21-31% This article will discuss the current definition of premature ejaculation from a urological perspective. It will provide an understanding of the pathogenesis of premature ejaculation, as well as assessment and management options. Premature ejaculation can have a significant adverse effect on the quality of life for the patient and his sexual partners. It can potentially lead to psychological distress, diminished self- esteem, anxiety, erectile dysfunction, reduced libido and poor interpersonal relationships. Most men feel reluctant to discuss premature ejaculation with their general practitioner despite its psychological, emotional and relational effects. Effective, evidence-based treatment options are available and physicians should feel confident when exploring ways to improve the quality of life for men with sexual dysfunction.

  6. [Pharmacological treatment of the premature ejaculation].

    PubMed

    Jurado López, A R

    2014-07-01

    Biomedical approach to premature ejaculation (PE) has permited a better phisiopatologycal knowledge and so the use of pharmacological agents for the treatment of this sexual dysfuncion. Most of the studies to evaluate the eficacy of these drugs were not carried at all the parameters which actually define PE: intravaginal ejaculatory latencie time (IELT) tested with watch, ejaculation control self perception cuantification (questionaries) and cuantification of generated consequences in patient and partner, if it existes. For this reason, it is difficult to analyse the scientific evidence and we use medicines with no approved indication for PE ("off label"). This text is a review of pharmacologycal agents with no approved indication (PDE type 5 inhibitors, α-blockers, tramadol, SSRI, clomipramine), and pharmacologycal agents developed to be used in the treatment of PE and having got indication in this sexual dysfunction or "on label" drugs (topic anesthesics, dapoxetine). Copyright © 2014 Elsevier España, S.L.U. y Sociedad Española de Medicina Rural y Generalista (SEMERGEN). All rights reserved.

  7. Classification and definition of premature ejaculation.

    PubMed

    Parnham, Arie; Serefoglu, Ege Can

    2016-08-01

    Premature ejaculation (PE) is a poorly understood condition and is considered as the most common sexual disorder in men. The ambiguity surrounding PE is in part due to the difficulty in conducting and interpreting research in the absence of a standardised definition that adequately encompasses the characteristics of these patients. An enhanced awareness of sexual dysfunctions in the recent decades has lead to an increase in scientific research that has challenged the traditional paradigm regarding PE. This has also enabled to establish a universal definition and classification of the disease. A move to a more evidence based approach has improved the clinicians' ability to define those who need medical treatment, as well as perform further research in this complex condition.

  8. Classification and definition of premature ejaculation

    PubMed Central

    Parnham, Arie

    2016-01-01

    Premature ejaculation (PE) is a poorly understood condition and is considered as the most common sexual disorder in men. The ambiguity surrounding PE is in part due to the difficulty in conducting and interpreting research in the absence of a standardised definition that adequately encompasses the characteristics of these patients. An enhanced awareness of sexual dysfunctions in the recent decades has lead to an increase in scientific research that has challenged the traditional paradigm regarding PE. This has also enabled to establish a universal definition and classification of the disease. A move to a more evidence based approach has improved the clinicians’ ability to define those who need medical treatment, as well as perform further research in this complex condition. PMID:27652214

  9. Effect of Interventions for Premature Ejaculation in the Treatment of Chronic Prostatitis with Secondary Premature Ejaculation.

    PubMed

    Chen, Chang-Qing; Yi, Qing-Tong; Chen, Chu-Hong; Gong, Min

    2016-08-01

    Objective To evaluate the effect of interventions for premature ejaculation (PE) in the management of patients with chronic prostatitis and secondary premature ejaculation. Methods Totally 90 patients diagnosed as chronic prostatitis with PE were randomly divided into control group (n=45) and interventional group (n=45). Control group received a conventional therapy consisted of oral administration of antibiotics,α-receptor blocker,and proprietary Chinese medicine for clearing away heat and promoting diuresis. Interventional group received a conventional therapy combined with treatment for ameliorating the PE symptom (oral dapoxetine on-demand and ejaculation control exercise).National Institutes of Health Chronic Prostatitis Symptom Index (NIH-CPSI),Chinese Index of Sexual Function for Premature Ejaculation (CIPE)-5 questionnaires,intravaginal ejaculatory latency time,and the number of coituses per week were applied for evaluating the treatment outcomes. Results Follow-up was accomplished in 35 and 38 patients in the control and interventional group.The CIPE-5 score,intravaginal ejaculatory latency time,and the number of coituses per week were significantly improved in both two groups but more significantly in interventional group (all P<0.05). The NIH-CPSI pain,urination,and quality of life subscores and total score were improved significantly in both two groups after treatment,but the NIH-CPSI pain and quality of life subscores had been improved more significantly in the interventional group (all P<0.05). The variation of NIH-CPSI was negatively correlated with that of CIPE-5 in both two groups (r=-0.362,P=0.016;r=-0.330,P=0.021). Conclusions For CP with secondary PE patients,the interventions for PE can not only improve the quality of sexual life but also help improve the NIH-CPSI pain and quality of life subscores. PE should be routinely screened and treated during the management of CP.p.

  10. Selective serotonin reuptake inhibitors in the treatment of premature ejaculation.

    PubMed

    Wang, Wei-fu; Chang, Le; Minhas, Suks; Ralph, David J

    2007-06-05

    To review and assess the update studies regarding selective serotonin reuptake inhibitors (SSRIs) in the treatment of premature ejaculation (PE) and then provide practical recommendations and possible mechanisms concerning state of the art knowledge for the use of SSRIs in alleviating PE. Using the Medline, 48 articles published from January 1st, 1996 to August 1st, 2006 concerning the use of SSRIs and their possible mechanisms in alleviating PE were found and reviewed. PE, rapid ejaculation, early ejaculation and SSRIs were employed as the keywords, and relevant articles about the use of SSRIs and their possible mechanisms in the treatment of PE were selected. Many kinds of SSRIs, such as fluoxetine, sertraline, paroxetine and citalopram, have widely been employed to treat PE. However, their effects are moderate and there is no a universal agreement about the kind, dose, protocol and duration. Dapoxetine, as the first prescription treatment of PE, may change this bottle-neck situation. SSRIs are suggested to be used in young men with lifelong PE, and acquired PE when etiological factors are removed but PE still exists. Phosphodiesterase 5 inhibitors (PDE(5)-Is) are suggested to be employed alone or combined with SSRIs when SSRIs fail to treat PE or sexual dysfunction associated with SSRIs occurs. The protocol of taking drugs on demand based on taking them daily for a suitable period is proposed to be chosen firstly. The possible mechanisms include increasing serotonergic neurotransmission and activating 5-hydroxytryptamine 2C (5-HT(2C)) receptors, then switching the ejaculatory threshold to a higher level, decreasing the penile sensitivity and their own effect of antidepression. The efficacies of the current SSRIs are moderate in the treatment of PE and they have not been approved by the FDA, therefore new SSRI like dapoxetine needs to be further evaluated.

  11. Magnesium in human semen: possible role in premature ejaculation.

    PubMed

    Omu, A E; Al-Bader, A A; Dashti, H; Oriowo, M A

    2001-01-01

    Although magnesium is involved in many biological process and it is found higher levels in semen than serum, its role in human semen has not been elucidated. This investigation was conducted to evaluate the relationship between premature ejaculation and the levels of seminal magnesium. The levels of magnesium, zinc, copper, and selenium were evaluated with an atomic absorption spectrophotometer in serum and seminal plasma in 3 groups of men: (a) normal sperm parameters (15) (b) oligoasthenozoospermia (15), and genuine premature ejaculation (9). There were normal serum and semen levels of all the elements in the three groups, but significantly lower seminal plasma magnesium levels in men with premature ejaculation. The hormonal profile, body mass index (BMI) had no association with premature ejaculation. Decreased levels of magnesium gives rise to vasoconstriction from increased thromboxane level, increased endothelial intracellular Ca2+, and decreased nitric oxide. This may lead to premature emission and ejaculation processes. Magnesium is probably involved in semen transport. More research into the role of magnesium in the male physiology of reproductive tract, especially its association with premature ejaculation, is advocated.

  12. Dapoxetine and the treatment of premature ejaculation

    PubMed Central

    Sangkum, Premsant; Badr, Rhamee; Serefoglu, Ege Can

    2013-01-01

    Background Premature ejaculation (PE) is the most common male sexual complaint. Off-label oral selective serotonin reuptake inhibitors (SSRIs) are commonly prescribed for the treatment of PE. Dapoxetine is a short-acting SSRI specifically designed for on-demand use. The objective of this communication is to summarize the clinical and physiological evidence regarding the role of the serotonergic pathway and specifically dapoxetine in the treatment of PE. Methods A PubMed search was conducted on articles reporting data on dapoxetine for the treatment of PE. Articles describing the pathophysiology and treatment options for PE were additionally included for review. Results The etiology of PE is multi-factorial in nature. There are many treatment options for PE such as psychological/behavioral therapy, topical anesthetic agents, phosphodiesterase type 5 (PDE-5) inhibitors, and tramadol hydrochloride. SSRIs play a major role in PE treatment. Animal and clinical studies in addition to its pharmacokinetic document dapoxetine’s clinical efficacy and safety for on-demand treatment of PE. Conclusions Dapoxetine demonstrates clinical efficacy and a favorable side effect profile. Dapoxetine is currently the oral drug of choice for on-demand treatment of PE. PMID:26816743

  13. Relationship between premature ejaculation and depression

    PubMed Central

    Xia, Yue; Li, Juanjuan; Shan, Guang; Qian, Huijun; Wang, Tao; Wu, Wei; Chen, Jun; Liu, Luhao

    2016-01-01

    Abstract Background: Premature ejaculation (PE) is the most prevalent male sexual dysfunction. Epidemiologic findings are inconsistent concerning the risk for depression associated with PE. Objective: The aim of this study was to investigate the potential association between between depression and risk of PE. Data sources: We conducted a literature search of PubMed, Embase, and the Cochrane Library from these databases’ inception through June 2014 for observational epidemiological studies examining the association between depression on risk of PE. Study eligibility criteria: Studies were selected if they reported the risk estimates for PE associated with depression. Participants: patients>18 years of age suffering from PE. Interventions: a history of depressive disorder. Study appraisal and synthesis methods: These odds ratios (ORs) were pooled using a random or fixed effects model and were tested for heterogeneity. Subgroup analysis was employed to explore heterogeneity. Results: Eight trials involving 18,035 patients were included in the meta-analysis. Depression were statistically significantly associated with the risk of PE (OR = 1.63, 95% CI:1.42–1.87). There was no evidence of between-study heterogeneity (P = 0.623, I2 = 0.0%). The association was similar when stratified by mean age, geographical area, study design, sample size, publication year, and controlling key confounders. Limitations: The severity of depression and PE could not be identified due to unavailable data of trials. No evidence of publication bias was observed. Conclusions: These findings provide evidence that depression is associated with a significantly increased risk of PE. In addition, more prospective studies are necessary to evaluate the association and identify the ideal treatment. Systematic review registration number: CRD42016041272 PMID:27583879

  14. Premature ejaculation: do we have effective therapy?

    PubMed Central

    Serefoglu, Ege Can; Saitz, Theodore R.; Trost, Landon

    2013-01-01

    Introduction Premature ejaculation (PE) is the most common sexual dysfunction, with the majority of PE patients remaining undiagnosed and undertreated. Despite its prevalence, there is a current paucity of data regarding available treatment options and mechanisms. The objective of the current investigation is to review and summarize pertinent literature on therapeutic options for the treatment of PE, including behavioral/psychologic, oral pharmacotherapy, and surgery. Methods A pubmed search was conducted on articles reporting data on available treatment options for PE. Articles describing potential mechanisms of action were additionally included for review. Preference was given towards randomized, controlled trials, when available. Results PE remains an underdiagnosed and undertreated disease process, with limited data available regarding potential underlying mechanisms and long-term outcomes of treatment options. Psychological/behavioral therapies, including the stop-start, squeeze, and pelvic floor rehabilitation techniques have demonstrated improvements in short-term series, with decreased efficacy with additional follow-up. Topical therapies, which are commonly utilized result in prolonged intravaginal ejaculatory latency time (IELT) at the expense of potential penile/vaginal Hypothesia. Oral therapies similarly demonstrate improved IELTs with variable side effect profiles and include selective serotonin reuptake inhibitors (daily or on demand), phosphodiesterase-5 inhibitors, alpha-1 adrenergic antagonists, and tramadol. Alternative therapies such as acupuncture have shown benefits in limited studies. Surgery is not commonly performed and is not recommended by available guidelines. Conclusions PE is a common condition, with limited data available regarding its underlying pathophysiology and treatment. Available therapies include topical, oral, behavioral/psychologic modification, or a combination thereof. Additional research is required to assess the optimal

  15. Current and emerging therapies in premature ejaculation: Where we are coming from, where we are going.

    PubMed

    Martin, Christopher; Nolen, Hunter; Podolnick, Jason; Wang, Run

    2017-01-01

    Premature ejaculation is the most common form of sexual dysfunction among men. The pathophysiology of premature ejaculation appears to be multifactorial, implicating the need for multimodal therapeutic regimens to successfully treat premature ejaculation. Multiple treatment regimens have been shown to be effective in extending the time between penetration and ejaculation. These treatment modalities include everything from behavioral modifications and medications to diet alterations and major surgery. The goal of the present article was to review the commonly used treatment regimens used in the treatment of premature ejaculation, as well as to introduce and discuss the newest treatment routines under study for the treatment of premature ejaculation.

  16. Comprehensive review of the anatomy and physiology of male ejaculation: Premature ejaculation is not a disease.

    PubMed

    Puppo, Vincenzo; Puppo, Giulia

    2016-01-01

    Human semen contains spermatozoa secreted by the testes and a mixture of components produced by the bulbo-urethral and Littre (paraurethral) glands, prostate, seminal vesicles, ampulla, and epididymis. Ejaculation is used as a synonym for the external ejection of semen, but it comprises two phases: emission and expulsion. As semen collects in the prostatic urethra, the rapid preorgasmic distension of the urethral bulb is pathognomonic of impeding orgasm, and the man experiences a sensation that ejaculation is inevitable (in women, emission is the only phase of orgasm). The semen is propelled along the penile urethra mainly by the bulbocavernosus muscle. With Kegel exercises, it is possible to train the perineal muscles. Immediately after the expulsion phase the male enters a refractory period, a recovery time during which further orgasm or ejaculation is physiologically impossible. Age affects the recovery time: as a man grows older, the refractory period increases. Sexual medicine experts consider premature ejaculation only in the case of vaginal intercourse, but vaginal orgasm has no scientific basis, so the duration of intercourse is not important for a woman's orgasm. The key to female orgasm are the female erectile organs; vaginal orgasm, G-spot, G-spot amplification, clitoral bulbs, clitoris-urethra-vaginal complex, internal clitoris and female ejaculation are terms without scientific basis. Female sexual dysfunctions are popular because they are based on something that does not exist, i.e. the vaginal orgasm. The physiology of ejaculation and orgasm is not impaired in premature ejaculation: it is not a disease, and non-coital sexual acts after male ejaculation can be used to produce orgasm in women. Teenagers and men can understand their sexual responses by masturbation and learn ejaculatory control with the stop-start method and the squeeze technique. Premature ejaculation must not be classified as a male sexual dysfunction. It has become the center of a

  17. Patient reported outcomes in the assessment of premature ejaculation

    PubMed Central

    2016-01-01

    The term ‘Patient Reported Outcome’, abbreviated as PRO, was introduced by the US Food and Drug Administration (FDA) which proposed guidance on the development and validation of PROs. Previously PROs were known as self-report diaries, event-logs, self-administered questionnaires, and clinician administered rating scales. PROs seek to capture the subjective perceptions of patients and/or partner’s related to their specific symptoms, degree of bother, efficacy of a medication or psychotherapy intervention, and quality of life issues related to a specific condition. This article reviews the essential psychometric and regulatory agency requirements in the development of PROs. The constructs of reliability, various forms of validity, sensitivity, and specificity as well as concerns with translating a PRO into a different language are reviewed. Three PROs, the Premature Ejaculation Profile (PEP), the Index of Premature Ejaculation (IPE) and the Premature Ejaculation Diagnostic Tool (PEDT) all used in the assessment of premature ejaculation (PE) are discussed. These questionnaires meet or exceed all the psychometric requirements and have been employed in clinical trials and observational studies of men with PE. The article concludes on discussing some of the limitations of PRO use and recommendations for the future. PMID:27652219

  18. Patient reported outcomes in the assessment of premature ejaculation.

    PubMed

    Althof, Stanley E

    2016-08-01

    The term 'Patient Reported Outcome', abbreviated as PRO, was introduced by the US Food and Drug Administration (FDA) which proposed guidance on the development and validation of PROs. Previously PROs were known as self-report diaries, event-logs, self-administered questionnaires, and clinician administered rating scales. PROs seek to capture the subjective perceptions of patients and/or partner's related to their specific symptoms, degree of bother, efficacy of a medication or psychotherapy intervention, and quality of life issues related to a specific condition. This article reviews the essential psychometric and regulatory agency requirements in the development of PROs. The constructs of reliability, various forms of validity, sensitivity, and specificity as well as concerns with translating a PRO into a different language are reviewed. Three PROs, the Premature Ejaculation Profile (PEP), the Index of Premature Ejaculation (IPE) and the Premature Ejaculation Diagnostic Tool (PEDT) all used in the assessment of premature ejaculation (PE) are discussed. These questionnaires meet or exceed all the psychometric requirements and have been employed in clinical trials and observational studies of men with PE. The article concludes on discussing some of the limitations of PRO use and recommendations for the future.

  19. Relevance of serum nitric oxide levels and the efficacy of selective serotonin reuptake inhibitors treatment on premature ejaculation: decreased nitric oxide is associated with premature ejaculation.

    PubMed

    Otunctemur, A; Ozbek, E; Kirecci, S L; Ozcan, L; Dursun, M; Cekmen, M; Ozdogan, H K

    2014-01-01

    The aim of the present study was to determine the relevance of serum nitric oxide levels and the efficacy of selective serotonin reuptake inhibitors (SSRI) treatment on premature ejaculation. Sixty married men (aged 20-50) with lifelong premature ejaculation and forty healthy men (aged 24-48) as control group were included in this study. The patients were evaluated by intravaginal ejaculation latency time (IELT) for premature ejaculation (PE). IELT<1 min is accepted PE. Patients with diabetes mellitus, chronic disorders or erectile dysfunction and heavy smokers were excluded. All patients were evaluated with history, physical examination, International Index of Erectile Dysfunction-5 (IIEF-5) score and IELT by stopwatch method. Nitric oxide levels were measured by Griess reaction, and all samples were frozen at -80 °C. Patients were randomly categorised 4 group to receive fluoxetine 20 mg day(-1) (Group 1), paroxetine 20 mg day(-1) (Group 2), sertraline 50 mg day(-1) (Group 3) and healthy control (Group 4) for 4 weeks. Baseline and post-treatment findings were compared between the four groups. At the end of 4 weeks, in fluoxetine, paroxetine, sertraline groups mean IELT values showed a statistically significant improvement from the baseline values (P < 0.001, P < 0.001, P = 0.03; respectively). Baseline and 1st month follow-up mean IIEF scores were 24.5 and 23.05, 24.70 and 23.60 (P < 0.05) in group 1 and group 3 respectively; also 23.09 and 23.32 (P > 0.05) in group 2. Baseline serum NO levels were 31.8, 30.44, 30.8 and 42.84 in fluoxetine, paroxetine, sertraline and healthy control groups respectively. NO levels were statistically lower in patients with PE. After treatment of fluoxetine, paroxetine and sertraline, NO levels were increased baseline (35.8, 36.4, 38.08) (P < 0.05). Our findings indicated that PE is associated with decreased serum NO levels. After the SSRI treatment increased, NO may retard ejaculation presumably by central

  20. [An update on ejaculation physiology and premature ejaculation definition, prevalence data, and etiology].

    PubMed

    Mas, M

    2014-07-01

    Ejaculation consists of two synchronized phases: a) emission, the contraction of the vas deferens, prostate and seminal vesicles and bladder neck expelling the seminal fluid to the urethra; it is mediated by sympathetic nerves, and b) expulsion, seminal fluid outward propulsion by the rhythmic contraction of perineal muscles. Ejaculation results from a complex spinal reflex having its essential components within the lumbosacral cord. The main afferent signals derive from mechanical stimulation of the glans penis and are conveyed by sacral sensory roots. The ejaculatory reflex is under strong modulatory influence from the brain through both facilitatory and inhibitory descending signals. Several central neurotransmitters including serotonin and dopamine modulate the ejaculatory reflex. The intravaginal ejaculatory latency time (IELT), measured or estimated, provides clinically useful assessment of the ejaculatory reflex. The new DSM-5 definition of premature ejaculation (PE) includes a specified time to ejaculation criterion (IELT of about one minute or shorter). Four subtypes of PE, showing different prevalence rates, have been proposed. PE etiology is multifactorial with interacting psychological and biological factors contributing to the disorder. A number of genetic polymorphisms related to serotonin and dopamine neurotransmission may predispose the bearers to developing PE. High prevalence rates of PE have been found in patients with chronic prostatitis, hyperthyroidism, and premature ejaculation.

  1. [Detection and diagnosis of the premature ejaculation in the clinical practice].

    PubMed

    Sánchez Sánchez, F; Fernández Lozano, A

    2014-07-01

    Recently, a new classification of the premature ejaculation has been proposed. According to this classification, four clinical forms are distinguished: primary premature ejaculation, secondary or acquired premature ejaculation, normal variant that appears in certain situations and a false premature ejaculation that is given in misinformed patients or with exaggerate sexual expectations. To know these clinical forms is important for the clinical boarding of this sexual disorder. In the same way, the detection of premature ejaculation in medical practise requires doctors being receptive and suitable to make an active detection into risk groups for this sexual dysfunction, also describe in the present work. Furthermore, essential aspects of the clinical interview in patients with premature ejaculation, criteria to get an accurate diagnosis, and basic aspects of the physical exploration, complementary studies and main specific questionnaires are described. Copyright © 2014 Elsevier España, S.L.U. y Sociedad Española de Medicina Rural y Generalista (SEMERGEN). All rights reserved.

  2. Relationship between premature ejaculation and depression in Korean males.

    PubMed

    Son, Hwancheol; Song, Sang Hoon; Lee, Jun-Young; Paick, Jae-Seung

    2011-07-01

    The psychological impacts of premature ejaculation (PE), which include guilt, anxiety, and distress, have been well established in Western countries. However, in Asia, although a substantial number of epidemiological studies have surveyed the prevalence of PE, researchers have not thoroughly investigated the relationship between PE and depression, or have defined PE properly. We studied the association between PE and depression and other psychological disturbances, in a Korean cohort by applying an appropriate definition for PE and validated outcome measures of depression. METHODS.  A total of 956 males (≥20 years) were initially approached via an Internet survey company. Participants were asked to complete a questionnaire requesting detailed medical and sexual histories, which included questions from the Erectile Function Domain score in the International Index of Erectile Function (IIEF-EF) and the Beck Depression Inventory (BDI). The prevalence of PE was evaluated using two different definitions-self-assessed PE and presumed PE. Presumed PE was defined as a short ejaculation time (an estimated intravaginal ejaculatory latency time ≤5 minutes), an inability to control ejaculation, and the presence of distress resulting from PE. Ejaculation-related questionnaire, the IIEF-EF, and BDI. A total of 334 men were evaluated. The prevalence of PE was 10.5% according to the Presumed PE definition, whereas by self-assessment, it was 25.4%. Self-assessed PE patients suffered from various psychological problems, such as depression, low self-esteem, bother, and low sexual satisfaction. Even after excluding erectile dysfunction (ED) subjects, a significant relationship was found between self-assessed PE and depression. Moreover, after further classification of the Self-assessed PE group, we found that subjects included in this group, but not in the Presumed PE group, suffered more from psychological burden than any other members of the cohort. Korean men with subjective

  3. The prevalence of premature ejaculation in young Turkish men.

    PubMed

    Karabakan, M; Bozkurt, A; Hirik, E; Celebi, B; Akdemir, S; Guzel, O; Nuhoglu, B

    2016-11-01

    This study was conducted to investigate the prevalence of premature ejaculation (PE) in young Turkish men and to evaluate PE in a population having good physical and mental health. A total of 1230 healthy university graduates aged between 24 and 30 attending the police academy having no physical or mental problems were included in the study. To identify the presence of PE, the participants were asked to complete the premature ejaculation diagnostic tool (PEDT). The mean ages in the PE and non-PE group were 27.3 and 26.7 respectively. There was no statistically significant difference between the two groups concerning age, body mass index (BMI), smoking status and alcohol consumption (P > 0.05). The PE prevalence was found to be 9.2%. The mean PEDT score was calculated as 6.3. Of the participants, 92 scored 11 and higher (9.2%), 66 scored 9 and 10 (6.6%), and the remaining 842 obtained a score equal to or lower than 8 (84.2%). The lower prevalence of PE in young Turkish men compared to the results of studies in the literature can be attributed to the physical and mental well-being of the participants. This study showed that the prevalence of PE in young men with good physical and mental health is lower than that found in the literature. © 2016 Blackwell Verlag GmbH.

  4. Surgery is not indicated for the treatment of premature ejaculation.

    PubMed

    Anaissie, James; Yafi, Faysal A; Hellstrom, Wayne J G

    2016-08-01

    Premature ejaculation (PE) is considered the most common male sexual disorder, affecting up to 75% of men at some point in their lives. While medical management is the mainstay of therapy, surgical options such as dorsal nerve neurectomy (DNN), hyaluronic acid (HA) gel glans penis augmentation, and circumcision have been studied as alternative forms of treatment. Preliminary studies have suggested that DNN and HA gel glans penis augmentation are relatively safe and effective, but due to a lack of large, multicenter, randomized-control trials with long-term follow-up, the International Society of Sexual Medicine (ISSM) has been unable to endorse DNN or HA gel glans penis augmentation as options in the treatment of PE. Conflicting data regarding the efficacy and safety of circumcision has similarly led to its exclusion from ISSM recommendations for the treatment of PE. Ethical concerns, particularly the fundamental concept of non-maleficence, are also barriers to the implementation of surgery for PE.

  5. Surgery is not indicated for the treatment of premature ejaculation

    PubMed Central

    Anaissie, James; Yafi, Faysal A.

    2016-01-01

    Premature ejaculation (PE) is considered the most common male sexual disorder, affecting up to 75% of men at some point in their lives. While medical management is the mainstay of therapy, surgical options such as dorsal nerve neurectomy (DNN), hyaluronic acid (HA) gel glans penis augmentation, and circumcision have been studied as alternative forms of treatment. Preliminary studies have suggested that DNN and HA gel glans penis augmentation are relatively safe and effective, but due to a lack of large, multicenter, randomized-control trials with long-term follow-up, the International Society of Sexual Medicine (ISSM) has been unable to endorse DNN or HA gel glans penis augmentation as options in the treatment of PE. Conflicting data regarding the efficacy and safety of circumcision has similarly led to its exclusion from ISSM recommendations for the treatment of PE. Ethical concerns, particularly the fundamental concept of non-maleficence, are also barriers to the implementation of surgery for PE. PMID:27652232

  6. Current therapeutic strategies for premature ejaculation and future perspectives

    PubMed Central

    Xin, Zhong-Cheng; Zhu, Yi-Chen; Yuan, Yi-Ming; Cui, Wan-Shou; Jin, Zhe; Li, Wei-Ren; Liu, Tao

    2011-01-01

    Premature ejaculation (PE) is a common sexual disorder in men that is mediated by disturbances in the peripheral and central nervous systems. Although all pharmaceutical treatments for PE are currently used ‘off-label', some novel oral agents and some newer methods of drug administration now provide important relief to PE patients. However, the aetiology of this condition has still not been unified, primarily because of the lack of a standard animal model for basic research and the absence of a widely accepted definition and assessment tool for evidence-based clinical studies in patients with PE. In this review, we focus on the current therapeutic strategies and future treatment perspectives for PE. PMID:21532601

  7. Impact of prostate volume on erectile dysfunction and premature ejaculation.

    PubMed

    Lee, Jun Ho; Lee, Sung Won

    2016-06-01

    We evaluated the impact of total prostate volume (TPV) on the international index of erectile function-5 (IIEF) and the premature ejaculation diagnostic tool (PEDT). A cross-sectional study was conducted that included 8336 men who had participated in a health examination. PEDT, IIEF and transrectal ultrasonography were used. A full metabolic work-up and serum testosterone level checks were also performed. The median age of participants was 51.0 years. In total, 40.1% had IIEF scores ≤16. Additionally, 24.7% were classified as demonstrating premature ejaculation (PE) (PEDT > 10). The severity of erectile dysfunction (ED) significantly increased with the TPV (p trend < 0.001). After adjusting for potential confounding factors, the odds ratio (OR) for IIEF scores ≤ 16 significantly increased in the group with TPVs of 30-39 cm(3) and the group with TPVs ≥ 40 cm(3) compared with the group with TPVs ≤ 19 cm(3) (TPV 30-39 cm(3), OR: 1.204, 95% confidence interval: 1.034-1.403; TPV ≥ 40 cm(3), OR: 1.326: 95% confidence interval: 1.051-1.733) and this relationship was maintained after adjusting for propensity score (TPV ≥ 30 cm(3), OR: 1.138: 95% confidence interval: 1.012-1.280). However, neither PEDT nor PE was correlated with TPV. In conclusion, TPV is significantly and independently correlated with IIEF but not with PEDT. Future investigations should explore the temporal relationship between TPV and ED.

  8. Interrelationships among measures of premature ejaculation: the central role of perceived control.

    PubMed

    Patrick, Donald L; Rowland, David; Rothman, Margaret

    2007-05-01

    Domains of premature ejaculation (PE) include short intravaginal ejaculatory latency time (IELT), poor perceived control over ejaculation, decreased satisfaction with sexual intercourse, and personal distress and interpersonal difficulty related to ejaculation. How these measures interrelate is unknown. Here, we evaluated the interrelationships between these PE-specific variables, applying cross-sectional data from a large U.S. observational study of men with PE. We analyzed data from men with PE identified in a previously reported observational study. PE was diagnosed by experienced clinicians using the criteria specified in the Diagnostic and Statistical Manual of Mental Disorders, fourth edition, text revision. Subjects reported their stopwatch-measured IELT, perceived control over ejaculation, satisfaction with sexual intercourse, personal distress related to ejaculation, and interpersonal difficulty related to ejaculation. Relationships between variables were assessed using bivariate correlations, and the strength and significance of direct or indirect effects between variables were evaluated using a form of regression analysis known as path analysis. Bivariate Pearson correlation coefficients for all relationships were significant at the P ejaculation. When all variables were included in the model, IELT showed a significant direct effect on perceived control over ejaculation but did not show a significant direct effect on ejaculation-related personal distress or satisfaction with sexual intercourse. Perceived control over ejaculation showed a significant direct effect on both ejaculation-related personal distress and satisfaction with sexual intercourse, which each showed direct effects on interpersonal difficulty related to ejaculation. The patient's perception of control over ejaculation is central to understanding how PE is associated with satisfaction with sexual

  9. The role of short frenulum and the effects of frenulectomy on premature ejaculation.

    PubMed

    Gallo, Luigi; Perdonà, Sisto; Gallo, Antonio

    2010-03-01

    The role of short frenulum and the effects of frenulectomy on premature ejaculation (PE) were never investigated. The aims of this study were to evaluate the prevalence of short frenulum in a population of patients affected by lifelong PE and to investigate the role of frenulectomy as first-line treatment for this condition. We performed frenulectomy to patients complaining of lifelong PE in which we found the presence of a short frenulum at physical examination. We evaluated intravaginal ejaculatory latency time (IELT) and the score of a validated PE questionnaire at baseline and after frenulectomy. We evaluated the change in mean IELT and in mean PE questionnaire score. We found the presence of a short frenulum in 59 out of 137 (43%) subjects who came to our center complaining of lifelong PE. Mean age of study population was 38.2 years (+/-5.3 standard deviation). At baseline period, mean IELT was 1.65 minutes (+/-1.15), and mean PE questionnaire score was 15.8 (+/-2.85). No complications related to surgery occurred. Mean follow-up time was 7.3 months (+/-3.18). After frenulectomy, mean IELT was 4.11 minutes (+/-1.77), and mean PE questionnaire score was 9.85 (+/-3.2). An increase in mean IELT of 2.46 minutes (P < 0.0001) and a reduction in mean PE questionnaire symptoms score of 5.95 (P < 0.0001) were noted. Short frenulum is a genital anomaly found in 43% of individuals affected by lifelong PE in our data set. We suggest always ruling out at physical examination the presence of a short frenulum in all patients complaining of PE and to propose frenulectomy as first-line treatment in these cases.

  10. The design and methodology of premature ejaculation interventional studies

    PubMed Central

    2016-01-01

    Large well-designed clinical efficacy and safety randomized clinical trials (RCTs) are required to achieve regulatory approval of new drug treatments. The objective of this article is to make recommendations for the criteria for defining and selecting the clinical trial study population, design and efficacy outcomes measures which comprise ideal premature ejaculation (PE) interventional trial methodology. Data on clinical trial design, epidemiology, definitions, dimensions and psychological impact of PE was reviewed, critiqued and incorporated into a series of recommendations for standardisation of PE clinical trial design, outcome measures and reporting using the principles of evidence based medicine. Data from PE interventional studies are only reliable, interpretable and capable of being generalised to patients with PE, when study populations are defined by the International Society for Sexual Medicine (ISSM) multivariate definition of PE. PE intervention trials should employ a double-blind RCT methodology and include placebo control, active standard drug control, and/or dose comparison trials. Ejaculatory latency time (ELT) and subject/partner outcome measures of control, personal/partner/relationship distress and other study-specific outcome measures should be used as outcome measures. There is currently no published literature which identifies a clinically significant threshold response to intervention. The ISSM definition of PE reflects the contemporary understanding of PE and represents the state-of-the-art multi-dimensional definition of PE and is recommended as the basis of diagnosis of PE for all PE clinical trials. PMID:27652224

  11. Integrating psychotherapy and pharmacotherapy in the treatment of premature ejaculation

    PubMed Central

    Ciocca, Giacomo; Limoncin, Erika; Mollaioli, Daniele; Gravina, Giovanni Luca; Di Sante, Stefania; Carosa, Eleonora; Lenzi, Andrea; Jannini, Emmanuele A.

    2013-01-01

    Objectives To describe the different approaches to the treatment of premature ejaculation (PE), with a final focus on integrated treatment, as conventional theories and therapies for PE are based on an organic or psychogenic dichotomy. Methods We list the principal hypotheses of the causes and therapy of PE on the basis of psychological and medical perspectives, after identifying all relevant studies available on Medline up to 2012. Results The cognitive feedback from PE can lead to a ‘performance anxiety’, which can combine with other conditions to further impair ejaculatory control. For these reasons, a psychological approach is always useful in treating PE, the most useful of which are sex therapy and behavioural therapy. For pharmacological treatment, reports suggest that dapoxetine (60 mg) significantly improves the control of the ejaculatory reflex, and it thus represents the first-line officially approved pharmacotherapy for PE. Conclusions A holistic approach which considers the biological, psychological and relational aspects is the advised treatment for PE. Integrated medical and psycho-sexological therapy requires a mutual understanding of and respect for the different disciplines involved in sexology. In this aspect two very important roles are those of the physician and the psychologist. PMID:26558097

  12. The design and methodology of premature ejaculation interventional studies.

    PubMed

    McMahon, Chris G

    2016-08-01

    Large well-designed clinical efficacy and safety randomized clinical trials (RCTs) are required to achieve regulatory approval of new drug treatments. The objective of this article is to make recommendations for the criteria for defining and selecting the clinical trial study population, design and efficacy outcomes measures which comprise ideal premature ejaculation (PE) interventional trial methodology. Data on clinical trial design, epidemiology, definitions, dimensions and psychological impact of PE was reviewed, critiqued and incorporated into a series of recommendations for standardisation of PE clinical trial design, outcome measures and reporting using the principles of evidence based medicine. Data from PE interventional studies are only reliable, interpretable and capable of being generalised to patients with PE, when study populations are defined by the International Society for Sexual Medicine (ISSM) multivariate definition of PE. PE intervention trials should employ a double-blind RCT methodology and include placebo control, active standard drug control, and/or dose comparison trials. Ejaculatory latency time (ELT) and subject/partner outcome measures of control, personal/partner/relationship distress and other study-specific outcome measures should be used as outcome measures. There is currently no published literature which identifies a clinically significant threshold response to intervention. The ISSM definition of PE reflects the contemporary understanding of PE and represents the state-of-the-art multi-dimensional definition of PE and is recommended as the basis of diagnosis of PE for all PE clinical trials.

  13. Behavioral Therapies for Management of Premature Ejaculation: A Systematic Review

    PubMed Central

    Cooper, Katy; Martyn-St James, Marrissa; Kaltenthaler, Eva; Dickinson, Kath; Cantrell, Anna; Wylie, Kevan; Frodsham, Leila; Hood, Catherine

    2015-01-01

    Introduction Premature ejaculation (PE) is defined by short ejaculatory latency and inability to delay ejaculation causing distress. Management may involve behavioral and/or pharmacological approaches. Aim To systematically review the randomized controlled trial (RCT) evidence for behavioral therapies in the management of PE. Methods Nine databases including MEDLINE were searched up to August 2014. Included RCTs compared behavioral therapy against waitlist control or another therapy, or behavioral plus drug therapy against drug treatment alone. [Correction added on 10 September 2015, after first online publication: Search period has been amended from August 2013 to August 2014.] Main Outcome Measure Intravaginal ejaculatory latency time (IELT), sexual satisfaction, ejaculatory control, and anxiety and adverse effects. Results Ten RCTs (521 participants) were included. Overall risk of bias was unclear. All studies assessed physical techniques, including squeeze and stop-start, sensate focus, stimulation device, and pelvic floor rehabilitation. Only one RCT included a psychotherapeutic approach (combined with stop-start and drug treatment). Four trials compared behavioral therapies against waitlist control, of which two (involving squeeze, stop-start, and sensate focus) reported IELT differences of 7–9 minutes, whereas two (web-based sensate focus, stimulation device) reported no difference in ejaculatory latency posttreatment. For other outcomes (sexual satisfaction, desire, and self-confidence), some waitlist comparisons significantly favored behavioral therapy, whereas others were not significant. Three trials favored combined behavioral and drug treatment over drug treatment alone, with small but significant differences in IELT (0.5–1 minute) and significantly better results on other outcomes (sexual satisfaction, ejaculatory control, and anxiety). Direct comparisons of behavioral therapy vs. drug treatment gave mixed results, mostly either favoring drug

  14. Is there a place for surgical treatment of premature ejaculation?

    PubMed Central

    2016-01-01

    Management of premature ejaculation (PE) has evolved tremandoulsy over the last 20 years. Selective serotonin reuptake inhibitor (SSRI) antidepressants and local anesthetics are the most and best studied treatments. This evidence has led to the establishment of an evidence-based definition of PE and the International Society for Sexual Medicine (ISSM) guidelines for the diagnosis and treatment of PE. The current treatment of choice for PE according to the ISSM guidelines is a centrally acting SSRI or peripherally acting topical anesthetics. Despite the progress in threating PE, the drawbacks of these medical treatments are controversial. Before the ISSM guidelines were established, selective dorsal neurectomy (SDN) and glans penis augmentation (GPA) using a hyaluronic acid (HA) gel were developed to decrease sensitivity of the glans penis but later ISSM guidelines do not recommend surgical treatment because of possible permanent loss of sexual function and insufficient reliable data. Despite the drawbacks of medical treatments and debates about the ISSM guideline, surgical treatment for PE has increased continuously in Asian countries for non-responders to medical treatment. In contrast to the concerns outlined in the ISSM guidelines, SDN has been reported as effective and safe with rare sensory loss. Percutaneous computed tomography-guided cryoablation of the dorsal penile nerve and neuromodulation of the dorsal penile nerve by pulsed radiofrequency are reported as effective and safe for PE. It is time to re-evaluate rather than ignore surgical treatments for PE because doctors and patients need surgical alternatives for patients with PE who are not satisfied with medical treatment. SDN has a definite role in the efficacy but needs more safety data to be used as standard surgical treatment for PE. SDN must be performed carefully and more well-designed studies are needed. GPA with a HA gel does not induce serious sensory loss in patients with ED erectile

  15. Is there a place for surgical treatment of premature ejaculation?

    PubMed

    Moon, Du Geon

    2016-08-01

    Management of premature ejaculation (PE) has evolved tremandoulsy over the last 20 years. Selective serotonin reuptake inhibitor (SSRI) antidepressants and local anesthetics are the most and best studied treatments. This evidence has led to the establishment of an evidence-based definition of PE and the International Society for Sexual Medicine (ISSM) guidelines for the diagnosis and treatment of PE. The current treatment of choice for PE according to the ISSM guidelines is a centrally acting SSRI or peripherally acting topical anesthetics. Despite the progress in threating PE, the drawbacks of these medical treatments are controversial. Before the ISSM guidelines were established, selective dorsal neurectomy (SDN) and glans penis augmentation (GPA) using a hyaluronic acid (HA) gel were developed to decrease sensitivity of the glans penis but later ISSM guidelines do not recommend surgical treatment because of possible permanent loss of sexual function and insufficient reliable data. Despite the drawbacks of medical treatments and debates about the ISSM guideline, surgical treatment for PE has increased continuously in Asian countries for non-responders to medical treatment. In contrast to the concerns outlined in the ISSM guidelines, SDN has been reported as effective and safe with rare sensory loss. Percutaneous computed tomography-guided cryoablation of the dorsal penile nerve and neuromodulation of the dorsal penile nerve by pulsed radiofrequency are reported as effective and safe for PE. It is time to re-evaluate rather than ignore surgical treatments for PE because doctors and patients need surgical alternatives for patients with PE who are not satisfied with medical treatment. SDN has a definite role in the efficacy but needs more safety data to be used as standard surgical treatment for PE. SDN must be performed carefully and more well-designed studies are needed. GPA with a HA gel does not induce serious sensory loss in patients with ED erectile

  16. New insights on premature ejaculation: a review of definition, classification, prevalence and treatment

    PubMed Central

    C Serefoglu, Ege; Saitz, Theodore R

    2012-01-01

    There are ongoing debates about the definition, classification and prevalence of premature ejaculation (PE). The first evidence-based definition of PE was limited to heterosexual men with lifelong PE who engage in vaginal intercourse. Unfortunately, many patients with the complaint of PE do not meet these criteria. However, these men can be diagnosed as one of the PE subtypes, namely acquired PE, natural variable PE or premature-like ejaculatory dysfunction. Nevertheless, the validity of these subtypes has not yet been supported by evidence. The absence of a universally accepted PE definition and lack of standards for data acquisition have resulted in prevalence studies that have reported conflicting rates. The very high prevalence of 20%–30% is probably due to the vague terminology used in the definitions at the time when such surveys were conducted. Although many men may complain of PE when questioned for a population-based prevalence study, only a few of them will actively seek treatment for their complaint, even though most of these patients would define symptoms congruent with PE. The complaints of acquired PE patients may be more severe, whereas complaints of patients experiencing premature-like ejaculatory dysfunction seem to be least severe among men with various forms of PE. Although numerous treatment modalities have been proposed for management of PE, only antidepressants and topical anaesthetic creams have currently been proven to be effective. However, as none of the treatment modalities have been approved by the regulatory agencies, further studies must be carried to develop a beneficial treatment strategy for PE. PMID:23064688

  17. New insights on premature ejaculation: a review of definition, classification, prevalence and treatment.

    PubMed

    Serefoglu, Ege C; Saitz, Theodore R

    2012-11-01

    There are ongoing debates about the definition, classification and prevalence of premature ejaculation (PE). The first evidence-based definition of PE was limited to heterosexual men with lifelong PE who engage in vaginal intercourse. Unfortunately, many patients with the complaint of PE do not meet these criteria. However, these men can be diagnosed as one of the PE subtypes, namely acquired PE, natural variable PE or premature-like ejaculatory dysfunction. Nevertheless, the validity of these subtypes has not yet been supported by evidence. The absence of a universally accepted PE definition and lack of standards for data acquisition have resulted in prevalence studies that have reported conflicting rates. The very high prevalence of 20%-30% is probably due to the vague terminology used in the definitions at the time when such surveys were conducted. Although many men may complain of PE when questioned for a population-based prevalence study, only a few of them will actively seek treatment for their complaint, even though most of these patients would define symptoms congruent with PE. The complaints of acquired PE patients may be more severe, whereas complaints of patients experiencing premature-like ejaculatory dysfunction seem to be least severe among men with various forms of PE. Although numerous treatment modalities have been proposed for management of PE, only antidepressants and topical anaesthetic creams have currently been proven to be effective. However, as none of the treatment modalities have been approved by the regulatory agencies, further studies must be carried to develop a beneficial treatment strategy for PE.

  18. Safety and efficacy of tramadol hydrochloride on treatment of premature ejaculation.

    PubMed

    Eassa, Bayoumy I; El-Shazly, Mohamed A

    2013-01-01

    Premature ejaculation (PE) is the most common sexual disorder. It affects 20%-30% of adult men; the aetiology of this condition has not yet been elucidated. The aim of this study is to evaluate the efficacy, safety, tolerability, undesirable effects and improved satisfaction with sexual intercourse with tramadol hydrochloride at different dosages for the treatment of PE. A total of 300 patients who presented with lifelong (primary) PE were included in this study. The study was performed for 28 weeks, in which placebo (starch tablet) was given for 4 weeks, and active ingredient (tramadol hydrochloride) was administered at different therapeutic dosages for 24 weeks. Patients were divided into three equal groups, each consisting of 100 patients. The first group (A) was given tramadol hydrochloride capsule 25 mg. The second group (B) was given tramadol hydrochloride capsule 50 mg. The third group (C) was given tramadol hydrochloride capsule 100 mg. All of the 300 participants included completed the study voluntarily. The age of the patients varied from 25 to 50 years. After the treatment period, the recorded data were collected for each group and analysed. The results showed a highly significant increase in the mean intravaginal ejaculatory latency time (IELT) in all groups compared to baseline data (P<0.0001). We concluded that using tramadol hydrochloride at different doses on demand for the treatment of PE is effective, safe and tolerable, with minimal undesirable effects, and approval for this indication should be sought.

  19. Evaluation of Stambhanakaraka Yoga and counseling in the management of Shukragata Vata (premature ejaculation).

    PubMed

    Kulkarni, Prasad V; Chandola, Harimohan

    2013-01-01

    Premature Ejaculation (PE) is a very common male sexual problem. Anxiety, stress, fear etc., are the main predisposing factors of PE. In Ayurveda, this condition can be correlated with Shukragata Vata. In the present study, fifty five patients with PE were grouped into two and were treated with Stambhanakaraka Yoga (n = 30) and Placebo (n = 20) for a duration of two months, with luke warm water as anupana. Psychological counseling was given to the patients in both the groups. After completion of treatment, Stambhanakaraka Yoga showed significant results against placebo in all parameters, namely Intravaginal Ejaculation Latency Time (IELT), voluntary control over ejaculation, patient and partner's satisfaction, performance anxiety.

  20. Evaluation of Stambhanakaraka Yoga and counseling in the management of Shukragata Vata (premature ejaculation)

    PubMed Central

    Kulkarni, Prasad V.; Chandola, Harimohan

    2013-01-01

    Premature Ejaculation (PE) is a very common male sexual problem. Anxiety, stress, fear etc., are the main predisposing factors of PE. In Ayurveda, this condition can be correlated with Shukragata Vata. In the present study, fifty five patients with PE were grouped into two and were treated with Stambhanakaraka Yoga (n = 30) and Placebo (n = 20) for a duration of two months, with luke warm water as anupana. Psychological counseling was given to the patients in both the groups. After completion of treatment, Stambhanakaraka Yoga showed significant results against placebo in all parameters, namely Intravaginal Ejaculation Latency Time (IELT), voluntary control over ejaculation, patient and partner's satisfaction, performance anxiety. PMID:24049404

  1. Efficacy of type-5 phosphodiesterase inhibitors in the drug treatment of premature ejaculation: a systematic review.

    PubMed

    McMahon, Chris G; McMahon, Chelsea N; Leow, Liang Joo; Winestock, Christopher G

    2006-08-01

    This review examines the role of nitric oxide (NO) as a neurotransmitter involved in the central and peripheral control of ejaculation, the methods of phosphodiesterase type 5 inhibitor (PDE5I) drug treatment studies for premature ejaculation (PE), the adherence of methods to the contemporary consensus of ideal PE drug trial design, the impact of methods on treatment outcomes and the role of PDE5Is in the treatment of PE. NO/cGMP transduction is involved in both the central and peripheral control of emission, but evidence for a direct central or peripheral effect of PDE5Is on ejaculation is speculative. Thirteen of the 14 studies reviewed failed to fulfil the evidence-based medicine criteria for ideal PE drug trial design. Limitations of the studies include inadequately defined study populations, the lack of a double-blind placebo-controlled study design, and the absence of consistent objective physiological measures or sensitive, validated outcome assessment instruments as study endpoints. The broad range of intravaginal ejaculatory latency time (IELT) fold-increases reported with PDE5Is, on-demand selective serotonin re-uptake inhibitor (SSRI) drugs, and combined PDE5I/on-demand SSRIs is testament to the unreliability of data and conclusions from methodologically flawed studies. The one study that fulfilled the evidence-based medicine criteria of an ideal clinical trial design reported that treatment with sildenafil failed to significantly increase baseline IELT, supporting our conclusion that there is no convincing evidence to support any role for PDE5Is in the treatment of men with lifelong PE and normal erectile function. However, there is limited evidence to support a potential role for PDE5Is alone or combined with daily or on-demand SSRIs in the treatment of acquired PE in men with comorbid erectile dysfunction. Further controlled studies adhering to the contemporary consensus of ideal clinical trial design are required to clarify the role of PDE5Is in this

  2. Complementary and Alternative Medicine for Management of Premature Ejaculation: A Systematic Review.

    PubMed

    Cooper, Katy; Martyn-St James, Marrissa; Kaltenthaler, Eva; Dickinson, Kath; Cantrell, Anna; Ren, Shijie; Wylie, Kevan; Frodsham, Leila; Hood, Catherine

    2017-03-01

    Premature ejaculation (PE) is defined as ejaculation within 1 minute (lifelong PE) or 3 minutes (acquired PE), inability to delay ejaculation, and negative personal consequences. Management includes behavioral and pharmacologic approaches. To systematically review effectiveness, safety, and robustness of evidence for complementary and alternative medicine in managing PE. Nine databases including Medline were searched through September 2015. Randomized controlled trials evaluating complementary and alternative medicine for PE were included. Studies were included if they reported on intravaginal ejaculatory latency time (IELT) and/or another validated PE measurement. Adverse effects were summarized. Ten randomized controlled trials were included. Two assessed acupuncture, five assessed Chinese herbal medicine, one assessed Ayurvedic herbal medicine, and two assessed topical "severance secret" cream. Risk of bias was unclear in all studies because of unclear allocation concealment or blinding, and only five studies reported stopwatch-measured IELT. Acupuncture slightly increased IELT over placebo in one study (mean difference [MD] = 0.55 minute, P = .001). In another study, Ayurvedic herbal medicine slightly increased IELT over placebo (MD = 0.80 minute, P = .001). Topical severance secret cream increased IELT over placebo in two studies (MD = 8.60 minutes, P < .001), although inclusion criteria were broad (IELT < 3 minutes). Three studies comparing Chinese herbal medicine with selective serotonin reuptake inhibitors (SSRIs) favored SSRIs (MD = 1.01 minutes, P = .02). However, combination treatment with Chinese medicine plus SSRIs improved IELT over SSRIs alone (two studies; MD = 1.92 minutes, P < .00001) and over Chinese medicine alone (two studies; MD = 2.52 minutes, P < .00001). Adverse effects were not consistently assessed but where reported were generally mild. There is preliminary evidence for the effectiveness of acupuncture, Chinese herbal medicine

  3. A new treatment for premature ejaculation: the rehabilitation of the pelvic floor.

    PubMed

    La Pera, G; Nicastro, A

    1996-01-01

    This study evaluated pelvic floor rehabilitation as a possible treatment for premature ejaculation. In this treatment it is assumed that the pelvic muscles are involved in the control of the ejaculatory reflex. The treatment avails itself of a method already used for fecal and urinary incontinence. Eighteen patients with premature ejaculation were recruited. Fifteen (83%) of them had suffered from this disturbance for at least five years. Most of them had experienced other therapies without success. After 15-20 sessions of pelvic floor rehabilitation, 11 (61%) patients were cured and are able to control the ejaculatory reflex; seven (39%) patients had no improvement. All patients were followed for a minimum of 6 months to a maximum of 14 months. This therapy is easy to perform, has no side effects, and can be included among the therapuetic options for patients with premature ejaculation.

  4. Black stone - a natural remedy for premature ejaculation and performance enhancement, or maybe not?

    PubMed

    Bush, Carly; O'Farrell, Nigel

    2014-08-01

    We describe the use of a non-prescribed aid (Black stone) for premature ejaculation that resulted in a chemical burn on the penis with an appearance similar to severe balanitis. © The Author(s) 2014 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.

  5. Evaluating the content and quality of information about premature ejaculation on the Internet: what are men being exposed to ?

    PubMed

    Gul, M; Kaynar, M

    2017-03-01

    Premature ejaculation is one of the most common male sexual dysfunctions; however, only a few patients with premature ejaculation are seeking professional help or advice. Internet has become an important source of knowledge, and thus, more patients are looking online for health information. According to our best knowledge, no study has evaluated the content and quality of websites on premature ejaculation. We, therefore, aimed to evaluate the content and quality of currently available Internet-based information on premature ejaculation. A sample was obtained comprising the 50 top sites retrieved from Google, Bing and Yahoo search engines using the terms 'premature ejaculation'. Each site then was reviewed based on some predefined evaluation criteria to determine the general quality, condition-specific content quality, popularity index and ownership. The websites reviewed were differed highly in terms of quality and ownership. Only a few sites provided comprehensive medical and complete information on premature ejaculation. The online information available is often of uncertain calibre; therefore, men are being exposed to information about premature ejaculation with a highly variable degree quality. This fact should be considered both by health professionals and website owners, and better online resources should be provided for these patients. © 2016 Blackwell Verlag GmbH.

  6. Selective serotonin reuptake inhibitors for premature ejaculation: review of erectile and ejaculatory side effects.

    PubMed

    Lasker, George F; Halis, Fikret; Gokce, Ahmet

    2014-01-01

    Premature ejaculation is one of the most prevalent sexual disorders affecting men today. The lack of approved therapies has resulted in the prescription of many 'off-label' treatments to manage the condition. Selective serotonin reuptake inhibitors have an interesting side effect of prolonging ejaculatory latency. Consequently, these agents are often considered a first line treatment for patients suffering from premature ejaculation. Erectile dysfunction is another common side effect reported by men treated with selective serotonin reuptake inhibitors. Nitric oxide is the primary mediator of erectile function. Preclinical studies have provided evidence that selective serotonin reuptake inhibitors decrease nitric oxide bioavailability. This invited mini-review aims to examine the physiology of the erectile and ejaculatory responses, discuss the indicated and 'off-label' clinical utility of selective serotonin reuptake inhibitors, and to summarize evidence from basic science and clinical studies pertaining to mechanisms of how selective serotonin reuptake inhibitor therapy modifies ejaculatory and erectile function.

  7. Penile Traumatic Neuroma: A Late Complication of Penile Dorsal Neurotomy to Treat Premature Ejaculation.

    PubMed

    Park, Hyun Jun; Kim, Tae Nam; Baek, Seung Ryong; Lee, Kyung Min; Choi, Kyung-Un; Park, Nam Cheol

    2016-09-01

    Traumatic neuroma is a reactive process caused by the regeneration of an injured nerve that usually forms a nodular proliferation of small nerve bundles. Penile traumatic neuroma is rare; only a few cases related to circumcision have been reported. To report on a case of traumatic neuroma in the penis after selective dorsal neurotomy (SDN) to treat premature ejaculation. The penile traumatic neuroma was successfully removed by excision and confirmed by histopathology. A 55-year-old man who had had several painless, slow-growing nodules on his penis for 2 years presented to our hospital. He had no history of genital trauma, urinary tract infection, or penile surgery, except SDN to treat premature ejaculation. The nodules were excised and the final diagnosis was traumatic neuroma. No recurrence has been detected during 1 year of follow-up. The main complications of SDN are recurrence of premature ejaculation, pain or paresthesia on the glans penis, and erectile dysfunction. However, no traumatic neuroma has been reported as a complication. We report that a traumatic neuroma can occur after SDN. Copyright © 2016 The Authors. Published by Elsevier Inc. All rights reserved.

  8. Changing paradigms from a historical DSM-III and DSM-IV view toward an evidence-based definition of premature ejaculation. Part II--proposals for DSM-V and ICD-11.

    PubMed

    Waldinger, Marcel D; Schweitzer, Dave H

    2006-07-01

    In the Diagnostic and Statistical Manual of Mental Disorders (DSM), a descriptive definition for premature ejaculation (PE) that was based on historical assumptions has been accepted. To formulate a new functional definition of PE in the DSM. A "syndrome" approach instead of a "complaint" approach is applied and evidence-based data from epidemiological and clinical studies are used. A new functional definition of PE should pertain to a cluster of "symptoms" of a distinct "syndrome." A syndrome rather than a descriptive definition should distinguish Lifelong and Acquired PE variants. Evidence-based data also suggest another PE type "Natural Variable PE," which is not a typical syndrome but rather a cluster of inconsistent symptoms of rapid ejaculation. Moreover, in "Natural Variable PE" the occurrence of rapid ejaculation is not based on neurobiological or psychological pathology, but belongs to the normal variability of sexual performance. Its prevalence is probably much higher than that of Lifelong and Acquired PE. We propose three separate operationalized definitions of these three PE types for the pending DSM-V and ICD-11, which include a quantification of the ejaculation time (intravaginal ejaculation latency time), inability of ejaculatory control, and a description of severity of PE in terms of psychological distress. The use of the intravaginal ejaculation latency time into the DSM-V and ICD-11 would mean that statistical evidence becomes accepted as one of the mainstays for establishing an evidence-based definition of the three PE types.

  9. Acquired premature ejaculation and male accessory gland infection: relevance of ultrasound examination.

    PubMed

    La Vignera, Sandro; Condorelli, Rosita A; Vicari, Enzo; Favilla, Vincenzo; Morgia, Giuseppe; Calogero, Aldo E

    2016-01-01

    We have previously demonstrated a high frequency of premature ejaculation (PE) among patients with male accessory gland infection (MAGI). The aim of this study was to evaluate the ultrasound (US) features of patients with MAGI and acquired premature ejaculation (APE) associated (MAGI-APEpos). US evaluation of 50 MAGI-APEpos patients compared to 50 patients with MAGI without PE (MAGI-PEneg) which represent the control group. The diagnosis of APE was made through the evaluation of Intravaginal ejaculation latency time (IELT) and confirmed with the questionnaire PEDT (Premature Ejaculation Diagnostic Tool). The main outcome measure was represented by the frequency of US criteria suggestive of P (prostatitis), V (vesiculitis), and E (epididymitis) in MAGI-APEpos and MAGI-PEneg patients. MAGI-APEpos patients showed a total number of US criteria significantly higher compared to MAGI-PEneg patients. MAGI-APEpos showed a higher frequency of US criteria of V and E (complicated forms of MAGI). Finally, in MAGI-APEpos group, it was found a positive relationship between the anteroposterior diameter (APD) of the caudal tract of the epididymis and the APD of the seminal vesicles, as well as between both diameters and the PEDT score. MAGI-APEpos patients have a peculiar US characterization compared to MAGI-PEneg patients. According to these results, US evaluation of the epididymal and of the prostato vesicular tract should be considered in the practical clinical approach of patients with MAGI and APE. In particular, it could be a support for a possible pathophysiological interpretation of this clinical problem in these patients.

  10. Premature ejaculation results from partners' mismatch: development and validation of index of intra-vaginal ejaculation latency time.

    PubMed

    Cai, L; Wen, Y; Jiang, M; Zeng, M; Zhang, B

    2016-05-01

    Mismatch of partners in premature ejaculation (PE) regarding intra-vaginal ejaculation latency time (IELT) is usually neglected. Here we proposed the concept and evaluated the use of index of IELT (IIELT) as an objective diagnostic tool for PE. Data from 103 self-reporting PE patients and 59 normal controls were collected. The expected IELTs of both the male and female partners were provided by each participating couple in two questionnaires. IIELT=stopwatch IELT/(1/2 the male's expected IELT+1/2 the female's expected IELT). The stopwatch IELTs were 1.74±1.4 min (PE group) and 14.45±11.0 min (control group), P<0.05. The expected IELTs were 15.65±8.7 min (men) and 14.16±6.9 min (women) in the PE group, and 21.3±16.1 min (men) and 20.04±13.47 min (women) in the control group, P<0.05. The calculated IIELTs were 0.14±0.12 (PE group) and 0.83±0.60 (control group), P<0.05. The best cut-off point was 0.658, the Youden index was 0.652, sensitivity was 0.991, specificity was 0.661, positive predictive probability was 83.46% and negative predictive probability was 97.6%. We concluded that IIELT was an integrated measurement of the couples' sexual equilibrium and demonstrated that it provided a simple and objective screening indicator for diagnosing self-reported PE.

  11. Understanding the Pathophysiology of Premature Ejaculation: Bridging the Link between Pharmacological and Psychological Interventions.

    PubMed

    Sidi, Hatta; Yusof, Farid; Das, Srijit; Midin, Marhani; Kumar, Jaya; Hatta, Muhammd Hizri

    2016-12-15

    Premature ejaculation (PE) is one of the commonest male sexual dysfunctions. It is characterized by ejaculation which occurs before or soon after vaginal penetration, which causes significant psychological distress to the individual, and his partner. The exact cause of PE is still unknown but several mechanisms are proposed, and these involve complex interactions of neurophysiological, psychosocial, and cognitive factors. We discuss the role of serotonin, nitric oxide, phosphodiesterase enzymes and other neurotransmitters. Treatment of PE tends to co-occur with other sexual difficulties, especially erectile dysfunction (ED). Treatment with selective serotonin reuptake inhibitors (SSRIs) and Dapoxitene are also discussed in detail. The treatment strategy requires a comprehensive holistic approach incorporating both combination of psychopharmacological agent and cognitive-behavioral therapy (CBT). The present review highlights the integration of the hypothalamic-neural and reverberating emotional circuit and discusses the etiology and treatment for patients with PE.

  12. Erectile dysfunction and premature ejaculation in men who have sex with men

    PubMed Central

    Shindel, Alan W.; Vittinghoff, Eric; Breyer, Benjamin N.

    2011-01-01

    Introduction Quantitative research into sexual function and dysfunction in men who have sex with men (MSM) has been sparse due in large part to a lack of validated, quantitative instruments for the assessment of sexuality in this population. Aim To assess prevalence and associations of erectile problems and premature ejaculation in MSM. Methods MSM were invited to complete an online survey of sexual function. Ethnodemographic, sexuality, and health related factors were assessed. Main Outcome Measure Participants completed a version of the International Index of Erectile Function modified for use in MSM (IIEF-MSM) and the Premature Ejaculation Diagnostic Tool. Total score on the erectile function domain of the IIEF-EF (IIEF-MSM-EF) was used to stratify erectile dysfunction (ED) severity (25–30=no ED, 16–24 mild or mild moderate ED, 11–15 moderate ED, and ≤ 10 severe ED). PEDT scores were used to stratify risk of premature ejaculation (PE, diagnosed as PEDT score ≥9). Results Nearly 80% of the study cohort of 2,640 men resided in North America. The prevalence of ED was higher in older men whereas the prevalence of PE was relatively constant across age groups. Multivariate logistic regression revealed that increasing age, HIV seropositivity, prior use of erectogenic therapy, lower urinary tract symptoms (LUTS), and lack of a stable sexual partner were associated with greater odds of ED. A separate multivariate analysis revealed that younger age, LUTS, and lower number of lifetime sexual partners were associated with greater odds of PE. Conclusions Risk factors for sexual problems in MSM are similar to what has been observed in quantitative studies of non-MSM males. Urinary symptoms are associated with poorer sexual function in MSM. PMID:22214402

  13. [Efficacy of Shugan Yiyang Capsules combined with sertraline on premature ejaculation].

    PubMed

    Wu, Xiao-wei; Zeng, Yu-yan

    2015-11-01

    To observe the clinical effect of Shugan Yiyang Capsules combined with sertraline in the treatment of premature ejaculation (PE). We randomly assigned 192 PE patients to receive sertraline hydrochloride 50 mg qd (control group, n = 96) or sertraline hydrochloride 50 mg qd plus Shugan Yiyang Capsules at the dose of 4 capsules tid ( combination therapy group, n = 96) , both for 6 weeks. We compared the intravaginal ejaculatory latency time (IELT) and Chinese Index of Premature Ejaculation ( CIPE) scores between the two groups of patients before and after medication and at 6 weeks after drug withdrawal. Compared with the baseline, the IELT was significantly increased after 6 weeks of medication in the combination therapy group ([1.41 ± 0.53] vs [6.69 ± 3.56] min, P < 0.05) and the control group ([1.43 ± 0.48] vs [5.37 ± 2.91] min, P < 0.05), and so was the CIPE score in the former (9. 80 ± 2.06 vs 21.62 ± 4.76, P < 0.05) and the latter group ([9.41 ± 1.97] vs [20.85 ± 4.83] , P < 0.05). In comparison with the pre-medication indexes, the IELT ([3.77 ± 1.63] min) and CIPE score (16.92 ± 3.37) of the combined therapy group were remarkably improved at 6 weeks after drug withdrawal (P < 0.05), but not those of the control ([1.19 ± 1.34] min and 10.59 ± 2.38, P > 0.05). Shugan Yiyang Capsules combined with sertraline have a definite and lasting effect on premature ejaculation.

  14. Relation of size of seminal vesicles on ultrasound to premature ejaculation.

    PubMed

    Hong, Zhi-Wei; Feng, Yu-Ming; Ge, Yi-Feng; Jing, Jun; Hu, Xue-Chun; Shen, Jia-Ming; Peng, Long-Ping; Yao, Bing; Xin, Zhong-Cheng

    2016-08-19

    Myriad biological factors have been proposed to explain premature ejaculation (PE). However, data correlating PE with seminal vesicles (SVs) are sparse. The study aimed to evaluate the relationship between the size of SV and PE. The cross-sectional study included 44 outpatients with PE and 44 volunteers without PE, and the size of SV was compared. Self-estimated intravaginal ejaculatory latency time, the Premature Ejaculation Diagnostic Tool (PEDT), the International Index of Erectile Function-15, and the National Institutes of Health-Chronic Prostatitis Symptom Index were used for assessment of symptoms. Compared to the control group, the PE group had significantly higher mean anterior-posterior diameter (APD) of SV (P < 0.001). The optimal mean APD of SV cutoff level was 9.25 mm for PE. In the PE group, PEDT was also higher with a mean APD of SV ≥9.25 mm compared with mean APD of SV <9.25 mm. PEDT was significantly correlated with the mean APD of SV (r = 0.326, P = 0.031). The seminal plasma proteins were compared between six PE and six matched control cases by mass spectrometry and it was shown that 102 proteins were at least 1.5-fold up- or down-regulated. Among them, GGT1, LAMC1, and APP were significantly higher in the PE group. These results indicated that men with a larger mean APD of SV might have a higher PEDT score. Transrectal ultrasound of SV should be considered in the evaluation of patients with premature ejaculation. SV might be a potential target for the treatment of patients with PE and ultrasound change in SV.

  15. Effects of adult male circumcision on premature ejaculation: results from a prospective study in China.

    PubMed

    Gao, Jingjing; Xu, Chuan; Zhang, Jingjing; Liang, Chaozhao; Su, Puyu; Peng, Zhen; Shi, Kai; Tang, Dongdong; Gao, Pan; Lu, Zhaoxiang; Liu, Jishuang; Xia, Lei; Yang, Jiajia; Hao, Zongyao; Zhou, Jun; Zhang, Xiansheng

    2015-01-01

    The purpose of this study is to investigate the effects of adult male circumcision on premature ejaculation (PE). Therefore, between December 2009 and March 2014, a total of 575 circumcised men and 623 uncircumcised men (control group) were evaluated. Detailed evaluations (including circumcision and control groups) on PE were conducted before circumcision and at the 3-, 6-, 9-, and 12-month follow-up visits after circumcision. Self-estimated intravaginal ejaculatory latency time (IELT), Patient-Reported Outcome measures, and 5-item version of the International Index of Erectile Function were used to measure the ejaculatory and erectile function for all subjects. The results showed that, during the one-year follow-up, men after circumcision experienced higher IELT and better scores of control over ejaculation, satisfaction with sexual intercourse, and severity of PE than men before circumcision (P < 0.001 for all). Similarly, when compared with the control group, the circumcised men reported significantly improved IELT, control over ejaculation, and satisfaction with sexual intercourse (P < 0.001 for all). These findings suggested that circumcision might have positive effects on IELT, ejaculatory control, sexual satisfaction, and PE severity. In addition, circumcision was significantly associated with the development of PE.

  16. Premature ejaculation in type II diabetes mellitus patients: association with glycemic control

    PubMed Central

    Arafa, Mohamed; Al-Said, Sami; Dabbous, Zeinab; Aboulsoud, Samar; Khalafalla, Kareim; Elbardisi, Haitham

    2016-01-01

    Background Premature ejaculation (PE) is a highly prevalent sexual dysfunction among patients with diabetes mellitus (DM). Despite this, the underlying mechanism of this association is poorly understood. In this study, we aimed to investigate the prevalence of PE in a group of patients with DM and explore possible associations linking both conditions together. Methods This was a prospective study of subjects recruited with advertisement pamphlets and whose sexual function was assessed using the international index of erectile function-5 (IIEF-5) and the Arabic index of premature ejaculation (AIPE) questionnaires together with stopwatch measured intravaginal ejaculatory latency time (ELT). Participants were divided into two groups; group A subjects had DM and group B were healthy adult males. Results A total of 488 subjects were recruited. Group A included 199 (40.8%) subjects, while group B included 289 (59.2%). The prevalence of PE and ED was significantly higher in group A subjects (P<0.001). Mean ELT ± standard deviation (SD) was 3.6±2.7 in group A versus 4.3±2.8 in group B (P<0.014). Diabetic patients with erectile dysfunction (ED) showed a significantly higher incidence of PE with significantly shorter ELT. Conclusions PE is more prevalent in diabetic patients. DM is a multi-systemic disorder with complications that could help explain the pathophysiology of PE. PMID:27141454

  17. Relation between blood vitamin B12 levels with premature ejaculation: case-control study.

    PubMed

    Kadihasanoglu, M; Kilciler, M; Kilciler, G; Yucetas, U; Erkan, E; Karabay, E; Toktas, M G; Kendirci, M

    2016-09-29

    The aim of this study was to investigate whether vitamin B12 levels are associated with premature ejaculation (PE). A total of 109 subjects (56 PE and 53 controls) were included in this study. PE was defined as self-reported intravaginal ejaculatory latency time (IELT) based on the Diagnostic and Statistical Manual of Mental Disorders IV criteria and those who had had an IELT of <2 min was considered as PE. All participants were evaluated using premature ejaculation diagnostic tool (PEDT), International Index of Erectile Function (IIEF) and Beck Depression Inventory (BDI). The vitamin 12 levels were measured in all subjects. The mean age between the PE and controls was comparable (p = .084). Mean IIEF and BDI scores between the two groups did not statistically differ. The mean IELT values in the PE group were significantly lower than in the control group (p < .0001). PE patients reported significantly lower vitamin B12 levels compared with the controls (213.14 vs. 265.89 ng ml(-1) ; p < .001). The ROC analysis showed a significant correlation between the diagnosis of PE and lower vitamin B12 levels. This study has demonstrated that lower vitamin B12 levels are associated with the presence of PE. This work also shows a strong correlation between vitamin B12 levels and the PEDT scores as well as the IELT values.

  18. Tramadol for the management of premature ejaculation: a timely systematic review.

    PubMed

    Kirby, E W; Carson, C C; Coward, R M

    2015-07-01

    Premature ejaculation (PE) represents a common sexual dysfunction and is associated with a negative impact on quality of life and relationships. Recent evidence suggests that on-demand dosing of tramadol is effective at increasing intra-vaginal ejaculatory latency time (IELT) and improving subjective measures of satisfaction. A literature review was performed of journal articles published between January 2000 and July 2014 that matched the keywords 'tramadol' and 'premature ejaculation'. We identified eight relevant articles with the criteria that each article be published in a peer-reviewed journal, represent original work and be written in English. IELT was used as the primary outcome in each of the papers reviewed for efficacy. Additional subjective outcome measures were reviewed where available. Safety was assessed using adverse event data from the individual studies. We found that tramadol in on-demand dosing is effective at lengthening IELT in men with varying degrees of PE and improves patient satisfaction. Tramadol was generally well tolerated, particularly among those taking 25 and 50 mg doses. Although there is a risk of abuse and dependence, these events are rare, particularly at low doses taken intermittently. In conclusion, tramadol is an effective oral therapy for PE that is overall safe and well tolerated.

  19. The relationship between acquired premature ejaculation and metabolic syndrome: a prospective, comparative study.

    PubMed

    Bolat, D; Kocabas, G U; Gunlusoy, B; Aydogdu, O; Aydin, M E

    2017-02-09

    The aim of this study was to investigate the relationship between metabolic syndrome (MetS) and acquired premature ejaculation (PE). A total of 100 patients with acquired PE and 100 control cases were enrolled in the study. After obtaining a detailed medical history, anthropometric (weight, height and waist circumference) and blood pressure measurements were performed. Ejaculation and erection functions were evaluated by Premature Ejaculation Diagnostic Tool (PEDT) and International Index of Erectile Function-5 (IIEF-5), respectively. Self-estimated intravaginal ejaculatory latency time (IELT) of the participants was recorded. Fasting blood samples were taken for biochemical and hormonal work-up. The median PEDT scores were 16 (9-22) and 4.5 (2-8) in acquired PE and control groups, respectively (P<0.001). The mean estimated IELT values in PE patients and controls were 36.1±46.5  versus 488.2±313.8 s (P<0.001). MetS was diagnosed in 51 patients (51%) in the PE group and 24 (24%) participants in the control group (P<0.001). A significant negative correlation was observed between the components of MetS and estimated IELT, except for diastolic blood pressure. Moreover, there was a significant positive correlation between the all components of MetS and total PEDT score, except for fasting blood glucose and high-density lipoprotein cholesterol (HDL) levels. Logistic regression analysis revealed that, except blood pressure and HDL levels, MetS components were significant risk factors for PE after adjusting for age and total testosterone. In conclusion, MetS is associated with acquired PE.International Journal of Impotence Research advance online publication, 9 February 2017; doi:10.1038/ijir.2017.3.

  20. An Update of the International Society of Sexual Medicine's Guidelines for the Diagnosis and Treatment of Premature Ejaculation (PE)

    PubMed Central

    Althof, Stanley E; McMahon, Chris G; Waldinger, Marcel D; Serefoglu, Ege Can; Shindel, Alan W; Adaikan, P Ganesan; Becher, Edgardo; Dean, John; Giuliano, Francois; Hellstrom, Wayne JG; Giraldi, Annamaria; Glina, Sidney; Incrocci, Luca; Jannini, Emmanuele; McCabe, Marita; Parish, Sharon; Rowland, David; Segraves, R Taylor; Sharlip, Ira; Torres, Luiz Otavio

    2014-01-01

    Introduction In 2009, the International Society for Sexual Medicine (ISSM) convened a select panel of experts to develop an evidence-based set of guidelines for patients suffering from lifelong premature ejaculation (PE). That document reviewed definitions, etiology, impact on the patient and partner, assessment, and pharmacological, psychological, and combined treatments. It concluded by recognizing the continually evolving nature of clinical research and recommended a subsequent guideline review and revision every fourth year. Consistent with that recommendation, the ISSM organized a second multidisciplinary panel of experts in April 2013, which met for 2 days in Bangalore, India. This manuscript updates the previous guidelines and reports on the recommendations of the panel of experts. Aim The aim of this study was to develop clearly worded, practical, evidenced-based recommendations for the diagnosis and treatment of PE for family practice clinicians as well as sexual medicine experts. Method A comprehensive literature review was performed. Results This article contains the report of the second ISSM PE Guidelines Committee. It offers a new unified definition of PE and updates the previous treatment recommendations. Brief assessment procedures are delineated, and validated diagnostic and treatment questionnaires are reviewed. Finally, the best practices treatment recommendations are presented to guide clinicians, both familiar and unfamiliar with PE, in facilitating treatment of their patients. Conclusion Development of guidelines is an evolutionary process that continually reviews data and incorporates the best new research. We expect that ongoing research will lead to a more complete understanding of the pathophysiology as well as new efficacious and safe treatments for this sexual dysfunction. We again recommend that these guidelines be reevaluated and updated by the ISSM in 4 years. Althof SE, McMahon CG, Waldinger MD, Serefoglu EC, Shindel AW, Adaikan PG

  1. Somatosensory evoked potentials assess the efficacy of circumcision for premature ejaculation.

    PubMed

    Xia, J-D; Jiang, H-S; Zhu, L-L; Zhang, Z; Chen, H; Dai, Y-T

    2016-07-01

    To assess the efficacy and mechanism of circumcision in the treatment of premature ejaculation (PE) with redundant prepuce, we enrolled a total of 81 PE patients who received circumcision. The patients' ejaculatory ability and sexual performances were evaluated before and after circumcision by using questionnaires (Intravaginal ejaculation latency time (IELT), Chinese Index of PE with 5 questions (CIPE-5) and International Index of Erectile function- 5 (IIEF-5)). Furthermore, somatosensory evoked potentials (SEPs) including dorsal nerve (DNSEP) and glans penis (GPSEP) of the patients were also measured. The mean IELTs of preoperation and post operation were 1.10±0.55 and 2.48±2.03 min, respectively (P<0.001). In addition, the geometric mean IELT after operation was 2.16 min, compared with the baseline 1.07 min before the operation, the fold increase of the IELT was 2.02. Compared with the uncircumcised status, scores of CIPE-5 showed a significant increase after circumcision (P<0.001). The mean latencies (and amplitudes) of GPSEP and DNSEP were 38.1±4.0 ms (3.0±1.9 uV) and 40.5±3.4 ms (2.8±1.6 uV) before circumcision, respectively; and 42.8±3.3 ms (2.8±1.6 uV) and 40.5±4.1 ms (2.4±1.2 uV) in the follow-up end point after circumcision. Only the latencies of GPSEP showed significant prolongation before and after circumcision (P<0.001). The ejaculation time improvement after circumcision is so small, and equal to placebo response, therefore it could not be interpreted as a therapeutic method in men with PE.

  2. Diagnosis and Treatment of Premature Ejaculation by Urologists in South Korea

    PubMed Central

    Seo, Deok Ha; Jeh, Seong Uk; Choi, See Min; Kam, Sung Chul; Kim, Sae Woong; Yang, Dae Yul; Moon, Du Geon; Yang, Sang Kuk; Moon, Ki Ha

    2016-01-01

    Purpose This study discusses the treatment of premature ejaculation (PE) using various approaches with the goal of evaluating the methods of diagnosis and treatment of PE in clinical practice in 2014 in South Korea. Materials and Methods We surveyed 200 urologists and andrologists who treated patients with PE from July 1, 2014 to July 29, 2014 using an online questionnaire. The questionnaire was composed of 4 parts: disease, comorbidities, diagnosis, and treatment. Using the answers to this survey, current trends in the diagnosis and treatment of PE were investigated using weighted averages. Results The median number per month of patients who were diagnosed with PE was 14 patients (interquartile range, 7~24). The time to ejaculation necessary for a diagnosis of PE was considered to be <1 minute by 12% of respondents, <2 minutes by 27%, <3 minutes by 28%, <5 minutes by 13%, and 20% stated that diagnosis was based on a patient's subjective complaint. The treatment methods preferred by PE patients were reported to be pharmacological treatment (87%), surgical treatment (9.5%), and behavioral management (3.5%). The treatment methods used by respondents were pharmacological treatment (77%), surgical treatment (15%), and behavioral management (14%). The most commonly used pharmacological treatment was the oral administration of dapoxetine (97%). Conclusions In 2014 in South Korea, various methods were used to diagnose and treat PE. The most commonly used treatment for PE was the oral administration of dapoxetine. It was also found that surgical treatment was applied in some cases. PMID:28053952

  3. The aetiology of premature ejaculation and the mind-body problem: implications for practice.

    PubMed

    Rowland, D L; Motofei, I G

    2007-01-01

    Recent attempts to find effective pharmacological treatments for premature ejaculation (PE) have spurred significant interest in the causes of, consequences of, and existing therapies for this common male sexual dysfunction. The recurring tendency in science and medicine, however, to dichotomise causes of such problems into either biological or psychological is not only counterproductive, it is misguided. Ejaculatory response should be viewed as a system of integrated and inseparable hardwired and softwired central and peripheral responses, some being readily modifiable, others not. Such a view argues that treatment of PE aimed at multiple levels of functioning will be self-enhancing and ultimately more effective in producing positive therapeutic outcomes than strategies relying solely on either psychological or biological approaches.

  4. Dapoxetine, a novel selective serotonin transport inhibitor for the treatment of premature ejaculation

    PubMed Central

    Kendirci, Muammer; Salem, Emad; Hellstrom, Wayne JG

    2007-01-01

    Premature ejaculation (PE) is the most common male sexual disorder, estimated to affect up to 30% of men. Over the past one or two decades, clinical investigators have participated in an increasing number of studies that are helping in our understanding of PE, which will undoubtedly facilitate future treatments. Apart from a number of behavioral approaches, the treatment of PE consists of primarily off-label use of oral selective serotonin reuptake inhibitors (SSRIs) via either on-demand or daily delivery. However, various undesirable side-effects of these medications have led researchers to search for and develop new therapeutic approaches for PE. Dapoxetine is a short-acting SSRI developed specifically for the treatment of PE. Early trials with dapoxetine have documented successful outcomes without serious short- or long-term side-effects. This review addresses the definition, classification, diagnosis, physiology, and neurobiopathology of PE, and evaluates therapeutic strategies with novel treatments for PE. PMID:18360636

  5. Dapoxetine, a novel selective serotonin transport inhibitor for the treatment of premature ejaculation.

    PubMed

    Kendirci, Muammer; Salem, Emad; Hellstrom, Wayne Jg

    2007-06-01

    Premature ejaculation (PE) is the most common male sexual disorder, estimated to affect up to 30% of men. Over the past one or two decades, clinical investigators have participated in an increasing number of studies that are helping in our understanding of PE, which will undoubtedly facilitate future treatments. Apart from a number of behavioral approaches, the treatment of PE consists of primarily off-label use of oral selective serotonin reuptake inhibitors (SSRIs) via either on-demand or daily delivery. However, various undesirable side-effects of these medications have led researchers to search for and develop new therapeutic approaches for PE. Dapoxetine is a short-acting SSRI developed specifically for the treatment of PE. Early trials with dapoxetine have documented successful outcomes without serious short- or long-term side-effects. This review addresses the definition, classification, diagnosis, physiology, and neurobiopathology of PE, and evaluates therapeutic strategies with novel treatments for PE.

  6. Interplay Between Premature Ejaculation and Erectile Dysfunction: A Systematic Review and Meta-Analysis.

    PubMed

    Corona, Giovanni; Rastrelli, Giulia; Limoncin, Erika; Sforza, Alessandra; Jannini, Emmanuele A; Maggi, Mario

    2015-12-01

    The specific determinants and underlying factors linking erectile dysfunction (ED) and premature ejaculation (PE) have yet to be clearly identified. The aim of this study was to review and meta-analyze all available data regarding the link between ED and PE. An extensive Medline Embase and Cochrane search was performed including the following words: "premature ejaculation" and "erectile dysfunction". All observational trials comparing the risk of ED in relation to PE were included. Data extraction was performed independently by two of the authors (G.R, G.C.), and conflicts resolved by the third investigator (M.M.). Out of 474 retrieved articles, 18 were included in the study for a total of 57,229 patients, of which 12,144 (21.2%) had PE. The presence of PE, however defined, was associated with a significant increase in ED risk (odds ratio: 3.68[2.61;5.18]; P < 0.0001). Meta-regression analysis showed that the risk of ED in PE subjects was higher in older individuals as well as in those with a lower level of education and in those who reported a stable relationship less frequently. In addition, subjects with PE and ED more often reported anxiety and depressive symptoms and a lower prevalence of organic associated morbidities, including diabetes mellitus, hypertension and dyslipidemia. All the latter associations were confirmed even after adjustment for age. Finally the risk of PE-related ED increased with the increased proportion of acquired ejaculatory problems (adj r = 0.414; P < 0.0001 after the adjustment for age). In conclusion, the present data showed that ED and PE are not distinctly separate entities, but should be considered from a dimensional point of view. Understanding this dimensional perspective might help sexual health care professionals in providing the most appropriate therapeutic approach to realistically increase patient related outcomes in sexual medicine. © 2015 International Society for Sexual Medicine.

  7. Urologist's Practice Patterns Including Surgical Treatment in the Management of Premature Ejaculation: A Korean Nationwide Survey.

    PubMed

    Yang, Dae Yul; Ko, Kyungtae; Lee, Won Ki; Park, Hyun Jun; Lee, Sung Won; Moon, Ki Hak; Kim, Sae Woong; Kim, Soo Woong; Cho, Kang Su; Moon, Du Geon; Min, Kweonsik; Yang, Sang Kuk; Son, Hwancheol; Park, Kwangsung

    2013-12-01

    According to previous studies, the prevalence of premature ejaculation (PE) in Korea ranges from 11.3% to 33%. However, the actual practice patterns in managing patients with PE is not well known. In this study, we have endeavored to determine how contemporary urologists in Korea manage patients with PE. The e-mailing list was obtained from the Korean Urological Association Registry of Physicians. A specifically designed questionnaire was e-mailed to the 2,421 urologists in Korea from May 2012 to August 2012. UROLOGISTS IN KOREA DIAGNOSED PE USING VARIOUS CRITERIA: the definition of the International Society for Sexual Medicine (63.4%), Diagnostic and Statistical Manual of Mental Disorders (43.8%), International Statistical Classification of Disease, 10th edition (61.7%), or perceptional self-diagnosis by the patient himself (23.5%). A brief self-administered questionnaire, the Premature Ejaculation Diagnostic Tool, was used by only 42.5% of the urologists. Selective-serotonin reuptake inhibitor (SSRI) therapy was the main treatment modality (91.5%) for PE patients. 40.2% of the urologists used phosphodiesterase type 5 inhibitors, 47.6% behavior therapy, and 53.7% local anesthetics. Further, 286 (54.3%) urologists managed PE patients with a surgical modality such as selective dorsal neurotomy (SDN). A majority of Korean urologists diagnose PE by a multidimensional approach using various diagnostic tools. Most urologists believe that medical treatment with an SSRI is effective in the management of PE. At the same time, surgical treatment such as SDN also investigated as one of major treatment modality despite the lack of scientific evidence.

  8. Urologist's Practice Patterns Including Surgical Treatment in the Management of Premature Ejaculation: A Korean Nationwide Survey

    PubMed Central

    Yang, Dae Yul; Ko, Kyungtae; Lee, Won Ki; Park, Hyun Jun; Moon, Ki Hak; Kim, Sae Woong; Kim, Soo Woong; Cho, Kang Su; Moon, Du Geon; Min, Kweonsik; Yang, Sang Kuk; Son, Hwancheol; Park, Kwangsung

    2013-01-01

    Purpose According to previous studies, the prevalence of premature ejaculation (PE) in Korea ranges from 11.3% to 33%. However, the actual practice patterns in managing patients with PE is not well known. In this study, we have endeavored to determine how contemporary urologists in Korea manage patients with PE. Materials and Methods The e-mailing list was obtained from the Korean Urological Association Registry of Physicians. A specifically designed questionnaire was e-mailed to the 2,421 urologists in Korea from May 2012 to August 2012. Results Urologists in Korea diagnosed PE using various criteria: the definition of the International Society for Sexual Medicine (63.4%), Diagnostic and Statistical Manual of Mental Disorders (43.8%), International Statistical Classification of Disease, 10th edition (61.7%), or perceptional self-diagnosis by the patient himself (23.5%). A brief self-administered questionnaire, the Premature Ejaculation Diagnostic Tool, was used by only 42.5% of the urologists. Selective-serotonin reuptake inhibitor (SSRI) therapy was the main treatment modality (91.5%) for PE patients. 40.2% of the urologists used phosphodiesterase type 5 inhibitors, 47.6% behavior therapy, and 53.7% local anesthetics. Further, 286 (54.3%) urologists managed PE patients with a surgical modality such as selective dorsal neurotomy (SDN). Conclusions A majority of Korean urologists diagnose PE by a multidimensional approach using various diagnostic tools. Most urologists believe that medical treatment with an SSRI is effective in the management of PE. At the same time, surgical treatment such as SDN also investigated as one of major treatment modality despite the lack of scientific evidence. PMID:24459656

  9. Topical anaesthetics for premature ejaculation: a systematic review and meta-analysis.

    PubMed

    Martyn-St James, Marrissa; Cooper, Katy; Ren, Kate; Kaltenthaler, Eva; Dickinson, Kath; Cantrell, Anna; Wylie, Kevan; Frodsham, Leila; Hood, Catherine

    2016-04-01

    Eutectic Mixture of Local Anaesthetics (EMLA) is recommended for use off-label as a treatment for premature ejaculation (PE). Other topical anaesthetics are available, some of which have been evaluated against oral treatments. The purpose of this systematic review was to evaluate the evidence from randomised controlled trials (RCTs) for topical anaesthetics in the management of PE. Bibliographic databases including MEDLINE were searched to August 2014. The primary outcome was intra-vaginal ejaculatory latency time (IELT). Methodological quality of RCTs was assessed. IELT and other outcomes were pooled across RCTs in a meta-analysis. Between-trial heterogeneity was assessed. Nine RCTs were included. Seven were of unclear methodological quality. Pooled evidence (two RCTs, 43 participants) suggests that EMLA is significantly more effective than placebo at increasing IELT (P<0.00001). Individual RCT evidence also suggests that Topical Eutectic-like Mixture for Premature Ejaculation (TEMPE) spray and lidocaine gel are both significantly more effective than placebo (P=0.003; P<0.00001); and lidocaine gel is significantly more effective than sildenafil or paroxetine (P=0.01; P=0.0001). TEMPE spray is associated with significantly more adverse events than placebo (P=0.003). More systemic adverse events are reported with tramadol, sildenafil and paroxetine than with lidocaine gel. Diverse methods of assessing sexual satisfaction and ejaculatory control with topical anaesthetics are reported and evidence is conflicting. Topical anaesthetics appear more effective than placebo, paroxetine and sildenafil at increasing IELT in men with PE. However, the methodological quality of the existing RCT evidence base is uncertain.

  10. Combination therapy with selective serotonin reuptake inhibitors and phosphodiesterase-5 inhibitors in the treatment of premature ejaculation.

    PubMed

    Polat, E C; Ozbek, E; Otunctemur, A; Ozcan, L; Simsek, A

    2015-06-01

    We aimed to evaluate the effectiveness of paroxetine and tadalafil combination in the treatment of premature ejaculation (PE). A total of 150 primary (lifelong)PE patients were randomly distributed into three groups of 50 patients each. Group 1 received 20 mg paroxetine every day for 1 month, Group 2 received 20 mg tadalafil on demand 2 h before intercourse, and Group 3 received paroxetine and tadalafil on demand 2 h before intercourse. Intravaginal ejaculatory latency times (IELT) scores were evaluated at baseline, at the end of the first month of therapy and 1 month after discontinuation of the treatment, while International Index of Erectile Function (IIEF) questionnaire scores were evaluated both prior to and after the treatment. At the end of the first month of therapy, IELT scores were compared with the basal values and statistically significant changes were detected (60.6 ± 30.2-117.3 ± 67.3, 68.5 ± 21.4-110.2 ± 37.3, 71.56 ± 40.23-175.2 ± 60.2)(P < 0.01). IELT scores after discontinuation of treatment were found to be close to the baseline IELT scores (P > 0.05). IIEF scores were evaluated both prior to and after the treatment, and no statistically significant difference was detected (P > 0.05). It is concluded that utilisation of selective serotonin reuptake inhibitors (SSRI) and phosphodiesterase-5 inhibitors (PDE5i) combination before intercourse seems to provide significantly longer ejaculatory latency times as compared with SSRI alone for a long time in patients with PE.

  11. Effectiveness of ‘on demand’ silodosin in the treatment of premature ejaculation in patients dissatisfied with dapoxetine: a randomized control study

    PubMed Central

    Shastry, Anuradha

    2016-01-01

    Introduction Premature ejaculation is a common sexual disorder, which is usually underreported. Multiple treatment methodologies are in use due to the absence of an effective, universally acceptable treatment modality. The most common drug used is dapoxetine, which has adverse effects limiting its long-term use. Hence, we decided to evaluate the effectiveness of ‘on demand’ silidosin 4 mg in patients with premature ejaculation, who were dissatisfied with dapoxetine 30 mg. Material and methods The study included 64 patients who reported premature ejaculation who were unhappy with the treatment with ‘on demand’ dapoxetine 30 mg, either due to its adverse effects or because of its overall inefficacy. They were divided into two groups of 33 and 31 respectively by simple randomization, with Group A treated with ‘on demand’ silodosin 4 mg three hours prior to intercourse, whereas Group B was treated with placebo. Pre- and post-treatment intravaginal ejaculatory latency time (IELT), premature ejaculation profile (PEP) and clinical global impression of change (CGIC) for premature ejaculation were evaluated. Results Patients in Group A (silodosin 4 mg) reported statistically significant improvement (p <0.005) in intravaginal ejaculatory latency time (IELT), premature ejaculation profile (PEP) and clinical global impression of change (CGIC) for premature ejaculation, with four patients reporting uncomfortably-delayed ejaculation. Conclusions ‘On demand’ silodosin 4 mg is an effective treatment option with very few adverse events in those patients suffering from premature ejaculation, who are dissatisfied with dapoxetine 30 mg due to its adverse effects or inefficacy. PMID:27729995

  12. Comparison of Alpha Blockers in Treatment of Premature Ejaculation: A Pilot Clinical Trial

    PubMed Central

    Akin, Yigit; Gulmez, Hakan; Ates, Mutlu; Bozkurt, Aliseydi; Nuhoglu, Baris

    2013-01-01

    Background: Premature ejaculation (PE) is the most common sexual disorder in men and studies reported prevalence up to 30% (1, 2). PE is not a life-threatening medical condition but it influences the quality of life (QoL). Objectives: The aim of this study was to compare the efficiency, and safety of alpha blocker drugs in the treatment of patients with premature ejaculation (PE). Additionally we investigated the quality of life (QoL) in patients with PE who were treated with alpha blocker drugs. Materials and Methods: This study was a pilot clinical trial. Prospectively documented 108 patients with PE were treated and were followed-up in urology outpatient clinic. All patients were divided into 5 groups according to used alpha blocker agents which were determined by simple randomization. Silodosin 4mg (Group 1, n = 21), tamsulosin hydrochloride 0.4mg (Group 2, n = 23), alfuzosin 10mg (Group 3, n = 22), terazosin 5mg (Group 4, n = 21), doksazosin mesylate 4mg (Group5, n = 21), were used for treatment. The demographic parameters of patients, pre and post treatment intravaginal ejaculation latency time (IELT), PE Profile (PEP), and QoL index were recorded and evaluated. Effectiveness of treatment was evaluated by measuring IELT. Additionally, side effects of drugs were recorded. P < 0.05 was considered statistically significant. Results: All alpha blocker drugs were statistically effective for preventing PE. Notably, silodosin seemed to be more effective for preventing PE than other alpha blockers (P < 0.05). However all alpha blockers provided development in QoL scores, silodosin was a little better than other drugs in statistical analyses. Furthermore statistical increase in IELT and decrease in PEP were provided more in Group 1 than other groups (P < 0.05). Conclusions: Silodosin seems to be able to even more prevent PE. Silodosin may provide development in QoL than other alpha blocker agents. Additionally, lower systemic adverse events and more effectivity are

  13. Prevalence of prostatitis-like symptoms in outpatients with four premature ejaculation syndromes: a study in 438 men complaining of ejaculating prematurely

    PubMed Central

    Tang, Dongdong; Zhang, Xiansheng; Hao, Zongyao; Zhou, Jun; Liang, Chaozhao

    2014-01-01

    Objective: To evaluate the incidence of prostatitis-like symptoms (PLS) in men with or without PE, and the differences among the 438 outpatients with the four PE syndromes. Subjects and methods: Between January 2012 and January 2013, 438 consecutive heterosexual men complaining of PE and another 493 male healthy subjects without the complaint were included in this study. Each of them completed a detailed face-to-face questionnaire for information of demographics, National Institutes of Health-Chronic Prostatitis Symptom Index (NIH-CPSI), and International Index of Erectile Function-5 (IIEF-5). Each patient was classified as one of the four PE subtypes: lifelong PE (LPE), acquired PE (APE), natural variable PE (NVPE), or premature-like ejaculatory dysfunction (PLED). Results: There were no significant difference between patients and control subjects regarding demographics. In the PE group, the prevalence of PLS were 32%, showing statistical significance compared with control subjects (15.8%, P<0.001). And the NIH-CPSI score was 10.0±7.9, showing significant difference compared with control subjects (6.0± 5.4, P<0.001). Among the four PE syndromes, patients with PLED had the highest prevalence of PLS (42.3%, P<0.001), but the difference of NIH-CPSI scores among the four PE syndromes was not significant (P=0.055). Conclusions: PLS were more common in patients with PE. Also, patients had worse NIH-CPSI scores than the control subjects. Therefore, patients with PLED had the highest incidence of PLS. PMID:25126187

  14. Phosphodiesterase-5 inhibitors for premature ejaculation: a systematic review and meta-analysis

    PubMed Central

    Cooper, Katy; Ren, Shijie; Kaltenthaler, Eva; Dickinson, K; Cantrell, A; Wylie, Kevan; Frodsham, Leila; Hood, Catherine

    2016-01-01

    Context Phosphodiesterase-5 inhibitors (PDE5is) are prescribed off-label for the treatment of premature ejaculation (PE). Objective To systematically review the evidence from randomised controlled trials (RCTs) for PDE5is in the management of PE. Evidence acquisition MEDLINE and other databases were searched to September 2015. Quality of RCTs was assessed. Intra-vaginal ejaculatory latency time (IELT) data were pooled in a meta-analysis. Heterogeneity was assessed. Evidence synthesis Fifteen RCTs were included. The majority were of unclear methodological quality. Pooled IELT evidence suggests: PDE5is are significantly more effective than placebo (231 participants, p<0.00001); there is no difference between PDE5is and selective serotonin reuptake inhibitors (SSRIs) (405 participants, p=0.50); and that PDE5is combined with an SSRI are significantly more effective than SSRIs alone (521 participants, p=0.001). However, high levels of statistical heterogeneity are evident (I2≥40%). Single RCT evidence suggests that sildenafil is significantly more effective than the squeeze technique; but both lidocaine gel and tramadol are significantly more effective than sildenafil. Sildenafil combined with behavioural therapy is significantly more effective than behavioural therapy alone. Sexual satisfaction and ejaculatory control appear better with PDE5is compared with placebo and with PDE5is combined with an SSRI compared with an SSRI alone. Adverse events are reported with both PDE5is and other agents. Conclusions PDE5is are significantly more effective than placebo and PDE5is combined with an SSRI are significantly more effective than SSRIs alone at increasing IELT and improvement in other effectiveness outcomes. However, heterogeneity is evident across RCTs. The methodological quality of the majority of RCTs is unclear. Patient summary We reviewed PDE5is for treating premature ejaculation. We found evidence to suggest that PDE5is are effective compared with placebo and that

  15. Ancient Chinese Fangzhongshu (Sexual Skills and Methods) Therapy for Premature Ejaculation.

    PubMed

    Zhu, Yong; Chen, Qiang; Gu, Yuexing; Yue, Jin; Zeng, Qingqi

    2016-12-01

    Premature ejaculation (PE) is a common male sexual dysfunction that can have significant effects on a couple's relationship. Behavioral therapy and psychotherapy are both safe and effective methods of treating PE. Ancient Chinese fangzhongshu (sexual skills and methods), which reflects a summary of expert experiences in sexology, contains many therapies for sexual dysfunction that are similar to those used in behavioral therapy or psychotherapy. A brief introduction dealing with the latest definitions of PE and treatment strategies drawn from behavioral therapy and psychotherapy is provided. Typical therapies for PE from ancient Chinese fangzhongshu are listed and briefly analyzed in order to define their domain of applicability and instructions for use. Ancient Chinese fangzhongshu contains many effective and safe therapies for PE. It should be incorporated into modern medical practice after critical analysis, and its scientific aspects should be promoted as a way of improving reproductive health, both to benefit individuals affected by PE and to promote traditional Chinese culture. Based on an analysis of the condition of the individual patient, one or multiple therapies guided by fangzhongshu can be expected to have an effect on the patient. Ancient Chinese fangzhongshu is of great value and should to be popularized and applied as a remedy for PE.

  16. Ancient Chinese Fangzhongshu (Sexual Skills and Methods) Therapy for Premature Ejaculation

    PubMed Central

    Zhu, Yong; Chen, Qiang; Gu, Yuexing; Yue, Jin

    2016-01-01

    Premature ejaculation (PE) is a common male sexual dysfunction that can have significant effects on a couple's relationship. Behavioral therapy and psychotherapy are both safe and effective methods of treating PE. Ancient Chinese fangzhongshu (sexual skills and methods), which reflects a summary of expert experiences in sexology, contains many therapies for sexual dysfunction that are similar to those used in behavioral therapy or psychotherapy. A brief introduction dealing with the latest definitions of PE and treatment strategies drawn from behavioral therapy and psychotherapy is provided. Typical therapies for PE from ancient Chinese fangzhongshu are listed and briefly analyzed in order to define their domain of applicability and instructions for use. Ancient Chinese fangzhongshu contains many effective and safe therapies for PE. It should be incorporated into modern medical practice after critical analysis, and its scientific aspects should be promoted as a way of improving reproductive health, both to benefit individuals affected by PE and to promote traditional Chinese culture. Based on an analysis of the condition of the individual patient, one or multiple therapies guided by fangzhongshu can be expected to have an effect on the patient. Ancient Chinese fangzhongshu is of great value and should to be popularized and applied as a remedy for PE. PMID:28053946

  17. The role of dapoxetine hydrochloride on-demand for the treatment of men with premature ejaculation.

    PubMed

    De Hong, Cao; Ren, Liu Liang; Yu, Huang; Qiang, Wei

    2014-12-01

    Premature ejaculation (PE) is the most common male sexual dysfunction. Dapoxetine hydrochloride, belonging to a class of drugs known as selective serotonin reuptake inhibitors or, was the first drug originally approved for the on-demand treatment of men with PE. We aimed to compare the intravaginal ejaculatory latency time (IELT), patient-reported global impression of change (PGIC), and adverse effect (AE) incidence associated with the use of dapoxetine (30 mg and 60 mg) versus placebo, and evaluate the differences in administering 60 mg versus 30 mg as on-demand medical oral therapy for the treatment of PE via a literature review and meta-analysis. Relevant randomized controlled trials (RCTs) were identified from PubMed, EMBASE, and Cochrane Central Register of Controlled Trials (Cochrane Library) databases. Ultimately, a total of seven RCTs with 8039 patients were included. Our meta-analysis demonstrated that dapoxetine (in the 30 mg and 60 mg subgroup) resulted in significantly higher IELT, PGIC, and AE incidence relative to the placebo, with higher proportions observed for 60 mg versus 30 mg of dapoxetine administration. The most common AEs were mild and tolerable. We conclude that dapoxetine (particularly the 60 mg dosage) may be considered a safe and effective drug for patients with PE.

  18. Further definition on the multiple partner choice arena: a potential animal model for the study of premature ejaculation.

    PubMed

    Olayo-Lortia, Jesús; Ferreira-Nuño, Armando; Velázquez-Moctezuma, Javier; Morales-Otal, Adriana

    2014-10-01

    The multiple partner choice arena (MPCA) is an experimental setup in which male rats display a significant shortening of ejaculation latency, which is the main characteristic of premature ejaculation (PE) in men. Thus, the MPCA is a potential animal model for PE. In this study, we further analyze whether the features of the MPCA satisfy the validity criteria for it to be considered an animal model as well as the possible participation of the serotoninergic system in the faster ejaculation exhibited by male rats in the MPCA. In Experiment 1, male rats were tested in a standard arena to assess their sexual behavior, then were assessed 1 week later in the MPCA. Another group was first tested in the MPCA, then in a standard arena. In Experiment 2, male rats divided into two groups were treated daily with WAY-100635 (5-HT(1A) antagonist) or vehicle for 15 days. In each group, half of the subjects were tested in a standard arena and half were tested in the MPCA on days 1, 8, and 15 of treatment. Number of intromissions and intromission and ejaculation latencies were the main outcome measures. In Experiment 1, males tested in the MPCA ejaculated significantly faster, regardless of the order in which they were evaluated in both arenas. In Experiment 2, the administration of WAY-100635 increased intromission and ejaculation latencies, and the number of intromissions in the MPCA. The results obtained in the MPCA support its use as an animal model for PE evaluation. © 2014 International Society for Sexual Medicine.

  19. Mucosal cuff length to penile length ratio may affect the risk of premature ejaculation in circumcised males.

    PubMed

    Yuruk, E; Temiz, M Z; Colakerol, A; Muslumanoglu, A Y

    2016-01-01

    Data regarding the relation between premature ejaculation (PE) and post-circumcision mucosal cuff length are controversial. The aim of this study is to analyze the relation between post-circumcision mucosal cuff length/penile length ratio (MCR) and PE. After exclusion of patients with erectile dysfunction, penile deformity, history of penile surgery and severe lower urinary tract symptoms, 49 circumcised men with PE were included. The control group is constituted of 50 healthy volunteers with normal ejaculatory function. Self-estimated intravaginal ejaculation latency time (IELT) and premature ejaculation profile (PEP) measures of all subjects were recorded, and the MCRs of patients and controls were compared. The mean age of PE patients and controls was 35.82 ± 7.73 (range 23-54) and 38.78 ± 13.42 (range 19-71) years, respectively (P=0.183). Although mucosal cuff length was not associated with either self-estimated IELT (r=-0.185, P=0.067) or PEP (r=-0.098, P=0.336), there was a negative correlation between MCR and self-estimated IELT (r=-0.205, P=0.0001) and PEP measures (r=-0.308, P=0.002). The length of the mucosal cuff after circumcision may have an impact on ejaculatory function. Surgeons should avoid leaving excessive amount of mucosa during circumcision.

  20. [Sertraline hydrochloride combined with four-spot caressing for primary premature ejaculation].

    PubMed

    Zhu, Yong; Yue, Jin; Liu, Zheng-jian; Huang, Jian; Bian, Ting-song; Wang, Jin-song; Zeng, Qing-qi

    2015-12-01

    To investigate the clinical effectiveness of sertraline hydrochloride combined with four-spot caress in the treatment of primary premature ejaculation (PE). We randomly assigned 90 primary PE patients to three groups of equal number. The patients in group A (aged [28.1 ± 5.2] yr and with a disease course of [3.1 ± 1.9] yr) were treated with oral sertraline hydrochloride at 50 mg qd, those in B (aged [27.8 ± 4.1] yr and with a disease course of [3.2 ± 2.0] yr) by four-spot caressing (caressing the tongue, breasts, and vulva prior to intercourse), and those in C (aged [27.1 ± 4.7] yr and with a disease course of [3.1 ± 2.0] yr) by the combination of oral sertraline hydrochloride and four-spot caressing, all for 12 weeks. Before and after 4, 8, and 12 weeks of treatment, we obtained the intravaginal ejaculatory latency time (IELT) and Chinese Index of Sexual Function for Premature Ejaculation-5 (CIPE-5) scores and compared them among the three groups of patients. The IELT was dramatically prolonged in groups A, B, and C after 4 weeks ([1.08 ± 0.29], [0.93 ± 0.28] and [1.21 ± 0.27] min), 8 weeks ([1.43 ± 0.30], [1.20 ± 0.33] and [1.72 ± 0.42] min) and 12 weeks of treatment ([2.12 ± 0.63], [1.90 ± 0.65] and [2.67 ± 0.82] min) as compared with the baseline ([0.63 ?0.14] , [0.60 ?0.14] and [0.62 ?0.11] min) (P < 0.05), even longer in group C than in A and B (P < 0.05). The CIPE-5 scores were markedly improved in groups A, B and C after 4 weeks ([15.17 ± 1.74], [14.57 ± 1.94] and [15.60 ± 1.63] min), 8 weeks ([17.13 ± 1.63], [16.37 ± 1.97] and [18.00 ± 1.05] min) and 12 weeks of intervention ([18.93 ± 1.57], [18.53 ± 1.67] and [20.00 ± 1.46] min ) as compared with the baseline ([12.57 ± 2.05], [13.20 ± 2.51] and [13.07 ± 2.01] min) (P < 0.05), even higher in group C than in A and B (P < 0.05). Sertraline hydrochloride combined with four-spot caressing, with its definite efficacy and rare adverse reactions, deserves wide clinical application in

  1. A randomized single-center study to compare the efficacy and tolerability of tadalafil once daily plus lidocaine anesthetic spray on premature ejaculation.

    PubMed

    Dell'Atti, L; Galosi, A B; Ippolito, C

    2017-03-01

    The use of topical local anesthetics in the form of creams, gel or spray is the oldest method of retarding ejaculation. However, several studies have suggested that phosphodiesterase type 5 inhibitors (5-PDEiS) show a potential therapeutic use in the treatment of premature ejaculation (PE). The aim of this study was to compare the efficacy and tolerability of tadalafil-only, tadalafil plus local anesthetic spray (lidocaine), and topical lidocaine spray-only before intercourse on the intravaginal ejaculatory latency time (IELT) of patients with lifelong PE. The study included 78 men in stable heterosexual, monogamous relationships (of ≥3 months) who were diagnosed with lifelong PE. The patients were divided into three groups: G1: 25 patients who received lidocaine spray 10 g/100 ml at 5 min before intercourse; G2: 27 patients who received tadalafil 5 mg once daily; G3: 26 patients who treated with tadalafil once daily plus lidocaine spray before planned sexual activity. The treatments were continued for up to three months in all groups. Moreover, the quality of their sexual attempts was rated on a 5-point scale. Follow-up was made at 1-month and 3-month. Not statistically significant differences emerged between the three groups at baseline. Mean ejaculatory latency time at the 3-month follow-up in G1, G2 and G3 was 3.7±1.3, 3.4±1.5, 5.6±1.7 (p<0.001). Mean satisfaction score was at the 3-month follow-up in G1: 2.8±1.4, in G2: 2.9±1.8, and G3: 3.7±1.5 (p<0.002). None of the patients withdrew from the study because of these adverse events. This study demonstrates that tadalafil used daily has a role on treatment in lifelong PE. This action is valid when combined strategically to the synergistic action of lidocaine spray applied before intercourse increasing significantly the mean IELT.

  2. Regional differences in men attending a sexual health clinic in Sydney for premature ejaculation.

    PubMed

    Frewen, Amie; Rapee, Ronald M; Bowden, Pip; Lagios, Katerina

    2007-11-01

    Previous investigation from UK sexual health clinics has suggested that men from Central Asian and Middle Eastern backgrounds are more likely to present with premature ejaculation (PE) than men from Western backgrounds. This interesting finding requires replication, especially in populations from other countries. The current study aimed to determine whether men who had sought treatment for PE from a community sexual health clinic were more likely to come from Central Asian and Middle Eastern backgrounds than from Western backgrounds. Demographic and clinical data were collected retrospectively from patient files over a 3-year period. Patient-defined ethnicity for outpatients seeking psychological interventions for PE was compared to the ethnicity of those attending for other sexual dysfunctions and also to local population census data. Clinical files for 215 men seeking psychological interventions for sexual dysfunctions at an urban sexual health clinic in Sydney were examined. Men were included in the study if they reported being born in one of two regional groups: Western countries or Middle Eastern/Central Asian countries. The rates of men seeking help for PE vs. other sexual dysfunctions were compared between these two regional groups and were compared with the representation of each region in the broader sexual health service as well as the local population. Relative to men born in Western regions, men from Central Asian/Middle Eastern countries were more likely to present with PE than with other sexual dysfunctions. The proportion of men from Central Asian/Middle Eastern countries presenting with PE was considerably higher than expected for the population attending the sexual health clinic or the broader local community. Consistent with previous research, Asian and Middle Eastern men living in a Western society appear to be more likely than Western men to report difficulties with PE.

  3. Changes of cerebral current source by audiovisual erotic stimuli in premature ejaculation patients.

    PubMed

    Hyun, Jae-Seog; Kam, Sung-Chul; Kwon, Oh-Young

    2008-06-01

    Premature ejaculation (PE) is one of the most common forms of male sexual dysfunction. The mechanisms of PE remain poorly understood, despite its high prevalence. To investigate the pathophysiology and causes of PE in the central nervous system, we tried to observe the changes in brain current source distribution by audiovisual induction of sexual arousal. Electroencephalograpies were recorded in patients with PE (45.0 +/- 10.3 years old, N = 18) and in controls (45.6 +/- 9.8 years old, N = 18) during four 10-minute segments of resting, watching a music video excerpt, resting, and watching an erotic video excerpt. Five artifact-free 5-second segments were used to obtain cross-spectral low-resolution brain electromagnetic tomography (LORETA) images. Statistical nonparametric maps (SnPM) were obtained to detect the current density changes of six frequency bands between the erotic video session and the music video session in each group. Comparisons were also made between the two groups in the erotic video session. In the SnPM of each spectrum in patients with PE, the current source density of the alpha band was significantly reduced in the right precentral gyrus, the right insula, and both superior parietal lobules (P < 0.01). Comparing the two groups in the erotic video session, the current densities of the beta-2 and -3 bands in the PE group were significantly decreased in the right parahippocampal gyrus and left middle temporal gyrus (P < 0.01). Neuronal activity in the right precental gyrus, the right insula, both the superior parietal lobule, the right parahippocampal gyrus, and the left middle temporal gyrus may be decreased in PE patients upon sexual arousal. Further studies are needed to evaluate the meaning of decreased neuronal activities in PE patients.

  4. Prevalence of premature ejaculation and its correlation with chronic prostatitis in Chinese men.

    PubMed

    Liang, Chao-Zhao; Hao, Zong-Yao; Li, Hong-Jun; Wang, Zhi-Ping; Xing, Jun-Ping; Hu, Wei-Lie; Zhang, Tao-Fu; Ge, Wei-Wei; Zhang, Xian-Sheng; Zhou, Jun; Li, Yu; Zhou, Zheng-Xing; Tang, Zhi-Guo; Tai, Sheng

    2010-10-01

    Chronic pelvic pain syndrome is a common and serious health problem affecting the quality of life of men. We evaluated the prevalence of premature ejaculation (PE) in Chinese men with chronic pelvic pain syndrome and studied its correlation to chronic prostatitis. A total of 15,000 men (aged 15-60 years) were randomly recruited to take part in a survey to provide questionnaire-elicited information for sociodemographics, sexual function, National Institutes of Health-Chronic Prostatitis Symptom Index, and International Index of Erectile Function 5-item questionnaire. The eligible subjects of the present investigation were married with sexual activity. Responses were collected from 12 743 men (84.95%). Of these men, 1071 (8.4%) reported having prostatitis-like symptoms. The incidence of chronic prostatitis was 4.5% (n = 571) for the entire group. Of the 7372 eligible men, the incidence of prostatitis-like symptoms, chronic prostatitis, and PE was 10.5% (n = 771), 5.0% (n = 370), and 15.3% (n = 1127), respectively. The group with PE had worse National Institutes of Health-Chronic Prostatitis Symptom Index scores (P < .05) and lower International Index of Erectile Function 5-item questionnaire scores (P < .05) than the patients without PE. Also, the percentage of prostatitis-like symptoms in the PE group was greater than that in the non-PE group (P < .05). The prevalence of PE was 64.1% and 36.9% in the prostatitis-like symptom and chronic prostatitis group, respectively, of the 7372 eligible men. The results of our study showed a high prevalence of PE in patients with chronic prostatitis. An examination of the prostate, physically and microbiologically, should be considered during the assessment of patients with PE. Copyright © 2010 Elsevier Inc. All rights reserved.

  5. Relationship between premature ejaculation and depression: A PRISMA-compliant systematic review and meta-analysis.

    PubMed

    Xia, Yue; Li, Juanjuan; Shan, Guang; Qian, Huijun; Wang, Tao; Wu, Wei; Chen, Jun; Liu, Luhao

    2016-08-01

    Premature ejaculation (PE) is the most prevalent male sexual dysfunction. Epidemiologic findings are inconsistent concerning the risk for depression associated with PE. The aim of this study was to investigate the potential association between between depression and risk of PE. We conducted a literature search of PubMed, Embase, and the Cochrane Library from these databases' inception through June 2014 for observational epidemiological studies examining the association between depression on risk of PE. Studies were selected if they reported the risk estimates for PE associated with depression. patients>18 years of age suffering from PE. a history of depressive disorder. These odds ratios (ORs) were pooled using a random or fixed effects model and were tested for heterogeneity. Subgroup analysis was employed to explore heterogeneity. Eight trials involving 18,035 patients were included in the meta-analysis. Depression were statistically significantly associated with the risk of PE (OR = 1.63, 95% CI:1.42-1.87). There was no evidence of between-study heterogeneity (P = 0.623, I = 0.0%). The association was similar when stratified by mean age, geographical area, study design, sample size, publication year, and controlling key confounders. The severity of depression and PE could not be identified due to unavailable data of trials. No evidence of publication bias was observed. These findings provide evidence that depression is associated with a significantly increased risk of PE. In addition, more prospective studies are necessary to evaluate the association and identify the ideal treatment. CRD42016041272.

  6. Clinical correlates of erectile dysfunction and premature ejaculation in men with couple infertility.

    PubMed

    Lotti, Francesco; Corona, Giovanni; Rastrelli, Giulia; Forti, Gianni; Jannini, Emmanuele A; Maggi, Mario

    2012-10-01

    The frequency and the clinical characteristics of erectile dysfunction (ED) and premature ejaculation (PE) in infertile men have been poorly investigated. To assess the prevalence of ED and PE and their clinical correlates in men seeking medical care for couple infertility. A consecutive series of 244 men (mean age 35.2±7.8) with couple infertility was systematically evaluated. Erectile function was investigated with the International Index of Erectile Function-15 erectile function domain (IIEF-15-EFD) whereas ejaculatory status with the PE diagnostic tool (PEDT). All patients underwent psychological (Middlesex Hospital Questionnaire [MHQ]), prostatitis symptoms (National Institutes of Health-chronic prostatitis symptom index [NIH-CPSI]); hormonal, seminal, and interleukin 8 (sIL-8; a surrogate marker of prostatitis) evaluation; along with scrotal and transrectal color Doppler ultrasound (CDU) assessment. ED was found in 43 (17.8%) and PE in 38 (15.6%) subjects. After adjusting for age, IIEF-15-EFD score was negatively associated with depressive symptoms (MHQ-D score), somatization (MHQ-S score), NIH-CPSI total, and quality of life subdomain score. In a logistic multivariate model, among all these variables, only depression was significantly associated with ED (adjusted odds ratio [OR]=1.19 [1.02-1.39]; P<0.05). PEDT score was positively associated with prostatitis symptoms and signs, such as sIL-8 and prostate CDU abnormalities (including arterial prostatic peak systolic velocity, APPSV), phobic anxiety (MHQ-P score), and calculated free testosterone (cFT). The association between PE and NIH-CPSI score or APPSV was confirmed even after adjustment for age, MHQ-P score and cFT (adjusted OR=1.11 [1.05-1.17]; P<0.0001 and 1.22 [1.03-1.44]; P=0.02, for NIH-CPSI score and APPSV, respectively). ED and PE are reported by one in six infertile patients. ED is mainly associated with depressive symptoms, while PEDT score is positively associated with prostatitis symptoms and

  7. Comparison of the effect of sertraline with behavioral therapy on semen parameters in men with primary premature ejaculation.

    PubMed

    Akasheh, Goudarz; Sirati, Leila; Noshad Kamran, Ali Reza; Sepehrmanesh, Zahra

    2014-04-01

    To investigate the effects of sertraline on semen parameters and comparison of its effect with behavioral therapy (BT) in men with primary premature ejaculation. In this single-blinded clinical trial, a total of 60 married men with primary premature ejaculation were randomly divided into 2 groups: the sertraline group (n = 30, sertraline 25 mg/day for 1 week followed by 50 mg/day for 3 months) and the BT group (n = 30, using BT technique for 3 months). Semen analysis was applied, and the results were compared between groups before and 3 months after intervention. The significant reduction in sperm concentration (10(5)/mL) and percentage of normal morphology was reported in sertraline group (P <.05). The percentage of sperm deoxyribonucleic acid fragmentation after intervention in sertraline group was significantly higher than BT group (P = .004). There was no significant change in semen parameters in patients treated using BT. Our study revealed detrimental effects of sertraline on some semen parameters. It should particularly be considered in patients who are trying to conceive. It seems BT is a safe method without any side effect on semen analysis parameters. Copyright © 2014 Elsevier Inc. All rights reserved.

  8. Disorders of orgasm and ejaculation in men.

    PubMed

    McMahon, Chris G; Abdo, Carmita; Incrocci, Luca; Perelman, Michael; Rowland, David; Waldinger, Marcel; Xin, Zhong Cheng

    2004-07-01

    Ejaculatory/orgasmic disorders, common male sexual dysfunctions, include premature ejaculation, inhibited ejaculation, anejaculation, retrograde ejaculation and anorgasmia. To provide recommendations/guidelines concerning state-of-the-art knowledge for management of ejaculation/orgasmic disorders in men. An International Consultation in collaboration with the major urology and sexual medicine associations assembled over 200 multidisciplinary experts from 60 countries into 17 committees. Committee members established specific objectives and scopes for various male and female sexual medicine topics. The recommendations concerning state-of-the-art knowledge in the respective sexual medicine topic represent the opinion of experts from five continents developed in a process over a 2-year period. Concerning the Disorders of Ejaculation/Orgasm in Men Committee, there were nine experts from six countries. Expert opinion was based on grading of evidence-based medical literature, widespread internal committee discussion, public presentation and debate. Premature ejaculation management is dependent upon etiology. When secondary to ED, etiology-specific treatment is employed. When lifelong, initial pharmacotherapy (SSRI, topical anesthesia, PDE5 inhibitors) is appropriate. When associated with psychogenic/relationship factors, behavioral therapy is indicated. When acquired, pharmacotherapy and/or behavioral therapies are preferred. Retrograde ejaculation, diagnosed with spermatozoa and fructose in centrifuged post-ejaculatory voided urine, is managed by education, patient reassurance, pharmacotherapy or bladder neck reconstruction. Men with anejaculation or anorgasmia have a biologic failure of emission and/or psychogenic inhibited ejaculation. Men with age-related penile hypoanesthesia should be educated, reassured and be instructed in revised sexual techniques which maximize arousal. More research is needed in understanding management of men with ejaculation

  9. Disorders of orgasm and ejaculation in men.

    PubMed

    Rowland, David; McMahon, Chris G; Abdo, Carmita; Chen, Juza; Jannini, Emmanuele; Waldinger, Marcel D; Ahn, Tai Young

    2010-04-01

    Ejaculatory/orgasmic disorders are common male sexual dysfunctions, and include premature ejaculation (PE), inhibited ejaculation, anejaculation, retrograde ejaculation, and anorgasmia. To provide recommendations and guidelines concerning current state-of-the-art knowledge for management of ejaculation/orgasmic disorders in men. An international consultation in collaboration with the major urology and sexual medicine associations assembled over 200 multidisciplinary experts from 60 countries into 25 committees. Committee members established specific objectives and scopes for various male and female sexual medicine topics. The recommendations concerning state-of-the-art knowledge of disorders of orgasm and ejaculation represent the opinion of seven experts from seven countries developed in a process over a 2-year period. Expert opinion was based on grading of evidence-based medical literature, widespread internal committee discussion, public presentation and debate. Premature ejaculation management is largely dependent upon etiology. Lifelong PE is best managed with PE pharmacotherapy (selective serotonin re-uptake inhibitor [SSRI] and/or topical anesthetics). The management of acquired PE is etiology specific and may include erectile dysfunction (ED) pharmacotherapy in men with comorbid ED. Behavioral therapy is indicated when psychogenic or relationship factors are present and is often best combined with PE pharmacotherapy in an integrated treatment program. Retrograde ejaculation is managed by education, patient reassurance, pharmacotherapy, or bladder neck reconstruction. Delayed ejaculation, anejaculation, and/or anorgasmia may have a biogenic and/or psychogenic atiology. Men with age-related penile hypoanesthesia should be educated, reassured, and instructed in revised sexual techniques which maximize arousal. Additional research is required to further the understanding of the disorders of ejaculation and orgasm.

  10. The impact of premature ejaculation on the subjective perception of orgasmic intensity: validation and standardisation of the 'Orgasmometer'.

    PubMed

    Limoncin, E; Lotti, F; Rossi, M; Maseroli, E; Gravina, G L; Ciocca, G; Mollaioli, D; Di Sante, S; Maggi, M; Lenzi, A; Jannini, E A

    2016-09-01

    To the best of our knowledge, no psychometric tools have been specifically developed to measure if premature ejaculation (PE) is related to low sexual pleasure in terms of perception of orgasmic intensity. Hence, the aim of this study was to evaluate if men with PE suffer from a low perception of orgasmic intensity using a new tool, the 'Orgasmometer', to quantitatively measure the intensity of orgasmic pleasure. Among 329 subjects attending our andrological unit for suspected PE, 257 men fulfilled the inclusion criteria. Of these, 156 (60.7%; 156/257) were affected by PE (PE group) and 101 (39.3%; 101/257) did not have any sexual dysfunction (Control group). Men were requested to fill out the Premature Ejaculation Diagnostic Tool (PEDT) and the Orgasmometer, a new visual tool recording orgasm intensity on a Likert scale. Interestingly, MANCOVA analysis revealed a statistically significant difference between the two groups (p = 0.044) in the subjective perception of orgasm intensity with the PE group scoring lower on the Orgasmometer (mean 5.8; 95% CI 5.191-6.409) than the Control group (mean 7.95; 95% CI 7.033-8.87). In addition, multiple linear regression revealed an inverse correlation between the PEDT and the Orgasmometer scores (p < 0.0001). Hence, higher PEDT scores were associated with a lower subjective perception of orgasmic intensity. The Orgasmometer was well understood, had good test-retest reliability and a high AUC in differentiating between men with high and low orgasmic pleasure intensity. The ROC curve analysis showed that a cut-off ≤6 had 87.7% sensitivity (95% CI 79.6-92.6), 95% specificity (95% CI 88.7-98.4), 95.3% positive predictive value (PPV) and 86.4% negative predictive value (NPV). Men affected by premature ejaculation perceived significantly lower orgasmic intensity than sexually healthy men. The Orgasmometer is an easy-to-perform, user-friendly tool for measuring orgasmic intensity.

  11. Event-level impact of Promescent on quality of sexual experience in men with subjective premature ejaculation.

    PubMed

    Mark, K P; Kerner, I

    2016-11-01

    Promescent is a lidocaine-based ejaculation delaying spray that absorbs into the skin of the penis prior to sexual activity. This article aimed to evaluate the effect of Promescent on the experience of orgasm, ejaculatory latency time and quality of sexual experience (QSE). Additionally, we assessed ease of application of Promescent and the extent to which it enhanced or interrupted the sexual experience. The analytic sample consisted of 91 men with self-reported subjective premature ejaculation who were sent a sample of Promescent and completed a 14-day internet-based prospective daily electronic report. Average ejaculatory latency time was 11.16 min during product use events, compared with 6.81 min during product non-use events. Both members of the couple had an orgasm 65.6% of the time when they used the product, compared with 44.1% when they did not use the product. QSE was significantly improved on product use days (P<0.05). Quality also significantly improved each subsequent time the product was used (P<0.01). The product was reported as easy to use and did not interrupt the sexual experience. Findings suggest that the use of this topical spray significantly improves QSE and perception of partner experience, and that these improve with longer duration of use.

  12. Event-level impact of Promescent on quality of sexual experience in men with subjective premature ejaculation

    PubMed Central

    Mark, K P; Kerner, I

    2016-01-01

    Promescent is a lidocaine-based ejaculation delaying spray that absorbs into the skin of the penis prior to sexual activity. This article aimed to evaluate the effect of Promescent on the experience of orgasm, ejaculatory latency time and quality of sexual experience (QSE). Additionally, we assessed ease of application of Promescent and the extent to which it enhanced or interrupted the sexual experience. The analytic sample consisted of 91 men with self-reported subjective premature ejaculation who were sent a sample of Promescent and completed a 14-day internet-based prospective daily electronic report. Average ejaculatory latency time was 11.16 min during product use events, compared with 6.81 min during product non-use events. Both members of the couple had an orgasm 65.6% of the time when they used the product, compared with 44.1% when they did not use the product. QSE was significantly improved on product use days (P<0.05). Quality also significantly improved each subsequent time the product was used (P<0.01). The product was reported as easy to use and did not interrupt the sexual experience. Findings suggest that the use of this topical spray significantly improves QSE and perception of partner experience, and that these improve with longer duration of use. PMID:27557610

  13. A randomized study examining the effect of 3 SSRI on premature ejaculation using a validated questionnaire

    PubMed Central

    Arafa, Mohamed; Shamloul, Rany

    2007-01-01

    Aim This study reports the results of a large prospective single-blinded clinical trial of 3 SSRI (paroxetine, fluoxetine and escitalopram) in PE using a validated questionnaire. Methods A total of 100 normally potent men suffering from PE were enrolled in a randomized single-blinded comparative study of fluoxetine, paroxetine and escitalopram Patients were randomized into 3 treatment groups. Group 1 comprised 33 men who received fluoxetine 20 mg daily, group 2 comprised 37 men who received escitalopram 10 mg and group 3 comprised 30 men who received paroxetine 20 mg daily. All drug regimens were given in early morning dose and continued for 4 weeks. Results All 100 (100%) patients experienced a significant increase in their AIPE total score after drug treatment. There was no significant difference regarding any of the 7 items of the AIPE between the 3 treatment groups. All 3 drugs were generally well tolerated. Conclusions Our relatively large study, using a validated questionnaire confirmed similar useful effect of paroxetine, fluoxetine and escitalopram on ejaculation time. Further large cohort studies with long-term follow up are needed to evaluate the sustained effects of these drugs on ejaculation latency. PMID:18472973

  14. Genetic polymorphism in the serotonin transporter gene-linked polymorphic region and response to serotonin reuptake inhibitors in patients with premature ejaculation

    PubMed Central

    Ozbek, Emin; Otunctemur, Alper; Simsek, Abdulmuttalip; Polat, Emre Can; Ozcan, Levent; Köse, Osman; Cekmen, Mustafa

    2014-01-01

    OBJECTIVES: Serotonin plays a central role in ejaculation and selective serotonin reuptake inhibitors have been successfully used to treat premature ejaculation. Here, we evaluated the relationship between a polymorphism in the serotonin transporter gene-linked polymorphic region (5-HTTLPR) and the response of patients with premature ejaculation to SSRI medication. METHODS: Sixty-nine premature ejaculation patients were treated with 20 mg/d paroxetine for three months. The Intravaginal Ejaculatory Latency Time and International Index of Erectile Function scores were compared with baseline values. The patients were scored as having responded to therapy when a 2-fold or greater increase was observed in Intravaginal Ejaculatory Latency Time compared with baseline values after three months. Three genotypes of 5-HTTLPR were studied: LL, LS and SS. The appropriateness of the allele frequencies in 5-HTTLPR were analyzed according to Hardy-Weinberg equilibrium using the χ2-test. RESULTS: The short (S) allele of 5-HTTLPR was significantly more frequent in responders than in nonresponders (p<0.05). Out of the 69 total PE patients, 41 patients (59%) responded to therapy. There was no significant difference in the International Index of Erectile Function score at the end of therapy between the responder and nonresponder groups. The frequencies of the L allele and S allele were 20% and 39%, respectively, in the responder group (p<0.05). CONCLUSION: We conclude that premature ejaculation patients with the SS genotype respond well to selective serotonin reuptake inhibitor therapy. Further studies with large patient groups are necessary to confirm this conclusion. PMID:25518026

  15. Self-reported premature ejaculation prevalence and characteristics in Korean young males: community-based data from an internet survey.

    PubMed

    Son, Hwancheol; Song, Sang Hoon; Kim, Soo Woong; Paick, Jae-Seung

    2010-01-01

    Premature ejaculation (PE) is suspected to be the most prevalent male sexual complaint, and the prevalence of PE is considerably high also in the younger generation. We investigated the PE prevalence based on the Diagnostic and Statistical Manual of Mental Disorders (4th ed text revision; DSM-IV-TR) definition and the risk factors of PE in Korean young men via Internet survey. Subjects (n = 3980) aged from 20 to 59, who performed sexual intercourse more than once a month during the past 6 months were asked to participate in this study. Participants were asked to complete a questionnaire that consisted of questions on general, medical, and sexual history related to ejaculation. A total of 600 subjects were included in this study. PE prevalence was found to be 18.3%. Prevalences were not significantly different across age groups, after excluding subjects with erectile dysfunction (ED). Educational level, marital status and duration, average income, sexual orientation, smoking, alcohol consumption, and circumcision status showed no difference in the PE and non-PE groups. Partners perceived satisfaction rates were 45.0% in the PE group and 63.9% in the non-PE group. Significant differences were found between the PE and non-PE groups in terms of ED, obesity, and depression prevalence. However, multiple logistic regression analysis revealed that the significant risk factors of PE were age and the frequency of conversations with partners about sexual intercourse. This Internet-based study is limited because participants probably represent a selected population of Internet users with non-representative educational and socioeconomic profiles. This study is the first to report the prevalence of both self-reported PE and PE on the basis of the DSM-IV-TR definition in the Korean population. This study demonstrates that PE in Korea is as prevalent as it is in European countries and the United States.

  16. Possible association of the 5-HTTLPR serotonin transporter promoter gene polymorphism with premature ejaculation in a Turkish population

    PubMed Central

    Ozbek, Emin; Tasci, Ali I; Tugcu, Volkan; Ilbey, Yusuf O; Simsek, Abdulmuttalip; Ozcan, Levent; Polat, Emre C; Koksal, Vedat

    2009-01-01

    We evaluated the genotypes of the serotonin transporter gene (5-HTT) in patients with premature ejaculation (PE) to determine the role of genetic factors in the etiopathogenesis of PE and possibly to identify the patient subgroups. A total of 70 PE patients and 70 controls were included in this study. All men were heterosexual, had no other disorders and were either married or in a stable relationship. PE was defined as ejaculation that occurred within 1 min of vaginal intromission. Genomic DNA from patients and controls was analyzed using polymerase chain reaction, and allelic variations of the promoter region of the serotonin transporter gene (5-HTTLPR) were determined. The 5-HTTLPR (serotonin transporter promoter gene) genotypes in PE patients vs. controls were distributed as follows: L/L 16% vs. 17%, L/S 30% vs. 53% and S/S 54% vs. 28%. We examined the haplotype analysis for three polymorphisms of the 5-HTTLPR gene: LL, LS and SS. The appropriateness of the allele frequencies in the 5-HTTLPR gene was analyzed by the Hardy-Weinberg equilibrium using the χ2-test. The short (S) allele of the 5-HTTLPR gene was significantly more frequent in PE patients than in controls (P < 0.05). We suggest that the 5-HTTLPR gene plays a role in the pathophysiology of all primary PE cases. Further studies are needed to evaluate the relationship between 5-HTTLPR gene polymorphism and patient subgroup (such as primary and secondary PE) responses to selective serotonin reuptake inhibitors as well as ethnic differences. PMID:19252508

  17. Characterizing the burden of premature ejaculation from a patient and partner perspective: a multi-country qualitative analysis.

    PubMed

    Revicki, Dennis; Howard, Kellee; Hanlon, Jennifer; Mannix, Sally; Greene, Alison; Rothman, Margaret

    2008-05-12

    Premature ejaculation (PE) is a common sexual dysfunction among men which affects men and their partners. Little qualitative data are available to characterize the impact of PE on men and their partners about ejaculatory control, sexual satisfaction, emotional distress and relationships. The objective of this study was to assess the impact of PE from the perspective of men with PE and the female partners of men with PE on their sexual experience, distress and relationships. Qualitative data were collected through 14 focus groups in the US and through one-on-one interviews in the US, UK, Italy, France, Germany, and Poland. Study participants included heterosexual men with PE and female partners of males with PE. All participants were asked about how PE affects their daily life, including emotional impacts. One-on-one interviews also included obtaining feedback on the male and female versions of 4-single item measures of PE focusing on ejaculatory control, satisfaction with intercourse, interpersonal distress, and relationship difficulty. Participants included 172 males with PE and 67 female partners of men with PE. Lack of control over ejaculation and dissatisfaction with intercourse emerged as central themes of PE. Lack of ejaculatory control resulted in greater dissatisfaction and greater emotional distress, including feelings of inadequacy, disappointment, and anxiety. Continued PE ultimately leads to greater problems with partners and often disrupts partner relationships. Participants indicated that PE was keeping them from attaining complete intimacy in their relationships even when their partners were generally satisfied with sexual intercourse. Impacts of PE on sexual satisfaction, emotional distress and partner relationships were consistent across countries. Feedback on the single-item PE measures confirmed relevance of the item content and further confirmed major themes identified from the qualitative data. This qualitative study provides valuable insights

  18. Premature Ejaculation – Dose and Duration Dependent Effect of Fluoxetine: A Histological Study on Seminal Vesicle of Albino Rats

    PubMed Central

    Jethani, SL; Rohatagi, RK; Kalra, Juhi

    2014-01-01

    Introduction: Fluoxetine is a prototype drug of Selective Serotonin Reuptake Inhibitors. Its active demethylated metabolite has a half life of 7-10 d. Fluoxetine is used to treat depression and is also prescribed in premature ejaculation. Aim: In the present study dose and duration dependent effects of Fluoxetine on histology of seminal vesicle of the albino rats were observed. Materials and Methods: The present study was conducted on 36 adult male albino rats. Fluoxetine was administered intraperitoneally for 2 wk, 4 wk and 12 wk with mild (10mg/kg/day), moderate (20mg/kg/day) and severe doses (40mg/kg/day). Histological slides of Seminal vesicle were prepared and stained with Hematoxylin and Eosin stain. Results: On examination through the light microscope, the proliferation of primary, secondary and tertiary villi, increased crypt/alveoli, increased thickness of lamina propria, decreased epithelial cell height, metaplasia, changes in the amount of luminal eosinophilic secretory material in the form of scanty secretion in lumen of seminal vesicle. Conclusion: Low doses for long duration and high doses for short duration of Fluoxetine produce histological changes in seminal vesicle of albino rats. PMID:25386416

  19. Sexual function improvement in association with serum leptin level elevation in patients with premature ejaculation following sertraline treatment: a preliminary observation.

    PubMed

    Tang, Kun-Long; Wang, Bao-Long; Yang, Lin; Li, Li-Ming; Zhou, Yong; Yang, Chang-Hai

    2013-11-01

    The objective of our work was to evaluate the effect of sertraline hydrochloride on serum levels of leptin and sexual function in patients with premature ejaculation (PE). A total of 124 patients with a history of PE at least 6 months, aged 20-50 years, were treated with sertraline hydrochloride. One hundred and four age-matched normal males without a history of PE were included control subjects and were untreated. Before and after the 8 week experiment, sexual performance parameters including the intravaginal ejaculation latency time (IELT) and the Chinese premature ejaculation index (CIPE) were collected from both PE patients and control subjects through a questionnaire survey and analyzed. Serum levels of leptin were measured. Correlations of serum leptin with Body Mass Index (BMI) were analyzed. Before sertraline treatment, serum levels of leptin were significantly higher (32.9 vs 8.8 μg/L, p<0.001) but IELT and CIPE score were significantly lower (54 vs 590, p <0.001; 8.7 vs 22.3, p <0.0001) in PE patients than control subjects. After 8 weeks of treatment with sertraline, serum levels of leptinl in PE patients were decreased markedly to 8.0 μg/L, which was not significantly different from the levels in control subjects (p >0.05); and IELT and CIPE score in PE patients were increased to the values similar to those in control subjects. The sensitivity and specificity values were 87.5% and 96.3% for leptin as a diagnosis target. These observations suggest sertraline as a selective serotonin reuptake inhibitor may offer an effective option for treating premature ejaculation.

  20. Delayed ejaculation

    MedlinePlus

    Ejaculatory incompetence; Sex - delayed ejaculation; Retarded ejaculation; Anejaculation; Infertility - delayed ejaculation ... include: Religious background that makes the person view sex as sinful Lack of attraction for a partner ...

  1. Pharmacokinetics and tolerability of DA-8031, a novel selective serotonin reuptake inhibitor for premature ejaculation in healthy male subjects

    PubMed Central

    Shin, Dongseong; Lee, SeungHwan; Yi, Sojeong; Yoon, Seo Hyun; Cho, Joo-Youn; Bahng, Mi Young; Jang, In-Jin; Yu, Kyung-Sang

    2017-01-01

    Objective DA-8031 is a selective serotonin reuptake inhibitor under development for the treatment of premature ejaculation. This is the first-in-human study aimed at evaluating the pharmacokinetics and tolerability of DA-8031 and its metabolites (M1, M2, M4, and M5) in the plasma and urine after administration of a single oral dose in healthy male subjects. Methods A dose block-randomized, double-blind, placebo-controlled, single ascending dose study was conducted. Subjects received either placebo or a single dose of DA-8031 at 5, 10, 20, 40, 60, 80, or 120 mg. DA-8031 and its four metabolites were analyzed in the plasma and urine for pharmacokinetic evaluation. The effect of genetic polymorphisms of cytochrome-P450 (CYP) enzymes on the pharmacokinetics of DA-8031 was evaluated. Results After a single dose, plasma DA-8031 reached the maximum concentration at a median of 2–3 h and was eliminated with terminal elimination half-life of 17.9–28.7 h. The mean renal clearance was 3.7–5.6 L/h. Dose-proportional pharmacokinetics was observed over the dose range of 20–80 mg. Among the metabolites, M4 had the greatest plasma concentration, followed by M5 and M1. Subjects with CYP2D6 intermediate metabolizer had significantly greater dose-normalized Cmax and AUC0–t of DA-8031 as well as smaller metabolic ratios than those subjects with CYP2D6 extensive metabolizer. The most common adverse events were nausea, dizziness, and headache, and no serious adverse events were reported. Conclusion In conclusion, the systemic exposure of DA-8031 was increased proportionally to the dose within 20–80 mg. Genetic polymorphisms of CYP2D6 had an effect on the systemic exposure of DA-8031. DA-8031 was well tolerated after single doses of 80 mg or less. PMID:28331291

  2. Retrograde ejaculation, painful ejaculation and hematospermia

    PubMed Central

    Parnham, Arie

    2016-01-01

    Although there has been an increased interest on premature ejaculation in the recent years, our understanding regarding the disorders of retrograde ejaculation, painful ejaculation and hematospermia remain limited. All three of these conditions require a keen clinical acumen and willingness to engage in thinking outside of the standard established treatment paradigm. The development of novel investigational techniques and treatments has led to progress in the management of these conditions symptoms; however, the literature almost uniformly is limited to small series and rare randomised trials. Further investigation and randomised controlled trials are needed for progress in these often challenging cases. PMID:27652230

  3. Retrograde ejaculation, painful ejaculation and hematospermia.

    PubMed

    Parnham, Arie; Serefoglu, Ege Can

    2016-08-01

    Although there has been an increased interest on premature ejaculation in the recent years, our understanding regarding the disorders of retrograde ejaculation, painful ejaculation and hematospermia remain limited. All three of these conditions require a keen clinical acumen and willingness to engage in thinking outside of the standard established treatment paradigm. The development of novel investigational techniques and treatments has led to progress in the management of these conditions symptoms; however, the literature almost uniformly is limited to small series and rare randomised trials. Further investigation and randomised controlled trials are needed for progress in these often challenging cases.

  4. Results from a prospective observational study of men with premature ejaculation treated with dapoxetine or alternative care: the PAUSE study.

    PubMed

    Mirone, Vincenzo; Arcaniolo, Davide; Rivas, David; Bull, Scott; Aquilina, Joseph W; Verze, Paolo

    2014-04-01

    Dapoxetine hydrochloride is a selective serotonin reuptake inhibitor and the first drug approved for the on-demand treatment of premature ejaculation (PE). Its safety was established in a thorough clinical development program. To characterize the safety profile of dapoxetine in PE treatment and to report the incidence, severity, and type of adverse events. We conducted a 12-wk, open-label, observational study with a 4-wk, postobservational contact. A total of 10,028 patients were enrolled, with 6712 patients (67.6%) treated with dapoxetine 30-60 mg (group A) and 3316 (32.4%) treated with alternative care/nondapoxetine (group B). Treatment with dapoxetine or alternative care/nondapoxetine. Treatment-emergent adverse events (TEAEs) and concomitant therapy use during the 12-wk observational and the postobservational period were reported. The mean age for all patients was 40.5 yr. In group A, 93.0% of the patients were initially prescribed dapoxetine 30 mg. Treatment options for group B patients included clomipramine, paroxetine, fluoxetine, sertraline, topical drugs, condoms, and behavioral counseling. Both treatment regimens were well tolerated. TEAEs were reported by 12.0% and 8.9% of group A and group B, respectively, with the highest incidence observed in patients aged >65 yr for group A (21.4%) and 30-39 yr (9.8%) for group B. The most commonly reported TEAEs were nausea, headache, and vertigo, with a higher incidence in group A (3.1%, 2.6%, and 1.0%, respectively) than in group B (oral drugs: 2.3%, 1.3%, and 0.9%, respectively). There were no cases of syncope in group A and one case in group B. A major limitation is that this was a nonrandomized, open-label, short-term study lacking efficacy data. The results of this postmarketing observational study demonstrated that dapoxetine for treatment of PE has a good safety profile and low prevalence of TEAEs. Syncope and major cardiovascular adverse events were not reported. The high level of adherence by healthcare

  5. Chlamydia trachomatis infection is related to premature ejaculation in chronic prostatitis patients: results from a cross-sectional study.

    PubMed

    Cai, Tommaso; Pisano, Francesca; Magri, Vittorio; Verze, Paolo; Mondaini, Nicola; D'Elia, Carolina; Malossini, Gianni; Mazzoli, Sandra; Perletti, Gianpaolo; Gontero, Paolo; Mirone, Vincenzo; Bartoletti, Riccardo

    2014-12-01

    Chronic bacterial prostatitis (CBP) is reported to be a common finding in men with acquired premature ejaculation (PE). The impact of different pathogens on PE development in chronic prostatitis patients is, however, unknown. To assess a possible link between CBP caused by Chlamydia trachomatis (Ct) and PE. A consecutive series of 317 patients with clinical and instrumental diagnosis of CBP due to Ct was enrolled (group A) and compared with data obtained from a control group of 639 patients with CBP caused by common uropathogen bacteria (group B). Prostatitis symptoms were investigated with the National Institutes of Health-Chronic Prostatitis Symptom Index (NIH-CPSI), while the ejaculatory status of patients was assessed using the PE Diagnostic Tool (PEDT). All participants were asked to complete the NIH-CPSI, the International Index of Erectile Function-15 erectile function domain (IIEF-15-EFD), the PEDT, and the Short Form (SF)-36 questionnaires. Patient groups A and B had comparable scores of NIH-CPSI (P = 0.07), IPSS (P = 0.32), and IIEF-15-EFD (P = 0.33) tests. PE was assessed in 118 patients in group A (37.2%) and in 73 subjects in group B (11.5%). The two groups are different in terms of PE prevalence (P < 0.0002). Compared with group B, group A showed significantly higher scores of the PEDT test (11.3 [±2.6] vs. 4.5 [±2.9], P < 0.0001) and lower scores of the SF-36 tool (96.5 [±1.1] vs. 99.7 [±1.3], P < 0.0001). In our multivariate model assessment, being positive for a Ct infection marker was independently associated with the PEDT score even after adjusting for age, smoking habit, body mass index, and education level (adjusted odds ratio = 3.21; 95% confidence interval: 2.02-4.27; P < 0.003). Patients affected by CBP due to Ct infection reported higher prevalence of PE and lower quality of life when compared with patients affected by CBP caused by traditional uropathogenic bacteria. © 2014 International Society for

  6. The sympathetic skin response located in the penis as a predictor of the response to sertraline treatment in patients with primary premature ejaculation.

    PubMed

    Xia, Jiadong; Chen, Taowei; Chen, Jie; Han, Youfeng; Xu, Zhipeng; Zhou, Liuhua; Chen, Yun; Dai, Yutian

    2014-11-01

    The pathologic mechanisms of primary premature ejaculation (PPE) are complex and multifactorial, and hyperactivity of the sympathetic nervous system is one of the mechanisms. To examine the effects of sertraline on sympathetic nervous system activity and assess the predictive value of the sympathetic skin response located in the penis (PSSR) on the response to sertraline treatment in PPE patients. Sixty-one patients with PPE were recruited. Each received 50 mg sertraline daily for 8 weeks. Before and after the experiment, the patients were evaluated for PSSR tests and sexual performance parameters. Additionally, based on the latency of PSSR, we divided the patients into a normal PSSR group and an abnormal PSSR group, and compared the sertraline treatment efficacy between the two groups. Changes in intravaginal ejaculation latency time (IELT) and the Chinese premature ejaculation index-5 (CIPE-5), and the latencies and amplitudes of PSSR after sertraline treatment. Overall, 58 (95.1%) patients completed the entire study and were analyzed. After the 8-week sertraline treatment, compared with those of pretreatment, IELT and CIPE-5 scores were significantly increased (both P < 0.001), and the amplitudes and latencies of PSSR in the PPE patients were remarkably decreased and prolonged, respectively (both P < 0.001). In addition, the changes of the latencies of PSSR were positively correlated with the increment of IELT (r = 0.375, P = 0.004). The treatment outcome was better in patients with a baseline abnormal PSSR than in those with a baseline normal PSSR (P = 0.021). These results suggest that clinical improvement in response to sertraline in the PPE patients, at least in part, is mediated through reducing sympathetic nervous system activity indexed by PSSR. Measurement of the PSSR appears to provide useful information for predicting treatment responses in the PPE patients. © 2014 International Society for Sexual Medicine.

  7. Standard operating procedures in the disorders of orgasm and ejaculation.

    PubMed

    McMahon, Chris G; Jannini, Emmanuele; Waldinger, Marcel; Rowland, David

    2013-01-01

    Ejaculatory/orgasmic disorders are common male sexual dysfunctions and include premature ejaculation (PE), inhibited ejaculation, anejaculation, retrograde ejaculation, and anorgasmia. To provide recommendations and guidelines of the current state-of-the-art knowledge for management of ejaculation/orgasmic disorders in men as standard operating procedures (SOPs) for the treating health care professional. The International Society of Sexual Medicine Standards Committee assembled over 30 multidisciplinary experts to establish SOPs for various male and female sexual medicine topics. The SOP for the management of disorders of orgasm and ejaculation represents the opinion of four experts from four countries developed in a process over a 2-year period. Expert opinion was based on grading of evidence-based medical literature, limited expert opinion, widespread internal committee discussion, public presentation, and debate. PE management is largely dependent upon etiology. Lifelong PE is best managed with PE pharmacotherapy (selective serotonin reuptake inhibitors and/or topical anesthetics). The management of acquired PE is etiology specific and may include erectile dysfunction (ED) pharmacotherapy in men with comorbid ED. All men seeking treatment for PE should receive basic psychosexual education. Graded behavioral therapy is indicated when psychogenic or relationship factors are present and is often best combined with PE pharmacotherapy in an integrated treatment program. Delayed ejaculation, anejaculation, and/or anorgasmia may have a biogenic and/or psychogenic etiology. Men with age-related penile hypoanesthesia should be educated, reassured, and instructed in revised sexual techniques which maximize arousal. Retrograde ejaculation is managed by education, patient reassurance, and pharmacotherapy. Additional research is required to further the understanding of the disorders of ejaculation and orgasm. © 2012 International Society for Sexual Medicine.

  8. Rasch Analysis of the Premature Ejaculation Diagnostic Tool (PEDT) and the International Index of Erectile Function (IIEF) in an Iranian Sample of Prostate Cancer Patients

    PubMed Central

    Lin, Chung-Ying; Pakpour, Amir H.; Burri, Andrea; Montazeri, Ali

    2016-01-01

    Background Male sexual dysfunction is an increasing problem across a variety of general and clinical populations, such as cancer populations; especially among prostate cancer patients who tend to receive treatments that often result in erectile dysfunction (ED) and/or premature ejaculation (PE). Therefore, in order to diagnose ED and PE in these populations, adequate and efficient instruments such as the International Index of Erectile Function 5-item version (IIEF-5) and the Premature Ejaculation Diagnostic Tool (PEDT) are needed. However, since this is an important topic additional evidence of psychometric properties of the IIEF-5 and the PEDT in such samples are required. Thus the aim of the present study was to use Rasch models to investigate the construct validity, local dependency, score order, and differential item functioning (DIF) of both questionnaires in a sample of prostate cancer patients. Methods Prostate cancer patients (n = 1058, mean±SD age = 64.07±6.84 years) who visited urology clinics were invited to fill out the IIEF-5 and the PEDT. Construct validity was examined using infit and outfit mean square (MnSq) and local dependency using correlations between each two residual Rasch scores. Score order was investigated using step and average measures of difficulty and DIF using DIF contrast. Results All IIEF-5 and PEDT items had acceptable infit and outfit MnSq. Step measures revealed that all but two items had disordered categories in terms of scores 1 to 3. Only one local dependency was found, and no items displayed DIF across age, educational level, and help seeking. Conclusions The results showed that both the IIEF-5 and the PEDT had sound psychometric properties in the Rasch analyses, although some score disordering could be detected in both instruments. The results of no DIF items in both instruments suggest using them to compare ED and PE across age and educational level is adequate. PMID:27336626

  9. Effects of sertraline on brain current source of the high beta frequency band: analysis of electroencephalography during audiovisual erotic stimulation in males with premature ejaculation.

    PubMed

    Kwon, O Y; Kam, S C; Choi, J H; Do, J M; Hyun, J S

    2011-01-01

    To identify the effects of sertraline, a selective serotonin reuptake inhibitor, for the treatment of premature ejaculation (PE), changes in brain current-source density (CSD) of the high beta frequency band (22-30 Hz) induced by sertraline administration were investigated during audiovisual erotic stimulation. Eleven patients with PE (36.9±7.8 yrs) and 11 male volunteers (24.2±1.9 years) were enrolled. Scalp electroencephalography (EEG) was conducted twice: once before sertraline administration and then again 4 h after the administration of 50 mg sertraline. Statistical non-parametric maps were obtained using the EEG segments to detect the current-density differences in the high beta frequency bands (beta-3, 22-30 Hz) between the EEGs before and after sertraline administration in the patient group and between the patient group and controls after the administration of sertraline during the erotic video sessions. Comparing between before and after sertraline administration in the patients with PE, the CSD of the high beta frequency band at 4 h after sertraline administration increased significantly in both superior frontal gyri and the right medial frontal gyrus (P<0.01). The CSD of the beta-3 band of the patients with PE were less activated significantly in the middle and superior temporal gyrus, lingual and fusiform gyrus, inferior occipital gyrus and cuneus of the right cerebral hemisphere compared with the normal volunteers 4 h after sertraline administration (P<0.01). In conclusion, sertraline administration increased the CSD in both the superior frontal and right middle temporal gyrus in patients with PE. The results suggest that the increased neural activity in these particular cerebral regions after sertraline administration may be associated with inhibitory effects on ejaculation in patients with PE.

  10. The effect of on-demand caffeine consumption on treating patients with premature ejaculation: a double-blind randomized clinical trial.

    PubMed

    Saadat, Seyyed H; Ahmadi, Khodabakhsh; Panahi, Younes

    2015-01-01

    Premature ejaculation (PE) is an important and common sexual issue in male adults, since its etiology is still unknown. There are many suggested treatments such as paroxetine, clomipramine, dapoxetine, tramadol and topical agents; all of them have stigma or considerable side effects. Therefore, present study aimed to examine the effect of on-demand caffeine consumption on treating patients with PE. In this double blind RCT, 40 otherwise healthy individuals with PE were allocated into 2 groups of caffeine and placebo group. The caffeine group received 100 mg encapsulated caffeine for 3 weeks, 2 hours prior to each intercourse. Intravaginal ejaculation latency time (IELT) and index of sexual satisfaction (ISS) were measured before and after treatment in both groups. Suitable statistical analysis was performed. (Registration code: IRCT2013091614677N1). Mean age of the participants was 39.88±8.72 years. No significant difference was found between pre-treatment and post-treatment values of both IELT and ISS in the placebo group, but significant difference was seen in post treatment values between our two groups and pre-treatment and post-treatment values of the caffeine group (IELT: 144s vs 312s, p<0.001 and ISS: 77 vs 97, p<0.001; respectively). Furthermore, high significant correlation was found in post-treatment values (r>0.07, p<0.05). There are negligible scientific evidences regarding the beneficial effects of caffeine on several aspects of sexual life, which makes comparison impossible. Considering the fact that caffeine is a well-known and widely used drug in common disease, using this compound will not result in any stigma. Our study demonstrates that 100mg on-demand caffeine can significantly increase both IELT and ISS. Furthermore, the slope of these increasings is correlated with each other. More studies are needed to make stronger conclusions.

  11. [Retrograde ejaculation].

    PubMed

    Malossini, G; Ficarra, V; Caleffi, G

    1999-06-01

    Antegrade ejaculation requires intact anatomy and innervation of the bladder neck. Retrograde ejaculation is an uncommon cause of infertility and can be defined as the escape of seminal fluid from the posterior urethra into the bladder. This pathological condition can result from disturbances at the bladder neck due to anatomical lesions, neuropathic disorders or pharmacological influences. Also congenital and idiophatic causes have been described. The diagnosis may be confirmed by findings sperm in post-coital specimens of urine. Pharmacological manipulation, electro-ejaculation and vibro-ejaculation can be utilized to recovery ejaculation. When anterograde ejaculation in this patients cannot be restored artificial insemination using sperm recovered from the antegrade post-coital urine is indicated. The aim of this paper is to evaluate the data of literature on aetiology and therapy of retrograde ejaculation.

  12. Contemporary Management of Disorders of Male Orgasm and Ejaculation.

    PubMed

    Althof, Stanley E; McMahon, Chris G

    2016-07-01

    Ejaculatory disorders lie along a conceptual continuum with premature ejaculation anchoring one end, normal ejaculation in the center, and difficulties with delayed or anejaculation at the opposite end. Retrograde ejaculation, painful ejaculation, and postorgasmic illness syndrome can occur at any point on the continuum. This manuscript defines the ejaculatory dysfunctions, reviews the anatomy and physiology of orgasm and ejaculation, and summarizes the pharmacological, psychological, and combined treatment approaches to ejaculatory dysfunctions.

  13. Indicators of premature ejaculation and their associations with sexual distress in a population-based sample of young twins and their siblings.

    PubMed

    Jern, Patrick; Santtila, Pekka; Johansson, Ada; Varjonen, Markus; Witting, Katarina; Algars, Monica; Alanko, Katarina; von der Pahlen, Bettina; Sandnabba, Kenneth

    2008-09-01

    Recently, in anticipation of the Diagnostic and Statistical Manual of Mental Disorders V, much consideration has been given to the diagnostic criteria for premature ejaculation (PE). The scientific community is yet to agree not only on the etiology of PE, but also on the most suitable diagnosis and forms of treatment. It has been suggested that the diagnostic criteria of PE should be strictly empirical and rely on intravaginal latency time alone, whereas others stress the need to also include psychological and personal factors. To examine different indicators of PE and their relationship with and ability to predict sexual distress. Statistical analyses of data on sexual distress and different measures of ejaculatory function on a population-based sample of 3,332 Finnish men. The present study involved a population-based sample of 3,332 males, of which 2,328 were twins aged 18-33, and 1,004 were over 18-year-old siblings to the aforementioned (M = 26.17 years of age). The individual contributions of different PE-indicator variables to experienced sexual distress were investigated by calculating correlations and performing a regression analysis. All included indicators of PE were significantly associated with sexual distress, and significant and logical differences in sexual distress were found between intravariable levels for several of the indicator variables. Only variables relating to subjective experience (e.g., worrying about PE) were uniquely related to sexual distress when other indicators were controlled for. The results suggest that variables measuring subjective experience may be useful when considering diagnostic criteria if indicators that are related to sexual distress are considered useful. However, overall, the association between PE and sexual distress is not especially strong, emphasizing the fact that more objective indicators of PE may not necessarily be associated with significant distress.

  14. Early life exposure to endocrine-disrupting chemicals causes lifelong molecular reprogramming of the hypothalamus and premature reproductive aging.

    PubMed

    Gore, Andrea C; Walker, Deena M; Zama, Aparna M; Armenti, AnnMarie E; Uzumcu, Mehmet

    2011-12-01

    Gestational exposure to the estrogenic endocrine disruptor methoxychlor (MXC) disrupts the female reproductive system at the molecular, physiological, and behavioral levels in adulthood. The current study addressed whether perinatal exposure to endocrine disruptors re-programs expression of a suite of genes expressed in the hypothalamus that control reproductive function and related these molecular changes to premature reproductive aging. Fischer rats were exposed daily for 12 consecutive days to vehicle (dimethylsulfoxide), estradiol benzoate (EB) (1 mg/kg), and MXC (low dose, 20 μg/kg or high dose, 100 mg/kg), beginning on embryonic d 19 through postnatal d 7. The perinatally exposed females were aged to 16-17 months and monitored for reproductive senescence. After euthanasia, hypothalamic regions [preoptic area (POA) and medial basal hypothalamus] were dissected for real-time PCR of gene expression or pyrosequencing to assess DNA methylation of the Esr1 gene. Using a 48-gene PCR platform, two genes (Kiss1 and Esr1) were significantly different in the POA of endocrine-disrupting chemical-exposed rats compared with vehicle-exposed rats after Bonferroni correction. Fifteen POA genes were up-regulated by at least 50% in EB or high-dose MXC compared with vehicle. To understand the epigenetic basis of the increased Esr1 gene expression, we performed bisulfite conversion and pyrosequencing of the Esr1 promoter. EB-treated rats had significantly higher percentage of methylation at three CpG sites in the Esr1 promoter compared with control rats. Together with these molecular effects, perinatal MXC and EB altered estrous cyclicity and advanced reproductive senescence. Thus, early life exposure to endocrine disruptors has lifelong effects on neuroendocrine gene expression and DNA methylation, together with causing the advancement of reproductive senescence.

  15. Physiology and Pharmacology of Ejaculation.

    PubMed

    Clement, Pierre; Giuliano, François

    2016-10-01

    Ejaculation is the final stage of coitus in mammalian male and is mandatory for natural procreation. Two synchronized phases, emission and expulsion, form the ejaculatory response and involve specific organs and anatomical structures. The peripheral events leading to ejaculation are commanded by autonomic (sympathetic and parasympathetic) and somatic divisions of the nervous system. The autonomic and somatic motor efferents originate in spinal nuclei located in thoracolumbar and lumbosacral segments. Co-ordinated activation of autonomic and somatic spinal nuclei is orchestrated by a group of lumbar spinal interneurons defined as the spinal generator of ejaculation. The generator of ejaculation together with the autonomic and somatic spinal nuclei constitutes a spinal network that is under the strong influence of stimulating or inhibiting genital sensory and supraspinal inputs. A brain circuitry dedicated to ejaculation has been delineated that is part of a more global network controlling other aspects of the sexual response. This circuitry includes discrete neuronal populations distributed in all divisions of the brain. The corollary to the expanded CNS network is the variety of neurotransmitter systems participating in the ejaculatory process. Among them, serotonin neurotransmission plays a key role and its targeting led to the development of the first registered pharmacological treatment of premature ejaculation in human beings. Critical gaps remain in the understanding of neurophysiopharmacology of ejaculation and management of ejaculatory disorders in human beings needs improvement. Because the ejaculatory response in laboratory animals and in human beings shares many similarities, the use of animal models will certainly provide further advances in the field.

  16. Ejaculatory training lengthens the ejaculation latency and facilitates the functioning of the spinal generator for ejaculation of rats with rapid ejaculation.

    PubMed

    Rodríguez-Peña, M de L; Rodríguez-Manzo, G; Carro-Juárez, M

    2017-01-01

    A spinal pattern generator controls the ejaculatory response. Central pattern generators (CPGs) may be entrained to improve the motor patterns under their control. In the present study we tested the hypothesis that training of the spinal generator for ejaculation (SGE) by daily copulation until ejaculation, could promote substantive changes in its functioning permitting a better SGE control of the genital motor pattern of ejaculation (GMPE) and, as a consequence, a normalization of the ejaculation latency of rats with rapid ejaculation. To that aim, we evaluated in sexually experienced male rats with rapid ejaculation (1) the effects of daily copulation to ejaculation, following different entrainment schedules, on their ejaculation latencies, (2) the impact of these different ejaculatory entrainment schedules upon the parameters of the GMPE and (3) the possible emergence of persistent changes in the functioning of the SGE associated to the daily ejaculation entrainment schedules. The data obtained show that intense ejaculatory training of rats with rapid ejaculation lengthens the ejaculation latency during copulation and augments the ejaculatory capacity of the SGE in this population when spinalized. Thus, present data reveal that like other CPGs, the SGE can be trained and put forward that training of the SGE by daily copulation to ejaculation might be a promising alternative that should be taken into consideration for the treatment of premature ejaculation.

  17. An improved dosage regimen of sertraline hydrochloride in the treatment for premature ejaculation: an 8-week, single-blind, randomized controlled study followed by a 4-week, open-label extension study.

    PubMed

    Xu, G; Jiang, H-W; Fang, J; Wen, H; Gu, B; Liu, J; Zhang, L-M; Ding, Q; Zhang, Y-F

    2014-02-01

    This study aimed at evaluating the safety and efficacy of an improved dosage regimen of sertraline in patients with premature ejaculation (PE) and to examine whether the premature ejaculation diagnostic tool (PEDT) can be used as a measure of treatment response in these patients. A total of 218 PE patients were randomized into control (n = 61) and treatment (n = 157) groups to receive mycelium of cordyceps sinensis C4 and sertraline 50 mg daily for 8 weeks, respectively. Following this blinded stage, sixty-three patients chose to take sertraline 100 mg daily for an additional 4-week period, and 80 other patients continued treatment with sertraline 50 mg. Main outcome measures include intravaginal ejaculatory latency time (IELT), PEDT score and Clinical Global Impression of Change (CGIC) score. At weeks 4 and 8, mean IELT of patients who subsequently chose to take 100 mg of sertraline was significantly lower than that of patients who continued taking 50 mg of sertraline, although the IELT value was comparable between the two groups of patients at baseline. However, with an additional 4-week treatment, the mean IELT increased significantly more in the 100-mg group than in the 50-mg continuation group. Similar results were also obtained in the analyses of the PEDT and CGIC scores. Both regimens were well tolerated, and relapse rate did not differ significantly between the two groups. These findings suggest that PE patients not responding to an 8-week treatment with sertraline 50 mg can benefit from an additional 4-week treatment with sertraline 100 mg and that the PEDT may be a valid measure of treatment response in PE patients. © 2013 John Wiley & Sons Ltd.

  18. Central regulation of ejaculation.

    PubMed

    Coolen, Lique M; Allard, Julien; Truitt, William A; McKenna, Kevin E

    2004-11-15

    Ejaculation is a reflex mediated by a spinal control center, referred to as a spinal ejaculation generator. This spinal ejaculation generator coordinates sympathetic, parasympathetic and motor outflow to induce the two phases of ejaculation, i.e., emission and expulsion. In addition, the spinal ejaculation generator integrates this outflow with inputs that are related to the summation of sexual activity prior to ejaculation that are required to trigger ejaculation. Recently, a group of spinothalamic neurons in the lumbar spinal cord (LSt cells) were demonstrated to comprise an integral part of the spinal ejaculation generator. Specifically, lesions of LSt cells completely ablate ejaculatory function. Moreover, LSt cells are activated following ejaculation, but not following other components of sexual behavior. Furthermore, based on their relationship with autonomic nuclei, motoneurons and genital sensory inputs, LSt cells are also in the ideal anatomical position to integrate sensory inputs and autonomic and motor outflow. Additionally, the spinal ejaculation generator is under inhibitory and excitatory influence of supraspinal sites, including the nucleus paragigantocellularis (nPGi), the paraventricular nucleus of the hypothalamus (PVN) and the medial preoptic area (MPOA). Finally, sensory information related to ejaculation is processed in the spinal cord and brain, possibly contributing to the rewarding properties of ejaculation. One candidate pathway for relay of ejaculation-related cues consists of LSt cells and their projections to the parvocellular subparafascicular thalamic nucleus. Moreover, neural activation specifically related to ejaculation is observed in the brain and may reflect of processing of ejaculation-related sensory cues.

  19. No Evidence for Long-Term Causal Associations Between Symptoms of Premature Ejaculation and Symptoms of Anxiety, Depression, and Sexual Distress in a Large, Population-Based Longitudinal Sample.

    PubMed

    Ventus, Daniel; Gunst, Annika; Kärnä, Antti; Jern, Patrick

    2017-02-01

    Premature ejaculation (PE) is one of the most common male sexual complaints, but its etiology is unclear. Psychological problems, such as symptoms of anxiety and depression, have traditionally been seen as causal or maintaining etiological components of PE, and previous cross-sectional studies have found weak positive associations between them. The aim of the present study was to test possible causal pathways over time between PE and symptoms of the psychological problems anxiety, depression, and sexual distress. A sample of 985 male Finnish twins and brothers of twins completed a questionnaire in 2006 and 2012. Significant bivariate correlations were found both within and across time between PE and the psychological problems. When fitting structural equation models to test hypothesized causal pathways, symptoms of anxiety and sexual distress at the first measurement time point did not predict future PE. Likewise, PE symptoms at the first measurement did not predict increments or decrements in anxiety, sexual distress, or depression later on. These null findings regarding hypothesized associations may partly be explained by the relatively long time between measurements, or that the measures possibly did not capture the aspects of anxiety that are related to PE.

  20. AB220. Relationships between intravaginal ejaculatory latency time and National Institutes of Health-Chronic Prostatitis Symptom Index in the four types of premature ejaculation syndromes: a large observational study in China

    PubMed Central

    Gao, Jingjing; Xu, Chuan; Zhang, Xiansheng

    2016-01-01

    Objective We assessed the associations between intravaginal ejaculatory latency time (IELT) and National Institutes of Health-Chronic Prostatitis Symptom Index (NIH-CPSI) in men with different PE syndromes. Methods From September 2011 to September 2012, a total of 4,000 men were enrolled from the Anhui province of China. Subjects were required to complete a verbal questionnaire, including demographic information, medical and sexual history (e.g., IELT), and self-estimated scales (e.g., NIH-CPSI). Results Of 3,016 of the men evaluated, 25.80% complained of premature ejaculation (PE). Distribution of the four PE syndromes among men with complaints of PE was as follows: LPE, 12.34%; APE, 18.77%; VPE, 44.09%; and SPE, 24.81%. Men with complaints of PE reported worse NIH-CPSI scores and lower IELT than men without complaints of PE (P<0.001 for all). Moreover, total and subdomain scores of NIH-CPSI were higher in men with APE, and IELT was higher in men with SPE. IELT was negatively associated with NIH-CPSI scores in men with complaints of PE. Negative relationships between total and subdomain scores of NIH-CPSI and IELT were stronger in men with APE (total scores: adjusted r=−0.68, P<0.001; pain symptoms: adjusted r=−0.70, P<0.001; urinary symptoms: adjusted r=−0.67, P<0.001; quality of life impact: adjusted r=−0.64, P<0.001). Conclusions Men with complaints of PE reported worse NIH-CPSI scores than men without complaints of PE. Relationships between IELT and NIH-CPSI scores were strongest in men with APE.

  1. Effect of botulinum-A toxin injection into bulbospongiosus muscle on ejaculation latency in male rats.

    PubMed

    Serefoglu, Ege C; Hawley, Wayne R; Lasker, George F; Grissom, Elin M; Mandava, Sree H; Sikka, Suresh C; Dohanich, Gary P; Hellstrom, Wayne J G

    2014-07-01

    Premature ejaculation (PE) is the most common male sexual dysfunction. A variety of pharmacotherapeutic strategies have been employed to treat men suffering with lifelong PE. However, there are currently no pharmaceuticals approved by the U.S. Food and Drug Administration specifically designed for PE treatment. Given that the bulbospongiosus muscle is involved in the ejaculatory reflex in both humans and rodents and that local administration of botulinum-A can abolish muscle contractions, the current study examined the effect of injection of botulinum-A toxin into the bulbospongiosus muscle on the ejaculatory latency of male rats. After screening for normal sexual activity with sexually receptive female rats, 33 sexually experienced male Long-Evans rats (Harlan Laboratories, Indianapolis, IN, USA) underwent an additional four pretreatment sexual exposures over the course of the following week, during which all components of sexual behavior were video recorded by trained observers. On the day after their fourth experience, rats were anesthetized and received a single injection of either 0.5 unit (n = 11) or 1 unit (n = 11) of botulinum-A toxin or saline vehicle (n = 11). Botulinum-A toxin was dissolved in 0.1 mL of saline vehicle and injected bilaterally into the bulbospongiosus muscle by the percutaneous route. Beginning 2 days after treatment, sexual behaviors were reexamined over the course of the following week on four separate occasions. The latency to achieve ejaculation, and the frequencies and latencies of mounts and intromissions were video recorded by trained observers in a blinded fashion. Relative to pretreatment measurements, bilateral injection of saline vehicle into the bulbospongiosus muscle did not affect ejaculation latencies. However, rats treated with either 0.5 or 1 unit of botulinum-A toxin exhibited significantly longer latencies to achieve ejaculation relative to pretreatment performance. Of note, botulinum-A toxin did not

  2. Epidemiology of delayed ejaculation

    PubMed Central

    Di Sante, Stefania; Mollaioli, Daniele; Gravina, Giovanni Luca; Ciocca, Giacomo; Limoncin, Erika; Carosa, Eleonora; Lenzi, Andrea

    2016-01-01

    A large body of literature on diminished ejaculatory disorders has been generated without the use of a clear diagnostic definition. Many studies have not distinguished between the orgasm and ejaculation disorders leading to doubtful results. Delayed ejaculation (DE) is one of the diminished ejaculatory disorders, which range from varying delays in ejaculatory latency to a complete inability to ejaculate. The present review is aimed at providing a comprehensive overview of the current knowledge on the definition and epidemiology of diminished ejaculatory disorders. We focus on the acquired diseases, such as benign prostatic hyperplasia (BPH) and specific drug regimens that may cause an iatrogenic form of ejaculatory disorder. In addition, the impact of aging is discussed since the prevalence of DE appears to be moderately but positively related to age. Finally, we also focus on the importance of the hormonal milieu on male ejaculation. To date, evidence on the endocrine control of ejaculation is derived from small clinical trials, but the evidence suggests that hormones modulate the ejaculatory process by altering its overall latency. PMID:27652226

  3. Epidemiology of delayed ejaculation.

    PubMed

    Di Sante, Stefania; Mollaioli, Daniele; Gravina, Giovanni Luca; Ciocca, Giacomo; Limoncin, Erika; Carosa, Eleonora; Lenzi, Andrea; Jannini, Emmanuele A

    2016-08-01

    A large body of literature on diminished ejaculatory disorders has been generated without the use of a clear diagnostic definition. Many studies have not distinguished between the orgasm and ejaculation disorders leading to doubtful results. Delayed ejaculation (DE) is one of the diminished ejaculatory disorders, which range from varying delays in ejaculatory latency to a complete inability to ejaculate. The present review is aimed at providing a comprehensive overview of the current knowledge on the definition and epidemiology of diminished ejaculatory disorders. We focus on the acquired diseases, such as benign prostatic hyperplasia (BPH) and specific drug regimens that may cause an iatrogenic form of ejaculatory disorder. In addition, the impact of aging is discussed since the prevalence of DE appears to be moderately but positively related to age. Finally, we also focus on the importance of the hormonal milieu on male ejaculation. To date, evidence on the endocrine control of ejaculation is derived from small clinical trials, but the evidence suggests that hormones modulate the ejaculatory process by altering its overall latency.

  4. Retrograde ejaculation in a stallion.

    PubMed

    Brinsko, S P

    2001-02-15

    Retrograde ejaculation was diagnosed in a 10-year-old Arabian stallion. Despite behavioral signs consistent with ejaculation, the collection receptacle of an artificial vagina remained devoid of semen on numerous occasions. Catheterization of the urinary bladder yielded large numbers of spermatozoa, even when an ejaculate was obtained, whereas low numbers (< 1 X 10(6)/ml) of spermatozoa are found in the bladder of clinically normal stallions after ejaculation. Endoscopic examination of the urethra, seminal colliculus, and bladder failed to reveal abnormalities. Medical treatment with imipramine hydrochloride apparently resulted in improvement initially, but was not curative. Further diagnostic and treatment measures were declined and the stallion was castrated. For stallions that seemingly fail to ejaculate or for ejaculates that contain lower seminal volumes or numbers of spermatozoa than expected, obtaining a urine sample after ejaculation via bladder catheterization is a simple diagnostic procedure that may be used to investigate the possibility of retrograde ejaculation.

  5. Retrograde ejaculation: simpler treatment.

    PubMed

    Leiva, Rene

    2007-07-01

    To report a case of successful treatment of complete retrograde ejaculation by use of a novel, simple, and noninvasive home-based protocol. Case report. Private family medicine clinic. A couple with primary infertility due to the male's complete retrograde ejaculation due to childhood's bladder surgery. The woman was healthy with normal menstrual cycles. After intercourse, the male patient voided a urine-semen mixture from a previously alkalinized urine and proceeded to inseminate it intravaginally into his wife. Determination of best time for intercourse was done by use of the ovulation (Billings) method. This protocol has been used successfully by this couple to conceive two healthy children. To our knowledge, this is the second reported case of successful management of infertility through this protocol. It might be appropriate to try this method first on select patients with retrograde ejaculation.

  6. The history of female ejaculation.

    PubMed

    Korda, Joanna B; Goldstein, Sue W; Sommer, Frank

    2010-05-01

    The existence of female ejaculation and the female prostate is controversial; however, most scientists are not aware that historians of medicine and psychology described the phenomenon of female ejaculation approximately 2,000 years ago. To review historical literature in which female ejaculation is described. A comprehensive systematic literature review. Emission of fluid at the acme of orgasm and/or sexual pleasure in females was considered as a description of female ejaculation and therefore all documents referring to this phenomenon are included. Physicians, anatomists, and psychologists in both eastern and western culture have described intellectual concepts of female ejaculation during orgasm. In ancient Asia female ejaculation was very well known and mentioned in several Chinese Taoist texts starting in the 4th century. The ancient Chinese concept of female ejaculation as independent of reproduction was supported by ancient Indian writings. First mentioned in a 7th century poem, female ejaculation and the Gräfenberg spot (G-spot) are described in detail in most works of the Kāmaśāstra. In ancient Western writings the emission of female fluid is mentioned even earlier, depicted about 300 B.C. by Aristotle and in the 2nd century by Galen. Reinjier De Graaf in the 16th century provided the first scientific description of female ejaculation and was the first to refer to the periurethral glands as the female prostate. This concept was held by other scientists during the following centuries through 1952 A.D. when Ernst Gräfenberg reported on "The role of the urethra in female orgasm. Current research provides insight into the anatomy of the female prostate and describes female ejaculation as one of its functions. Credible evidence exists among different cultures that the female prostate and female ejaculation have been discovered, described and then forgotten over the last 2,000 years.

  7. Lifelong Learning

    ERIC Educational Resources Information Center

    Berry, Mary F.

    1977-01-01

    The Lifelong Learning Project (established under the U.S. Department of Health, Education, and Welfare) and possible approaches toward the development of effective and efficient Federal-State relationships in carrying out adult learning programs in communities are discussed along with other implications of the project. (TA)

  8. Lifelong Readers.

    ERIC Educational Resources Information Center

    Sorba, Barbara

    A brief review of the literature on the various approaches which have been used to help children formulate their emerging attitudes towards reading and literature helps clarify the goal of creating lifelong readers. Samway (1991), discussing literature study circles, relates that students read the book they have selected, answer assigned…

  9. Spontaneous Ejaculations Associated with Aripiprazole

    PubMed Central

    EĞİLMEZ, Oğuzhan; ÇELİK, Mustafa; KALENDEROĞLU, Aysun

    2016-01-01

    Sexual side effects are common with antipsychotic use. Spontaneous ejaculations without sexual arousal have been previously described with several typical and atypical antipsychotics. We report the case of a man who had spontaneous ejaculations after stopping risperidone and starting 30 mg/day aripiprazole. Spontaneous ejaculations ceased 3 days after decreasing the aripiprazole dose to 15 mg/day. He denied sexual fantasies or increased sexual desire during the period in which he had spontaneous ejaculations. The partial agonistic effect of aripiprazole on D2 receptors may have augmented the mesolimbic dopaminergic pathway, which was suppressed by risperidone, causing spontaneous ejaculations in this patient. Serotoninergic effects of aripiprazole should also be considered. This unusual side effect should be questioned, particularly in patients who recieve aripiprazole after D2-blocking antipsychotics; otherwise, this side effect may cause embarrassement and noncompliance. PMID:28360773

  10. Iloperidone-induced retrograde ejaculation.

    PubMed

    Freeman, Scott A

    2013-05-01

    This case series describes the development of retrograde ejaculation with the antipsychotic iloperidone. Iloperidone is a relatively new antipsychotic and has a strong α-1 receptor antagonism, which may explain this rare adverse effect.

  11. Managing early ejaculation: what does the future hold?

    PubMed

    O'leary, Michael P

    2004-01-01

    Recent attention in the field of male sexual dysfunction has focused on erectile dysfunction. However, premature ejaculation (PE) is an extremely common condition that warrants clinical study and exploration of pharmacologic treatments. Until recently, PE was thought to be a behavioral problem for which the best remedy was a learned control technique. However, some drugs currently on the market, including sildenafil and the selective serotonin reuptake inhibitors, appear to have efficacy in the treatment of PE. More research is needed before FDA approval of such agents for this indication, but more and better options for men with PE are anticipated as attention to ejaculatory disorders grows and, hopefully, the associated stigma decreases.

  12. [Physiology and pharmacology of ejaculation].

    PubMed

    Rampin, Olivier; Giuliano, François

    2004-01-01

    Ejaculation requires an interplay of peripheral actors comprising, among others, smooth and skeletal fibers, glandular and endothelial cells. These actors are driven by vegetative and somatic innervations, deriving essentially from the spinal cord, in turn controlled by cerebral structures and endocrine factors, mostly steroids; These controls require sensitive afferences and command two steps, emission under autonomic control, and ejaculation per se which further involves somatic motoneurons. This review first describes the peripheral innervation of the part of the genital tract concerned in ejaculation, in which the sympathetic component is predominant and releases noradrenalin and neuropeptides; however parasympathetic and somatic components also play a role. At the spinal level, control circuits are organized into networks influenced by spinal structures, which have been discovered through selective lesions or stimulations, as well as by retrograde trans-synaptic tracing with neurotropic viruses. Among these structures, the median preoptic area and the hypothalamic paraventricular nucleus are major regulation sites. On the other hand, serotoninergic and also dopaminergic and adrenergic systems are implicated as well in the command of ejaculation; the latter constitute priviledged targets for a pharmacological treatment of dysfunctions.

  13. The pathophysiology of delayed ejaculation

    PubMed Central

    2016-01-01

    Delayed ejaculation (DE) is probably least studied, and least understood of male sexual dysfunctions, with an estimated prevalence of 1–4% of the male population. Pathophysiology of DE is multifactorial and including psychosexual-behavioral and cultural factors, disruption of ejaculatory apparatus, central and peripheral neurotransmitters, hormonal or neurochemical ejaculatory control and psychosocial factors. Although knowledge of the physiology of the DE has increased in the last two decade, our understanding of the different pathophysiological process of the causes of DE remains limited. To provide a systematic update on the pathophysiology of DE. A systematic review of Medline and PubMed for relevant publications on ejaculatory dysfunction (EjD), DE, retarded ejaculation, inhibited ejaculation, and climax was performed. The search was limited to the articles published between the January 1960 and December 2015 in English. Of 178 articles, 105 were selected for this review. Only those publications relevant to the pathophysiology, epidemiology and prevalence of DE were included. The pathophysiology of DE involves cerebral sensory areas, motor centers, and several spinal nuclei that are tightly interconnected. The biogenic, psychogenic and other factors strongly affect the pathophysiology of DE. Despite the many publications on this disorder, there still is a paucity of publications dedicated to the subject. PMID:27652227

  14. The Lifelong Learner.

    ERIC Educational Resources Information Center

    Gross, Ronald

    Designed to provide a general guide and stimuli for lifelong learning, this book examines all the positive factors of independent study. Lifelong learning is defined as self-directed growth free from the traditional schooling procedures. Chapters discuss the following: the lifelong learner; profiles of such learners in action; how to be…

  15. Integrating Lifelong Learning Perspectives.

    ERIC Educational Resources Information Center

    Medel-Anonuevo, Carolyn, Ed.

    This publication is comprised of 43 papers on the topic of promoting lifelong learning. The papers in Part 1, Overcoming False Dichotomies, are "Lifelong Learning in the North, Education for All in the South" (Torres); "Practice of Lifelong Learning in Indigenous Africa" (Omolewa); "Gender and Information Societies"…

  16. The Lifelong Learner.

    ERIC Educational Resources Information Center

    Gross, Ronald

    Designed to provide a general guide and stimuli for lifelong learning, this book examines all the positive factors of independent study. Lifelong learning is defined as self-directed growth free from the traditional schooling procedures. Chapters discuss the following: the lifelong learner; profiles of such learners in action; how to be…

  17. Premature Menopause

    PubMed Central

    Okeke, TC; Anyaehie, UB; Ezenyeaku, CC

    2013-01-01

    Premature menopause affects 1% of women under the age of 40 years. The women are at risk of premature death, neurological diseases, psychosexual dysfunction, mood disorders, osteoporosis, ischemic heart disease and infertility. There is need to use simplified protocols and improved techniques in oocyte donation to achieve pregnancy and mother a baby in those women at risk. Review of the pertinent literature on premature menopause, selected references, internet services using the PubMed and Medline databases were included in this review. In the past, pregnancy in women with premature menopause was rare but with recent advancement in oocyte donation, women with premature menopause now have hoped to mother a child. Hormone replacement therapy is beneficial to adverse consequences of premature menopause. Women with premature menopause are at risk of premature death, neurological diseases, psychosexual dysfunction, mood disorders, osteoporosis, ischemic heart disease and infertility. Public enlightenment and education is important tool to save those at risk. PMID:23634337

  18. Successful treatment of retrograde ejaculation with amezinium.

    PubMed

    Ichiyanagi, O; Sasagawa, I; Suzuki, Y; Matsuki, S; Itoh, K; Miura, M; Tomita, Y

    2003-01-01

    The effect of amezinium, a new type of antihypotensive agent, on retrograde ejaculation was evaluated in 3 patients with retrograde ejaculation. The patients received 10 mg amezinium orally once a day. All patients achieved antegrade ejaculation. Semen analyses revealed 6-50 x 10(6)/mL (mean 28.7 x 10(6)/mL) sperm with a motility of 20-50% (mean 36.7%). The wives of 2 patients became pregnant within 6 months of the initial treatment. None of the patients had any side effects. It would appear that amezinium is a useful treatment for retrograde ejaculation.

  19. Effect of SSRI antidepressants on ejaculation: a double-blind, randomized, placebo-controlled study with fluoxetine, fluvoxamine, paroxetine, and sertraline.

    PubMed

    Waldinger, M D; Hengeveld, M W; Zwinderman, A H; Olivier, B

    1998-08-01

    Depression is a common cause of sexual dysfunction, but also antidepressant medication is often associated with sexual side effects. This article includes two related studies. The first double-blind, placebo-controlled study was conducted in men with lifelong rapid ejaculation and aimed to assess putative differences between the major selective serotonin reuptake inhibitors (SSRIs) (fluoxetine, fluvoxamine, paroxetine, and sertraline) with regard to their ejaculation-delaying effect. Sixty men with an intravaginal ejaculation latency time (IELT) of 1 minute or less were randomly assigned to receive fluoxetine 20 mg/day, fluvoxamine 100 mg/day, paroxetine 20 mg/day, sertraline 50 mg/day, or placebo for 6 weeks. During the 1-month baseline and 6-week treatment periods, the men measured their IELT at home using a stopwatch. The trial was completed by 51 men. During the 6-week treatment period, the geometric mean IELT in the placebo group was constant at approximately 20 seconds. Analysis of variance revealed a between-groups difference in the evolution of IELT delay (p = 0.0004); in the paroxetine, fluoxetine, and sertraline groups there was a gradual increase to about 110 seconds, whereas in the fluvoxamine group, IELT was increased to only approximately 40 seconds. The paroxetine, fluoxetine, and sertraline groups differed significantly (p < 0.001, p < 0.001, p = 0.017, respectively) from placebo but the fluvoxamine group did not (p = 0.38). Compared with baseline, paroxetine exerted the strongest delay in ejaculation, followed by fluoxetine and sertraline. There was no clinically relevant delay in ejaculation with fluvoxamine. In men with lifelong rapid ejaculation, paroxetine delayed ejaculation most strongly, whereas fluvoxamine delayed ejaculation the least. The second double-blind, placebo-controlled study was carried out in men with lifelong rapid ejaculation (IELT < or = 1 minute) and in men with lifelong less-rapid ejaculation (IELT > 1 minute) to

  20. Analysis of human ejaculation using color Doppler ultrasonography: a comparison between antegrade and retrograde ejaculation.

    PubMed

    Nagai, Atsushi; Watanabe, Masami; Nasu, Yasutomo; Iguchi, Hiroki; Kusumi, Norihiro; Kumon, Hiromi

    2005-02-01

    To observe the phenomenon of human ejaculation dynamically using color Doppler ultrasonography. Human ejaculation was observed using transrectal color Doppler ultrasonography in a healthy man and a patient with retrograde ejaculation. Ejaculation was induced manually with audiovisual sexual stimulation. The ejaculatory phenomenon was analyzed and compared with that of retrograde ejaculation. In the healthy man, the prostatic urethra flattened slightly and the bladder neck contracted just before expulsion. The ejaculatory stream spurted from the seminal vesicles to the bulbous urethra through the ejaculatory duct. In the patient with retrograde ejaculation, the ejaculatory stream from the seminal vesicles and inframontanal and distal prostatic urethras distended into a globular-shaped sac filled with semen. No seminal flow toward the bulbous urethra occurred. The semen remaining in the prostatic urethra began flowing slowly into the bladder. Differences between antegrade and retrograde ejaculation can be clearly detected by color Doppler ultrasonography, providing a noninvasive method to diagnose ejaculatory disorders.

  1. [Premature orgasm in the male].

    PubMed

    Köhn, F M

    2003-11-13

    To date, we have no uniform definition of ejaculatio praecox. In a qualitative approach, premature ejaculation is ascribed to a failure to control excitement. As causes, organic disorders and erectile dysfunction must be excluded. The majority of cases, however, are due to psychological or partnership problems. The history-taking should aim, in particular, to uncover possible anxiety in conjunction with premature orgasm, and also to establish the reactions of the partner. As therapy, medication (local anesthetics, antidepressive agents, PDE-5 inhibitors) and sexual-therapeutic measures are available. Since few sufferers take the initiative in seeking treatment, particular importance attaches to providing the public with information about the therapeutic options for treating this common disorder.

  2. Premature menarche

    PubMed Central

    Murram, D; Dewhurst, John; Grant, D B

    1983-01-01

    Follow-up information was obtained from 12 women aged 16-34 years who had been seen previously because of premature isolated menstrual bleeding (premature menarche) starting between ages 9 months and 9 years. All the women reported normal regular menses and fertility was normal in the 6 women who had married. PMID:6830291

  3. Lifelong Learning: Emergent Enactments

    ERIC Educational Resources Information Center

    Edwards, Richard

    2010-01-01

    This article represents four emergences through which to explore the significance of lifelong learning. Drawing in particular on complexity theory and actor-network theory, it seeks to develop an understanding of the reductions and emergences, and purifications and translations to which lifelong learning is subject. To do this, the article also…

  4. Lifelong Learning: Emergent Enactments

    ERIC Educational Resources Information Center

    Edwards, Richard

    2010-01-01

    This article represents four emergences through which to explore the significance of lifelong learning. Drawing in particular on complexity theory and actor-network theory, it seeks to develop an understanding of the reductions and emergences, and purifications and translations to which lifelong learning is subject. To do this, the article also…

  5. Nurturing Lifelong Readers

    ERIC Educational Resources Information Center

    Judkins, Gerri

    2010-01-01

    In this paper the author relates how the thing he enjoys most about his job as a school librarian is nurturing lifelong readers, in particular readers of children's literature. In talking about nurturing lifelong readers and, referring to students, staff and school librarians, the author discusses: (1) The Southwell Library Programme; (2) The Lit…

  6. Orchid sexual deceit provokes ejaculation.

    PubMed

    Gaskett, A C; Winnick, C G; Herberstein, M E

    2008-06-01

    Sexually deceptive orchids lure pollinators by mimicking female insects. Male insects fooled into gripping or copulating with orchids unwittingly transfer the pollinia. The effect of deception on pollinators has been considered negligible, but we show that pollinators may suffer considerable costs. Insects pollinating Australian tongue orchids (Cryptostylis species) frequently ejaculate and waste copious sperm. The costs of sperm wastage could select for pollinator avoidance of orchids, thereby driving and maintaining sexual deception via antagonistic coevolution or an arms race between pollinator learning and escalating orchid mimicry. However, we also show that orchid species provoking such extreme pollinator behavior have the highest pollination success. How can deception persist, given the costs to pollinators? Sexually-deceptive-orchid pollinators are almost exclusively solitary and haplodiploid species. Therefore, female insects deprived of matings by orchid deception could still produce male offspring, which may even enhance orchid pollination.

  7. EEG during masturbation and ejaculation.

    PubMed

    Graber, B; Rohrbaugh, J W; Newlin, D B; Varner, J L; Ellingson, R J

    1985-12-01

    The occurrence of a distinctive EEG pattern specifically related to sexual arousal and orgasm would provide a reliable and convenient means of identifying such events in the laboratory and would also provide clues to cerebral structures involved in the processes. EEG-polygraph recordings were obtained under rigorously controlled conditions in four normal male subjects during masturbation and ejaculation. The EEG data were subjected to both impressionistic and quantitative analyses. They showed no remarkable changes during the sequence of relevant physiological responses. The sole effect was a slight depression of alpha activity, a well-known nonspecific effect associated with changes in attention and arousal. Examination of the literature shows little agreement among reported results of studies of EEG changes during orgasm. It is likely that at least some reported changes were artifactual. It is concluded that the case for the existence of EEG changes specifically related to sexual arousal and orgasm remains unproven.

  8. Validation of Three Early Ejaculation Diagnostic Tools: A Composite Measure Is Accurate and More Adequate for Diagnosis by Updated Diagnostic Criteria

    PubMed Central

    Jern, Patrick; Piha, Juhana; Santtila, Pekka

    2013-01-01

    Purpose To validate three early ejaculation diagnostic tools, and propose a new tool for diagnosis in line with proposed changes to diagnostic criteria. Significant changes to diagnostic criteria are expected in the near future. Available screening tools do not necessarily reflect proposed changes. Materials and Methods Data from 148 diagnosed early ejaculation patients (Mage = 42.8) and 892 controls (Mage = 33.1 years) from a population-based sample were used. Participants responded to three different questionnaires (Premature Ejaculation Profile; Premature Ejaculation Diagnostic Tool; Multiple Indicators of Premature Ejaculation). Stopwatch measured ejaculation latency times were collected from a subsample of early ejaculation patients. We used two types of responses to the questionnaires depending on the treatment status of the patients 1) responses regarding the situation before starting pharmacological treatment and 2) responses regarding current situation. Logistic regressions and Receiver Operating Characteristics were used to assess ability of both the instruments and individual items to differentiate between patients and controls. Results All instruments had very good precision (Areas under the Curve ranging from .93-.98). A new five-item instrument (named CHecklist for Early Ejaculation Symptoms – CHEES) consisting of high-performance variables selected from the three instruments had validity (Nagelkerke R2 range .51-.79 for backwards/forwards logistic regression) equal to or slightly better than any individual instrument (i.e., had slightly higher validity statistics, but these differences did not achieve statistical significance). Importantly, however, this instrument was more in line with proposed changes to diagnostic criteria. Conclusions All three screening tools had good validity. A new 5-item diagnostic tool (CHEES) based on the three instruments had equal or somewhat more favorable validity statistics compared to the other three tools, but is

  9. Iatrogenic ejaculation disorders and their prevention.

    PubMed

    Terrone, C; Castelli, E; Aveta, P; Cugudda, A; Rocca Rossetti, S

    2001-03-01

    Ejaculation is mediated by sympathetic fibers originating from the D10-L2 medullar center. These nerves rise from the lumbar ganglia of the paravertebral sympathetic trunk and travel posteriorly to the vena cava and then to the interaortocaval space, on the right side, and laterally to the aorta, on the left side. They are the principal constituents of the superior hypogastric plexus. Many surgical operations can cause an ejaculation disorder, but the most important is retroperitoneal lymphadenectomy (RL) for testis cancer, because it involves young patients and it has been the subject of important researches in order to perform lymph node dissection without ejaculation loss (unilateral lymphadenectomy and nerve sparing lymphadenectomy). Our experience concerns 41 patients who underwent RL for testis cancer from 1983 to 1998. Survival rate was 95.2% (mean follow up 64 months). RL was performed bilaterally in 14 patients. Two of them died of metastases within 2 years after the operation. Ejaculation was maintained in only 4 of the 12 surviving patients (33%). All the 17 patients (100%) underwent right monolateral RL and 7 of the 10 (70%) underwent left monolateral RL preserved ejaculation. The anatomosurgical concepts of the RL sparing the ejaculation can be adopted in other retroperitoneal surgical operations that can produce ejaculation disorders, such as wide lymphadenectomy for renal cell carcinoma or tumors of the upper urinary tract, exeresis of pre- aortic tumors, exeresis or disjunction of horseshoe kidney and aorto-iliac revascularization. Surgical therapy of benign prostatic hyperplasia (BPH) (open surgery or transurethral prostatic resection) is associated with retrograde ejaculation in nearly 100% of cases. The mechanism of the dysfunction is clear, if following the procedure the bladder neck remains opened. Loss of ejaculation is reported in variable percentage after the newer endoscopic techniques for the treatment of BPH. Transurethral needle ablation

  10. Urethral anatomy and semen flow during ejaculation

    NASA Astrophysics Data System (ADS)

    Kelly, Diane

    2016-11-01

    Ejaculation is critical for reproductive success in many animals, but little is known about its hydrodynamics. In mammals, ejaculation pushes semen along the length of the penis through the urethra. Although the urethra also carries urine during micturition, the flow dynamics of micturition and ejaculation differ: semen is more viscous than urine, and the pressure that drives its flow is derived primarily from the rhythmic contractions of muscles at the base of the penis, which produce pulsatile rather than steady flow. In contrast, Johnston et al. (2014) describe a steady flow of semen through the crocodilian urethral groove during ejaculation. Anatomical differences of tissues associated with mammalian and crocodilian urethral structures may underlie these differences in flow behavior.

  11. Pontine control of ejaculation and female orgasm.

    PubMed

    Huynh, Hieu K; Willemsen, Antoon T M; Lovick, Thelma A; Holstege, Gert

    2013-12-01

    The physiological component of ejaculation shows parallels with that of micturition, as both are essentially voiding activities. Both depend on supraspinal influences to orchestrate the characteristic pattern of activity in the pelvic organs. Unlike micturition, little is known about the supraspinal pathways involved in ejaculation and female orgasm. To identify brainstem regions activated during ejaculation and female orgasm and to compare them with those activated during micturition. Ejaculation in men and orgasm in women were induced by manual stimulation of the penis or clitoris by the participants' partners. Positron emission tomography (PET) with correction for head movements was used to capture the pattern of brain activation at the time of sexual climax. PET scans showing areas of activation during sexual climax. Ejaculation in men and orgasm in women resulted in activation in a localized region within the dorsolateral pontine tegmentum on the left side and in another region in the ventrolateral pontine tegmentum on the right side. The dorsolateral pontine area was also active in women who attempted but failed to have an orgasm and in women who imitated orgasm. The ventrolateral pontine area was only activated during ejaculation and physical orgasm in women. Activation of a localized region on the left side in the dorsolateral pontine tegmentum, which we termed the pelvic organ-stimulating center, occurs during ejaculation in men and physical orgasm in women. This same region has previously been shown to be activated during micturition, but on the right side. The pelvic organ-stimulating center, via projections to the sacral parasympathetic motoneurons, controls pelvic organs involved in voiding functions. In contrast, the ventrolateral pontine area, which we term the pelvic floor-stimulating center, produces the pelvic floor contractions during ejaculation in men and physical orgasm in women via direct projections to pelvic floor motoneurons. © 2013

  12. Premature infant

    MedlinePlus

    ... infant is a baby born before 37 completed weeks of gestation (more than 3 weeks before the due date). ... one of the following: Premature (less than 37 weeks gestation) Full term (37 to 42 weeks gestation) ...

  13. Premature Babies

    MedlinePlus

    ... or preemies. A premature birth is when a baby is born before 37 completed weeks of pregnancy. ... early, preemies weigh much less than full-term babies. They may have health problems because their organs ...

  14. Ejaculate allocation by male sand martins, Riparia riparia.

    PubMed Central

    Nicholls, E H; Burke, T; Birkhead, T R

    2001-01-01

    Males of many species allocate sperm to ejaculates strategically in response to variation in the risk and intensity of sperm competition. The notable exception is passerine birds, in which evidence for strategic allocation is absent. Here we report the results of a study testing for strategic ejaculate allocation in a passerine bird, the sand martin (Riparia riparia). Natural ejaculates were collected from males copulating with a model female. Ejaculates transferred in the presence of a rival male contained significantly more sperm than ejaculates transferred in the absence of a rival male. There was no evidence that this difference was due to the confounding effects of the year of ejaculate collection, the identity of the model female, the colony, the stage of season or the period of the day in which ejaculates were collected. A more detailed examination of the ejaculate patterns of individual males, achieved by the DNA profiling of ejaculates, provided additional evidence for strategic allocation of sperm. PMID:11410153

  15. The seminal symphony: how to compose an ejaculate

    PubMed Central

    Perry, Jennifer C.; Sirot, Laura; Wigby, Stuart

    2016-01-01

    Ejaculates are fundamental to fitness in sexually-reproducing animals: males gain all their direct fitness via the ejaculate and females require ejaculates to reproduce. Both sperm and non-sperm components of the ejaculate (including parasperm, seminal proteins, water and macromolecules) play vital roles in post-copulatory sexual selection and conflict, processes that can potentially drive rapid evolutionary change and reproductive isolation. Here, we assess the increasing evidence that considering ejaculate composition as a whole – and potential trade-offs among ejaculate components – has important consequences for predictions about male reproductive investment and female responses to ejaculates. We review current theory and empirical work, and detail how social and environmental effects on ejaculate composition have potentially far-reaching fitness consequences for both sexes. PMID:23582755

  16. Treatment of retrograde ejaculation and anejaculation.

    PubMed

    Kamischke, A; Nieschlag, E

    1999-01-01

    Treatment of retrograde ejaculation and anejaculation The various options for the treatment of retrograde ejaculation (RE) and anejaculation (AE) are discussed systematically in this review. A total of 88 studies dealing with patients with RE emphasize medical treatment for reversal of RE and retrieval of spermatozoa from urine. In 136 studies concerning patients with AE, the main emphasis is on medical treatment, electroejaculation (EE) and electrovibration stimulation (EVS) for the reversal of AE. Sperm quality in patients with RE and AE is often impaired. However, with the help of assisted reproduction techniques (ART) available today, both ejaculation disorders can be considered as treatable diseases. The major problem when analysing the studies was the uneven methodological quality of the original articles and the difficulties presented by different drugs and dosages, equipment and techniques, along with different criteria for success. In conclusion, controlled clinical trials comparing different treatment options appear urgently warranted.

  17. Recovery of abnormal ejaculation by intermittent tamsulosin treatment.

    PubMed

    Goktas, Serdar; Kibar, Yusuf; Kilic, Selim; Topac, Hasret; Coban, Hidayet; Seckin, Bedrettin

    2006-02-01

    We assessed the impact of intermittent tamsulosin treatment on abnormal ejaculation. This prospective study was performed between January 2001 and December 2004. It included 405 patients who were at least 50 years old with lower urinary tract symptoms. This study was divided into 2 phases. In phase 1 patients received a 0.4 mg tamsulosin capsule daily after breakfast for at least 3 months. The second phase of this study was performed in the 30 patients with abnormal ejaculation. In this phase these patients received 0.4 mg tamsulosin once daily every other day. Patients were assessed at study entry and at study week 6. Abnormal ejaculation was reported as retrograde ejaculation by 18 patients, as decreased volume by 7 and as absent ejaculate by 5. Ejaculatory function recovered during intermittent tamsulosin treatment in 12 patients with retrograde ejaculation and in 7 with decreased volume or absent ejaculate. As a result, 19 of 30 patients (63.3%) with abnormal ejaculation recovered. A significant improvement in retrograde ejaculation was found after intermittent tamsulosin treatment (p = 0.02). Although there were improvements in decreased volume or absent ejaculate at week 6 of intermittent treatment, these differences were not statistically significant (p = 0.42 and 0.61, respectively). The results of the current study, which to our knowledge is the first report of the effect of intermittent tamsulosin treatment on abnormal ejaculation, show that this treatment modality is well tolerated and provides comparable improvements for abnormal ejaculation.

  18. Lifelong Qualifications. Developing Qualifications To Support Lifelong Learners.

    ERIC Educational Resources Information Center

    Wilson, Peter

    If Britain is to deliver a genuine framework for lifelong learning in the 21st century, a qualifications system must be developed to support this framework. The National Qualifications Framework may not be fit for the purpose of supporting lifelong learning. A policy on lifelong learning must explicitly connect with qualifications reform to have…

  19. The Next Step: Lifelong Learning

    ERIC Educational Resources Information Center

    Mondale, Walter F.

    1976-01-01

    Schools do not exist in a vacuum and neither do people. That fact is propelling the U.S. toward a national policy on lifelong learning. Provisions of the Senate Lifelong Learning Bill are included. (LBH)

  20. Management of the dry ejaculate: a systematic review of aspermia and retrograde ejaculation.

    PubMed

    Mehta, Akanksha; Sigman, Mark

    2015-11-01

    A dry ejaculate (aspermia), may occur either because of an inability to transport semen (anejaculation) or because of an inability to ejaculate in an antegrade direction (retrograde ejaculation). The treatment of aspermia varies with underlying etiology and includes medical therapy with sympathomimetics, urinary sperm retrieval, bladder neck reconstruction, prostatic massage, penile vibratory stimulation, electroejaculation, and surgical sperm retrieval. A systematic review of the current literature was performed for articles on ejaculatory dysfunction related to dry ejaculate. However, the data are insufficient to allow firm comparisons between treatment options. Treatments must be tailored to the individual patient, and treatment decisions should involve consideration of ease of administration, degree of invasiveness, and anticipated success. Copyright © 2015 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.

  1. Lifelong Learning and Prosperity.

    ERIC Educational Resources Information Center

    Couture, Pauline

    1993-01-01

    Discusses the need for lifelong learning to maintain a presence in a world economy. Looks at the widening gap between rich and poor and its relation to educational level and suggests that more emphasis must be placed on upgrading the skills of blue collar workers. (JOW)

  2. Death and Lifelong Learning

    ERIC Educational Resources Information Center

    Schuller, Tom

    2011-01-01

    Lifelong learning has a crucial role in enabling individuals to handle key transition points in their lives, but what can education do to prepare them for the final, inevitable transition. Some of the educational contribution to managing the final transition is very broad, a matter of general enlightenment. But there are some more specific…

  3. Loans for Lifelong Learning.

    ERIC Educational Resources Information Center

    Fletcher, Mick, Ed.

    This collection of eight papers looks at how a system of loans for lifelong learning in Great Britain and New Zealand might be positioned. It examines where such loans might work best and where they seem inappropriate. In particular, the collection assembles the available evidence about the role and impact of loans in the world of education and…

  4. Invitation to Lifelong Learning.

    ERIC Educational Resources Information Center

    Gross, Ronald, Ed.

    In this anthology of readings, 28 scholars and educators consider the theoretical and practical forces that shape the concept of lifelong learning. After Ronald Gross's introduction, the first section begins its consideration of the Western tradition in adult learning with Plato's metaphor of the cave and includes Pico della Mirandola's essay on…

  5. Invitation to Lifelong Learning.

    ERIC Educational Resources Information Center

    Gross, Ronald, Ed.

    In this anthology of readings, 28 scholars and educators consider the theoretical and practical forces that shape the concept of lifelong learning. After Ronald Gross's introduction, the first section begins its consideration of the Western tradition in adult learning with Plato's metaphor of the cave and includes Pico della Mirandola's essay on…

  6. Pakistan: Lifelong Literacy Project

    ERIC Educational Resources Information Center

    Literacy Work, 1974

    1974-01-01

    The article reports on progress towards lifelong literacy education in Pakistan, covering the project's introduction in 1972 and reviewing current activities in brief but concrete sketches of such topics as materials, operation of projects, and student drop-outs. Appendixes include a map and occupational breakdowns of teachers and students. (AJ)

  7. Lifelong Learning and Politics.

    ERIC Educational Resources Information Center

    Richardson, Penelope L.

    1979-01-01

    States that community colleges are in a good position to be centers of lifelong education and that adult educators must engage in politics in order to promote learning opportunities for adults. Suggests legislative, administrative, judicial, and electoral strategies for adult educators to use in influencing policymakers to support lifelong…

  8. Lifelong Learning: Capabilities and Aspirations

    ERIC Educational Resources Information Center

    Ilieva-Trichkova, Petya

    2016-01-01

    The present paper discusses the potential of the capability approach in conceptualizing and understanding lifelong learning as an agency process, and explores its capacity to guide empirical studies on lifelong learning. It uses data for 20 countries from the Adult Education Survey (2007; 2011) and focuses on aspirations for lifelong learning. The…

  9. New Technology and Lifelong Learning.

    ERIC Educational Resources Information Center

    Thorpe, Mary

    Key issues related to the relationship between new technology and lifelong learning in the United Kingdom and elsewhere were identified through reviews of the literature on information and communications technology (ICT) and the literature on lifelong learning. Two overarching issues related to the interplay of new technology and lifelong learning…

  10. RNA PROFILES OF EJACULATED HUMAN SPERMATOZOA

    EPA Science Inventory

    RNA Profiles of Ejaculated Human Spermatozoa

    Kary E. Thompson, Wenjun Bao, Sally D. Perreault, Hongzu Ren, John C. Rockett, Judith E. Schmid, Lillian F. Strader, David J. Dix
    Reproductive Toxicology Division, National Health and Environmental Effects Research Laboratory...

  11. RNA PROFILES OF EJACULATED HUMAN SPERMATOZOA

    EPA Science Inventory

    RNA Profiles of Ejaculated Human Spermatozoa

    Kary E. Thompson, Wenjun Bao, Sally D. Perreault, Hongzu Ren, John C. Rockett, Judith E. Schmid, Lillian F. Strader, David J. Dix
    Reproductive Toxicology Division, National Health and Environmental Effects Research Laboratory...

  12. Normal male sexual function: emphasis on orgasm and ejaculation

    PubMed Central

    Alwaal, Amjad; Breyer, Benjamin N.; Lue, Tom F.

    2016-01-01

    Orgasm and ejaculation are two separate physiological processes that are sometimes difficult to distinguish. Orgasm is an intense transient peak sensation of intense pleasure creating an altered state of consciousness associated with reported physical changes. Antegrade ejaculation is a complex physiological process that is composed of two phases (emission and expulsion), and is influenced by intricate neurological and hormonal pathways. Despite the many published research projects dealing with the physiology of orgasm and ejaculation, much about this topic is still unknown. Ejaculatory dysfunction is a common disorder, and currently has no definitive cure. Understanding the complex physiology of orgasm and ejaculation allows the development of therapeutic targets for ejaculatory dysfunction. In this article, we summarize the current literature on the physiology of orgasm and ejaculation, starting with a brief description of the anatomy of sex organs and the physiology of erection. Then, we describe the physiology of orgasm and ejaculation detailing the neuronal, neurochemical, and hormonal control of the ejaculation process. PMID:26385403

  13. Leading Through Lifelong Learning.

    PubMed

    Lambert, Dawn

    2016-07-01

    School nurses, as leaders, are able to exhibit leadership skills through embracing, advocating for, and demonstrating a commitment to lifelong learning. With the continual changes in healthcare and technology, ongoing education is essential to maintain a high standard of expertise and practice. School nurses have many opportunities for continuing education. This article will briefly explore various levels of continuing education, as well as relating ongoing learning to leadership principles. © 2016 The Author(s).

  14. The drug treatment of delayed ejaculation

    PubMed Central

    Elsaied, Moustafa A.; Mostafa, Taymour

    2016-01-01

    Delayed ejaculation (DE) is an uncommon and a challenging disorder to treat. It is often quite concerning to patients and it can affect psychosocial well-being. Here we reviewed how DE is treated pharmacologically .We also highlighted specific settings where drugs could be introduced to medical practice. Electronic databases were searched from 1966 to February 2016, including PubMed MEDLINE, EMBASE, EBCSO Academic Search Complete, Cochrane Systematic Reviews Database, and Google Scholar using key words; delayed ejaculation, retarded ejaculation, inhibited ejaculation, drugs, treatment, or pharmacology. To achieve the maximum sensitivity of the search strategy and to identify all studies, we combined “delayed ejaculation” as Medical Subject Headings (MeSH) terms or keywords with each of “testosterone” or “cabergoline” or “bupropion” or “amantadine” or “cyproheptadine” or “midodrine” or “imipramine” or “ephedrine” or “pseudoephedrine” or “yohimbine” or “buspirone” or “oxytocin” or “bethanechol” as MeSH terms or keywords. There are a number of drugs to treat patients with DE including: testosterone, cabergoline, bupropion, amantadine, cyproheptadine, midodrine, imipramine, ephedrine, pseudoephedrine, yohimbine, buspirone, oxytocin, and bethanechol. Although there are many pharmacological treatment options, the evidence is still limited to small trials, case series or case reports. Review of literature showed that evidence level 1 (Double blind randomized clinical trial) studies were performed with testosterone, oxytocin, buspirone or bethanechol treatment. It is concluded that successful drug treatment of DE is still in its infancy. The clinicians need to be aware of the pathogenesis of DE and the pharmacological basis underlying the use of different drugs to extend better care for these patients. Various drugs are available to address such problem, however their evidence of efficacy is still limited and their

  15. Who Is the Lifelong Learner? Globalization, Lifelong Learning and Hermeneutics

    ERIC Educational Resources Information Center

    Uggla, Bengt Kristensson

    2008-01-01

    The aim of this essay is to elaborate on the inner connection between three such diverse entities as lifelong learning, globalization and hermeneutics. After placing lifelong learning in a societal context framed by globalization, my intention is to reflect on the prerequisites for introducing a hermeneutical contribution to the understanding of…

  16. Who Is the Lifelong Learner? Globalization, Lifelong Learning and Hermeneutics

    ERIC Educational Resources Information Center

    Uggla, Bengt Kristensson

    2008-01-01

    The aim of this essay is to elaborate on the inner connection between three such diverse entities as lifelong learning, globalization and hermeneutics. After placing lifelong learning in a societal context framed by globalization, my intention is to reflect on the prerequisites for introducing a hermeneutical contribution to the understanding of…

  17. [Prevalence of retrograde ejaculation in infertility associated to hypospermia].

    PubMed

    Juárez-Bengoa, Armando; Bagnarello-González, Fiorella; Rodríguez-Perdomo, David Francisco; Rodríguez-Yee, Emmanuel

    2011-02-01

    Approximately 14% of couples of reproductive age have a fertility problem, defined as the inability to achieve pregnancy after a year of frequent intercourse without contraceptive protection. To determine the prevalence of retrograde ejaculation in infertile patients with hypospermia and to establish the effects of the treatment. Comparative study. A semen analysis of 207 patients with male infertility with hypospermia was performed. The patients with retrograde ejaculation were identified and its prevalence was calculated. Semen parameters were compared before and after treatment by means of a paired-t test. Hormonal levels also were compared between groups with and without retrograde ejaculation by means of a Mann-Whitney U test. Prevalence of retrograde ejaculation was 3.2% out of 2587 infertile patients. Within the group of 207 patients with hypospermia, 84 had retrograde ejaculation. After the treatment the seminal volume increased (from 1.2 to 1.5 milliliters) and the number of mobile cells increased (from 47.2 to 62.5 millions). The number of sperm in urine decreased (from 22 to 10 per high-power field). The patients with retrograde ejaculation had lower levels of follicle-stimulating hormone, luteinizing hormone and testosterone than those without retrograde ejaculation. Retrograde ejaculation and hypospermia are both considered infrequent but important alterations in infertility. Prevalence of retrograde ejaculation in patients with hypospermia is 40.5%. Treatment increased seminal volume and the number of mobile cells in the ejaculated semen. It is necessary to perform future studies in order to determine the impact of severity of retrograde ejaculation on infertility.

  18. Explorations of Lifelong Learning Ethics

    ERIC Educational Resources Information Center

    Igbinomwanhia, John

    2009-01-01

    The methodological approaches that were used in this research were ethnographic, quantitative and analysis of post-compulsory education policy documents 1945-2007. The article aims to explore the issues of ethics in lifelong learning, and an alternative approach to the analysis of the impact of lifelong learning policy, by focusing research…

  19. Lifelong Learning on the Web.

    ERIC Educational Resources Information Center

    Brown, Brian

    As a medium for delivering lifelong learning, the Internet makes it possible to customize education to individual needs, deliver education anywhere and anytime, and enable learners to interact with other learners and teachers collaboratively to solve problems and learn new skills. Nevertheless, as a medium for delivering lifelong learning, the…

  20. International Perspectives on Lifelong Learning.

    ERIC Educational Resources Information Center

    Holford, John, Ed.; Jarvis, Peter, Ed.; Griffin, Colin, Ed.

    This book contains 30 papers providing international perspectives on lifelong learning. The following papers are included: "Edgar Faure after 25 Years" (Roger Boshier); "Public Rhetoric and Public Policy" (Colin Griffin); "Lifelong Learning and the European Union" (Barry J. Hake); "Critical Perspectives and New…

  1. International Perspectives on Lifelong Learning.

    ERIC Educational Resources Information Center

    Holford, John, Ed.; Jarvis, Peter, Ed.; Griffin, Colin, Ed.

    This book contains 30 papers providing international perspectives on lifelong learning. The following papers are included: "Edgar Faure after 25 Years" (Roger Boshier); "Public Rhetoric and Public Policy" (Colin Griffin); "Lifelong Learning and the European Union" (Barry J. Hake); "Critical Perspectives and New…

  2. Online Education for Lifelong Learning

    ERIC Educational Resources Information Center

    Inoue, Yukiko, Ed.

    2007-01-01

    Distance education is rapidly becoming the global trend for lifelong learning. This book emphasizes the importance of conceptual understanding of online distance learning and focuses on theoretical and practical challenges of online teaching and learning. It illustrates lifelong learning strategies and how technology can support the course…

  3. Who Pays for Lifelong Learning?

    ERIC Educational Resources Information Center

    Watson, Louise

    Structural change in the economy has seen the emergence of human resource skills as an important intangible input to the value-adding process. The fastest growing sectors of the economy employ workers with high levels of skill. This has led to the development of a lifelong learning policy agenda that argues lifelong learning is the key to economic…

  4. Online Education for Lifelong Learning

    ERIC Educational Resources Information Center

    Inoue, Yukiko, Ed.

    2007-01-01

    Distance education is rapidly becoming the global trend for lifelong learning. This book emphasizes the importance of conceptual understanding of online distance learning and focuses on theoretical and practical challenges of online teaching and learning. It illustrates lifelong learning strategies and how technology can support the course…

  5. Federal Programs Supporting Lifelong Learning.

    ERIC Educational Resources Information Center

    Christoffel, Pam, Comp.

    Approximately 275 Federal programs support some form of lifelong learning. While the majority of the lifelong learning programs are administered by the various agencies within HEW, a significant number of programs are run by such Federal agencies as the Department of Justice, the National Foundation on the Arts and Humanities, and the Smithsonian…

  6. The physiological roles of the boar ejaculate.

    PubMed

    Rodríguez-Martínez, H; Kvist, U; Saravia, F; Wallgren, M; Johannisson, A; Sanz, L; Peña, F J; Martínez, E A; Roca, J; Vázquez, J M; Calvete, J J

    2009-01-01

    During ejaculation in the boar, sperm cohorts emitted in epididymal cauda fluid are sequentially exposed and resuspended in different mixtures of accessory sex gland secretion. This paper reviews the relevance of such unevenly composed fractions of seminal plasma (SP) in vivo on sperm transport and sperm function and how this knowledge could benefit boar semen processing for artificial insemination (AI). The firstly ejaculated spermatozoa (first 10 ml of the sperm-rich fraction, SRF [P1]) remain mainly exposed to epididymal cauda fluid and its specific proteins i.e. various lipocalins, including the fertility-related prostaglandin D synthase; than to prostatic and initial vesicular gland secretions. P1-spermatozoa are hence exposed to less bicarbonate, zinc or fructose and mainly to PSP-I spermadhesin; than if they were in the rest of the SRF and the post-SRF (P2). Since the P1-SP is less destabilizing for sperm membrane and chromatin, P1-spermatozoa sustain most in vitro procedures, including cryopreservation, the best. Moreover, ejaculated firstly, the P1-spermatozoa seem also those deposited by the boar as a vanguard cohort, thus becoming overrepresented in the oviductal sperm reservoir (SR). This vanguard SR-entry occurs before the endometrial signalling of SP components (as PSP-I/PSP-II and cytokines) causes a massive influx of the innate defensive PMNs to cleanse the uterus from eventual pathogens, superfluous spermatozoa and the allogeneic SP. The SP also conditions the mucosal immunity of the female genital tract, to tolerate the SR-spermatozoa and the semi-allogeneic conceptus. These in vivo gathered data can be extrapolated into procedures for handling boar spermatozoa in vitro for AI and other biotechnologies, including simplified cryopreservation.

  7. The basics of prematurity.

    PubMed

    Kelly, Michelle M

    2006-01-01

    Prematurity is the greatest single risk factor for death within the first year of life. The March of Dimes and Centers for Disease Control and Prevention define prematurity as birth before the completion of 37 weeks' gestation. In 2002, one in eight babies were delivered prematurely. This manuscript is Part I of a three-part series on premature infants. The overall goal of this series is to educate pediatric primary care providers regarding topics specific to delivering care to premature infants after discharge. Part I addresses the incidence of prematurity and the terminology used in neonatal literature and provides an overview of common comorbidities associated with prematurity. Part II will focus on the primary care management of uncomplicated premature infants. Part III will highlight issues of primary care for medically complex premature infants.

  8. Screening for subclinical inflammation in ejaculates.

    PubMed

    Eggert-Kruse, W; Probst, S; Rohr, G; Aufenanger, J; Runnebaum, B

    1995-11-01

    To determine the clinical significance of albumin determination in ejaculates by means of an easy office test to screen semen samples for subclinical infection-inflammation. One hundred fifty-nine randomly chosen males of couples with longstanding infertility (median duration of infertility 4 years (range 1 to 19 years) without clinical signs or symptoms of genital tract infection. Outpatient Infertility Clinic of the University of Heidelberg, Germany. Screening of ejaculates for subclinical infection-inflammation by means of a ready-to-use kit for semiquantitative detection of albumin in addition to determination of leukocytes rates by means of monoclonal antibodies for differentiation of round cells and measurement of granulocyte elastase concentration in semen samples. Evaluation of sperm quality by means of standard sperm analysis including determination of local antisperm antibodies with the mixed antiglobulin reaction, evaluation of sperm functional capacity in vitro with the standardized sperm-cervical mucus (CM) penetration test, and semen cultures. All tests were performed from aliquots of the same ejaculates. Screening of semen samples for elevated albumin with the modified paper strips proved to be very easy, quick, and suitable for routine use. Positive results were not related markedly to medical history and outcome of clinical examination as well as to standard parameters of sperm analysis and were not influenced by local antisperm antibodies of the immunoglobulin (Ig)G and/or IgA class and microbial colonization. However, albumin-positive semen samples were significantly less frequent in case of very good outcome of the sperm-CM penetration test. A significant relationship was found with high rates of leukocytes of the round cells in semen samples (total range 0% to 96%) and the concentration of granulocyte elastase (total range 1 to 880 micrograms/L). The results of this prospective study suggest that the determination of albumin in semen samples

  9. Normal male sexual function: emphasis on orgasm and ejaculation.

    PubMed

    Alwaal, Amjad; Breyer, Benjamin N; Lue, Tom F

    2015-11-01

    Orgasm and ejaculation are two separate physiological processes that are sometimes difficult to distinguish. Orgasm is an intense transient peak sensation of intense pleasure creating an altered state of consciousness associated with reported physical changes. Antegrade ejaculation is a complex physiological process that is composed of two phases (emission and expulsion), and is influenced by intricate neurological and hormonal pathways. Despite the many published research projects dealing with the physiology of orgasm and ejaculation, much about this topic is still unknown. Ejaculatory dysfunction is a common disorder, and currently has no definitive cure. Understanding the complex physiology of orgasm and ejaculation allows the development of therapeutic targets for ejaculatory dysfunction. In this article, we summarize the current literature on the physiology of orgasm and ejaculation, starting with a brief description of the anatomy of sex organs and the physiology of erection. Then, we describe the physiology of orgasm and ejaculation detailing the neuronal, neurochemical, and hormonal control of the ejaculation process. Copyright © 2015 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.

  10. Bladder neck resection with preservation of antegrade ejaculation: Basir technique.

    PubMed

    Abdel-Basir Sayed, Mohamed

    2003-03-01

    To evaluate a new method of bladder neck resection and to determine if antegrade ejaculation is preserved thereafter. Two groups of patients were treated for their bladder neck obstruction. Group A, composed of 20 patients, was treated by bladder neck resection with preservation of more than 1 cm proximal to the verumontanum. Group B, also consisting of 20 patients, was treated by the old technique. Patients were evaluated before and after resection by semen volume, sperm count, symptoms, and urodynamic testing. In group A, antegrade ejaculation was maintained in 17 of the 20 patients (85%), while in 2 patients, only a small amount of semen was ejaculated and in 1 patient, complete retrograde ejaculation was reported. In group B, only 4 patients (20%) preserved antegrade ejaculation, and retrograde ejaculation occurred in 16 patients (80%). With preservation of >1 cm of the supramontanal part of the urethra during bladder neck resection, we could avoid the complication of retrograde ejaculation in those young patients who wish to preserve fertility.

  11. Condition-dependent ejaculate size and composition in a ladybird beetle

    PubMed Central

    Perry, Jennifer C.; Rowe, Locke

    2010-01-01

    Sexually selected male ejaculate traits are expected to depend on the resource state of males. Theory predicts that males in good condition will produce larger ejaculates, but that ejaculate composition will depend on the relative production costs of ejaculate components and the risk of sperm competition experienced by low- and high-condition males. Under some conditions, when low condition leads to poorer performance in sperm competition, males in low condition may produce ejaculates with higher sperm content relative to their total ejaculate and may even transfer more sperm than high-condition males in an absolute sense. Previous studies in insects have shown that males in good condition transfer larger ejaculates or more sperm, but it has not been clear whether increased sperm content represents a shift in allocation or simply a larger ejaculate, and thus the condition dependence of ejaculate composition has been largely untested. We examined condition dependence in ejaculate by manipulating adult male condition in a ladybird beetle (Adalia bipunctata) in which males transfer three distinct ejaculate components during mating: sperm, non-sperm ejaculate retained within the female reproductive tract, and a spermatophore capsule that females eject and ingest following mating. We found that high condition males indeed transferred larger ejaculates, potentially achieved by an increased rate of ejaculate transfer, and allocated less to sperm compared with low-condition males. Low-condition males transferred ejaculates with absolutely and proportionally more sperm. This study provides the first experimental evidence for a condition-dependent shift in ejaculate composition. PMID:20573622

  12. Retrograde ejaculation following open ureteric reimplantation: a case report.

    PubMed

    Au, Eleanor; Dasgupta, Ranan; Dasgupta, Prokar

    2009-08-18

    Retrograde ejaculation is not a recognized complication of ureteric reimplantation surgery. We describe this unusual complication in a 25-year-old man, with no other cause for his ejaculatory dysfunction. A 25-year-old Caucasian man presented with left hydronephrosis ascribed to a megaureter. Following open reimplantation of the ureter, the patient developed retrograde ejaculation that did not respond to medical therapy. The key result reported here is that retrograde ejaculation is a possible complication of open pelvic surgery, for which patients should receive counselling. This is relevant for both urologists and general physicians who consult relatively young men with ejaculatory difficulties.

  13. Efficacy of treatment with pseudoephedrine in men with retrograde ejaculation.

    PubMed

    Shoshany, O; Abhyankar, N; Elyaguov, J; Niederberger, C

    2017-07-01

    The use of pseudoephedrine, an alpha agonist, for the treatment of retrograde ejaculation is well-known, however, there is no clear consensus from the literature regarding its efficacy and treatment protocol. We evaluated the efficacy of pseudoephedrine treatment in patients with retrograde ejaculation, utilizing a yet undescribed short-period treatment protocol. Twenty men were medically treated with pseudoephedrine for retrograde ejaculation between January 2010 and May 2016 (12 with complete retrograde ejaculation and 8 with partial retrograde ejaculation). All patients had a semen analysis and post-ejaculatory urinalysis before and after treatment. The treatment protocol consisted of 60 mg of pseudoephedrine every 6 h on the day before semen analysis and two more 60 mg doses on the day of the semen analysis. Diabetes was the most common etiology for complete retrograde ejaculation (60%), whereas an idiopathic cause was the most common etiology for partial retrograde ejaculation (82%). Of the 12 complete retrograde ejaculation patients treated with pseudoephedrine prior to semen analysis, 7 (58.3%) recovered spermatozoa in the antegrade ejaculate, with a mean total sperm count of 273.5 ± 172.5 million. Of the eight patients with partial retrograde ejaculation, five (62.5%) had a ≥50% increase in the antegrade total sperm count. In this group, the mean total sperm count increased from 26.9 ± 8.5 million before treatment to 84.2 ± 24.6 million after treatment, whereas the percentage of spermatozoa in the urine declined from 43.2 ± 9% to 17 ± 10%, respectively (both p < 0.05). Overall, in men with retrograde ejaculation treated with a pseudoephedrine regimen prior to ejaculation, some improvement in seminal parameters occurred in 14 (70%) patients, with 10 patients (38.5% of all patients) achieving antegrade total sperm counts over 39 million. © 2017 American Society of Andrology and European Academy of Andrology.

  14. Retrograde ejaculation following open ureteric reimplantation: a case report

    PubMed Central

    2009-01-01

    Introduction Retrograde ejaculation is not a recognized complication of ureteric reimplantation surgery. We describe this unusual complication in a 25-year-old man, with no other cause for his ejaculatory dysfunction. Case presentation A 25-year-old Caucasian man presented with left hydronephrosis ascribed to a megaureter. Following open reimplantation of the ureter, the patient developed retrograde ejaculation that did not respond to medical therapy. Conclusion The key result reported here is that retrograde ejaculation is a possible complication of open pelvic surgery, for which patients should receive counselling. This is relevant for both urologists and general physicians who consult relatively young men with ejaculatory difficulties. PMID:19918274

  15. Retinopathy of Prematurity

    ERIC Educational Resources Information Center

    Steinweg, Sue Byrd; Griffin, Harold C.; Griffin, Linda W.; Gingras, Happy

    2005-01-01

    The eyes of premature infants are especially vulnerable to injury after birth. A serious complication is called retinopathy of prematurity (ROP), which is abnormal growth of the blood vessels in an infant's eye. Retinopathy of prematurity develops when abnormal blood vessels grow and spread throughout the retina, which is the nerve tissue at the…

  16. Retinopathy of Prematurity

    ERIC Educational Resources Information Center

    Steinweg, Sue Byrd; Griffin, Harold C.; Griffin, Linda W.; Gingras, Happy

    2005-01-01

    The eyes of premature infants are especially vulnerable to injury after birth. A serious complication is called retinopathy of prematurity (ROP), which is abnormal growth of the blood vessels in an infant's eye. Retinopathy of prematurity develops when abnormal blood vessels grow and spread throughout the retina, which is the nerve tissue at the…

  17. Anxiolytic-like effect of ejaculation upon frustration.

    PubMed

    Freidin, Esteban; Kamenetzky, Giselle; Mustaca, Alba Elisabeth

    2005-08-01

    In three experiments, we studied the consequences of ejaculation upon the frustrative or contrast response of male rats exposed to reward downshift situations (i.e., surprising changes from 32% to 4% sucrose solutions). Similar to what has been found after treatment with anxiolytic agents, consummatory suppression was partially reversed by previous ejaculations in a second postshift trial (Experiments 2 and 3), such a result not having been obtained in a first postshift trial (Experiment 1). Moreover, the effect of ejaculations upon males' behavior during a second postshift trial was transitory, disappearing when assessed during the third and fourth postshift trials (Experiment 3). These results are in accordance with both Amsel's (1958, 1992) frustration theory and Flaherty's (1996) multistage hypothesis of successive negative contrast; the diverse factors that are known to modulate contrast effects are considered, including an interpretation of the present data in terms of the anxiolytic-like effect of the ejaculation.

  18. Case report: anaesthetic ejaculation resolved in integrative sex therapy.

    PubMed

    Garippa, P A

    1994-01-01

    The following case illustrates the treatment of a relatively rare ejaculatory dysfunction wherein a patient does not experience any genital pleasure or sensation during his ejaculatory phase. However, ejaculation is physiologically normal with a propulsive ejection of semen.

  19. Prostatic urethra malformation associated with retrograde ejaculation: a case report.

    PubMed

    Zhao, Kai; Zhang, Jianzhong; Xu, Aiming; Zhang, Cheng; Wang, Zengjun

    2016-12-21

    Retrograde ejaculation can have anatomical, neurogenic, or pharmacological causes. Among these factors, malformation of the prostatic urethra is an uncommon cause. We describe a 29-year-old Han Chinese man with absence of his verumontanum combined with ejaculatory duct cysts, and no other cause for ejaculatory dysfunction. His verumontanum was replaced by a deep groove adjacent to his bladder neck, which could significantly influence bladder neck contraction. In addition, the large cysts in the ejaculatory duct could obstruct the anterior outlet of his prostatic urethra and prevent seminal fluid flow in an anterograde direction. There are few reports of retrograde ejaculation associated with congenital malformations of the posterior urethra. Malformations associated with bladder neck laxity and increased tone of the prostatic urethral outlet can contribute to retrograde ejaculation. Malformation of the prostatic urethra is an uncommon cause of retrograde ejaculation, and can be difficult to treat.

  20. An unusual cause of retrograde ejaculation and hypertension.

    PubMed

    Widjaja, A; Truss, M C; Rademaker, J; Stief, C B; von zur Mühlen, A

    2000-06-01

    A 39-year-old man presented with a 1-year history of retrograde ejaculation and a 10-year history of drug-resistant hypertension. Diagnostic abdominal ultrasound revealed an open bladder neck during the filling phase and a retroperitoneal tumor. After surgical excision histology revealed an extra-adrenal pheochromocytoma, which should be included in the differential diagnosis of patients presenting with retrograde ejaculation and hypertension.

  1. Side Effects of alpha-Blocker Use: Retrograde Ejaculation.

    PubMed

    Kaplan, Steven A

    2009-01-01

    There are currently 5 alpha-blockers that are approved by the US Food and Drug Administration to treat lower urinary tract symptoms (LUTS). The American Urological Association guidelines committee believes that all alpha-blockers are equally effective. However, alpha-blockers differ in their likelihood of causing abnormal ejaculation. This article discusses the effects on ejaculatory function, and specifically retrograde ejaculation, of the currently available alpha-blockers being used to treat men with LUTS due to benign prostatic hyperplasia.

  2. Prematurity and potential predictors.

    PubMed

    Field, Tiffany; Diego, Miguel; Hernandez-Reif, Maria

    2008-02-01

    Prematurity continues to be the leading cause of neonatal death and developmental disability, highlighting the importance of identifying potential predictors of prematurity as well as interventions that can be linked to the predictors. This review covers recent research on potential psychological, physiological, and biochemical predictors. Among the psychological stressors are depression, anxiety, difficult relationships, and lack of social support. Biochemical predictors include corticotropin-releasing hormone, cortisol, and fetal fibronectin. A program of research that links an intervention for prematurity with a predictor for prematurity, that is, massage therapy to reduce cortisol and, in turn, reduce prematurity, is then presented.

  3. Social media for lifelong learning.

    PubMed

    Kind, Terry; Evans, Yolanda

    2015-04-01

    Learning is ongoing, and can be considered a social activity. In this paper we aim to provide a review of the use of social media for lifelong learning. We start by defining lifelong learning, drawing upon principles of continuous professional development and adult learning theory. We searched Embase and MEDLINE from 2004-2014 for search terms relevant to social media and learning. We describe examples of lifelong learners using social media in medical education and healthcare that have been reported in the peer-reviewed literature. Medical or other health professions students may have qualities consistent with being a lifelong learner, yet once individuals move beyond structured learning environments they will need to recognize their own gaps in knowledge and skills over time and be motivated to fill them, thereby incorporating lifelong learning principles into their day-to-day practice. Engagement with social media can parallel engagement in the learning process over time, to the extent that online social networking fosters feedback and collaboration. The use of social media and online networking platforms are a key way to continuously learn in today's information sharing society. Additional research is needed, particularly rigorous studies that extend beyond learner satisfaction to knowledge, behaviour change, and outcomes.

  4. Premature birth as a risk factor for autism spectrum disorder.

    PubMed

    Goldin, Rachel L; Matson, Johnny L

    2016-06-01

    Autism spectrum disorder (ASD) is common, life-long in nature, and can be very debilitating. Thus, an intensive search is on to identify the potential risk factors for the disorder. Premature birth has been identified as one potential factor that could influence potential symptoms of ASD. The sample for this study consisted of 1655 at risk children for developmental delays who were 17-37 months of age. Participants were divided into those diagnosed with ASD (n = 916) and children with atypical development only (n = 739). Premature births were almost twice as common for the atypical development group versus the ASD group. Implications of these data are discussed.

  5. Psychological interventions for delayed ejaculation/orgasm.

    PubMed

    Althof, S E

    2012-01-01

    Of all the male sexual dysfunctions, delayed ejaculation (DE) is the least understood, least common and least studied. This paper aims to review and integrate the diverse psychological theories and proposed psychological interventions for DE. Clinicians will then be able to more clearly discern the relevant psychological/interpersonal issues of the patient/couple and implement systematically based effective interventions. After reviewing the literature, it is clear that no one theory accounts for all the varied presentations of DE, and no theory by itself has strong empirical support. However, awareness of the diverse points of view helps clinicians conduct better assessments and broaden their understanding of the patient's ejaculatory dysfunction. Similarly, no one psychological intervention works for all patients, nor will unsystematic random selection of interventions. This paper stresses on the need to clearly identify the source of the dysfunction and select treatments based upon the precipitating and maintaining factors. Much work remains to be done with regard to our understanding and treatment of DE. Specifically, we need to craft an evidence-based definition, assess the true prevalence of the dysfunction, demonstrate the efficacy of psychological interventions and design validated outcome measures.

  6. How to Choose a Lifelong Sport.

    ERIC Educational Resources Information Center

    Regin, Chuck

    1983-01-01

    Stresses the benefits of lifelong sports including self-expression, wholeness, relaxation, and physical health. Suggests methods of determining physical fitness status, setting goals, and selecting appropriate activities. Internal and external motivation for pursuing lifelong sports are discussed. (JAC)

  7. Season of ejaculate collection influences the freezability of boar spermatozoa.

    PubMed

    Barranco, Isabel; Ortega, Maria D; Martinez-Alborcia, Maria J; Vazquez, Juan M; Martinez, Emilio A; Roca, Jordi

    2013-12-01

    The aim of this retrospective study was to evaluate whether the season of ejaculate collection influences the freezability of porcine sperm. A total of 434 ejaculates were collected from boars of six different breeds over three years (2008-2011) and throughout the four seasons of the year identified in the northern hemisphere (winter, spring, summer and autumn). The ejaculates were cryopreserved using a standard 0.5 mL straw freezing protocol. Sperm quality was assessed before (fresh semen samples kept 24h at 17°C) and after freezing and thawing (at 30 and 150 min post-thawing in semen samples kept in a water bath at 37 °C), according to the percentages of total motility, as assessed by the CASA system, and viability, as assessed by flow cytometry after staining with SYBR-14, PI and PE-PNA. The data, in percentages, on sperm motility and viability after freezing and thawing were obtained at each evaluation time (recovered) and were normalized to the values before freezing (normalized). The season of ejaculate collection influenced (P<0.01) sperm quality before freezing and after thawing (recovered and normalized), irrespective of the breed of boar. Sperm quality was lower in summer, both in terms of motility and viability, and in autumn, in terms of motility, than in winter and spring. Seasonality in the normalized data indicates that the season of ejaculate collection influences sperm freezability, regardless of the season's influence on sperm quality before freezing. Consequently, the spermatozoa from ejaculates collected during summer and, to a lesser extent, also in autumn, are more sensitive to cryopreservation than those from ejaculates collected during winter and spring. Copyright © 2013 Elsevier Inc. All rights reserved.

  8. Prevalence Rate and Risk Factors of Depression in Outpatients with Premature Ejaculation

    PubMed Central

    Zhang, Xiansheng; Liu, Jishuang; Xia, Lei; Yang, Jiajia; Hao, Zongyao; Zhou, Jun; Liang, Chaozhao

    2013-01-01

    The purpose of this study is to investigate the prevalence rate and risk factors of depression in outpatients who were diagnosed with PE. Therefore, between September 2009 and September 2011, 1801 outpatients at andrology clinics were enrolled and consented to participate in our survey by completed a verbal questionnaire. It included the following: (1) demographic data (e.g., age, body mass index), (2) PE duration, medical history, and sexual history, (3) self-estimated intravaginal ejaculatory latency times, (4) the Zung Self-rating Depression Scale (SDS), and (5) the National Institute of Health Chronic Prostatitis Symptom Index (NIH-CPSI) and (6) the International Index of Erectile Function (IIEF-5). The results showed that a total of 1,206 patients were diagnosed with PE. The prevalence rate of depression in these PE patients was 26.78%. Depression was associated with PE duration, NIH-CPSI score, and IIEF-5 score. Risk factors for depression specifically included PE durations for 13–24, 25–60, or ≥61 months, CPSI scores of 15–30 or ≥31, and IIEF-5 scores <22. These findings suggested that several associated factors (PE duration, CPSI scores, and IIEF-5 scores) were the risk factors of depression in men with PE. PMID:23844361

  9. Gender, Masculinities and Lifelong Learning

    ERIC Educational Resources Information Center

    Bowl, Marion, Ed.; Tobias, Robert, Ed.; Leahy, Jennifer, Ed.; Ferguson, Graeme, Ed.; Gage, Jeffrey, Ed.

    2012-01-01

    "Gender, Masculinities and Lifelong Learning" reflects on current debates and discourses around gender and education, in which some academics, practitioners and policy-makers have referred to a crisis of masculinity. This book explores questions such as: Are men under-represented in education? Are women outstripping men in terms of…

  10. Gender, Masculinities and Lifelong Learning

    ERIC Educational Resources Information Center

    Bowl, Marion, Ed.; Tobias, Robert, Ed.; Leahy, Jennifer, Ed.; Ferguson, Graeme, Ed.; Gage, Jeffrey, Ed.

    2012-01-01

    "Gender, Masculinities and Lifelong Learning" reflects on current debates and discourses around gender and education, in which some academics, practitioners and policy-makers have referred to a crisis of masculinity. This book explores questions such as: Are men under-represented in education? Are women outstripping men in terms of…

  11. Sustainable Assessment for Lifelong Learning

    ERIC Educational Resources Information Center

    Nguyen, Tham T. H.; Walker, Melanie

    2016-01-01

    This paper explores the alignment of assessment practices in universities and lifelong learning as a key process and outcome for expansive student development. It outlines Boud's approach to assessment, operationalises this to analyse practices in two contrasting national contexts: the sociology departments of the Midlands University in the UK and…

  12. Self directed and lifelong learning.

    PubMed

    Alexander, Sylvia; Kernohan, George; McCullagh, Paul

    2004-01-01

    Given the many changes that occur in medicine, health care and information technologies we need to prepare all our students to engage in self directed and life long learning. There is considerable opportunity for self-directed and lifelong learning in health informatics bringing together students in exciting global learning environments, where they have much greater freedom and flexibility in their studies and potentially a wider variety of resources available to them. Self-directed learning focuses on the process by which adults take control of their own learning, in particular how they set their own learning goals, locate appropriate resources, decide on which learning methods to use and evaluate their progress. Lifelong learning happens in a variety of formal and informal settings building on both intentional and incidental learning experiences. In a lifelong learning situation the tutor must relinquish the role of expert and assume the role of facilitator, guiding learners to uncover their own knowledge. Against a back drop of rapid advances in technology which can be used to both deliver course materials and provide enhanced learning opportunities, this chapter outlines the pedagogic principles and practices which underpin self-directed and lifelong learning.

  13. The Promise of Lifelong Learning

    ERIC Educational Resources Information Center

    Gouthro, Patricia A.

    2017-01-01

    This paper explores how Peter Jarvis's work offers a comprehensive grounding in many of the key principles and insights offered through the field of adult education. His work directs us to the different factors--psychological, social, economic and political required for understanding lifelong learning contexts. As scholars and educators, he…

  14. What's Become of Lifelong Learning?

    ERIC Educational Resources Information Center

    Dainton, Sheila

    2009-01-01

    The author's father left school aged 13 at the start of the Great Depression. When he finally found work the wealth of educational opportunity he encountered inspired him with a lifelong love of learning. He signed up for evening classes and loved anything and everything to do with what he proudly called self-improvement. As a novice to retirement…

  15. Lifelong Learning, Policy and Desire

    ERIC Educational Resources Information Center

    Lynch, Heather

    2008-01-01

    Recent lifelong learning policies have been criticized for creating an illusion of freedom whilst simultaneously reducing choice. The concept of desire permits engagement with the conscious and unconscious drives that underpin individual decision-making, which direct the life course. Utilizing the ideas of Hume and Spinoza, the present article…

  16. Re-Thinking Lifelong Learning

    ERIC Educational Resources Information Center

    Hinchliffe, Geoff

    2006-01-01

    The current dominant concept of lifelong learning has arisen from the pressures of globalisation, economic change and the needs of the "knowledge economy". Its importance is not disputed in this paper. However, its proponents often advocate it in a form which places unrealistic demands on the individual without at the same time addressing their…

  17. Lifelong Learning and Welfare Reform.

    ERIC Educational Resources Information Center

    Griffin, Colin

    1999-01-01

    An alternative perspective on lifelong learning locates it in culture, civil society, and leisure/consumption lifestyles. Distinctions between education and learning and markets and quasi-markets are used to explore policy models. The relationship to welfare reform policies is discussed. (Author/SK)

  18. Developing Local Lifelong Guidance Strategies.

    ERIC Educational Resources Information Center

    Watts, A. G.; Hawthorn, Ruth; Hoffbrand, Jill; Jackson, Heather; Spurling, Andrea

    1997-01-01

    Outlines the background, rationale, methodology, and outcomes of developing local lifelong guidance strategies in four geographic areas. Analyzes the main components of the strategies developed and addresses a number of issues relating to the process of strategy development. Explores implications for parallel work in other localities. (RJM)

  19. Fiction, Empathy and Lifelong Learning

    ERIC Educational Resources Information Center

    Jarvis, Christine

    2012-01-01

    The article aims to demonstrate that the impact of fiction on adult learning could be illuminated by a deeper engagement with research into empathy. It recognises that the lifelong learning literature acknowledges the importance of empathy in adult learning and that discussions of the role of fiction in adult learning often refer to fiction's…

  20. Lifelong Learning as Transitional Learning

    ERIC Educational Resources Information Center

    Glastra, Folke J.; Hake, Barry J.; Schedler, Petra E.

    2004-01-01

    Globalization and individualization have radically changed both the economic system and the personal life world in industrial or postindustrial nation-states. To survive hypercompetition and volatile consumer choice, learning organizations and a workforce engaged in lifelong learning are needed. Constructing "the good life" has become an…

  1. Fiction, Empathy and Lifelong Learning

    ERIC Educational Resources Information Center

    Jarvis, Christine

    2012-01-01

    The article aims to demonstrate that the impact of fiction on adult learning could be illuminated by a deeper engagement with research into empathy. It recognises that the lifelong learning literature acknowledges the importance of empathy in adult learning and that discussions of the role of fiction in adult learning often refer to fiction's…

  2. What's Become of Lifelong Learning?

    ERIC Educational Resources Information Center

    Dainton, Sheila

    2009-01-01

    The author's father left school aged 13 at the start of the Great Depression. When he finally found work the wealth of educational opportunity he encountered inspired him with a lifelong love of learning. He signed up for evening classes and loved anything and everything to do with what he proudly called self-improvement. As a novice to retirement…

  3. Toward Life-Long Reading.

    ERIC Educational Resources Information Center

    Duquette, Raymond J.

    Developing life-long reading habits is a process that should begin in elementary school. Children should be encouraged not only to read what has been approved for classroom use but also to look beyond classroom walls to read for interest and enjoyment. "Looking beyond the walls" is a parable that suggests that school curriculum go beyond the…

  4. Lifelong Learning in Hong Kong.

    ERIC Educational Resources Information Center

    Lee, Grace O. M.

    Despite recent attempts at implementation, the government must play a more active role in promoting lifelong learning in Hong Kong. They did little until 1989, when the Open Learning Institute (OLI) was established. The OLI was innovative because it provided degree level courses for adults, without concern for prerequisite academic qualifications.…

  5. A Look at Lifelong Learning.

    ERIC Educational Resources Information Center

    Dutton, Donnie

    Adults must continue to learn. The accelerating pace of cultural change has made today's knowledge and skills tomorrow's obsolescence. A society that makes its educational investment almost entirely in children and youth is on the way to becoming obsolete and is reducing its survival chances. To promote the cause of lifelong learning, we need to…

  6. Sustainable Assessment for Lifelong Learning

    ERIC Educational Resources Information Center

    Nguyen, Tham T. H.; Walker, Melanie

    2016-01-01

    This paper explores the alignment of assessment practices in universities and lifelong learning as a key process and outcome for expansive student development. It outlines Boud's approach to assessment, operationalises this to analyse practices in two contrasting national contexts: the sociology departments of the Midlands University in the UK and…

  7. International Concepts and Agendas of Lifelong Learning

    ERIC Educational Resources Information Center

    Schuetze, Hans G.

    2006-01-01

    International organisations were the main proponents of Lifelong Learning when the concept was first developed in the early 1970s. Although different organisations used different labels--Lifelong Learning, recurrent education, education permanente--they all emphasised that learning is a lifelong process and that all education should be organised…

  8. Lifelong Education: A Stocktaking. UIE Monographs, 8.

    ERIC Educational Resources Information Center

    Cropley, A. J., Ed.; And Others

    Seven internationally known educators were asked to assess lifelong learning especially in relation to lifelong education and (1) revision of educational thinking and (2) educational practice. The authors addressed several key questions on lifelong education: For and by whom? Of and for what? How can it be achieved? The editor's overview and…

  9. The Routledge International Handbook of Lifelong Learning

    ERIC Educational Resources Information Center

    Jarvis, Peter, Ed.

    2010-01-01

    As lifelong learning grows in popularity, few comprehensive pictures of the phenomenon have emerged. The "Routledge International Handbook of Lifelong Learning" provides a disciplined and complete overview of lifelong learning internationally. The theoretical structure puts the learner at the centre and the book emanates from there,…

  10. The Routledge International Handbook of Lifelong Learning

    ERIC Educational Resources Information Center

    Jarvis, Peter, Ed.

    2010-01-01

    As lifelong learning grows in popularity, few comprehensive pictures of the phenomenon have emerged. The "Routledge International Handbook of Lifelong Learning" provides a disciplined and complete overview of lifelong learning internationally. The theoretical structure puts the learner at the centre and the book emanates from there,…

  11. Lifelong Learning--A Public Library Perspective.

    ERIC Educational Resources Information Center

    Kahlert, Maureen

    This paper presents a public library perspective on lifelong learning. The first section discusses the lifelong learning challenge, including the aims of the Australian National Marketing Strategy for Skills and Lifelong Learning, and findings of a national survey related to the value of and barriers to learning. The second section addresses the…

  12. Lifelong Learning: Policies, Practices, and Programs.

    ERIC Educational Resources Information Center

    Hatton, Michael J., Ed.

    The 26 articles in this book focus on lifelong learning policies, practices, and programs in 13 Asia Pacific countries. The following papers are included: "Half a Revolution: A Brief Survey of Lifelong Learning in New Zealand" (P. Methven and J. Hansen); "HRD in a Multicultural Workplace: The Need for Lifelong Learning" (M.…

  13. Lifelong Learning Policies, Paradoxes and Possibilities

    ERIC Educational Resources Information Center

    Tett, Lyn

    2014-01-01

    This paper argues that there are many ways of conceptualising lifelong learning and examines EU and Scottish lifelong learning policies in order to identify their underlying assumptions. Through an analysis of these policies, it is demonstrated that they draw on a number of inter-related fallacies that prioritise lifelong learning mainly in…

  14. Theoretical Analysis of Canadian Lifelong Education Development

    ERIC Educational Resources Information Center

    Mukan, Natalia; Barabash, Olena; Busko, Maria

    2014-01-01

    In the article, the problem of Canadian lifelong education development has been studied. The main objectives of the article are defined as theoretical analysis of scientific and pedagogical literature which highlights different aspects of the research problem; periods of lifelong education development; and determination of lifelong learning role…

  15. Towards a Conceptual Understanding of Lifelong Learning.

    ERIC Educational Resources Information Center

    McCannon, Roger S.

    Despite the lengthy existence of the concept of lifelong learning, there is still no one generally accepted theory of education as a lifelong process. More than an extension of adult education, lifelong learning rests on the belief that learning occurs throughout life, in different ways and through different processes. The key notion in lifelong…

  16. Theoretical Analysis of Canadian Lifelong Education Development

    ERIC Educational Resources Information Center

    Mukan, Natalia; Barabash, Olena; Busko, Maria

    2014-01-01

    In the article, the problem of Canadian lifelong education development has been studied. The main objectives of the article are defined as theoretical analysis of scientific and pedagogical literature which highlights different aspects of the research problem; periods of lifelong education development; and determination of lifelong learning role…

  17. Lifelong Learning: Policies, Practices, and Programs.

    ERIC Educational Resources Information Center

    Hatton, Michael J., Ed.

    The 26 articles in this book focus on lifelong learning policies, practices, and programs in 13 Asia Pacific countries. The following papers are included: "Half a Revolution: A Brief Survey of Lifelong Learning in New Zealand" (P. Methven and J. Hansen); "HRD in a Multicultural Workplace: The Need for Lifelong Learning" (M.…

  18. Ejaculation increases the serum prostate-specific antigen concentration.

    PubMed

    Tchetgen, M B; Song, J T; Strawderman, M; Jacobsen, S J; Oesterling, J E

    1996-04-01

    To determine the effect of ejaculation on the serum prostate-specific antigen (PSA) concentration in men at risk for developing prostate cancer. A prospective, community-based study was conducted in which 64 men, aged 49 to 79 years, underwent a serum PSA determination immediately before ejaculation (baseline) and at 1 hour, 6 hours, and 24 hours following ejaculation. The serum PSA also was measured 48 hours and 1 week after ejaculation if the concentration had not returned to the baseline value by the previous time interval. All subjects abstained from ejaculation for a minimum of 7 days prior to the study and until the PSA concentration returned to the baseline level. Absolute and relative change in serum PSA concentration, as well as the time to return to baseline PSA concentration following ejaculation, were assessed. The serum PSA concentration increased following ejaculation in 87% of the subjects. The mean baseline PSA was 1.8 ng/mL (median, 0.7 ng/mL). The mean absolute PSA change +/- standard deviation 1 hour, 6 hours, 24 hours, and 48 hours after ejaculation was 0.8 +/- 1.32 ng/mL, 0.3 +/- 0.66 ng/mL, 0.2 +/- 0.33 ng/mL, and 0.4 +/- 0.40 ng/mL, respectively. The mean relative PSA change +/- standard error 1 hour, 6 hours, 24 hours, and 48 hours after ejaculation was 41 +/- 4%, 9 +/- 1.5%, 8 +/- 1.3%, and 10 +/- 2.3%, respectively. The absolute and relative changes in PSA concentration noted 1 hour, 6 hours, and 24 hours after ejaculation were statistically significant (P = 0.0001). A strong correlation was observed between absolute change in PSA and baseline serum PSA, at each time interval (1 hour: r = 0.68, 6 hours: r = 0.77, 24 hours: r = 0.70; P < 0.0001) after ejaculation. Similarly, a significant correlation was noted between absolute change in PSA and patient age at each time interval (1 hour: r = 0.37, 6 hours: r = 0.38; P = 0.002, 24 hours: r = 0.55; P < 0.0001). Ninety-two percent of subjects returned to baseline by 24 hours (95% confidence

  19. Retrograde ejaculation after anterior lumbar spine surgery.

    PubMed

    Lindley, Emily M; McBeth, Zachary L; Henry, Sarah E; Cooley, Robert; Burger, Evalina L; Cain, Christopher M J; Patel, Vikas V

    2012-09-15

    A retrospective cohort study. To compare the incidence of retrograde ejaculation (RE) after anterior lumbar spine surgery with disc replacement versus fusion with the use of recombinant human bone morphogenetic protein-2 (BMP). Anterior lumbar interbody fusion (ALIF) has become a popular choice for treating a number of pathologies, largely because it preserves the posterior paravertebral muscles and ligaments. Despite these advantages, the anterior approach is also associated with various complications, one of which is RE. A recent study has questioned whether the risk of RE is increased by the use of BMP in ALIF procedures rather than by the approach alone. We conducted a retrospective review of all male patients who received ALIF using BMP or artificial disc replacement (ADR) on at least the L5-S1 level between 2004 and 2011. Medical records were evaluated for the occurrence of RE, and patients were contacted via the phone to obtain current information. The incidence of RE was then compared between the 2 anterior lumbar surgery procedures. Of the 95 cases of anterior surgery including L5-S1, 54 patients underwent ALIF with BMP (56.8%) and 41 patients were treated with ADR (43.2%). Postoperative RE occurred in 4 of the 54 ALIF patients (7.4%) and in 4 of the 41 ADR patients (9.8%). The incidence of RE was not significantly different between groups (P = 0.7226). At latest follow-up, 1 ALIF and 1 ADR patient reported resolution of the RE. This study found that RE occurred at a similar rate in patients treated with ADR and ALIF with BMP. The overall rate of RE after retroperitoneal anterior lumbar surgery was higher than expected, which underscores the importance of counseling patients about this risk and specifically questioning patients about the symptoms of RE at postoperative visits.

  20. The management of retrograde ejaculation: a systematic review and update.

    PubMed

    Jefferys, Amanda; Siassakos, Dimitrios; Wardle, Peter

    2012-02-01

    To determine the best management of retrograde ejaculation to optimize the chance of conception. Systematic review. Tertiary reproductive medicine center. Subfertile men with retrograde ejaculation. Systematic search of studies using search terms "management" or "therapy" or "treatment" and "retrograde ejaculation." We excluded case reports and papers not in English. Pregnancy and live birth rates and rates of achievement of antegrade ejaculation. Thirty-four studies met our criteria. Studies were mostly observational. Descriptions of predictive and confounding variables were often insufficient. The treatment options included urinary sperm retrieval and medical management with anticholinergics and sympathomimetics. Successful pregnancies and live births were also achieved using surgical techniques and electroejaculation; however, numbers were small. Many treatment options exist in the management of retrograde ejaculation; however, current literature is insufficient to allow firm comparisons between interventions. Treatment should be tailored, therefore, to the individual. Our findings support the need for further research in this area-including large randomized controlled trials. However, these would be difficult logistically and may not be possible. Copyright © 2012 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.

  1. Family Perspectives on Prematurity

    ERIC Educational Resources Information Center

    Zero to Three (J), 2003

    2003-01-01

    In this article, seven families describe their experiences giving birth to and raising a premature baby. Their perspectives vary, one from another, and shift over time, depending on each family's circumstances and the baby's developmental course. Experiences discussed include premature labor, medical interventions and the NICU, bringing the baby…

  2. Retinopathy of Prematurity.

    ERIC Educational Resources Information Center

    Trief, E.; And Others

    1989-01-01

    Retinopathy of prematurity (ROP) has increased due to a high incidence of premature, low birthweight infants. Stages of severity range from no visual damage to total blindness, and educational problems of ROP children parallel those of other visually impaired children, early intervention being crucial. Treatments are either pharmacological or…

  3. Retinopathy of Prematurity.

    ERIC Educational Resources Information Center

    Trief, E.; And Others

    1989-01-01

    Retinopathy of prematurity (ROP) has increased due to a high incidence of premature, low birthweight infants. Stages of severity range from no visual damage to total blindness, and educational problems of ROP children parallel those of other visually impaired children, early intervention being crucial. Treatments are either pharmacological or…

  4. Family Perspectives on Prematurity

    ERIC Educational Resources Information Center

    Zero to Three (J), 2003

    2003-01-01

    In this article, seven families describe their experiences giving birth to and raising a premature baby. Their perspectives vary, one from another, and shift over time, depending on each family's circumstances and the baby's developmental course. Experiences discussed include premature labor, medical interventions and the NICU, bringing the baby…

  5. Side Effects of α-Blocker Use: Retrograde Ejaculation

    PubMed Central

    Kaplan, Steven A

    2009-01-01

    There are currently 5 α-blockers that are approved by the US Food and Drug Administration to treat lower urinary tract symptoms (LUTS). The American Urological Association guidelines committee believes that all α-blockers are equally effective. However, α-blockers differ in their likelihood of causing abnormal ejaculation. This article discusses the effects on ejaculatory function, and specifically retrograde ejaculation, of the currently available α-blockers being used to treat men with LUTS due to benign prostatic hyperplasia. PMID:20126607

  6. Analysis of retrograde ejaculation using color Doppler ultrasonography before and after transurethral collagen injection.

    PubMed

    Nagai, A; Nasu, Y; Watanabe, M; Tsugawa, M; Iguchi, H; Kumon, H

    2004-10-01

    Transurethral bladder neck collagen injection therapy was performed in a patient with retrograde ejaculation. The phenomenon of retrograde ejaculation and its correction after the therapy were clearly demonstrated by color Doppler ultrasonography. To our knowledge this is the first report showing successful observation of retrograde ejaculation using color Doppler ultrasonography.

  7. Premature ovarian failure.

    PubMed

    Kalantaridou, S N; Davis, S R; Nelson, L M

    1998-12-01

    In 1% of women, premature ovarian failure develops by 40 years of age, a condition causing amenorrhea, infertility, sex steroid deficiency, and elevated gonadotropins. Early loss of ovarian function has significant psychosocial sequelae and major health implications. These young women have a nearly two-fold age-specific increase in mortality rate. Among women with spontaneous premature ovarian failure who have a normal karyotype, half have ovarian follicles remaining in the ovary that function intermittently. Indeed, pregnancies have occurred after the diagnosis of premature ovarian failure. Thus, premature ovarian failure should not be considered as a premature menopause. Young women with this disorder have a 5% to 10% chance for spontaneous pregnancy. Attempts at ovulation induction using various regimens fail to induce ovulation rates greater than those seen in untreated patients; however, oocyte donation for women desiring fertility is an option. Young women with premature ovarian failure need a thorough assessment, sex steroid replacement, and long-term surveillance to monitor therapy. Estrogen-progestin replacement therapy should be instituted as soon as the diagnosis is made. Androgen replacement should also be considered for women with low libido, persistent fatigue, and poor well-being despite taking adequate estrogen replacement. Women with premature ovarian failure should be followed up for the presence of associated autoimmune endocrine disorders such as hypothyroidism, adrenal insufficiency, and diabetes mellitus.

  8. Lifelong learning in nursing: a Delphi study.

    PubMed

    Davis, Lisa; Taylor, Heidi; Reyes, Helen

    2014-03-01

    In order to foster a culture of lifelong learning in nursing, it is important to identify what the concept means in the nursing profession as well as the characteristics of a lifelong learner. The purpose of this Delphi study was to conceptualize lifelong learning from the perspective of nursing, and to identify characteristics and essential elements of lifelong learning. A Delphi Study technique in three phases was completed using an online survey tool. Data were analyzed for conceptual description, ratings of characteristics and attributes, and expert consensus in these three phases. An online survey tool was used in this study. Recognized experts in nursing education, administration and public policy participated in this study. Lifelong learning in nursing is defined as a dynamic process, which encompasses both personal and professional life. This learning process is also both formal and informal. Lifelong learning involves seeking and appreciating new worlds or ideas in order to gain a new perspective as well as questioning one's environment, knowledge, skills and interactions. The most essential characteristics of a lifelong learner are reflection, questioning, enjoying learning, understanding the dynamic nature of knowledge, and engaging in learning by actively seeking learning opportunities. Keeping the mind active is essential to both lifelong learning and being able to translate knowledge into the capacity to deliver high quality nursing care. It is hoped that a clearer understanding of lifelong learning in nursing will foster more discussion and research about intentional, active inclusion of lifelong learning behaviors in nursing curricula. Copyright © 2013 Elsevier Ltd. All rights reserved.

  9. [Infections of the ejaculate by sexually transmissible pathogens].

    PubMed

    Ludwig, M; Kümmel, C; Diemer, T; Ringert, R H

    1994-05-01

    Certain ejaculate infections can be traced back to sexually transmitted microorganisms, such as Neisseria gonorrhoeae, Chlamydia trachomatis, Ureaplasma urealyticum and Trichomonas vaginalis. To varying extents, these microorganisms cause such classical genital infections as urethritis, epididymitis and prostatitis as well as subclinical genital tract infections. Several different pathomechanisms are under discussion for infection of the ejaculate: reduction of spermatogenesis resulting from testicular damage, autoimmune processes induced by inflammation, direct influence on the spermatozoal function, disturbances in spermatozoal transport, secretory dysfunction of the male accessory sex glands and leukocytospermia with secondary influence on ejaculate parameters. The relevance of these microorganisms for the localization of the inflammatory process within the genital tract are discussed in detail. Their importance for male fertility is a matter of debate. In particular, the significance of C. trachomatis and U. urealyticum, both of which are detectable in the urethra, is still uncertain and cannot be assessed conclusively. Further information allowing delimitation of an infection resulting from bacterial colonization may be provided, on the one hand, by biochemical markers for an inflammatory reaction and indicators of an immune response in the ejaculate, e.g. PMN elastase, complement C3, or coeruloplasmin, and on the other hand, by secretion markers such as alpha-glucosidase, PSA and phosphatase. Whether the assessment of these markers and indicators can help to clarify the inflammatory origin of infertility in individual cases remains doubtful.

  10. Prevention of premature birth.

    PubMed

    Fuchs, F

    1980-03-01

    With six different groups of pharmacologic agents that potentially can inhibit undesirable uterine contractions, prevention of premature births should be increasingly successful. The rationale for the use of each of these agents and their advantages and disadvantages are discussed.

  11. Premature rupture of membranes

    MedlinePlus

    ... gov/ency/patientinstructions/000512.htm Premature rupture of membranes To use the sharing features on this page, ... water that surrounds your baby in the womb. Membranes or layers of tissue hold in this fluid. ...

  12. Mentoring is a Lifelong Activity

    NASA Astrophysics Data System (ADS)

    Hamilton, Joseph

    2016-09-01

    One of the greatest personal benefits of mentoring and working with graduate students and postdoctoral fellows is the life-long journey together. Having graduate students who keep up with you, ask advice and sometimes get it when they haven't asked for it, being able to help them find a job, and in some cases, continuing to do research together for over 50 years is a real gift. Seeing the success of your students in their own research programs, or as Professors, or in industry, makes me feel proud like I do in my children, and when we gather at conferences, it does seem like a family.

  13. From Residency to Lifelong Learning.

    PubMed

    Brandt, Keith

    2015-11-01

    The residency training experience is the perfect environment for learning. The university/institution patient population provides a never-ending supply of patients with unique management challenges. Resources abound that allow the discovery of knowledge about similar situations. Senior teachers provide counseling and help direct appropriate care. Periodic testing and evaluations identify deficiencies, which can be corrected with future study. What happens, however, when the resident graduates? Do they possess all the knowledge they'll need for the rest of their career? Will medical discovery stand still limiting the need for future study? If initial certification establishes that the physician has the skills and knowledge to function as an independent physician and surgeon, how do we assure the public that plastic surgeons will practice lifelong learning and remain safe throughout their career? Enter Maintenance of Certification (MOC). In an ideal world, MOC would provide many of the same tools as residency training: identification of gaps in knowledge, resources to correct those deficiencies, overall assessment of knowledge, feedback about communication skills and professionalism, and methods to evaluate and improve one's practice. This article discusses the need; for education and self-assessment that extends beyond residency training and a commitment to lifelong learning. The American Board of Plastic Surgery MOC program is described to demonstrate how it helps the diplomate reach the goal of continuous practice improvement.

  14. Prematurity: present and future

    PubMed Central

    Tsimis, M. E.; Al-Hamayel, N. Abu; Germaine, H.; Burd, I.

    2014-01-01

    The study of preterm labor and prematurity, as with any medical science, has undergone a major transformation in its approach from an inevitable part of obstetrics with few answers to one in which science has led to knowledge and clinical intervention. Despite these advancements, understanding of preterm labor and prevention of prematurity is still limited. In the current review, we begin the discussion with fetal viability, first from a historical perspective and then from the understanding of this issue from a prospective of various professional organizations. We then present the scope of the problem of preterm birth from various countries including the discrepancy between the US and Europe. We continue with updates on extreme prematurity and outcomes with two longitudinal studies from the past 2 years. We further review available interventions for prematurity and discuss the use of antenatal corticosteroids. First, we examine their use in the context of professional recommendations and then examine the trajectory of their continued use in the late preterm period. We focus on a European-based trial with preliminary results and an ongoing American counterpart. The current knowledge of molecular mechanisms behind preterm labor is presented with a focus on the multiple etiologies of preterm labor, both known and presumed, with updates in the basic science realm. Furthermore, up-to-date studies on prediction of preterm birth and prematurity-related morbidity are presented. PMID:25300768

  15. Lifelong Learning in Action: Hong Kong Practitioners' Perspectives.

    ERIC Educational Resources Information Center

    Cribbin, John, Ed.; Kennedy, Peter, Ed.

    This document consists of 32 papers presenting Hong Kong practitioners' perspectives on lifelong learning. The following papers are included: "Lifelong Learning" (Albert Tuijnman); "Growth and Development of Lifelong Learning in Hong Kong " (John Cribbin); "Competition and Collaboration" (John Cribbin); "A…

  16. Lifelong Learning in Action: Hong Kong Practitioners' Perspectives.

    ERIC Educational Resources Information Center

    Cribbin, John, Ed.; Kennedy, Peter, Ed.

    This document consists of 32 papers presenting Hong Kong practitioners' perspectives on lifelong learning. The following papers are included: "Lifelong Learning" (Albert Tuijnman); "Growth and Development of Lifelong Learning in Hong Kong " (John Cribbin); "Competition and Collaboration" (John Cribbin); "A…

  17. Candlestick and Faces: Aspects of Lifelong Learning.

    ERIC Educational Resources Information Center

    Hunt, Cheryl

    1999-01-01

    Government policies view lifelong learning in terms of economic development. A SWOT (strengths, weaknesses, opportunities, threats) analysis of the environment of British community education councils revealed other views of lifelong learning: it takes time and political expediency and national policy can adversely affect what and how people learn.…

  18. Social Software for Life-Long Learning

    ERIC Educational Resources Information Center

    Klamma, Ralf; Chatti, Mohamed Amine; Duval, Erik; Hummel, Hans; Hvannberg, Ebba Thora; Kravcik, Milos; Law, Effie; Naeve, Ambjorn; Scott, Peter

    2007-01-01

    Life-long learning is a key issue for our knowledge society. With social software systems new heterogeneous kinds of technology enhanced informal learning are now available to the life-long learner. Learners outside of learning institutions now have access to powerful social communities of experts and peers who are together forging a new web 2.0.…

  19. The Nordic Model of Lifelong Learning

    ERIC Educational Resources Information Center

    Rubenson, Kjell

    2006-01-01

    This article explores how the so called Nordic welfare state, with its specific institutional make up, handles Lifelong Learning in a time characterised by the challenges of economic globalisation and the hegemonic impact of the neo-liberal agenda. The analysis reveals a high participation in the Nordic countries in Lifelong Learning and, in…

  20. Economics and Finance of Lifelong Learning.

    ERIC Educational Resources Information Center

    Verry, Donald

    This book represents one result of the international conference on "Lifelong Learning as an Affordable Investment," held December 6-8, 2000 in Ottawa, Canada. It examines the economic and financial issues that arise in implementing lifelong learning and considers how the public and private sectors are actually addressing or might address…

  1. WTO and Lifelong Education Strategies for Teachers

    ERIC Educational Resources Information Center

    Wang, Zhi-guo; Zheng, Yu

    2006-01-01

    After China's entry into the World Trade Organization (WTO), teachers have been confronted with many opportunities and challenges. Lifelong education strategies are problems we should take into account carefully. This article expounds the objective demands, ideas, content, measures and functions of lifelong education.

  2. Where's the Learning in Lifelong Participation?

    ERIC Educational Resources Information Center

    Williams, Joanna

    2012-01-01

    This article provides a retrospective review and analysis of New Labour's policies in relation to lifelong learning. New Labour's plans to promote social inclusion through lifelong learning resulted in a focus upon participation in terms of increasing the numbers of students involved in formal learning and increasing their participation in…

  3. A Design Model for Lifelong Learning Networks

    ERIC Educational Resources Information Center

    Koper, Rob; Giesbers, Bas; van Rosmalen, Peter; Sloep, Peter; van Bruggen, Jan; Tattersall, Colin; Vogten, Hubert; Brouns, Francis

    2005-01-01

    The provision of lifelong learning facilities is considered to be a major new direction for higher and distance teaching educational institutes catering for the demands of industry and society. ICT networks will in future support seamless, ubiquitous access to lifelong learning facilities at home, at work, in schools and universities. This implies…

  4. A Critical Look at Lifelong Learning

    ERIC Educational Resources Information Center

    Kaya, H. Eylem

    2014-01-01

    Education, which is a fundamental right of human being, has been transformed into a kind of lifelong prisoning by marketing step by step under the name of lifelong learning. Adult education as one of the most crucial parts of the educational system has also been affected by the global trend of an international actor, the European Union through its…

  5. A National Strategy for Lifelong Learning.

    ERIC Educational Resources Information Center

    Coffield, Frank, Ed.

    The first paper of this set of 12 conference papers, "Nine Learning Fallacies and Their Replacement by a National Strategy for Lifelong Learning," by Frank Coffield, synthesizes the opinions of other participants, and goes beyond them to set forth an outline of a strategy for lifelong learning in the United Kingdom. Following this…

  6. Lifelong Learning and the Absence of Gender

    ERIC Educational Resources Information Center

    Rogers, Alan

    2006-01-01

    This paper identifies that (with very few exceptions) in most of current literature on lifelong learning, gender issues are ignored or overlooked. An extensive review of the literature demonstrates this neglect. Some reasons are given for this, including the fact that most analyses of lifelong learning tend to stress the individual learning…

  7. Lifelong Career Development for Handicapped Individuals.

    ERIC Educational Resources Information Center

    Brolin, Donn E.; Carver, James T.

    Designed for individuals interested in implementing career development programs for disabled adults, this report presents information on the Lifelong Career Development (LCD) project and its potential for implementation in the community college. Chapter 1 examines lifelong learning and the career development needs of disabled individuals, presents…

  8. Lifelong Learning: A Pacification of "Know How"

    ERIC Educational Resources Information Center

    Nicoll, Katherine; Fejes, Andreas

    2011-01-01

    A tendency of previous studies of lifelong learning to focus on learning and learning subjectivities may have led to an underestimation of potential effects in terms of a system of knowledge constitutive processes that operates powerfully to shape our societies. In this paper we explore lifelong learning and practices in the construction of…

  9. Social Software for Life-Long Learning

    ERIC Educational Resources Information Center

    Klamma, Ralf; Chatti, Mohamed Amine; Duval, Erik; Hummel, Hans; Hvannberg, Ebba Thora; Kravcik, Milos; Law, Effie; Naeve, Ambjorn; Scott, Peter

    2007-01-01

    Life-long learning is a key issue for our knowledge society. With social software systems new heterogeneous kinds of technology enhanced informal learning are now available to the life-long learner. Learners outside of learning institutions now have access to powerful social communities of experts and peers who are together forging a new web 2.0.…

  10. Lifelong Learning Policy in Two National Contexts

    ERIC Educational Resources Information Center

    Rasmussen, Palle

    2014-01-01

    This article describes and discusses the development of lifelong learning policy in two EU member states, Denmark and Portugal. The purpose is to show how different societal and historical contexts shape the development and implementation of lifelong learning policies, even though these policies have significant common elements. As a basis for the…

  11. A Critical Look at Lifelong Learning

    ERIC Educational Resources Information Center

    Kaya, H. Eylem

    2014-01-01

    Education, which is a fundamental right of human being, has been transformed into a kind of lifelong prisoning by marketing step by step under the name of lifelong learning. Adult education as one of the most crucial parts of the educational system has also been affected by the global trend of an international actor, the European Union through its…

  12. Supporting Lifelong Learning in the Information Age

    ERIC Educational Resources Information Center

    Zhou, Wei; Yasuda, Takami; Yokoi, Shigeki

    2007-01-01

    Many countries are considering lifelong learning, which is becoming an important education goal, and promoting lifelong learning in the information age. With the development of Information and Communications Technology (ICT), digital divides have become a major concern in the world. In this study, we focus on three dimensions of digital divides in…

  13. Lifelong Learning: A Pacification of "Know How"

    ERIC Educational Resources Information Center

    Nicoll, Katherine; Fejes, Andreas

    2011-01-01

    A tendency of previous studies of lifelong learning to focus on learning and learning subjectivities may have led to an underestimation of potential effects in terms of a system of knowledge constitutive processes that operates powerfully to shape our societies. In this paper we explore lifelong learning and practices in the construction of…

  14. Researching the Rhetoric of Lifelong Learning.

    ERIC Educational Resources Information Center

    Edwards, Richard; Nicoll, Katherine

    2001-01-01

    In the analysis of lifelong-learning policies, the gap between rhetoric and reality has been avidly debated. Such critiques are misguided; an "exemplary" rhetorical analysis of lifelong-learning policy is possible. UK government publications suggest that rhetorical analysis helps identify the politics of discourse involved in…

  15. Lifelong Learning and Demographics: A Japanese Perspective

    ERIC Educational Resources Information Center

    Ogawa, Seiko

    2005-01-01

    This paper explores the social dimension of lifelong learning from the perspective of demographics, with particular focus on the issue of the birth of fewer children, which has become one of the most important current social issues in Japanese society. When considering the relationship between lifelong learning and demographics, the issues arising…

  16. The Nordic Model of Lifelong Learning

    ERIC Educational Resources Information Center

    Rubenson, Kjell

    2006-01-01

    This article explores how the so called Nordic welfare state, with its specific institutional make up, handles Lifelong Learning in a time characterised by the challenges of economic globalisation and the hegemonic impact of the neo-liberal agenda. The analysis reveals a high participation in the Nordic countries in Lifelong Learning and, in…

  17. Lifelong Learning Policy in Two National Contexts

    ERIC Educational Resources Information Center

    Rasmussen, Palle

    2014-01-01

    This article describes and discusses the development of lifelong learning policy in two EU member states, Denmark and Portugal. The purpose is to show how different societal and historical contexts shape the development and implementation of lifelong learning policies, even though these policies have significant common elements. As a basis for the…

  18. Policy on Lifelong Learning in Australia

    ERIC Educational Resources Information Center

    Chapman, Judith; Gaff, Janet; Toomey, Ron; Aspin, David

    2005-01-01

    This paper provides an account of the extent to which the concept of lifelong learning has been incorporated into the education policies of the Australian Commonwealth and State Governments and the Catholic and Independent schooling sectors, taking particular note of the application of lifelong learning to policies pertaining to teacher education.

  19. Recent Developments in Japan's Lifelong Learning Society.

    ERIC Educational Resources Information Center

    Makino, Atsushi

    In the wake of economic and social change in Japan, several lifelong learning initiatives have been implemented. Structural changes such as internationalization, the coming of the information age, and the maturation of Japanese society caused the formerly homogeneous society to become more flexible, paving the way for lifelong learning. Additional…

  20. Toward a Model of Lifelong Education.

    ERIC Educational Resources Information Center

    Knowles, Malcolm S.

    Some of the criticisms that have been leveled at the educational establishment by social analysts are discussed. It is suggested that one of the new realities is that education must be a lifelong process in order to avoid the catastrophe of human obsolescence. The assumptions and elements for a new model of education as a lifelong process are…

  1. Lifelong Learning and Demographics: A Japanese Perspective

    ERIC Educational Resources Information Center

    Ogawa, Seiko

    2005-01-01

    This paper explores the social dimension of lifelong learning from the perspective of demographics, with particular focus on the issue of the birth of fewer children, which has become one of the most important current social issues in Japanese society. When considering the relationship between lifelong learning and demographics, the issues arising…

  2. Autoimmune premature ovarian failure

    PubMed Central

    2017-01-01

    Premature ovarian failure (POF), also termed as primary ovarian insufficiency (POI), is a highly heterogenous condition affecting 0.5-3.0% of women in childbearing age. These young women comprise quite a formidable group with unique physical and psychological needs that require special attention. Premature ovarian senescence (POS) in all of its forms evolves insidiously as a basically asymptomatic process, leading to complete loss of ovarian function, and POI/POF diagnoses are currently made at relatively late stages. Well-known and well-documented risk factors exist, and the presence or suspicion of autoimmune disorder should be regarded as an important one. Premature ovarian failure is to some degree predictable in its occurrence and should be considered while encountering young women with loss of menstrual regularity, especially when there is a concomitant dysfunction in the immune system. PMID:28250725

  3. Imipramine-induced erection, masturbation, and ejaculation in male horses.

    PubMed

    McDonnell, S M; Garcia, M C; Kenney, R M; Van Arsdalen, K N

    1987-05-01

    Imipramine hydrochloride was administered to five male horses (400-500 kg b.wt.): one experienced young stallion, two mature normal breeding stallions, one 5-year-old stallion with erection and ejaculatory dysfunction, and one long-term castrated male horse. Oral imipramine treatment (100 to 600 mg, twice daily) led to frequent erection and masturbation while at rest in the stall in a nonsexual context. Intravenous imipramine treatment over a range of doses (50 to 1000 mg) similarly induced erection and masturbation in all animals. Erection typically occurred within 10 minutes after injection, and the erection and masturbation continued intermittently for 1 to 2 hours. These erections proceeded as during sexual excitement to a normal firmness and eventual engorgement of the glans penis. Two stallions ejaculated while masturbating. Mild ataxia and drowsiness appeared at the higher doses, but the animals remained responsive to auditory, visual, and tactile stimuli. Erection and masturbation were often interrupted by activities about the barn or the approach of the handler, suggesting cortical inhibitory control of the erection. When tested in a sexual context immediately following IV treatment (500 mg), the two mature breeding stallions bred normally. The 5-year-old stallion, which had not ejaculated over several months of breeding attempts, spontaneously ejaculated following IV imipramine treatment. Subsequently, this stallion has ejaculated during copulation while on low dose oral (100 mg. twice daily) imipramine treatment. Plasma total androgens increased during treatment in these stallions. The long-term castrate showed erection and masturbation following IV imipramine treatment, suggesting that the effect of imipramine is not testosterone dependent.

  4. Midodrine improves ejaculation in spinal cord injured men.

    PubMed

    Soler, J M; Previnaire, J G; Plante, P; Denys, P; Chartier-Kastler, E

    2007-11-01

    We evaluated the effect of the alpha1-adrenergic agonist midodrine given orally for anejaculation in spinal cord injured men. A total of 185 spinal cord injured patients who reported absent ejaculation during sexual intercourse and who failed to respond to penile vibratory stimulation were treated with midodrine 30 to 120 minutes before a new stimulation. The procedure was repeated weekly, increasing doses by 7.5 mg to a maximum of 30 mg. Cardiovascular effects were monitored throughout the procedure. Antegrade or retrograde ejaculation was achieved in 102 spinal cord injured men (64.6%). A positive response was more frequent in patients with complete lesions (American Spinal Injury Association A) and upper motor neuron lesions above T10. Midodrine induced a significant but moderate increase (maximum 10 mm Hg) in mean arterial pressure in all patients. The highest systolic blood pressure (more than 200 mm Hg) was seen in patients with quadriplegia. No other significant side effect was recorded. The average dose of midodrine required for ejaculation was 18.7 mg. Midodrine is a safe and efficient adjunct to penile vibratory stimulation for anejaculation in spinal cord injured patients.

  5. Inbreeding, fluctuating asymmetry, and ejaculate quality in an endangered ungulate.

    PubMed Central

    Roldan, E R; Cassinello, J; Abaigar, T; Gomendio, M

    1998-01-01

    An ever-increasing number of species are suffering marked reductions in population size as a consequence of human activities. To understand the impact of these changes it is essential to assess how small population size affects individual fitness and the viability of populations. This issue acquires special relevance among endangered species in which numbers have decreased to such an extent that captive breeding must be established with a few founders. A major risk associated with small population size is inbreeding depression. The effects of inbreeding upon male reproductive traits are the subject of an ongoing controversy, since the evidence linking lack of genetic variability and poor ejaculate quality at the population level has been criticized recently by several authors. We report that among Gazella cuvieri males, inbreeding coefficient shows a strong inverse relationship with ejaculate quality. Furthermore, the degree of fluctuating asymmetry is positively related to the coefficient of inbreeding and negatively related to the proportion of normal sperm, suggesting that it is a reliable indicator of genetic stress and of ejaculate quality. PMID:9493409

  6. Learning in Premature Infants.

    ERIC Educational Resources Information Center

    Thoman, Evelyn B.; Ingersoll, Evan W.

    1993-01-01

    Examined instrumental learning in premature infants by providing 45 infants at 33 weeks conceptual age with either a teddy bear that "breathed" quietly at the infant's respiration rate (BB) or a nonbreathing bear (NBB). Over a two-week period, infants provided with the BB decreased their latency to contact the bear; infants exposed to the NBB…

  7. Spontaneous ejaculation in a wild Indo-Pacific bottlenose dolphin (Tursiops aduncus).

    PubMed

    Morisaka, Tadamichi; Sakai, Mai; Kogi, Kazunobu; Nakasuji, Akane; Sakakibara, Kasumi; Kasanuki, Yuria; Yoshioka, Motoi

    2013-01-01

    Spontaneous ejaculation, which is defined as the release of seminal fluids without apparent sexual stimulation, has been documented in boreoeutherian mammals. Here we report spontaneous ejaculation in a wild Indo-Pacific bottlenose dolphin (Tursiops aduncus), and present a video of this rare behavior. This is the first report of spontaneous ejaculation by an aquatic mammal, and the first video of this behavior in animals to be published in a scientific journal.

  8. Your Premature Baby: Low Birthweight

    MedlinePlus

    ... blood pressure, diabetes and heart disease all together. Obesity . This means being very overweight. If you're ... research Research grants Prematurity research Birth defects research Infant health research Prematurity research centers For providers Info ...

  9. Virtual azoospermia and cryptozoospermia--fresh/frozen testicular or ejaculate sperm for better IVF outcome?

    PubMed

    Hauser, Ron; Bibi, Guy; Yogev, Leah; Carmon, Ariella; Azem, Foad; Botchan, Amnon; Yavetz, Haim; Klieman, Sandra E; Lehavi, Ofer; Amit, Ami; Ben-Yosef, Dalit

    2011-01-01

    Men diagnosed as having azoospermia occasionally have a few mature sperm cells in other ejaculates. Other men may have constant, yet very low quality and quantity of sperm cells in their ejaculates, resulting in poor intracytoplasmic sperm injection (ICSI) outcome. It has not been conclusively established which source of sperm cells is preferable for ICSI when both ejaculate and testicular (fresh or frozen) sperm cells are available. It is also unclear whether there is any advantage of fresh over frozen sperm if testicular sperm is to be used. We used ejaculate, testicular (fresh or frozen) sperm cells, or both for ICSI in 13 couples. Five of these couples initially underwent ICSI by testicular sperm extraction, because the males had total azoospermia, and in later cycles with ejaculate sperm cells. Ejaculate sperm cells were initially used for ICSI in the other 8 patients, and later with testicular sperm cells. The fertilization rate was significantly higher when fresh or frozen-thawed testicular sperm cells were used than when ejaculated sperm cells were used. Likewise, the quality of the embryos from testicular (fresh and frozen) sperm was higher than from ejaculated sperm (65.3% vs 53.2%, respectively, P < .05). The use of fresh testicular sperm yielded better implantation rates than both frozen testicular sperm and ejaculate. Therefore, fresh testicular sperm should be considered first for ICSI in patients with virtual azoospermia or cryptozoospermia because of their superior fertility.

  10. Ejaculate of sneaker males is pheromonally inconspicuous in the black goby, Gobius niger (Teleostei, Gobiidae).

    PubMed

    Locatello, L; Mazzoldi, C; Rasotto, M B

    2002-11-01

    The black goby, Gobius niger, shows alternative male mating tactics, i.e., parental and sneaker males. Males release a sexual pheromone that attracts females and stimulates aggressive displays in males. This pheromone is produced by the mesorchial gland, a structure well developed in parental males but markedly undeveloped in sneakers. We measured the behavioral response of parental males to the ejaculates of males performing different reproductive tactics. Parental males reacted to the ejaculate of other parental males, with stereotypic aggressive behaviors, but not to the ejaculate of sneakers; consequently sneaker male ejaculate appears to be pheromonally inconspicuous.

  11. Does repeated electro-ejaculation improve sperm quality in spinal cord injured men?

    PubMed

    Das, S; Dodd, S; Soni, B M; Sharma, S D; Gazvani, R; Lewis-Jones, D I

    2006-12-01

    Retrospective analysis. To assess the effect of repeated electro-ejaculation on the sperm quality in spinal cord injured men. Regional Spinal Injuries Unit, Southport, UK and Hewitt Center for Reproductive Medicine, Liverpool, UK. Retrospective, observational study of men with spinal cord injuries undergoing repeated electro-ejaculation as a part of fertility treatment. There was no improvement in the volume, sperm concentration, motility or the total motile count in the successive antegrade and retrograde samples following repeated electro-ejaculations. Electro-ejaculation is an invasive procedure and its use should be restricted to obtaining semen sample for carrying out assisted conception procedures only.

  12. The effect of sperm concentration in the ejaculate on morphological traits of bull spermatozoa.

    PubMed

    Kondracki, Stanisław; Banaszewska, Dorota; Wysokńjska, Anna; Iwanina, Maria

    2012-01-01

    Experiments were performed on 75 ejaculates obtained from 19 bulls representing different cattle breeds used at the Masovian Centre for Animal Breeding and Reproduction in Łowicz. Fresh ejaculates were measured in respect to their volume and sperm count in the ejaculates was determined. The ejaculates were classified based on the criterion of sperm concentration and divided into five groups. Sperm morphometric measurements were taken from each bull and assessment of semen morphology was done on the basis of examination under a microscope using preparations made from fresh ejaculates. For each slide, morphometric measurements were taken of 15 randomly selected spermatozoa characterised by normal morphology and well visible under the microscope. Additionally, in each preparation morphometry of 500 spermatozoa was evaluated, numbers of spermatozoa with normal morphology and morphological abnormalities were recorded and these were categorized into spermatozoa with major and minor defects. An insignificant correlation was observed between the sperm concentration in the ejaculate and morphological traits, dimensions and shapes of bull spermatozoa. The less concentrated ejaculates contained spermatozoa with a slightly larger head circumference and a more elongated head shape in comparison with the spermatozoa in the more concentrated ejaculates. The highest frequency of morphologically malformed spermatozoa, both in the case of primary and secondary alterations, was observed in ejaculates with sperm concentration of no more than 1000 x 10(3)/mm3.

  13. Lifelong learning: fostering a culture of curiosity.

    PubMed

    Eason, Toni

    2010-01-01

    Lifelong learning contributes to the development of knowledge and skill in nursing. A focus on continuous learning is necessary to remain current on trends, practices, and the newest treatments in the field of nursing. Creation of a culture where educational growth is supported and promoted is vital to advancement of the nursing profession. Nurses' satisfaction with their professional role can be further enhanced by demonstrated expertise through lifelong learning. Expertise in nursing is solidly founded on evidence-based practice. Research, education, and experience in nursing practice are linked to evidence-based practice and lifelong learning; both are essential to remaining well versed in health care service delivery.

  14. Thinking about Pregnancy After Premature Birth

    MedlinePlus

    ... research Research grants Prematurity research Birth defects research Infant health research Prematurity research centers For providers NICU ... babies by preventing birth defects, premature birth and infant mortality. Solving premature birth Featured articles Accomplishments and ...

  15. Micafungin in Premature and Non-premature Infants

    PubMed Central

    Wu, Chunzhang; Tweddle, Lorraine; Roilides, Emmanuel

    2014-01-01

    Background: Invasive fungal infections cause excessive morbidity and mortality in premature neonates and severely ill infants. Methods: Safety and efficacy outcomes of micafungin were compared between prematurely and non-prematurely born infants <2 years of age. Data were obtained from all completed phase I–III clinical trials with micafungin that had enrolled infants (<2 years of age) that were listed in the Astellas Clinical Study Database. Demographics, adverse events, hepatic function tests and treatment success data were extracted and validated by the Astellas biostatistical group for all micafungin-treated patients, <2 years of age, using the unique patient identifier. Results: One-hundred and sixteen patients included in 9 clinical trials, 48% premature [birth weight (BW) <2500 g and/or gestational age <37 weeks], 52% non-premature, received ≥1 dose of micafungin. Among premature patients, 14.5% were low BW (1500–2499 g), 36.4% very low BW (1000–1499 g) and 49.1% extremely low BW (<1000 g). Ninety patients (78%) completed the studies; 13 [11% (4 premature)] died. Significantly more non-premature than premature patients discontinued treatment (P = 0.003). Treatment-related adverse events were recorded in 23% of patients with no difference between groups. More extremely low BW (n = 4, 15%) and very low BW (n = 8, 40%) infants experienced treatment-related adverse events than low BW (n = 0) and there was no relation to micafungin dose or duration. For a subgroup of 30 patients with invasive candidiasis, treatment success was achieved in 73% in both premature and non-premature groups. Prophylaxis was successful in 4/5 non-premature hematopoietic stem cell transplant patients. Conclusion: Micafungin has a safe profile in premature and non-premature infants with substantial efficacy. PMID:24892849

  16. Reading Policy Texts: Lifelong Leaning as Metaphor.

    ERIC Educational Resources Information Center

    Nicoll, Katherine; Edwards, Richard

    2000-01-01

    Argues the necessity of a discursive approach to policy analysis. Emphasizes the importance of metaphor to the analysis. Explores the metaphorical role of lifelong learning in educational policy. (SK)

  17. Premature Aging in Fibromyalgia.

    PubMed

    Hassett, Afton L; Clauw, Daniel J; Williams, David A

    2015-01-01

    Chronic pain is highly prevalent in older adults, and until recently, was considered to be common but relatively "benign." Mounting evidence, however, suggests that some of the 116 million US adults who suffer from chronic pain are also at an increased risk for developing age-related diseases prematurely, suffering earlier cognitive and physical decline, and experiencing earlier mortality. Given the aging US population and the prevalence of chronic pain along with related healthcare consequences, there is a critical need to better understand the relationship between aging and chronic pain. Herein, we focus on one chronic pain state, fibromyalgia, and provide an overview of the evidence suggesting that individuals with this chronic pain condition show signs of premature aging.

  18. Lifestyle influences on prematurity.

    PubMed

    Creasy, R K

    1991-01-01

    It is apparent from this review that the lifestyle of an individual gravida can potentially lead to a premature delivery. Some of these adverse behavioral characteristics may be dealt with by education and motivation, and some with actual medical treatment. However, there also appears to be significant need for public policy reorientation if we are to make a significant impact on the problem of preterm delivery.

  19. Prematurely terminated slug tests

    SciTech Connect

    Karasaki, K. )

    1990-07-01

    A solution of the well response to a prematurely terminated slug test (PTST) is presented. The advantages of a PTST over conventional slug tests are discussed. A systematized procedure of a PTST is proposed, where a slug test is terminated in the midpoint of the flow point, and the subsequent shut-in data is recorded and analyzed. This method requires a downhole shut-in device and a pressure transducer, which is no more than the conventional deep-well slug testing. As opposed to slug tests, which are ineffective when a skin is present, more accurate estimate of formation permeability can be made using a PTST. Premature termination also shortens the test duration considerably. Because in most cases no more information is gained by completing a slug test to the end, the author recommends that conventional slug tests be replaced by the premature termination technique. This study is part of an investigation of the feasibility of geologic isolation of nuclear wastes being carried out by the US Department of Energy and the National Cooperative for the Storage of Radioactive Waste of Switzerland.

  20. Female ejaculation orgasm vs. coital incontinence: a systematic review.

    PubMed

    Pastor, Zlatko

    2013-07-01

    Women may expel various kinds of fluids during sexual arousal and at orgasm. Their origins, quantity, compositions, and expulsion mechanisms depend on anatomical and pathophysiological dispositions and the degree of sexual arousal. These are natural sexual responses but may also represent symptoms of urinary incontinence. The study aims to clarify the etiology of fluid leakage at orgasm, distinguish between associated physiological sexual responses, and differentiate these phenomena from symptoms of illness. A systematic literature review was performed. EMBASE (OvidSP) and Web of Science databases were searched for the articles on various phenomena of fluid expulsions in women during sexual arousal and at orgasm. Articles included focused on female ejaculation and its variations, coital incontinence (CI), and vaginal lubrication. Female ejaculation orgasm manifests as either a female ejaculation (FE) of a smaller quantity of whitish secretions from the female prostate or a squirting of a larger amount of diluted and changed urine. Both phenomena may occur simultaneously. The prevalence of FE is 10-54%. CI is divided into penetration and orgasmic forms. The prevalence of CI is 0.2-66%. Penetration incontinence occurs more frequently and is usually caused by stress urinary incontinence (SUI). Urodynamic diagnoses of detrusor overactivity (DOA) and SUI are observed in orgasmic incontinence. Fluid expulsions are not typically a part of female orgasm. FE and squirting are two different physiological components of female sexuality. FE was objectively evidenced only in tens of cases but its reported high prevalence is based mostly on subjective questionnaire research. Pathophysiology of squirting is rarely documented. CI is a pathological sign caused by urethral disorder, DOA, or a combination of both, and requires treatment. An in-depth appreciation of these similar but pathophysiologically distinct phenomena is essential for distinguishing normal, physiological sexual

  1. First stirrings: cultural notes on orgasm, ejaculation, and wet dreams.

    PubMed

    Janssen, Diederik F

    2007-05-01

    Both the findings and the limitations of numeric milestone research in sexology have a bearing on the pedagogical status of pleasure, as well as the cultural underpinnings of the notion of a psychosexual milestone. An overview is offered of international data pertaining to the chronology of three "milestones" in sexual autobiography: first orgasm (orgasmarche), first ejaculation (oigarche), and first wet dream (nocturnal emission). Methodological problems associated with the measurement of these variables are discussed. These problems are then situated in a culturalist perspective. It is concluded that orgasms are cultural artifacts in terms of their chronological occurrence as well as perceived salience, necessity, and "age appropriateness".

  2. Protein composition of seminal plasma in fractionated stallion ejaculates.

    PubMed

    Kareskoski, A M; del Alamo, M M Rivera; Güvenc, K; Reilas, T; Calvete, J J; Rodriguez-Martinez, H; Andersson, M; Katila, T

    2011-02-01

    Seminal plasma (SP) contains several types of compounds derived from the epididymides and accessory glands. The aim of this study was to examine the protein composition of different ejaculate fractions. Trial I: fractionated ejaculates were collected from two normal and two subfertile stallions. Samples containing pre-sperm fluid and the first sperm-rich jets (HIGH-1), the main sperm-rich portion (HIGH-2), the jets with low sperm concentrations (LOW), and a combined whole-ejaculate (WE) sample was centrifuged, and the SP was filtered and frozen. A part of each SP sample was stored (5°C, 24 h) with spermatozoa from HIGH-2 and skim milk extender. Sperm motility was evaluated after storage in extender mixed with the stallion's own SP or SP from one of the other stallions (sperm from a normal stallion stored in SP from a subfertile stallion and vice versa). Protein composition was analysed using reverse-phase liquid chromatography (RP-HPLC), N-terminal sequencing and mass spectrometry. The area-under-the-curve (AUC) was used for quantitative comparison of proteins within fractions. Trial II: semen samples were collected from seven stallions. Fractions with the highest (HIGH) and lowest (LOW) sperm concentrations and WE samples were examined using SDS-PAGE and densitometry. No significant differences emerged between fractions in the AUC-values of the Horse Seminal Protein-1 (HSP-1) and HSP-2 peaks, or the peak containing HSP-3 and HSP-4 (HSP-3/4). Levels of HSP-1, HSP-2 and HSP-3/4 were not significantly correlated with total sperm motility, progressive sperm motility or average path velocity after storage. Significant differences between ejaculate fractions in the amount of different protein groups present in SP were not found in Trial I; but in Trial II, the proteins in the 60-70 kDa range were more abundant in LOW than in HIGH and WE, indicating that this band contained proteins derived mainly from the seminal vesicles, which produce most of the SP in LOW.

  3. One-sided ejaculation of echidna sperm bundles.

    PubMed

    Johnston, S D; Smith, B; Pyne, M; Stenzel, D; Holt, W V

    2007-12-01

    We report for the first time an unusual ejaculatory mechanism in the short-beaked echidna in which each side of the bilaterally symmetrical, rosettelike glans penis is used alternately, with the other being shut down. This is unparalleled in mammals but is reminiscent of the use of hemipenes in squamate reptiles, providing further reproductive evidence of a sauropsidian lineage in the Monotremata. Further, we describe the occurrence of motile sperm bundles in ejaculated echidna semen and provide scanning electron micrographs of their morphology. Sperm bundling appears to confer increased sperm motility, which may provide the potential for sperm competition between males.

  4. Effect of sperm concentration in an ejaculate on morphometric traits of spermatozoa in Duroc boars.

    PubMed

    Kondracki, S; Wysokińska, A; Iwanina, M; Banaszewska, D; Sitarz, D

    2011-01-01

    The experimental material consisted of 75 ejaculates collected form 8 Duroc boars. The ejaculates were divided into three groups according to sperm concentration in an ejaculate. An ejaculate was obtained from each boar monthly and it was used to make microscopic preparations to examine spermatozoa morphology. In each preparation morphometric measurements were taken of fifteen randomly selected spermatozoa characterized by normal morphology. The following measurements of spermatozoa were taken: length and width of the spermatozoa head, head area, length of the flagellum, perimeter of the spermatozoon head and total spermatozoon length. The results were used to calculate indicators of spermatozoa morphology. Moreover, assessments were made of frequency of morphological defects to isolate spermatozoa with primary and secondary abnormalities following the Blom classification system. It was found that the concentration of spermatozoa in the ejaculate influenced the morphometric characteristics of spermatozoa. Ejaculates with low sperm concentrations are characterized by larger spermatozoa as compared to ejaculates with high sperm concentrations. However, sperm concentration in the ejaculate does not much influence the shape of spermatozoa.

  5. Giant hydronephrosis of a duplex system associated with ureteral ectopia: a cause of retrograde ejaculation.

    PubMed

    Lee, S S; Sun, G H; Yu, D S; Chen, H I; Chang, S Y

    2000-01-01

    Retrograde ejaculation is an extremely rare complication of the ectopic ureter or ectopic ureterocele. In the literature, only two cases have been reported worldwide. In this article the authors describe a patient who has a completely duplicated collecting system with massive dilatation of the upper pole system, which has manifested as a huge abdominal and retroperitoneal mass, complicated by retrograde ejaculation.

  6. Correlated evolution between male ejaculate allocation and female remating behaviour in seed beetles (Bruchidae).

    PubMed

    Katvala, M; Rönn, J L; Arnqvist, G

    2008-03-01

    Sperm competition theory suggests that female remating rate determines the selective regime that dictates the evolution of male ejaculate allocation. To test for correlated evolution between female remating behaviour and male ejaculate traits, we subjected detailed experimental data on female and male reproductive traits in seven-seed beetle species to phylogenetic comparative analyses. The evolution of a larger first ejaculate was positively correlated with the evolution of a more rapid decline in ejaculate size over successive matings. Further, as predicted by theory, an increase in female remating rate correlated with the evolution of larger male testes but smaller ejaculates. However, an increase in female remating was associated with the evolution of a less even allocation of ejaculate resources over successive matings, contrary to classic sperm competition theory. We failed to find any evidence for coevolution between the pattern of male ejaculate allocation and variation in female quality and we conclude that some patterns of correlated evolution are congruent with current theory, whereas some are not. We suggest that this may reflect the fact that much sperm competition theory does not fully incorporate other factors that may affect the evolution of male and female traits, such as trade-offs between ejaculate expenditure and other competing demands and the evolution of resource acquisition.

  7. Semen characteristics in pubertal boys. I. Semen quality after first ejaculation.

    PubMed

    Janczewski, Z; Bablok, L

    1985-01-01

    Semen specimens from 134 pubertal boys were examined, and some 274 assays were made. An analysis of the biological quality of semen in relation to the period of time after first ejaculation brings high values of statistical dependence of the volume of semen, its liquefaction, spermatozoal concentration, percentage of morphologically normal forms of spermatozoa, and normal spermatozoal motility on the period of time after first ejaculation. Normal figures for semen volume, semen liquefaction, spermatozoal concentration, and morphology are observed 12-14 months after first ejaculation. The percentage of normally motile spermatozoa becomes standard 21-23 months after first ejaculation. There were changes in semen characteristics from azoospermia through cryptozoospermia, oligozoospermia, and asthenozoospermia to normospermia. Azoospermia dominates until the fifth month after the first ejaculation, oligozoospermia from the sixth to the eleventh month, asthenozoospermia from the twelfth to the twentieth month, and normospermia from the twenty-first month.

  8. Case report: A healthy live birth following icsi with retrograde ejaculated sperm.

    PubMed

    Yakass, Michael B; Woodward, Bryan; Otoo, Mary A; Hiadzi, Edem K

    2014-12-01

    Retrograde ejaculation, sometimes called dry orgasm, refers to the medical condition when semen enters the urinary bladder (retrograde) instead of emerging through the penis after orgasm (antegrade). In some instances, a very minute quantity of antegrade semen appears in the ejaculate and may or may not be devoid of spermatozoa. Complete retrograde ejaculation causes male infertility. Intracytoplasmic sperm injection (ICSI) has been employed to achieve fertilization in some cases of male subfertility, e.g., severe oligoasthenoteratozoospermia. Assisted reproductive techniques to aid conception in cases of retrograde ejaculation have been described extensively elsewhere but there is paucity of knowledge on the occurrence and treatment in Africa. This case report describes the identification and successful treatment of a couple where the male partner suffered from retrograde ejaculation.

  9. Retrograde Ejaculation: A Rare Presenting Symptom of Type 1 Diabetes Mellitus.

    PubMed

    Kam, Jonathan; Tsang, Venessa H; Chalasani, Venu

    2017-01-01

    A 19 year old presented with a progressive decline in ejaculate volume over 2 weeks, followed by a complete absence of ejaculate emission. A post-ejaculatory urine specimen demonstrated spermatozoa confirming a diagnosis of retrograde ejaculation. Investigations revealed a raised blood glucose level of 24.5 mmol/L and HbA1c >15%, with positive tests for anti-GAD antibodies and anti-IA2 antibodies consistent with a diagnosis of Type 1 diabetes mellitus. Retrograde ejaculation in diabetes is associated with autonomic neuropathy and is a late feature of the disease. This case is unique with retrograde ejaculation being the primary presenting symptom of Type 1 diabetes mellitus.

  10. Youth and Lifelong Education: After-School Programmes as a Vital Component of Lifelong Education Infrastructure

    ERIC Educational Resources Information Center

    Lauzon, Allan C.

    2013-01-01

    This paper argues that after-school programmes need to be considered an essential part of lifelong learning infrastructure, particularly in light of the dominance of the economic discourse in both lifelong learning literature and the initial schooling literature. The paper, which is based upon existing literature, begins by providing an overview…

  11. Youth and Lifelong Education: After-School Programmes as a Vital Component of Lifelong Education Infrastructure

    ERIC Educational Resources Information Center

    Lauzon, Allan C.

    2013-01-01

    This paper argues that after-school programmes need to be considered an essential part of lifelong learning infrastructure, particularly in light of the dominance of the economic discourse in both lifelong learning literature and the initial schooling literature. The paper, which is based upon existing literature, begins by providing an overview…

  12. Associations between Salivary Testosterone Levels, Androgen-Related Genetic Polymorphisms, and Self-Estimated Ejaculation Latency Time.

    PubMed

    Jern, Patrick; Westberg, Lars; Ankarberg-Lindgren, Carina; Johansson, Ada; Gunst, Annika; Sandnabba, N Kenneth; Santtila, Pekka

    2014-08-01

    Recently, testosterone (T) has been shown to be associated with premature ejaculation (PE) symptoms in the literature. Furthermore, studies suggest that the etiology of PE is partly under genetic control. The aim of this study was to reassess findings suggesting an association between testosterone (T) and a key symptom of PE, ejaculation latency time (ELT), as well as exploratively investigating associations between six androgen-related genetic polymorphisms and ELT. Statistical analyses were performed on a population-based sample of 1,429 Finnish men aged 18-45 years (M = 26.9, SD = 4.7). Genotype information was available for 1,345-1,429 of these (depending on the polymorphism), and salivary T samples were available from 384 men. Two androgen receptor gene-linked, two 5-alpha-reductase type 2-gene-linked, and two sex hormone-binding globuline gene-linked polymorphisms were genotyped. Ejaculatory function was assessed using self-reported ELT. We found no association between salivary T levels and ELT. We found a nominally significant association between a 5-alpha-reductase type 2-gene-linked polymorphism (rs2208532) and ELT, but this association did not remain significant after correction for multiple testing. One single nucleotide polymorphism in the sex hormone-binding globulin gene (rs1799941) moderated (significantly after correction for multiple testing) the association between salivary T and ELT, so that A:A genotype carriers had significantly lower salivary T levels as a function of increasing ELT compared with other genotype groups. We were unable to find support for the hypothesis suggesting an association between T levels and ELT, possibly because of the low number of phenotypically extreme cases (the sample used in the present study was population based). Our results concerning genetic associations should be interpreted with caution until replication studies have been conducted. Jern P, Westberg L, Ankarberg-Lindgren C, Johansson A, Gunst A, Sandnabba NK

  13. [Music therapy for prematures].

    PubMed

    Haus, R; Hennecke, K-H

    2003-01-01

    More than ever before the neonatal care besides the medical and nursing work has to been balanced between protecting the child against over extension due to the concept of "minimal handling" and on the other hand the necessary fostering of the young patients psychic and sensomotor development during the long stationary treatment. In addition to known approaches of auditive stimulation as receptive music therapy a concept of active music therapy methods based on the Nordoff/Robbins creative music-therapy (University Witten/Herdecke) is presented in a case-report. The report describes in a single case-report the music-therapeutic work with a premature of the 23 + 3 (th) week of pregnancy at the neonatological unit of the Vestische Kinder- und Jugendklinik Datteln, Universität Witten/Herdecke. The main focus was the observation of the prematures reactions on specific synchronisation of motoric, sensor and acoustical stimulation. Positive reactions allow to presume the effectiveness of music therapy with early born children as they are already shown in clinical studies about receptive music therapy. On the level of involuntary motional actions in the area of head-, face- and hand movements increased directly reactions of awareness on the coordination of sensomotor and acoustical stimulation have been observed. Temporary increase of oxygen partial pressure and reduction of heart/pulse rate seem to cause positive physiological effects. Active music therapeutic treatment does not seem to be an other risk of over-tension for prematures, but offers through the coordination of different levels of perception an adequate development fostering stimulation.

  14. Premature ovarian failure

    PubMed Central

    Beck-Peccoz, Paolo; Persani, Luca

    2006-01-01

    Premature ovarian failure (POF) is a primary ovarian defect characterized by absent menarche (primary amenorrhea) or premature depletion of ovarian follicles before the age of 40 years (secondary amenorrhea). It is a heterogeneous disorder affecting approximately 1% of women <40 years, 1:10,000 women by age 20 and 1:1,000 women by age 30. The most severe forms present with absent pubertal development and primary amenorrhea (50% of these cases due to ovarian dysgenesis), whereas forms with post-pubertal onset are characterized by disappearance of menstrual cycles (secondary amenorrhea) associated with premature follicular depletion. As in the case of physiological menopause, POF presents by typical manifestations of climacterium: infertility associated with palpitations, heat intolerance, flushes, anxiety, depression, fatigue. POF is biochemically characterized by low levels of gonadal hormones (estrogens and inhibins) and high levels of gonadotropins (LH and FSH) (hypergonadotropic amenorrhea). Beyond infertility, hormone defects may cause severe neurological, metabolic or cardiovascular consequences and lead to the early onset of osteoporosis. Heterogeneity of POF is also reflected by the variety of possible causes, including autoimmunity, toxics, drugs, as well as genetic defects. POF has a strong genetic component. X chromosome abnormalities (e.g. Turner syndrome) represent the major cause of primary amenorrhea associated with ovarian dysgenesis. Despite the description of several candidate genes, the cause of POF remains undetermined in the vast majority of the cases. Management includes substitution of the hormone defect by estrogen/progestin preparations. The only solution presently available for the fertility defect in women with absent follicular reserve is ovum donation. PMID:16722528

  15. Abruption-associated prematurity

    PubMed Central

    Han, Christina S.; Schatz, Frederick; Lockwood, Charles J.

    2011-01-01

    SYNOPSIS Chronic, subacute decidual hemorrhage (i.e., abruptio placenta and retrochorionic hematoma formation) is an important contributor to preterm parturition. Such hemorrhage induces thrombin from decidual tissue factor, which play a pivotal role in the development of preterm premature rupture of membranes and preterm delivery by acting through protease-activated receptors to promote the production of pro-inflammatory cytokines, and matrix-degrading metalloproteinases. Severe, acute abruption can lead to maternal and fetal mortality. Current management of abruption is individualized based on severity of disease, underlying etiology, and gestational age. PMID:21890016

  16. Premature aging syndrome.

    PubMed

    Coppedè, Fabio

    2012-01-01

    Hutchinson-Gilford progeria syndrome and Werner syndrome are two of the best characterized human progeroid diseases with clinical features mimicking physiological aging at an early age. Both disorders have been the focus of intense research in recent years since they might provide insights into the pathology of normal human aging. The chapter contains a detailed description of the clinical features of both disorders and then it focuses on the genetics, the resulting biochemical alterations at the protein level and the most recent findings and hypotheses concerning the molecular basis of the premature aging phenotypes. A description of available diagnostic and therapeutic approaches is included.

  17. Premature rupture of membranes.

    PubMed Central

    Poma, P. A.

    1996-01-01

    The management of patients with premature rupture of membranes has changed markedly in the past several years. The basis for this is a combination of a better understanding of newborn physiology, improved neonatal care, refinements in antibiotic therapy, and the widespread use of maternal and fetal monitoring. The best outcome for both mother and infant undoubtedly reflects data based on a combination of factors, among which are gestational age survival, evidence of fetal distress, presence or absence of labor and sepsis, and of course, the cervical condition as it is related to labor-readiness. An important recent advance is the recognition that an active observation management program is associated with less morbidity and mortality than the classic management course of delivery within 12 hours of membrane rupture. The fact that preterm premature rupture of membranes tends to recur in subsequent pregnancies offers an opportunity for prevention. Moreover, advances in perinatal and neonatal care will continue to improve the outcomes of these women and their children. PMID:8583489

  18. [How do parents experience the premature birth of their child?].

    PubMed

    Bruns-Neumann, Erdmut

    2006-06-01

    Advising and guidance of parents of premature children represent an important field of care activity in paediatrics. Nursing personnel are expected to react appropriately and competently to the needs and problematic situations of parents of prematurely born children. Only a restricted basis of sound knowledge is available for the fulfilment of this demanding task. The aim and purpose of the following literature analysis is to collect the knowledge currently available and to make it available to nursing, in theory and practice, in a concise form. In this way, the tasks of nursing personnel in this field can be formulated and future training content can be defined in more detail. Several data banks and the keyword catalogue of the University and Regional Library of Münster and the Central Library for Medicine in Cologne were consulted using the key term "premature birth" and various combinations of terms. A look at the research results makes it clear that the perspective of nursing researchers is particularly restricted to the immediately present and acute problem situations of children and parents during the period of the postnatal stay in hospital. There are only very few studies -that inquire into long-term effects in the parents' experiencing and overcoming of the premature birth. The following literature study shows that mothers in particular display intense emotional reactions as a result of a premature birth. These emotions are expressed in the form of fear concerning the disablement or death of the child as well as in feelings of physical inadequacy and incomplete self-realisation. In view of the life-long increased morbidity of prematurely born children and the hospital stays related to it, nursing personnel could benefit from developing specific insight into and understanding for the difficult life situation of parents of a prematurely born child. Regarding the present state of research, it is striking that the aspects of how the parents of premature

  19. International trends in lifelong learning for pharmacists.

    PubMed

    Driesen, Annelies; Verbeke, Koen; Simoens, Steven; Laekeman, Gert

    2007-06-15

    Lifelong learning for community pharmacists is shifting from continuing education (CE) towards continuing professional development (CPD) in some countries. The objectives of this report were to compare lifelong learning frameworks for community pharmacists in different countries, and determine to what extent the concept of CPD has been implemented. A literature search was conducted as well as an Internet search on the web sites of professional pharmacy associations and authorities in 8 countries. The results of this review show that the concept of CPD has been implemented primarily in countries that have a long tradition in lifelong learning, such as Great Britain. However, most countries have opted for the CE approach, eg, France, or for a combination of CE and CPD, eg, New Zealand. This approach combines the controllability by regulatory organizations that CE requires with the advantage of sustained behavior change seen in successful CPD programs.

  20. Ejaculation profiles of men following radiation therapy for prostate cancer.

    PubMed

    Sullivan, John F; Stember, Doron S; Deveci, Serkan; Akin-Olugbade, Yemi; Mulhall, John P

    2013-05-01

    Radical prostatectomy (RP) is associated with anejaculation, which for some men is a source of bother and sexual dissatisfaction. Clinical experience has shown us some men after pelvic radiation therapy (RT) also experience anejaculation. This analysis was conducted to define the ejaculation profiles of men after RT for prostate cancer (PCa). As a routine part of the sexual health evaluation for post-RT patients, men provided information regarding their ejaculatory function and orgasm. Analysis was conducted of a sexual medicine database reviewing demographic data, PCa factors, erectile, ejaculatory, and orgasmic function. Men with prior history of RP, cryotherapy, focal therapies, and androgen deprivation therapy (ADT) were excluded. Patients completed the International Index of Erectile Function (IIEF) questionnaire at follow-up visits commencing with the first posttreatment visit and specific attention was paid to the IIEF orgasm domain. Three hundred and sixty-four consecutive patients were included. Two hundred and fifty-two patients had external beam, and 112 patients had brachytherapy (BT). Mean age was 64 ± 11 (42-78) years and mean follow-up after RT was 6 ± 4.5 years. Mean prostate size at time of RT was 42 ± 21 g. Of the entire population, 72% lost the ability to ejaculate in an antegrade fashion after prostate RT by their last visit. The proportion experiencing anejaculation at 1, 3, and 5 years after RT was 16%, 69%, and 89%, respectively. For men with at least two IIEF questionnaires completed, the orgasm domain scores decreased dramatically over the follow-up period; orgasm domain scores (0-10): <12 months post-RT 7.4, 13-24 months 5.4, 25-36 months 3.2, >36 months 2.8 (P < 0.01). Multivariable analysis identified several factors predictive of failure to ejaculate: older age, ADT, RT dose > 100 Gy, and smaller prostates at the time of RT. The vast majority of men after prostate RT will experience anejaculation and should be

  1. Quality and freezing qualities of first and second ejaculates collected from endangered Gulf Coast Native rams.

    PubMed

    Nel-Themaat, L; Harding, G D; Chandler, J E; Chenevert, J F; Damiani, P; Fernandez, J M; Humes, P E; Pope, C E; Godke, R A

    2006-10-01

    The Gulf Coast Native sheep, or Louisiana Native sheep, is an endangered previously feral domestic sheep population of European origin that has been under natural selection pressure for reproductive survival in their transplanted range while roaming in the southern Gulf Coast Region of the United States. This sheep population has an increased natural resistance to internal parasites, breeds year-around and has a greater percentage of live lambs as compared with other breeds of sheep raised in similar environments. To preserve the genetic diversity of this important feral sheep population, semen was collected by electro-ejaculation and subjected to cryopreservation for subsequent storage in a genome resource bank. Unrelated rams (n=5) were collected 3 days-a-week, allowing at least 2 days of rest between collections. Two ejaculates were obtained from each ram per collection day, with the second collection conducted 10min after the first ejaculation. Semen was processed using the standard Salamon cryopreservation procedure in a Tris-yolk-glycerol extender, frozen in 0.5ml plastic straws using liquid nitrogen (LN(2)) vapor and stored in LN(2). Each ejaculate was evaluated for volume, sperm concentration/ml (x10(9)/ml), number of spermatozoa/ejaculate (x10(9)), sperm progressive motility (%) for pre-cooled semen, cooled semen and semen after thawing. For the five rams, each semen variable for the first ejaculate was compared with that of the second ejaculate collected 10min later. The mean semen volume, sperm concentration and number of spermatozoa per ejaculate obtained from the first ejaculate were significantly greater (P< or =0.01) than those of the second ejaculate (comparisons being 1.62 and 1.06; 3.2 and 1.5; 5.4 and 1.8, respectively). Overall, the mean motility of pre-cooled (22 degrees Celsius), cooled (5 degrees Celsius) and frozen (-196 degrees Celsius) post-thawed spermatozoa was less (P< or =0.01) in the first ejaculate (71.5, 64.8 and 34.1%, respectively

  2. Neural mechanisms of sexual behavior in the male rat: emphasis on ejaculation-related circuits.

    PubMed

    Veening, J G; Coolen, L M

    2014-06-01

    Sexual behavior of the male rat can be described as a 'sequence': a series of behavioral transitions eventually leading to a consummatory act: ejaculation. A 'funnel-model' is presented to describe the behavioral progression during the sexual sequence. The ejaculation itself is extensively controlled by the 'spinal ejaculation generator', consisting of several elements with afferent sources of genitosensory information, with ascending projection fibers to inform the brainstem and forebrain as well as with descending afferent fibers providing the supraspinal control mechanisms with the opportunity to restrict ejaculations to the optimal moments and circumstances. The messages ascending from the spinal cord reach several interconnected thalamic, hypothalamic and limbic brain areas and are integrated with olfactory information. These brain areas play a role in mechanisms like 'sexual satiety' or a temporary interruption of sexual activities (post-ejaculatory interval), but the exact facilitatory and inhibitory mechanisms involved have not been elucidated yet. In the 'downward' mechanisms controlling the spinal 'release' of an ejaculation, the medial preoptic nucleus plays an important role in cooperation with a number of brainstem areas. This nucleus is also explicitly involved in the rewarding experiences coming with an ejaculation. Finally, the role of several neurotransmitters and-peptides on male sexual behavior are discussed shortly, because sometimes they show remarkable effects on specific aspects of the behavioral sequence. We conclude that, despite our increased knowledge about the brain mechanisms involved in the control of ejaculation, we are still far away from a complete understanding and quite a few questions remain to be resolved.

  3. [Pharmacologic stimulation of ejaculation with midodrine hydrochloride (Gutron) for medically assisted reproduction in spinal injury].

    PubMed

    Staerman, F; Bryckaert, P E; Youinou, Y; Colin, J; Brandt, B; Lardennois, B

    2001-12-01

    Midodrine hydrochloride (Gutron) is proposed to induce ejaculation in spinal injury patients desiring paternity as an alternative to vibromassage, electrostimulated ejaculation and surgical collection of spermatozoa. The authors report their experience in 10 spinal injury patients. 14 trials of pharmacologically-induced ejaculation were performed in a context of medically assisted reproduction (MAR) in 10 spinal injury patients (7 with paraplegia > T11; 1 with paraplegia < or = T11; 2 with quadriplegia) an average of 4.5 years after the injury. Patients had a mean age of 28.5 years (range: 18 to 36 years). Nine had persistent reflex erections. After IC injection of prostglandin E, 10 to 30 mg of Gutron was administered by slow i.v. infusion. Spermatozoa were collected during antegrade ejaculation and/or in previously alkalinised urine. Ejaculation was obtained in 10 cases (71.4%), either antegrade (7 cases), or retrograde (3 cases). The 4 failures corresponded to ejaculation failure in 3 cases and adverse effects of Gutron (hypertension) in 1 case. However, storage of spermatozoa could be performed in only 4 cases (40%), as pyospermia or severe necrospermia were observed in 6 cases. Midodrine hydrochloride gives good results in terms of ejaculation in spinal injury patients. However, the quality of semen collected is often poor due to the long interval since the initial trauma. Midodrine hydrochloride, ideally used after antibiotic treatment, can nevertheless constitute an alternative to other techniques.

  4. Ejaculatory dysfunction in spinal cord injury men is suggestive of dyssynergic ejaculation.

    PubMed

    Soler, J M; Previnaire, J G

    2011-12-01

    Spinal cord injury (SCI) is associated with impaired ejaculation. After SCI, more stimuli may be required to trigger what remains of sexual reflexes. Penile vibratory stimulation (PVS) induces a strong afferent nerve stimulation and intense activation of the autonomic nervous system, and is considered first-line treatment. Oral midodrine may come as an adjunct to PVS and enhance the success rate. Electroejaculation (EEJ) is successful in most cases of failed PVS. The typical PVS semen characteristics in chronic SCI men demonstrate a normal mean total sperm count, but a low motility rate. Significantly lower sperm motility rates and total motile sperm counts are seen in EEJ compared to PVS. The coordination between external and internal sphincters is essential. In case of a supraconal lesion, a dyssynergic ejaculation may occur, with imbalance between expulsion of the ejaculatory fluid out the prostatic urethra and impaired relaxation of the urethral external sphincter. This leads to incomplete or absent antegrade ejaculation and would explain the high percentage of retrograde ejaculation and the low ejaculate volume observed in SCI men. In some cases, retrograde ejaculation could simply refer to a fraction of ejaculate present in the posterior urethra.

  5. Ejaculation and sperm characteristics in men with cauda equina and conus medullaris syndromes.

    PubMed

    Hadiji, N; Mieusset, R; Previnaire, J G; Castel-Lacanal, E; Soler, J M

    2017-06-01

    Retrospective. The objective of the study was to describe the type of ejaculation in patients with cauda equina (CE) and conus medullaris (CM) lesions, and to analyse sperm quality. France. One hundred sixty-six patients with CE and CM lesions were included. Diagnosis was based on clinical (no motor responses, sensation or sacral reflexes) and urodynamic assessments (no detrusor activity). Vibromassage (VM) was used to induce ejaculation according to the recommendations for patients with spinal cord injury. If ejaculation did not occur, oral midodrine was administered in progressive doses. Retrograde ejaculation was systematically sought. Sperm parameters were analysed according to World Health Organisation recommendations (2010). Eighty-nine patients were included. Eleven ejaculated on the first VM trial (four anterograde (AE), six retrograde (RE) and one antero-retrograde (ARE)). Five patients continued trials of VM alone, two of whom ejaculated following a mean 1.9 trials (one RE, one ARE). Twenty-six patients underwent trials of VM+ midodrine, 18 of whom ejaculated following a mean 4.4 trials with a mean dose of 22.5 g of midodrine (2 AE, 13 RE and 5 ARE). Fifty-three ejaculates from 26 patients were analysed. Sperm concentration was low in 90.6% of samples; total necrospermia was found in 65% and asthenospermia in 95% of samples. Ejaculation is difficult to induce using VM in patients with CE and CM lesions, and requires high doses of midodrine. Sperm counts were generally low, and asthenospermia and necrospermia were found in the majority of specimens. Cryopreservation of sperm should be systematic in case of medically assisted procreation.

  6. Ejaculate traits in the Namibian cheetah (Acinonyx jubatus): influence of age, season and captivity.

    PubMed

    Crosier, Adrienne E; Marker, Laurie; Howard, JoGayle; Pukazhenthi, Budhan S; Henghali, Josephine N; Wildt, David E

    2007-01-01

    The objective was to examine the influence of animal age, season and captivity status on seminal quality in wild-born cheetahs (Acinonyx jubatus) in Namibia, Africa. Animals were divided into three age categories: juvenile (14-24 months; n = 16 males, 23 ejaculates); adult (25-120 months; n = 76 males, 172 ejaculates); and aged (>120 months; n = 5 males, 5 ejaculates). Seasons were categorised into hot-wet (January-April), cold-dry (May-August) and hot-dry (September-December). A comparison between freshly wild-caught (n = 29 males, 41 ejaculates) and captive-held cheetahs (n = 68 males, 159 ejaculates) was also conducted. Raw ejaculates contained 69.0 +/- 1.1% motile spermatozoa (mean +/- s.e.m.) with 73.6 +/- 1.5% of these cells containing an intact acrosome. Overall, 18.4 +/- 0.9% of spermatozoa were morphologically normal, with midpiece anomalies being the most prevalent (approximately 39%) defect. Juvenile cheetahs produced ejaculates with poorer sperm motility, forward progressive status, lower seminal volume and fewer total motile spermatozoa than adult and aged animals. Spermatogenesis continued unabated throughout the year and was minimally influenced by season. Proportions of sperm malformations were also not affected by season. Ejaculates from captive cheetahs had increased volume and intact acrosomes, but lower sperm density than wild-caught counterparts. In summary, Namibian cheetahs produce an extraordinarily high proportion of pleiomorphic spermatozoa regardless of age, season or living (captive versus free-ranging) status. Young males less than 2 years of age produce poorer ejaculate quality than adult and aged males. Because (1) all study animals were wild born and (2) there was little difference between freshly caught males and those maintained in captivity for protracted periods, our results affirm that teratospermia in the cheetah is mostly genetically derived. It also appears that an ex situ environment for the Namibian cheetah can ensure sperm

  7. Intrauterine infection and prematurity.

    PubMed

    Gonçalves, Luís F; Chaiworapongsa, Tinnakorn; Romero, Roberto

    2002-01-01

    Intrauterine infection is a major cause of premature labor with and without intact membranes. Intrauterine infection is present in approximately 25% of all preterm births and the earlier the gestational age at delivery, the higher the frequency of intra-amniotic infection. Microorganisms may also gain access to the fetus before delivery. A fetal inflammatory response syndrome elicited in response to microbial products is associated with the impending onset of preterm labor and also with multi-systemic organ involvement in the human fetus and a higher rate of perinatal morbidity. The most common microorganisms involved in intrauterine infections are Ureaplasma urealyticum, Fusobacterium species and Mycoplasma hominis. The role of Chlamydia trachomatis and viruses in preterm labor remain to be determined. Use of molecular microbiology techniques to diagnose intrauterine infection may uncover the role of fastidious microorganisms that have not yet been discovered. Antibiotic administration to patients with asymptomatic bacteriuria is associated with a significant reduction in the rate of preterm birth. However, such benefit has not been demonstrated for patients with bacterial vaginosis, or women who carry Streptococcus agalactia, Ureaplasma urealyticum or Trichomonas vaginalis. Antibiotic administration to patients with preterm premature rupture of membranes is associated with prolongation of pregnancy and a reduction in the rate of clinical chorioamnionitis and neonatal sepsis. The benefit has not been demonstrated in patients with preterm labor and intact membranes. Major efforts are required to determine why some women develop an ascending intrauterine infection and others do not and also what interventions may reduce the deleterious effect of systemic fetal inflammation. Copyright 2002 Wiley-Liss, Inc.

  8. [Molecular identification of Ca2+ channels in human ejaculated sperm].

    PubMed

    Li, Lu; Liu, Ji-Hong; Li, Jia-Gui; Ye, Zhang-Qun; Wang, Xiu-Lai

    2006-10-01

    To identify the types of voltage-dependent Ca2+ channels (VDCCs) in human ejaculated sperm using molecular technology. Based on the WHO criteria, the donated semen was screened by computer-aided sperm analysis (CASA), the sperm optimized by swim-up method, and the VDCCs' alpha1 subunits examined by reverse transcription polymerase chain reaction (RT-PCR). Such mRNA messages as alpha1H, alpha1G, alpha1E, alpha1B and alpha1C were detected, but alpha1A and alpha1D were not. Human motile sperms express multiple VDCC RNAs, among which T-type and non-L-type channel messages are likely to be predominantly expressed. Not only T-type but also non-L-type calcium channels may be major gates for the external calcium influx, which helps regulate sperm motility and acrosome reaction.

  9. Sperm number trumps sperm size in mammalian ejaculate evolution

    PubMed Central

    Fitzpatrick, John L.

    2015-01-01

    Postcopulatory sexual selection is widely accepted to underlie the extraordinary diversification of sperm morphology. However, why does it favour longer sperm in some taxa but shorter in others? Two recent hypotheses addressing this discrepancy offered contradictory explanations. Under the sperm dilution hypothesis, selection via sperm density in the female reproductive tract favours more but smaller sperm in large, but the reverse in small, species. Conversely, the metabolic constraint hypothesis maintains that ejaculates respond positively to selection in small endothermic animals with high metabolic rates, whereas low metabolic rates constrain their evolution in large species. Here, we resolve this debate by capitalizing on the substantial variation in mammalian body size and reproductive physiology. Evolutionary responses shifted from sperm length to number with increasing mammalian body size, thus supporting the sperm dilution hypothesis. Our findings demonstrate that body-size-mediated trade-offs between sperm size and number can explain the extreme diversification in sperm phenotypes. PMID:26582027

  10. Zinner syndrome: an uncommon cause of painful ejaculation

    PubMed Central

    Sundar, Raghav; Sundar, Gaurav

    2015-01-01

    Zinner syndrome refers to the triad of ipsilateral renal agenesis, seminal vesicle cysts and ejaculatory duct obstruction. Ipsilateral renal agenesis may be associated with seminal vesicle cysts in 70% of cases, but a remnant ureteral bud has been shown to coexist in only 27% of these cases. While some patients may remain asymptomatic and are discovered incidentally, others present with symptoms related to seminal vesicle cysts or ejaculatory duct obstruction: voiding or ejaculatory difficulty or pain. The diagnosis is made with imaging findings, and differentiation from other pelvic cysts requires a multimodality approach. In this report, we present typical imaging findings of a patient who presented with painful ejaculation where there was a congenital seminal vesicle cyst with ipsilateral renal agenesis associated with a remnant ureteral bud draining into the seminal vesicle cyst and also associated with a cyst of the prostatic utricle. We discuss the relevant embryological basis for this unusual combination of findings. PMID:25750220

  11. Apnea of Prematurity (For Parents)

    MedlinePlus

    ... other babies. The apnea of prematurity does not cause brain damage. A healthy baby who is apnea free for a week will probably never have AOP again. Although sudden infant death syndrome (SIDS) does happen more often in premature infants, no relationship between AOP and SIDS has ...

  12. Can a Short Term of Repeated Ejaculations Affect Seminal Parameters?

    PubMed Central

    Mayorga-Torres, Jose Manuel; Agarwal, Ashok; Roychoudhury, Shubhadeep; Cadavid, Angela; Cardona-Maya, Walter Dario

    2016-01-01

    Background: The aim of the study was to assess the effect of four repeated ejaculations on the same day at two-hour intervals on conventional and functional semen parameters. Methods: Three healthy men (32±3.6 years) donated the first semen samples after 3–4 days of sexual abstinence followed by three subsequent samples on the same day at two-hour interval each. Semen samples were processed and analyzed according to the World Health Organization (WHO) 2010 guidelines. Furthermore, intracellular reactive oxygen (ROS) production, sperm DNA fragmentation and mitochondrial function were evaluated by flow cytometry. Results: An overall decreasing trend was noted in the conventional semen parameters at second, third and fourth evaluations after two hours of abstinence in comparison to first evaluation after 3–4 days of abstinence. The statistical comparison of the conventional semen parameters at fourth evaluation after 2 hr of abstinence revealed significant reduction (p<0.05) in the parameters of concentration, total sperm count and total motile sperm count at fourth evaluation. The functional parameter of intracellular ROS production showed a decreasing trend with each subsequent evaluation, the difference being significant (p<0.05) at fourth evaluation in comparison to first evaluation. An increasing trend was noted for DNA fragmentation index (DFI), although it remained within acceptable levels (<29%). The ΔΨm high permatozoa and the integrity of the plasma membrane remained stable throughout the evaluations. Conclusion: The findings of the present study indicate the potential use of additional semen samples with repeated ejaculations at short abstinence times in assisted reproduction procedures particularly from severe oligospermic men. PMID:27478772

  13. Delayed ejaculation and alexithymia: what is the relationship?

    PubMed Central

    Michetti, Paolo Maria; Eleuteri, Stefano; Giuliani, Marta; Rossi, Roberta; Simonelli, Chiara

    2013-01-01

    Delayed Ejaculation (DE) is probably the least studied and understood of the male sexual dysfunctions (MSD). There is still little unanimity concerning its psychological/interpersonal aetiology. Previous studies found that MSD are strongly related with alexithymia, a multifaceted personality construct that describes a disturbance in the regulation of emotions.The aim of this study was to investigate the presence of alexithymia in men with DE and correlate alexithymia levels with DE severity. According to specific features of the symptoms, we hypothesized that alexithymia would not be correlated with this specific sexual disorder. 54 outpatients with a diagnosis of DE assessed at the Institute of Clinical Sexology and the Urology Department of Sapienza, University in Rome were enrolled in the study. DE was diagnosed after a specialist examination and according to Diagnostic and Statistical Manual of Mental Disorders -IV-TR criteria. Participants were provided with the Toronto Alexithymia Scale (20 items; TAS-20), a self-measure of the Intravaginal Ejaculation Latency Time and an ad hoc questionnaire to collect anamnestic data. 9.3% of patients could be categorized as alexithymics, 9.3% of them as borderline, while 81.4% of the sample was found to be non-alexithymic. The overall average TAS-20 score was 45.46. Results show that alexithymia is correlated neither with the presence of DE nor with its severity, in contrast to other MSDs, where this condition was found in about 30% of patients. The data presented suggest that DE, although not correlated to alexithymia, is probably related to other psychogenic features such as hypercontrol configuration. This paper can contribute to the understanding of DE, by excluding one of the possible etiological factors, previously found to be important in the onset and the maintenance of the other MSDs. More studies are needed in order to better understand DE and provide recommendations about treatment. PMID:24627775

  14. Informal science education: lifelong, life-wide, life-deep.

    PubMed

    Sacco, Kalie; Falk, John H; Bell, James

    2014-11-01

    Informal Science Education: Lifelong, Life-Wide, Life-Deep Informal science education cultivates diverse opportunities for lifelong learning outside of formal K-16 classroom settings, from museums to online media, often with the help of practicing scientists.

  15. Educational Reform in Japan for Lifelong Learning

    ERIC Educational Resources Information Center

    Kawachi, Paul

    2008-01-01

    This report describes the current state of affairs and reform in Japan in 2007 of the theory, policy, and practice of lifelong education. As in most countries, Japan has been talking of decentralisation in government, of giving more local autonomy to communities and of promoting individuality in education. In line with these aims, the government…

  16. Lifelong Learning in Nepal: Contexts and Prospects

    ERIC Educational Resources Information Center

    Regmi, Kapil Dev

    2011-01-01

    Learning is a lifelong process. Many countries in the world, basically the European and Organization for Economic Cooperation and Development (OECD) countries, have adopted it as an important vehicle for human development. They have also made it a policy agenda for meeting the human capital need for twenty first century for economic prosperity.…

  17. Lifelong Learning: Workforce Development and Economic Success.

    ERIC Educational Resources Information Center

    Lee, Alice

    Lifelong learning through a strong, policy-supported information technology (IT) infrastructure is critical to the success of Asia Pacific Economic Cooperation (APEC) member economies. There is a great need to upgrade the quality of skills within the workforce, and there have been unprecedented investments in infrastructure and advanced…

  18. Lifelong Learning and the Limits of Tolerance

    ERIC Educational Resources Information Center

    Bagnall, Richard G.

    2006-01-01

    Lifelong education or learning theory is presented by its apologists as a universal normative ethic. That ethic may be understood as an aretaic ethic, embracing a number of ethical values or informed commitments and a teleology of optimising universal human flourishing through learning. In an effort to examine possible barriers to the universality…

  19. Elders' Lifelong Connection with the Natural Environment

    ERIC Educational Resources Information Center

    Carman, Jack

    2011-01-01

    Our interaction with nature does not end just because we age. People have a lifelong connection with the outdoor environment in varying degrees. For some, this participation may be subtle by simply watching others interact with the outdoor environment. For others, there is a deeper connection with nature through gardening, birding, exercise,…

  20. Lifelong Learning within HE in The Netherlands

    ERIC Educational Resources Information Center

    van den Dungen, Marja

    2009-01-01

    This article focuses on work-based learning in higher vocational education and training in relation to lifelong learning. It begins with an overview of the Dutch National Policy and the ambitions of a national Project Directorate Learning & Working. It then goes on to the concrete results of projects within higher education (HE) aimed at the…

  1. Flexible Querying of Lifelong Learner Metadata

    ERIC Educational Resources Information Center

    Poulovassilis, A.; Selmer, P.; Wood, P. T.

    2012-01-01

    This paper discusses the provision of flexible querying facilities over heterogeneous data arising from lifelong learners' educational and work experiences. A key aim of such querying facilities is to allow learners to identify possible choices for their future learning and professional development by seeing what others have done. We motivate and…

  2. The Philosophical Roots of Lifelong Learning.

    ERIC Educational Resources Information Center

    Lewis, Rosa B.

    The philosophical roots of the concept of lifelong learning are considered in relation to the views of Socrates, Plato, and Aristotle. They pioneered in their analyses of intellectual development and in the importance of the use of the mind throughout the life span. Plato and Aristotle added metaphysical arguments to support their systems of…

  3. Designing Instruction to Improve Lifelong Inquiry Learning

    ERIC Educational Resources Information Center

    Lin, Marcia C.; Eylon, Bat-Sheva; Rafferty, Anna; Vitale, Jonathan M.

    2015-01-01

    Citizens need the capability to conduct their own inquiry projects so that they can make sense of claims about new energy policies, health remedies, or financial opportunities. To develop the lifelong capability to grapple with these dilemmas, we report on ways to design precollege units that engage students in realistic, personally relevant…

  4. The Waikiki Lifelong Learning Center. Final Report.

    ERIC Educational Resources Information Center

    Ching, Noelani; Mahuka, Ruth

    The Waikiki Lifelong Learning Center (WLLC) project was undertaken to establish a literacy consortium of visitor industry businesses and the University of Hawaii at Manoa and to develop/implement an instructional program that included bilingual/English-as-a-second language (ESL) and General Educational Development (GED)/pre-GED components. After…

  5. Students' Plans for Lifelong Learning and Teaching

    ERIC Educational Resources Information Center

    Plavšic, Marlena; Dikovic, Marina

    2015-01-01

    One of the roles of higher education is to prepare and encourage students for lifelong learning. However, no evidence can be found about students' plans for further learning and teaching related to formal, non-formal and informal context. The purpose of this study was to explore these students' plans in relation to their study group, level of…

  6. Promoting Lifelong Learning through Education Partnership.

    ERIC Educational Resources Information Center

    Berkeley, John

    1998-01-01

    The Rover Group, a British auto manufacturer, supports work-related curriculum through partnership centers at its major plants and school-based facilities, annual awards, and learning agreements for students in work experience programs. Quality, long-term commitment, and promotion of lifelong learning remain relevant but elusive goals. (SK)

  7. Lifelong Learning for the Global Networked Society.

    ERIC Educational Resources Information Center

    Guest, Graham

    Professionals have normally become qualified through a period of formal education followed by a structured training program and continuing professional development. This traditional pattern is being replaced with a process of lifelong learning that, thanks to the development and application of a wide range of information and communication…

  8. Changing Lives through Lifelong Learning Accounts

    ERIC Educational Resources Information Center

    Council for Adult and Experiential Learning (NJ1), 2007

    2007-01-01

    As conceived by the Council for Adult and Experiential Learning (CAEL), Lifelong Learning Accounts (LiLAs[SM]) are employer-matched, portable individual accounts used to finance employee education and training. They provide employees with an affordable means of upgrading their skills and knowledge, while helping to meet the needs of employers and…

  9. Credit for Lifelong Learning. Fourth Edition.

    ERIC Educational Resources Information Center

    Mann, Carolyn M.

    This guide to developing a prior learning portfolio was prepared to assist students in the Credit for Lifelong Learning Program (CLLP) at Sinclair Community College (SCC) in Dayton, Ohio, through the process of identifying college-level prior learning, matching their learning to specific courses, and articulating and documenting their learning.…

  10. European Year of Lifelong Learning 1996.

    ERIC Educational Resources Information Center

    Commission of the European Communities, Brussels (Belgium). Directorate-General for Education, Training, and Youth.

    This publication provides glimpses of how different individuals and organizations have responded to the spirit of lifelong learning during the European Year. Each case study consists of the project's location, name, and objective and brief description. They include the following: Chapito Project, Lisbon, Portugal; Ligerius Project, a…

  11. Visual Imagery, Lifecourse Structure and Lifelong Learning

    ERIC Educational Resources Information Center

    Schuller, Tom

    2004-01-01

    Imagery could add an extra dimension to analyses of lifelong learning, which need to draw on diverse sources and techniques. This article has two principal components. First I suggest that the use of images might be divided into three categories: as illustration; as evidence; and as heuristic. I go on to explore the latter two categories, first by…

  12. Life-Long Education in Israel.

    ERIC Educational Resources Information Center

    Yaron, Kalman, Ed.

    The essays in this collection describe some of the main aspects--theories, programs and practices--of adult education in Israel. The 22 essays are: "Problems and Objectives of Adult Education," by Elad Peled; "The Principle of Dialogue in Education," by Martin Buber; "The Jewish Tradition of Life-long Learning," by…

  13. Virtual Reality for Training and Lifelong Learning

    ERIC Educational Resources Information Center

    Mellet-d'Huart, Daniel

    2009-01-01

    This article covers the application of virtual reality (VR) to training and lifelong learning. A number of considerations concerning the design of VR applications are included. The introduction is dedicated to the more general aspects of applying VR to training. From multiple perspectives, we will provide an overview of existing applications with…

  14. Life-Long Education in Israel.

    ERIC Educational Resources Information Center

    Yaron, Kalman, Ed.

    The essays in this collection describe some of the main aspects--theories, programs and practices--of adult education in Israel. The 22 essays are: "Problems and Objectives of Adult Education," by Elad Peled; "The Principle of Dialogue in Education," by Martin Buber; "The Jewish Tradition of Life-long Learning," by…

  15. Designing Instruction to Improve Lifelong Inquiry Learning

    ERIC Educational Resources Information Center

    Lin, Marcia C.; Eylon, Bat-Sheva; Rafferty, Anna; Vitale, Jonathan M.

    2015-01-01

    Citizens need the capability to conduct their own inquiry projects so that they can make sense of claims about new energy policies, health remedies, or financial opportunities. To develop the lifelong capability to grapple with these dilemmas, we report on ways to design precollege units that engage students in realistic, personally relevant…

  16. Elders' Lifelong Connection with the Natural Environment

    ERIC Educational Resources Information Center

    Carman, Jack

    2011-01-01

    Our interaction with nature does not end just because we age. People have a lifelong connection with the outdoor environment in varying degrees. For some, this participation may be subtle by simply watching others interact with the outdoor environment. For others, there is a deeper connection with nature through gardening, birding, exercise,…

  17. Visual Imagery, Lifecourse Structure and Lifelong Learning

    ERIC Educational Resources Information Center

    Schuller, Tom

    2004-01-01

    Imagery could add an extra dimension to analyses of lifelong learning, which need to draw on diverse sources and techniques. This article has two principal components. First I suggest that the use of images might be divided into three categories: as illustration; as evidence; and as heuristic. I go on to explore the latter two categories, first by…

  18. The Double-Dialectic and Lifelong Learning

    ERIC Educational Resources Information Center

    Parkinson, David

    2004-01-01

    This paper was provoked by Ted Bailey's article, 'Analogy, dialectics and lifelong learning' which appeared in the March-April 2003 edition of this journal. Dr. Bailey argued that students can be enabled to learn the key concepts of the subjects they are studying through the dialectical operation of analogy which makes new knowledge accessible by…

  19. Lifelong Learning and the Limits of Tolerance

    ERIC Educational Resources Information Center

    Bagnall, Richard G.

    2006-01-01

    Lifelong education or learning theory is presented by its apologists as a universal normative ethic. That ethic may be understood as an aretaic ethic, embracing a number of ethical values or informed commitments and a teleology of optimising universal human flourishing through learning. In an effort to examine possible barriers to the universality…

  20. Lifelong Learning in Higher Education. Third Edition.

    ERIC Educational Resources Information Center

    Knapper, Christopher K.; Cropley, Arthur J.

    This book, which is intended for academics, educators, educational managers, and policymakers concerned with higher education, examines how universities and colleges can prepare their students for lifelong learning through continuing education, specialized courses for adults, and mainstream teaching programs geared toward traditional students. The…

  1. The Philosophical Foundations of Lifelong Learning.

    ERIC Educational Resources Information Center

    Michopoulos, Aristotle

    The current lifelong learning movement, the new force toward global education, owes much to the League of Nations and the United Nations that sponsored an expanded multiracial "polis." Its philosophical foundations go back, however, to ancient China, India, and especially Greece, where philosophers and scientists got their creative…

  2. The Cognitive Constraints of Lifelong Learning.

    ERIC Educational Resources Information Center

    Morais, Jose; Kolinsky, Regine

    1996-01-01

    Acquisition of linguistic and perceptual abilities takes place at a very early age, and later learning involves knowledge and information processing strategies. Aging has greater impact on retention of the latter. Lifelong learning must accommodate the constraints of aging on cognitive abilities. (SK)

  3. Lifelong Learning as Being: The Heideggerian Perspective

    ERIC Educational Resources Information Center

    Su, Ya-hui

    2011-01-01

    This article contends that the development of lifelong learning needs to be grounded within the framework of "being," a concept inspired by Heidegger, rather than within the framework of "having." This article also describes the problems of the adult education literature, which favors the pragmatic sense of being and, thus, may undertheorize the…

  4. European Year of Lifelong Learning 1996.

    ERIC Educational Resources Information Center

    Commission of the European Communities, Brussels (Belgium). Directorate-General for Education, Training, and Youth.

    This publication provides glimpses of how different individuals and organizations have responded to the spirit of lifelong learning during the European Year. Each case study consists of the project's location, name, and objective and brief description. They include the following: Chapito Project, Lisbon, Portugal; Ligerius Project, a…

  5. Lifelong Learning as Being: The Heideggerian Perspective

    ERIC Educational Resources Information Center

    Su, Ya-hui

    2011-01-01

    This article contends that the development of lifelong learning needs to be grounded within the framework of "being," a concept inspired by Heidegger, rather than within the framework of "having." This article also describes the problems of the adult education literature, which favors the pragmatic sense of being and, thus, may undertheorize the…

  6. Educational Reform in Japan for Lifelong Learning

    ERIC Educational Resources Information Center

    Kawachi, Paul

    2008-01-01

    This report describes the current state of affairs and reform in Japan in 2007 of the theory, policy, and practice of lifelong education. As in most countries, Japan has been talking of decentralisation in government, of giving more local autonomy to communities and of promoting individuality in education. In line with these aims, the government…

  7. Assessing physicians' orientation toward lifelong learning.

    PubMed

    Hojat, Mohammadreza; Veloski, Jon; Nasca, Thomas J; Erdmann, James B; Gonnella, Joseph S

    2006-09-01

    Despite the importance of lifelong learning as an element of professionalism, no psychometrically sound instrument is available for its assessment among physicians. To assess the validity and reliability of an instrument developed to measure physicians' orientation toward lifelong learning. Mail survey. Seven hundred and twenty-one physicians, of whom 444 (62%) responded. The Jefferson Scale of Physician Lifelong Learning (JSPLL), which includes 19 items answered on a 4-point Likert scale, was used with additional questions about respondents' professional activities related to continuous learning. Factor analysis of the JSPLL yielded 4 subscales entitled: "professional learning beliefs and motivation,"scholarly activities,"attention to learning opportunities," and "technical skills in seeking information," which are consistent with widely recognized features of lifelong learning. The validity of the scale and its subscales was supported by significant correlations with a set of criterion measures that presumably require continuous learning. The internal consistency reliability (coefficient alpha) of the JSPLL was 0.89, and the test-retest reliability was 0.91. Empirical evidence supports the validity and reliability of the JSPLL.

  8. Assessing Physicians' Orientation Toward Lifelong Learning

    PubMed Central

    Hojat, Mohammadreza; Veloski, Jon; Nasca, Thomas J; Erdmann, James B; Gonnella, Joseph S

    2006-01-01

    BACKGROUND Despite the importance of lifelong learning as an element of professionalism, no psychometrically sound instrument is available for its assessment among physicians. OBJECTIVE To assess the validity and reliability of an instrument developed to measure physicians' orientation toward lifelong learning. DESIGN Mail survey. PARTICIPANTS Seven hundred and twenty-one physicians, of whom 444 (62%) responded. MEASUREMENT The Jefferson Scale of Physician Lifelong Learning (JSPLL), which includes 19 items answered on a 4-point Likert scale, was used with additional questions about respondents' professional activities related to continuous learning. RESULTS Factor analysis of the JSPLL yielded 4 subscales entitled: “professional learning beliefs and motivation,”“scholarly activities,”“attention to learning opportunities,” and “technical skills in seeking information,” which are consistent with widely recognized features of lifelong learning. The validity of the scale and its subscales was supported by significant correlations with a set of criterion measures that presumably require continuous learning. The internal consistency reliability (coefficient α) of the JSPLL was 0.89, and the test-retest reliability was 0.91. CONCLUSIONS Empirical evidence supports the validity and reliability of the JSPLL. PMID:16918737

  9. Can Lifelong Learning Reshape Life Chances?

    ERIC Educational Resources Information Center

    Evans, Karen; Schoon, Ingrid; Weale, Martin

    2013-01-01

    Despite the expansion of post-school education and incentives to participate in lifelong learning, institutions and labour markets continue to interlock in shaping life chances according to starting social position, family and private resources. The dominant view that the economic and social returns to public investment in adult learning are too…

  10. Lifelong Learning for the 21st Century.

    ERIC Educational Resources Information Center

    Goodnight, Ron

    The Lifelong Learning Center for the 21st Century was proposed to provide personal renewal and technical training for employees at a major United States automotive manufacturing company when it implemented a new, computer-based Computer Numerical Controlled (CNC) machining, robotics, and high technology facility. The employees needed training for…

  11. Wise Up. The Challenge of Lifelong Learning.

    ERIC Educational Resources Information Center

    Claxton, Guy

    This book on lifelong learning has two overarching themes: the three Rs of learning power (resilience, resourcefulness, and reflectiveness) and a good learner's toolkit of learning strategies. An introduction previews the main conclusions. Chapter 1 explains how different communities can hold different beliefs about learning. Chapter 2 explores…

  12. Lifelong Learning: Thematic Bibliography. 2nd Edition.

    ERIC Educational Resources Information Center

    EURYDICE European Unit, Brussels (Belgium).

    This seventh publication in the Eurydice European Unit series of thematic bibliographies draws attention to a selection of publications on the topic of lifelong learning. This annotated bibliography lists 268 books, articles, publications, and reports that have appeared since 1994. Some earlier items of published literature of special historical…

  13. Lifelong Learning and Leadership. IDRA Focus.

    ERIC Educational Resources Information Center

    IDRA Newsletter, 1996

    1996-01-01

    This theme issue focuses on programs that promote lifelong learning through literacy education, parent empowerment, or parent leadership training. "Adult Literacy Outreach Innovations: Porque Significa Tanto" (Christie L. Goodman) describes a Texas outreach project that focuses on raising public awareness about adult education and…

  14. Flexible Studies as Strategy for Lifelong Learning

    ERIC Educational Resources Information Center

    Bugge, Liv Susanne; Wikan, Gerd

    2016-01-01

    Many countries face a challenge in recruiting teachers. At the same time, the labour market is changing and the demand for re-education is increasing. In this situation, lifelong learning is seen as relevant and higher education institutions are asked to offer flexible and decentralised study programmes in order to accommodate the need for formal…

  15. Can Lifelong Learning Reshape Life Chances?

    ERIC Educational Resources Information Center

    Evans, Karen; Schoon, Ingrid; Weale, Martin

    2013-01-01

    Despite the expansion of post-school education and incentives to participate in lifelong learning, institutions and labour markets continue to interlock in shaping life chances according to starting social position, family and private resources. The dominant view that the economic and social returns to public investment in adult learning are too…

  16. Determining the Value of Lifelong Learning.

    ERIC Educational Resources Information Center

    Parrott, Allen

    2002-01-01

    In contemporary educational discourse, value in relation to lifelong learning can mean a moral/ethical concept, economic or monetary value, or mathematical or numerical value. "Added value" is devoid of ethical/moral meaning; it encourages a view of learning that is purely technical. (SK)

  17. Lifelong Learning Strategies and Practice in Latvia and Thailand

    ERIC Educational Resources Information Center

    Luka, Ineta; Sungsri, Sumalee

    2015-01-01

    The importance of lifelong learning has been recognized for many years and consequently many countries, disregarding their geographical location, differences in education systems and traditions, have adopted their lifelong learning policies to develop the lifelong learning system. The goal of the present comparative research is to study the…

  18. Towards an Integrated Approach for Research on Lifelong Learning

    ERIC Educational Resources Information Center

    van Merrienboer, Jeroen J. G.; Kirschner, Paul A.; Paas, Fred; Sloep, Peter B.; J. Caniels, Marjolein C.

    2009-01-01

    There is little dispute that lifelong learning is essential to the further development of the knowledge society. Nonetheless, lifelong learning is not reaching its full potential because the currently used approaches to lifelong learning are too fragmented and, often, formal approaches to education and learning are simply "translated" from initial…

  19. Lifelong Learning: An Instrument for Improving School Education in Japan?

    ERIC Educational Resources Information Center

    Sawano, Yukiko

    Although Japanese society has long valued and practiced lifelong learning, it has not yet been successful in building an ethic that prizes learning, teaches creativity, and includes everyone. Bureaucratic and legal mechanisms undertaken in Japan to promote lifelong learning have included the establishment of Lifelong Learning Councils, a system…

  20. Lifelong Learning Strategies and Practice in Latvia and Thailand

    ERIC Educational Resources Information Center

    Luka, Ineta; Sungsri, Sumalee

    2015-01-01

    The importance of lifelong learning has been recognized for many years and consequently many countries, disregarding their geographical location, differences in education systems and traditions, have adopted their lifelong learning policies to develop the lifelong learning system. The goal of the present comparative research is to study the…

  1. Articulation and Transfer: Critical Contributions to Lifelong Learning -- Discussion Supplement.

    ERIC Educational Resources Information Center

    Kintzer, Frederick C.

    This document is a discussion supplement to Frederick Kintzer's paper in the book: "Lifelong Learning: Policies, Practices and Programs." It is designed as a contribution to the third discussion session: Participation Issues and Lifelong Learning. The introduction provides definitions and a description of the rise of lifelong learning…

  2. Blood pressure changes during sexual stimulation, ejaculation and midodrine treatment in men with spinal cord injury.

    PubMed

    Courtois, Frédérique J; Charvier, Kathleen F; Leriche, Albert; Vézina, Jean-Guy; Côté, Magalie; Bélanger, Marc

    2008-02-01

    To explore the effectiveness of various sources of self-stimulation, including oral midodrine, in triggering ejaculation in men with spinal cord injury (SCI), and to document the systematic variations in blood pressure at ejaculation and consider a revised definition of autonomic dysreflexia. The study included 62 men with SCI lesions from C2 to L2. Ejaculation potential was assessed with various sources of stimulation, beginning with natural stimulation, followed, if the test was negative, by penile vibrator stimulation (PVS) followed, if the test was again negative, by PVS combined with oral midodrine, started at 5 mg and increased in 5 mg steps up to 25 mg. The success rate of ejaculation was recorded, as were blood pressure (BP) changes measured at baseline and at ejaculation (or on the last trial if the test was negative). Reported sensations were also recorded and compared during positive and negative tests. Overall, 89% of the patients reached ejaculation with one mode or another of stimulation. When patients had a negative result with natural stimulation, 56% were salvaged by PVS, and when PVS was negative, another 22% were salvaged by midodrine combined with PVS. The mean systolic BP increased by 35 mmHg at ejaculation during PVS and by 11 mmHg after midodrine, and a subsequent 29 mmHg at ejaculation during PVS combined with midodrine. By contrast, negative tests showed a relatively stable BP; the difference in changes in BP during positive and negative tests was significant (P < 0.01). Increases in BP during positive tests declined significantly more often within the limits of autonomic dysreflexia than negative tests (P < 0.01). These results support the view that most men with SCI can obtain an ejaculation when a wide spectrum of stimulation is used, including natural stimulation, PVS, and PVS combined with oral midodrine. Positive tests were associated with significant increases in BP, in contrast to negative tests, where BP was relatively stable. This

  3. [Ejaculation capacity in spinal cord injured patients carrying an endo-urethral stent for incontinentation: Descriptive study].

    PubMed

    Tamarelle, B; Charvier, K; Del Aguila, C; Courtois, F; Rode, G; Ruffion, A

    2015-06-01

    To assess the impact of endo-urethral stent (EUP) of incontinentation in spinal cord injured (SCI) men on ejaculation capacity. Presence of ejaculation after EUP. Modification on ejaculation type, stimulation mode, possibility of sperm conservation in the same population. A descriptive monocentric study including SCI subjects which underwent placement or change of temporary (Mémokath™ or Allium™) or definitive (Mémotherm™) EUP between January 2004 and January 2014 with at least one ejaculatory test. Are identified for each patient: the presence of ejaculation, type of ejaculation, stimulation mode used, number of frozen specimen and results from semen analysis. Over 11 men with tetraplegia, complete for motricity, there were 8 (72%) for whom ejaculation was possible after laying EUP. Of these, 6 (55%) had an antegrade or antero-retrograde ejaculation. It was not possible to make a freezing straw in four of them due to infection of semen (2) or terato-oligo-astenospermia (1) or absence of reproductive project (1). In this small sample, it was found that over 70% ejaculation have been preserved after laying EUP and more than 50% with antegrade or antero-retrograde ejaculation. A larger study would identify how EUP may alter the ejaculatory capacity or quality of the ejaculate. 4. Copyright © 2015 Elsevier Masson SAS. All rights reserved.

  4. Outcome of retinopathy of prematurity.

    PubMed

    Holmström, Gerd; Larsson, Eva

    2013-06-01

    In prematurely born children, various visual and ophthalmologic sequelae occur because of both retinopathy of prematurity (ROP) and preterm birth per se. Several long-term follow-up studies have described the outcome of ROP. Visual impairment and blindness are well-known consequences, but the prevalence varies globally because of differing neonatal and ophthalmologic care. Improving treatment options and criteria for the treatment of ROP are continuously changing the ophthalmologic outcome. The anatomic outcome has improved with treatment, but good anatomic outcome in treated severe ROP does not always reflect the functional outcome. There is no consensus regarding long-term follow-up of prematurely born children.

  5. Ejaculate components delay reproductive senescence while elevating female reproductive rate in an insect

    PubMed Central

    Reinhardt, Klaus; Naylor, Richard A.; Siva-Jothy, Michael T.

    2009-01-01

    Increased female reproductive rates usually result in accelerated senescence. This correlation provides a link between the evolutionary conflict of the sexes and aging when ejaculate components elevate female reproductive rates at the cost of future reproduction. It is not clear whether this female cost is manifest as shorter lifespan or an earlier onset or a steeper rate of reproductive senescence. It also is unclear whether beneficial ejaculates release females from reproductive trade-offs and, if so, which senescence parameters are affected. We examined these issues in the bedbug, Cimex lectularius, a long-lived insect that shows reduced female lifespan as well as female reproductive senescence at the male-determined mating frequency. We demonstrate experimentally that, independently of the mating frequency, females receiving more ejaculate show increased reproductive rates and enter reproductive senescence later than females receiving less ejaculate. The rate of reproductive senescence did not differ between treatments, and reproductive rates did not predict mortality. The ejaculate effects were consistent in inter- and intra-population crosses, suggesting they have not evolved recently and are not caused by inbreeding. Our results suggest that ejaculate components compensate for the costs of elevated female reproductive rates in bedbugs by delaying the onset of reproductive senescence. Ejaculate components that are beneficial to polyandrous females could have arisen because male traits that protect the ejaculate have positive pleiotropic effects and/or because female counteradaptations to antagonistic male traits exceed the neutralization of those traits. That males influence female reproductive senescence has important consequences for trade-offs between reproduction and longevity and for studies of somatic senescence. PMID:19996174

  6. Within-population variation in ejaculate characteristics in a prolonged breeder, Peron's tree frog, Litoria peronii

    NASA Astrophysics Data System (ADS)

    Sherman, Craig D. H.; Uller, Tobias; Wapstra, Erik; Olsson, Mats

    2008-11-01

    Sperm number is often a good predictor of success in sperm competition; however, it has become increasingly clear that, for some species, variation in probability of paternity cannot be explained by sperm number alone. Intraspecific variation in ejaculate characteristics, such as the number of viable sperm and sperm longevity, may play an equally important role in determining fertilization success. Here, we assess variation among ejaculates in three factors that may contribute to fertilization success (number of sperm per ejaculate, viability, and longevity), in a population of Peron’s tree frog ( Litoria peronii). We detected large variation among males in the number of sperm per ejaculate and the proportion of viable sperm within ejaculates, which could not be explained by variation in either male size or body condition. However, the proportion of viable sperm released by males increased over the season. Finally, we assessed sperm longevity (proportion viable sperm determined using a dual-fluorochrome vital dye) at two different temperatures. At 23°C, on average, 75% of sperm remained viable after 2 h, but there were significant differences amongst males with the percentage of viable sperm ranging from 43% to 95%. For sperm incubated at 4°C, ejaculates varied fivefold in sperm longevity with some males having 50% viable sperm after 5 days. Our data suggest that ejaculate characteristics (sperm number, viability, and longevity) vary widely in Peron’s tree frog and may therefore play an important role in determining siring success both in the presence and absence of sperm competition. We discuss the results in relation to selection on ejaculate traits via natural and sexual selection in this and other amphibians.

  7. Within-population variation in ejaculate characteristics in a prolonged breeder, Peron's tree frog, Litoria peronii.

    PubMed

    Sherman, Craig D H; Uller, Tobias; Wapstra, Erik; Olsson, Mats

    2008-11-01

    Sperm number is often a good predictor of success in sperm competition; however, it has become increasingly clear that, for some species, variation in probability of paternity cannot be explained by sperm number alone. Intraspecific variation in ejaculate characteristics, such as the number of viable sperm and sperm longevity, may play an equally important role in determining fertilization success. Here, we assess variation among ejaculates in three factors that may contribute to fertilization success (number of sperm per ejaculate, viability, and longevity), in a population of Peron's tree frog (Litoria peronii). We detected large variation among males in the number of sperm per ejaculate and the proportion of viable sperm within ejaculates, which could not be explained by variation in either male size or body condition. However, the proportion of viable sperm released by males increased over the season. Finally, we assessed sperm longevity (proportion viable sperm determined using a dual-fluorochrome vital dye) at two different temperatures. At 23 degrees C, on average, 75% of sperm remained viable after 2 h, but there were significant differences amongst males with the percentage of viable sperm ranging from 43% to 95%. For sperm incubated at 4 degrees C, ejaculates varied fivefold in sperm longevity with some males having 50% viable sperm after 5 days. Our data suggest that ejaculate characteristics (sperm number, viability, and longevity) vary widely in Peron's tree frog and may therefore play an important role in determining siring success both in the presence and absence of sperm competition. We discuss the results in relation to selection on ejaculate traits via natural and sexual selection in this and other amphibians.

  8. Copulation and ejaculation in male rats under sexual satiety and the Coolidge effect.

    PubMed

    Tlachi-López, José L; Eguibar, Jose R; Fernández-Guasti, Alonso; Lucio, Rosa Angélica

    2012-07-16

    Sexually satiated males cease copulating after several ejaculations with the same female; and the presence of an unknown receptive female renews copulation including ejaculation, a process named the Coolidge effect. It is believed that the Coolidge effect has the aim to impregnate another female, although it is known that the sperm count gradually decreases after consecutive ejaculations. The main goal was to investigate if sexually satiated males during the Coolidge effect can reestablish seminal expulsion associated to the ejaculation behavior and/or penile erection associated to the intromission behavior. The results show that during the Coolidge effect, most of the sexually satiated males showed the motor ejaculatory behavior, however, no sperm in the uterine horns or seminal plug in the vagina were detected. Such lack of sperm was not related with the number of ejaculations required to achieve sexual satiety nor with the number of intromissions needed for ejaculating (experiment 1: 2.4.1.). After the behavioral ejaculation, during the Coolidge effect, there was a 44% decrease in sperm count in the epididymal caudae (experiment 1: 2.4.2.). Males that mated for 8 behavioral ejaculations (close to sexual satiety) deposited tiny seminal plugs but no sperm in the female reproductive tract (experiment 1: 2.4.3.). Interestingly, sexually satiated and non-satiated-animals displayed similar number of intromissions and spent a similar time in dislodging the seminal plug from the vagina deposited by other males (experiment 2). These results suggest that sexually satiated males during the Coolidge effect have the capacity for penile erection and vaginal insertion, because they are able to dislodge seminal plugs; but are unable to expel seminal fluid, because neither form seminal plugs nor deposit sperm in the female genital tract. Copyright © 2012 Elsevier Inc. All rights reserved.

  9. Multiple effects of sibutramine on ejaculation and on vas deferens and seminal vesicle contractility

    SciTech Connect

    Nojimoto, Fernanda D.; Piffer, Renata C.; Kiguti, Luiz Ricardo de A.; Lameu, Claudiana; Camargo, Antonio C.M. de; Pupo, Andre S.

    2009-09-15

    Sibutramine is an inhibitor of norepinephrine and 5-HT reuptake largely used in the management of obesity. Although a fairly safe drug, postmarketing adverse effects of sibutramine were reported including abnormal ejaculation in men. This study investigates the effects of sibutramine on ejaculation and vas deferens and seminal vesicle contractility. Adult male rats received sibutramine (5; 20; or 50 mg kg{sup -1}, ip) and after 60 min were exposed to receptive females for determination of ejaculation parameters. The vasa deferentia and seminal vesicles of untreated rats were mounted in isolated organ baths for recording of isometric contractions and HEK293 cells loaded with fluorescent calcium indicator were used to measure intracellular Ca{sup 2+} transients. Sibutramine 5 and 20 mg kg{sup -1} reduced ejaculation latency whereas 50 mg kg{sup -1} increased ejaculation latency. Sibutramine 3 to 30 {mu}M greatly increased the sensitivity of the seminal vesicle and vas deferens to norepinephrine, but at concentrations higher than 10 {mu}M there were striking depressions of maximal contractions induced by norepinephrine, carbachol and CaCl{sub 2}. In HEK293 cells, sibutramine 10 to 100 {mu}M inhibited intracellular Ca{sup 2+} transients induced by carbachol. Depending on the doses, sibutramine either facilitates or inhibits ejaculation. Apart from its actions in the central nervous system, facilitation of ejaculation may result from augmented sensitivity of smooth muscles to norepinephrine while reductions of intracellular Ca{sup 2+} may be involved in the delayed ejaculation observed with high doses of sibutramine.

  10. Ejaculate components delay reproductive senescence while elevating female reproductive rate in an insect.

    PubMed

    Reinhardt, Klaus; Naylor, Richard A; Siva-Jothy, Michael T

    2009-12-22

    Increased female reproductive rates usually result in accelerated senescence. This correlation provides a link between the evolutionary conflict of the sexes and aging when ejaculate components elevate female reproductive rates at the cost of future reproduction. It is not clear whether this female cost is manifest as shorter lifespan or an earlier onset or a steeper rate of reproductive senescence. It also is unclear whether beneficial ejaculates release females from reproductive trade-offs and, if so, which senescence parameters are affected. We examined these issues in the bedbug, Cimex lectularius, a long-lived insect that shows reduced female lifespan as well as female reproductive senescence at the male-determined mating frequency. We demonstrate experimentally that, independently of the mating frequency, females receiving more ejaculate show increased reproductive rates and enter reproductive senescence later than females receiving less ejaculate. The rate of reproductive senescence did not differ between treatments, and reproductive rates did not predict mortality. The ejaculate effects were consistent in inter- and intra-population crosses, suggesting they have not evolved recently and are not caused by inbreeding. Our results suggest that ejaculate components compensate for the costs of elevated female reproductive rates in bedbugs by delaying the onset of reproductive senescence. Ejaculate components that are beneficial to polyandrous females could have arisen because male traits that protect the ejaculate have positive pleiotropic effects and/or because female counteradaptations to antagonistic male traits exceed the neutralization of those traits. That males influence female reproductive senescence has important consequences for trade-offs between reproduction and longevity and for studies of somatic senescence.

  11. The effect of electro-ejaculation on aversive behaviour and plasma cortisol concentration in rams.

    PubMed

    Stafford, K J; Spoorenberg, J; West, D M; Vermunt, J J; Petrie, N; Lawoko, C R

    1996-06-01

    Electro-ejaculation is used in rams to collect semen for fertility and bacteriological evaluation. Concern has been expressed about animal welfare implications of EE. Two experiments were carried out to compare the aversiveness of electro-ejaculation, part shearing and free movement, and to determine the changes in plasma cortisol concentration produced by electro-ejaculation, shearing and lateral restraint. In the aversion test, transit time was greater (p<0.003) for rams subjected to part shearing than free movement. There were no major differences in the transit time between the rams subjected to electro-ejaculation and those subjected to part shearing or free movement. In addition, there was no significant difference in the effort required to move rams from the three treatment groups into or through the experimental route. These results suggest that electro-ejaculation is no more aversive than part shearing. There were no significant differences in the cortisol response of the rams subjected to electro-ejaculation, shearing or lateral restraint, indicating that there were no significant differences in the distress caused by the three procedures.

  12. Sperm competition, mating rate and the evolution of testis and ejaculate sizes: a population model

    PubMed Central

    Parker, G.A; Ball, M.A

    2005-01-01

    There are various ways to estimate ejaculate expenditure. Ejaculate size or sperm number (s) is an absolute number of units of ejaculate. Relative ejaculate expenditure (E) is the expenditure on the ejaculate as the proportion of the total expenditure on all aspects of the mating, including finding and acquiring a female, and so on. Relative testis size or gonadosomatic index (σ) is testes mass divided by body mass; it is assumed to reflect the product of mating rate (M) and ejaculate mass (s). In a new model, where mating rate, sperm competition and sperm allocation interact, and where the female's inter-clutch interval is assumed to be independent of s or M, we show that σ is directly proportional to the mean E for a species; across species σ and E increase monotonically with sperm competition. However, the relation between s and sperm competition across species depends on the range of sperm competition (low risk or high intensity): s increases with sperm competition at low risk levels, but decreases with sperm competition at high intensity levels. This situation arises because s∝E/M; both E and M increase with sperm competition, but E increases differently with sperm competition in its two ranges. PMID:17148175

  13. Selection on female remating interval is influenced by male sperm competition strategies and ejaculate characteristics

    PubMed Central

    Alonzo, Suzanne H.; Pizzari, Tommaso

    2013-01-01

    Female remating rate dictates the level of sperm competition in a population, and extensive research has focused on how sperm competition generates selection on male ejaculate allocation. Yet the way ejaculate allocation strategies in turn generate selection on female remating rates, which ultimately influence levels of sperm competition, has received much less consideration despite increasing evidence that both mating itself and ejaculate traits affect multiple components of female fitness. Here, we develop theory to examine how the effects of mating on female fertility, fecundity and mortality interact to generate selection on female remating rate. When males produce more fertile ejaculates, females are selected to mate less frequently, thus decreasing levels of sperm competition. This could in turn favour decreased male ejaculate allocation, which could subsequently lead to higher female remating. When remating simultaneously increases female fecundity and mortality, females are selected to mate more frequently, thus exacerbating sperm competition and favouring male traits that convey a competitive advantage even when harmful to female survival. While intuitive when considered separately, these predictions demonstrate the potential for complex coevolutionary dynamics between male ejaculate expenditure and female remating rate, and the correlated evolution of multiple male and female reproductive traits affecting mating, fertility and fecundity. PMID:23339235

  14. Imipramine for successful treatment of retrograde ejaculation caused by retroperitoneal surgery.

    PubMed

    Ochsenkühn, R; Kamischke, A; Nieschlag, E

    1999-06-01

    Retrograde ejaculation is a known complication following retroperitoneal lymph node dissection. Without further therapy, achieving paternity may be impossible. We evaluated the use of the tricyclic antidepressant imipramine in a new ovarian cycle-dependent dose regime for reversal of retrograde ejaculation in 11 patients desiring fertility. Ten patients with retroperitoneal lymph node dissection performed because of testicular cancer, and one with aortic surgery (thromboendarterectomy) were treated in an open, uncontrolled study with imipramine given at a daily oral dose increasing from 25 to 50 mg for 7 days prior to the planned ejaculation or the expected ovulation of the female partner. In all 11 patients, antegrade ejaculation could be induced (sperm counts: 3.9-276.0 x 10(6)/mL). Major side-effects were not observed, but half of the patients complained of minor degrees of dizziness, weakness, nausea or sweating during medication. Under treatment, two patients with normal sperm concentrations induced a spontaneous pregnancy. One ICSI cycle each was performed in 2 patients, with successful fertilization, out no pregnancy. In conclusion, temporary oral intake of imipramine is an effective and safe treatment to re-establish antegrade ejaculation in patients with retrograde ejaculation following retroperitoneal surgery, thus providing possibilities for paternity either through intercourse or by assisted fertilization.

  15. Successful treatment of retrograde ejaculation with sperm recovered from bladder washings. A report of two cases.

    PubMed

    Silva, P D; Larson, K M; Van Every, M J; Silva, D E

    2000-11-01

    Retrograde ejaculation causes < 2% of male infertility but is the leading cause of aspermia. The incidence of retrograde ejaculation is increasing due to the aggressiveness of modern urologic cancer surgery and an increase in diabetes mellitus. Generally, the only adverse effect is on fertility. Various approaches have been proposed for treatment, ranging from insemination with sperm-rich urine obtained after masturbation to intracytoplasmic sperm injection (ICSI). We used a protocol involving bladder washing. Case 1 involved a man with retrograde ejaculation secondary to a successful right orchiectomy and retroperitoneal lymph node dissection for stage B1 embryonal cell carcinoma. He was treated with bladder washing and intrauterine insemination. He fathered three children from six insemination cycles. Case 2 involved a man with idiopathic retrograde ejaculation and a wife with ovulatory dysfunction. He received treatment similar to that in case 1 and fathered one child from two insemination cycles. Larger studies need to be done specifically comparing treatments. Our method resulted in four normal infants in two couples over eight total insemination cycles and, taken together with other results from the literature, seems a good choice for clinicians who are treating retrograde ejaculation for the first time. We agree with others who have recommended that in vitro fertilization/ICSI not be the first step for treating the usual couples with retrograde ejaculation.

  16. ICSI outcome in patients with high DNA fragmentation: Testicular versus ejaculated spermatozoa.

    PubMed

    Arafa, M; AlMalki, A; AlBadr, M; Burjaq, H; Majzoub, A; AlSaid, S; Elbardisi, H

    2017-05-12

    Sperm DNA fragmentation (SDF) has emerged as an important biomarker in the assessment of male fertility potential with contradictory results regarding its effect on ICSI. The aim of this study was to evaluate intracytoplasmic sperm injection (ICSI) outcomes in male patients with high SDF using testicular versus ejaculated spermatozoa. This is a prospective study on 36 men with high-SDF levels who had a previous ICSI cycle from their ejaculates. A subsequent ICSI cycle was performed using spermatozoa retrieved through testicular sperm aspiration. Results of the prior ejaculate ICSI were compared with those of the TESA-ICSI. The mean (SD) SDF level was 56.36% (15.3%). Overall, there was no difference in the fertilization rate and embryo grading using ejaculate and testicular spermatozoa (46.4% vs. 47.8%, 50.2% vs. 53.4% respectively). However, clinical pregnancy was significantly higher in TESA group compared to ejaculated group (38.89% [14 of 36] vs. 13.8% [five of 36]). Moreover, 17 live births were documented in TESA group, and only three live births were documented in ejaculate group (p < .0001). We concluded that the use of testicular spermatozoa for ICSI significantly increases clinical pregnancy rate as well as live-birth rate in patients with high SDF. © 2017 Blackwell Verlag GmbH.

  17. Health Issues of Premature Babies

    MedlinePlus

    ... Breastfeeding Crying & Colic Diapers & Clothing Feeding & Nutrition Preemie Sleep Teething & Tooth Care Toddler Preschool Gradeschool Teen Young Adult Healthy Children > Ages & Stages > Baby > Preemie > Health Issues of Premature Babies Ages & ...

  18. [Premature ovarian failure: present aspects].

    PubMed

    Vilodre, Luiz Cesar; Moretto, Marcelo; Kohek, Maria Beatriz da Fonte; Spritzer, Poli Mara

    2007-08-01

    Premature ovarian failure occurs in approximately 1:1000 women before 30 years, 1:250 by 35 years and 1:100 by the age of 40. It is characterized by primary or secondary amenorrhea and cannot be considered as definitive because spontaneous conception may occur in 5 to 10% of cases. In 95% of cases, premature ovarian failure is sporadic. The known causes of premature ovarian failure include chromosomal defects, autoimmune diseases, exposure to radiation or chemotherapy, surgical procedures, and certain drugs. Frequently, however, the etiology is not clear and these cases are considered to be idiopathic. Premature ovarian failure is defined by gonadal failure and high serum follicle-stimulating hormone (FSH) levels. Clinical approach includes emotional support, hormonal therapy with estrogens and progesterone or progestogens, infertility treatment, and prevention of osteoporosis and potential cardiovascular risk.

  19. Lifelong literacy: Some trends and issues in conceptualising and operationalising literacy from a lifelong learning perspective

    NASA Astrophysics Data System (ADS)

    Hanemann, Ulrike

    2015-06-01

    In a fast-changing and highly inequitable world, lifelong learning is becoming increasingly important, not only as a key organising principle for all forms of education and learning but also as an absolute necessity for everyone. It is particularly important for disadvantaged individuals and groups who have been excluded from or failed to acquire basic competencies through formal schooling. Within a lifelong learning framework, literacy and numeracy are viewed as foundation skills which are the core of basic education and indispensable to full participation in society. This article discusses recent developments in conceptualising literacy as a foundation of lifelong learning. Starting from the evolving notions of adult literacy, the author identifies some current trends, the most important being that literacy is now perceived as a learning continuum of different proficiency levels. Dichotomous states of being either "literate" or "illiterate" no longer apply. She analyses (1) findings extracted from UNESCO Member States' national reports submitted to the UNESCO Institute for Lifelong Learning (UIL) for the 2nd Global Report on Adult Learning and Education; (2) a desk study of national literacy campaigns and programmes as well as (3) some recent developments in formal education. Her suggested three-dimensional analytical framework considers literacy as a lifelong and life-wide learning process and as part of lifelong learning systems. She draws a number of conclusions for policy and practice of literacy as a foundation of lifelong learning. These conclusions are a timely contribution to the ongoing post-2015 education debate, in particular to the challenge of how to mainstream youth and adult literacy into the implementation of the sustainable development agenda for 2015-2030.

  20. Measurement and correlates of physicians' lifelong learning.

    PubMed

    Hojat, Mohammadreza; Veloski, J Jon; Gonnella, Joseph S

    2009-08-01

    To examine the psychometric properties and correlates of an instrument to measure physicians' orientation toward lifelong learning with attention to differences between full-time and academic clinicians. The authors mailed a survey in 2006 to a national sample of 5,349 alumni of Jefferson Medical College who graduated between 1975 and 2000; 3,195 (60%) responded. The respondents were classified as full-time clinicians (n = 1,127) and academic clinicians (n = 1,612). The other 456 respondents were involved in administration or research. The revised Jefferson Scale of Physician Lifelong Learning (JeffSPLL) was included in the survey. Factor analysis, regression analysis, and analysis of variance were used to examine the construct- and criterion-related validities of the scale. Factor analysis of the JeffSPLL items resulted in three factors designated as "learning beliefs and motivation," "attention to learning opportunities," and "skills in seeking information," which supported its construct validity. Alpha reliability coefficients were 0.85 and 0.86, and test-retest reliability coefficients were 0.72 and 0.77 for full-time clinicians and academic clinicians, respectively. For full-time clinicians and academic clinicians, scores on the JeffSPLL were significantly (P < .01) correlated with measures of learning motivation, professional accomplishments, career satisfaction, and commitment to lifelong learning, which supported the criterion-related validity of the scale. The findings indicate that the JeffSPLL is a psychometrically sound instrument that measures physicians' orientation toward lifelong learning among full-time clinicians and academic clinicians. The instrument can be used to monitor educational programs, assess educational outcomes, and examine group differences.

  1. Surfing and Swimming of Ejaculated Sperm in the Mouse Oviduct.

    PubMed

    Ishikawa, Yu; Usui, Tomoyuki; Yamashita, Misuzu; Kanemori, Yoshinori; Baba, Tadashi

    2016-04-01

    To accomplish fertilization in the oviductal ampulla, ejaculated sperm are required to migrate through the female reproductive tract. However, this fundamental process largely remains unknown. In this study, we focused on the role of oviductal smooth muscle (myosalpinx) contractions in the sperm migration. Administration of prifinium bromide, padrin, to mice effectively suppressed myosalpinx contractions, resulting in a decreased rate of fertilization in a dose-dependent manner, and an abrogation of high-speed back-and-forth/shuttling flows of oviductal fluids around the isthmus. Regardless of padrin administration, no shuttling flows were found near the ampulla. In the isthmus, sperm formed a tight assemblage that was synchronized with the shuttling flows. The sperm assemblage was gradually loosened and then completely abolished near the ampulla. No sperm assemblage was formed in the isthmus when padrin was administrated. These results suggest that myosalpinx contractions play important roles in the formation of sperm assemblage in the isthmus, and in the transport of the assemblage to the middle region of the oviduct. It is also suggested that the motility of sperm is essential for the migration of sperm from the middle oviductal region to the ampulla.

  2. Larger testes are associated with a higher level of polyandry, but a smaller ejaculate volume, across bushcricket species (Tettigoniidae)

    PubMed Central

    Vahed, Karim; Parker, Darren J.; Gilbert, James D. J.

    2011-01-01

    While early models of ejaculate allocation predicted that both relative testes and ejaculate size should increase with sperm competition intensity across species, recent models predict that ejaculate size may actually decrease as testes size and sperm competition intensity increase, owing to the confounding effect of potential male mating rate. A recent study demonstrated that ejaculate volume decreased in relation to increased polyandry across bushcricket species, but testes mass was not measured. Here, we recorded testis mass for 21 bushcricket species, while ejaculate (ampulla) mass, nuptial gift mass, sperm number and polyandry data were largely obtained from the literature. Using phylogenetic-comparative analyses, we found that testis mass increased with the degree of polyandry, but decreased with increasing ejaculate mass. We found no significant relationship between testis mass and either sperm number or nuptial gift mass. While these results are consistent with recent models of ejaculate allocation, they could alternatively be driven by substances in the ejaculate that affect the degree of polyandry and/or by a trade-off between resources spent on testes mass versus non-sperm components of the ejaculate. PMID:21068028

  3. Larger testes are associated with a higher level of polyandry, but a smaller ejaculate volume, across bushcricket species (Tettigoniidae).

    PubMed

    Vahed, Karim; Parker, Darren J; Gilbert, James D J

    2011-04-23

    While early models of ejaculate allocation predicted that both relative testes and ejaculate size should increase with sperm competition intensity across species, recent models predict that ejaculate size may actually decrease as testes size and sperm competition intensity increase, owing to the confounding effect of potential male mating rate. A recent study demonstrated that ejaculate volume decreased in relation to increased polyandry across bushcricket species, but testes mass was not measured. Here, we recorded testis mass for 21 bushcricket species, while ejaculate (ampulla) mass, nuptial gift mass, sperm number and polyandry data were largely obtained from the literature. Using phylogenetic-comparative analyses, we found that testis mass increased with the degree of polyandry, but decreased with increasing ejaculate mass. We found no significant relationship between testis mass and either sperm number or nuptial gift mass. While these results are consistent with recent models of ejaculate allocation, they could alternatively be driven by substances in the ejaculate that affect the degree of polyandry and/or by a trade-off between resources spent on testes mass versus non-sperm components of the ejaculate.

  4. Larger ejaculate volumes are associated with a lower degree of polyandry across bushcricket taxa

    PubMed Central

    Vahed, Karim

    2006-01-01

    In numerous insects, including bushcrickets (Tettigoniidae), males are known to transfer substances in the ejaculate that inhibit the receptivity of females to further matings, but it has not yet been established whether these substances reduce the lifetime degree of polyandry of the female. The aim of this study was to test the hypothesis that larger ejaculate volumes should be associated with a lower degree of polyandry across tettigoniid taxa, controlling for male body mass and phylogeny. Data on ejaculate mass, sperm number, nuptial gift mass and male mass were taken primarily from the literature. The degree of polyandry for 14 species of European bushcrickets was estimated by counting the number of spermatodoses within the spermathecae of field-caught females towards the end of their adult lifespans. Data for four further species were obtained from the literature. Data were analysed by using both species regression and independent contrasts to control for phylogeny. Multiple regression analysis revealed that, as predicted, there was a significant negative association between the degree of polyandry and ejaculate mass, relative to male body mass, across bushcricket taxa. Nuptial gift size and sperm number, however, did not contribute further to interspecific variation in the degree of polyandry. A positive relationship was found, across bushcricket taxa, between relative nuptial gift size and relative ejaculate mass, indicating that larger nuptial gifts allow the male to overcome female resistance to accepting large ejaculates. This appears to be the first comparative evidence that males can manipulate the lifetime degree of polyandry of their mates through the transfer of large ejaculates. PMID:16928643

  5. Larger ejaculate volumes are associated with a lower degree of polyandry across bushcricket taxa.

    PubMed

    Vahed, Karim

    2006-09-22

    In numerous insects, including bushcrickets (Tettigoniidae), males are known to transfer substances in the ejaculate that inhibit the receptivity of females to further matings, but it has not yet been established whether these substances reduce the lifetime degree of polyandry of the female. The aim of this study was to test the hypothesis that larger ejaculate volumes should be associated with a lower degree of polyandry across tettigoniid taxa, controlling for male body mass and phylogeny. Data on ejaculate mass, sperm number, nuptial gift mass and male mass were taken primarily from the literature. The degree of polyandry for 14 species of European bushcrickets was estimated by counting the number of spermatodoses within the spermathecae of field-caught females towards the end of their adult lifespans. Data for four further species were obtained from the literature. Data were analysed by using both species regression and independent contrasts to control for phylogeny. Multiple regression analysis revealed that, as predicted, there was a significant negative association between the degree of polyandry and ejaculate mass, relative to male body mass, across bushcricket taxa. Nuptial gift size and sperm number, however, did not contribute further to interspecific variation in the degree of polyandry. A positive relationship was found, across bushcricket taxa, between relative nuptial gift size and relative ejaculate mass, indicating that larger nuptial gifts allow the male to overcome female resistance to accepting large ejaculates. This appears to be the first comparative evidence that males can manipulate the lifetime degree of polyandry of their mates through the transfer of large ejaculates.

  6. Condition-dependent ejaculate production affects male mating behavior in the common bedbug Cimex lectularius.

    PubMed

    Kaldun, Bettina; Otti, Oliver

    2016-04-01

    Food availability in the environment is often low and variable, constraining organisms in their resource allocation to different life-history traits. For example, variation in food availability is likely to induce condition-dependent investment in reproduction. Further, diet has been shown to affect ejaculate size, composition and quality. How these effects translate into male reproductive success or change male mating behavior is still largely unknown. Here, we concentrated on the effect of meal size on ejaculate production, male reproductive success and mating behavior in the common bedbug Cimex lectularius. We analyzed the production of sperm and seminal fluid within three different feeding regimes in six different populations. Males receiving large meals produced significantly more sperm and seminal fluid than males receiving small meals or no meals at all. While such condition-dependent ejaculate production did not affect the number of offspring produced after a single mating, food-restricted males could perform significantly fewer matings than fully fed males. Therefore, in a multiple mating context food-restricted males paid a fitness cost and might have to adjust their mating strategy according to the ejaculate available to them. Our results indicate that meal size has no direct effect on ejaculate quality, but food availability forces a condition-dependent mating rate on males. Environmental variation translating into variation in male reproductive traits reveals that natural selection can interact with sexual selection and shape reproductive traits. As males can modulate their ejaculate size depending on the mating situation, future studies are needed to elucidate whether environmental variation affecting the amount of ejaculate available might induce different mating strategies.

  7. Ejaculated Mouse Sperm Enter Cumulus-Oocyte Complexes More Efficiently In Vitro than Epididymal Sperm

    PubMed Central

    Suarez, Susan S.

    2015-01-01

    The mouse is an established and popular animal model for studying reproductive biology. Epididymal mouse sperm, which lack exposure to secretions of male accessory glands and do not precisely represent ejaculated sperm for the study of sperm functions, have been almost exclusively used in studies. We compared ejaculated and epididymal sperm in an in vitro fertilization setting to examine whether ejaculated sperm enter cumulus-oocyte complexes more efficiently. In order to prepare sperm for fertilization, they were incubated under capacitating conditions. At the outset of incubation, ejaculated sperm stuck to the glass surfaces of slides and the incidences of sticking decreased with time; whereas, very few epididymal sperm stuck to glass at any time point, indicating differences in surface charge. At the end of the capacitating incubation, when sperm were added to cumulus-oocyte complexes, the form of flagellar movement differed dramatically; specifically, ejaculated sperm predominantly exhibited increased bending on one side of the flagellum (a process termed pro-hook hyperactivation), while epididymal sperm equally exhibited increased bending on one or the other side of the flagellum (pro-hook or anti-hook hyperactivation). This indicates that accessory sex gland secretions might have modified Ca2+ signaling activities in sperm, because the two forms of hyperactivation are reported to be triggered by different Ca2+ signaling patterns. Lastly, over time, more ejaculated than epididymal sperm entered the cumulus oocyte complexes. We concluded that modification of sperm by male accessory gland secretions affects the behavior of ejaculated sperm, possibly providing them with an advantage over epididymal sperm for reaching the eggs in vivo. PMID:25996155

  8. Retrograde ejaculation and sexual dysfunction in men with diabetes mellitus: a prospective, controlled study.

    PubMed

    Fedder, J; Kaspersen, M D; Brandslund, I; Højgaard, A

    2013-07-01

    Retrograde ejaculation (RE) and erectile dysfunction may be caused by diabetes mellitus (DM), but the prevalence of RE among DM patients is unknown. A prospective, blinded case-control study comparing men with DM with matched controls according to RE and erectile dysfunction was performed. Twenty-seven men with DM matched the inclusion criteria and agreed to participate in the study, and of these 26 delivered an ejaculate. We were able to recruit 18 matching controls, and of these 16 delivered an ejaculate. Nine of 26 men with DM who delivered an ejaculate had RE, whereas none of 16 controls had RE (p < 0.01). The mean duration of DM was longer for DM patients with RE (20 years) compared with DM patients in whom RE could not be demonstrated (13 years), but the difference was not statistically significant. RE could not be associated with BMI, waist circumference, blood pressure, Haemoglobin A1c (HgbA1c), high-density lipoprotein HDL cholesterol, triglycerides, fasting glucose, or s-testosterone. Diabetics suffering from RE more frequently exhibited erectile dysfunction compared with non-diabetics and diabetics without RE, and the last-mentioned group again more frequently than controls. These findings could not be explained by use of antihypertensive drugs. Whereas none of the included control participants showed signs of abnormal ejaculation, every third man with DM exhibited retrograde ejaculation. It is important to be aware of this association, and that post-ejaculatory urine is routinely analysed from aspermic fertility clinic attendants and diabetics with low ejaculate volumes. © 2013 American Society of Andrology and European Academy of Andrology.

  9. Prenatal stress, prematurity and asthma

    PubMed Central

    Medsker, Brock; Forno, Erick; Simhan, Hyagriv; Celedón, Juan C.

    2016-01-01

    Asthma is the most common chronic disease of childhood, affecting millions of children in the U.S. and worldwide. Prematurity is a risk factor for asthma, and certain ethnic or racial minorities such as Puerto Ricans and non-Hispanic Blacks are disproportionately affected by both prematurity and asthma. In this review, we examine current evidence to support maternal psychosocial stress as a putative link between prematurity and asthma, while also focusing on disruption of the hypothalamic-pituitary-adrenal (HPA) axis and immune responses as potential underlying mechanisms for stress-induced “premature asthma”. Prenatal stress may not only cause abnormalities in the HPA axis but also epigenetic changes in the fetal glucocorticoid receptor gene (NR3C1), leading to impaired glucocorticoid metabolism. Moreover, maternal stress can alter fetal cytokine balance, favoring Th2 (allergic) immune responses characteristic of atopic asthma: IL-6, which has been associated with premature labor, can promote Th2 responses by stimulating production of IL-4 and IL-13. Given a link among stress, prematurity, and asthma, future research should include birth cohorts aimed at confirming and better characterizing “premature asthma”. If confirmed, clinical trials of prenatal maternal stress reduction would be warranted to reduce the burden of these common co-morbidities. While awaiting the results of such studies, sound policies to prevent domestic and community violence (e.g. from firearms) are justified, not only by public safety but also by growing evidence of detrimental effects of violence-induced stress on psychiatric and somatic health. PMID:26676148

  10. Risk Factors for Retinopathy of Prematurity in Premature Born Children

    PubMed Central

    Alajbegovic-Halimic, Jasmina; Zvizdic, Denisa; Alimanovic-Halilovic, Emina; Dodik, Irena; Duvnjak, Sanela

    2015-01-01

    Introduction: Retinopathy of Prematurity (ROP) represent disease of the eye in premature born children which affects immature blood vessels of the retina during their development. The emergence of retinopathy of prematurity depends on the interaction of multiple factors, such as: gestational age, low birth weight, hypoxia, duration of oxygen supplementation, respiratory distress syndrome, twin pregnancy, anemia, blood transfusions, sepsis, intraventricular hemorrhage, hypotension, hypothermia, etc. If remain unrecognized and untreated it can cause severe visual impairment and blindness in children, but can also be prevented with timely screening. Goals: To establish the number of patients with development of retinopathy of prematurity active forms in the observed time period and examine which risk factors have most significant impact on its origin. Material and methods: In a clinical, retrospective study we observed a total of 80 premature born children in the period from January to May 2015 with regard to listed risk factors identified for eye examination. Results: From a total of 80 premature newborns sample included 48.8% male and 51.2% female children. The active form of ROP developed in 6.2% of cases, while in 93.8% of cases there was a spontaneous resolution. Patients who developed active form of ROP have significantly younger gestational age (26.4±1.5 weeks) and lower birth weight (874±181 grams), lower Apgar score in the first and fifth minute and were longer on oxygen therapy (20±3.4 days). Conclusion: Of the potential risk factors that could affect the development of ROP active form following factors have a statistically significant influence: early gestational age, low birth weight, lower Apgar score and prolonged oxygen therapy (p <0.05). PMID:26843736

  11. [Inhibition of premature uterine contractions].

    PubMed

    Troszyński, M; Leibschang, J; Chazan, B; Adamowicz, R; Brankowska, J

    1979-01-01

    Various drugs used to stop premature uterine contractions are discussed in the paper. Particular attention is paid to beta-mimetic drugs. The results of ming Partusisten, one of beta-mimetic drugs, is presented on the material of 104 patients with threatening immature and premature labour. Partusisten was administered in the form of intravenous drip infusion or tablets. During treatment monitoring of the uterine contractility and of foetal heart rate took place. Inhibition of the uterine contraction activity was successful in 100 per cent of cases. In 60,9 per cent in the group of threatening immature labour and in 38,1 per cent in the group threatening premature labour, the delay of delivery was more then 28 days. The delay of delivery by 48 hours was 87 per cent and 84 per cent in both groups respectively. Tachycardia was one of the first side effects observed in 15,2 per cent of cases. There is also presented an example of pregnancy when delivery was delayed by 21 days in spite of premature outflow of amniotic fluid (at a high rupture of membrane). The authors are of the opinion that Partusisten is very effective and gives little side effects, preventing premature uterine contractions. Dosage should be individualized according to the case and labour advancement, and should be based on topographic evaluation of uterine contraction. Negative influence of the drug on foetuses was not observed.

  12. Educational paper: Retinopathy of prematurity.

    PubMed

    Casteels, Ingele; Cassiman, Catherine; Van Calster, Joachim; Allegaert, Karel

    2012-06-01

    Retinopathy of prematurity (ROP) is a proliferative retinal vascular disease affecting the premature infant with an incompletely vascularized retina. The spectrum of ophthalmological findings in ROP exists from minimal sequelae, which do not affect vision, to bilateral retinal detachment and total blindness. With the increased survival of very small infants, retinopathy of prematurity has become one of the leading causes of childhood blindness. Over the past two decades, major advances have been made in understanding the pathogenesis of ROP, to a large extent as a result of changes in clinical risk factors (oxygen and non-oxygen related) and characteristics observed in ROP cases. This article provides a literature review on the evolution in clinical characteristics, classification and treatment modalities and indications of ROP. Special attention is hereby paid to the neonatal factors influencing the development of ROP and to the necessity for everyone caring for premature babies to have a well-defined screening and treatment protocol for ROP. Such screening protocol needs to be based on a unit-specific ROP risk profile and, consequently, may vary between different European regions. Retinopathy of prematurity is an important cause of ocular morbidity and blindness in children. With better understanding of the pathogenesis, screening and treatment guidelines have changed over time and are unit specific.

  13. Retrograde ejaculation after anterior lumbar interbody fusion: transperitoneal versus retroperitoneal exposure.

    PubMed

    Sasso, Rick C; Kenneth Burkus, J; LeHuec, Jean-Charles

    2003-05-15

    In this multicenter, prospective, 2-year study, 146 male patients underwent a single-level anterior lumbar interbody fusion with a tapered threaded titanium fusion device. All the patients were advised before surgery of the risk for retrograde ejaculation. After surgery, any case of retrograde ejaculation was recorded as an adverse event, and the patient was observed up for the remainder of the study. To determine the incidence of retrograde ejaculation in male patients treated for single-level degenerative lumbar disc disease at L4-L5 or L5-S1 with a stand-alone anterior interbody fusion using tapered, threaded titanium fusion cages. The incidence of retrograde ejaculation in men after anterior lumbosacral spinal surgery has been reported to range from 0.42% to 5.9%. Various risk factors that increase the chance of retrograde ejaculation have been proposed. In this prospective study, 146 male patients underwent an open surgical exposure of the lumbosacral junction and a single-level interbody fusion at either L4-L5 or L5-S1. Assessment of a patient's clinical outcome was based on written questionnaires at 6 weeks and then 3, 6, 12, and 24 months after surgery. Patients were questioned about adverse events at each of these assessments, and any case of retrograde ejaculation was recorded and followed. Retrograde ejaculation developed in 6 of the 146 men after open anterior lumbar interbody fusion surgery. Two cases (1.7%; 2/116) involved patients who underwent a retroperitoneal surgical exposure. Four cases (13.3%; 4/30) involved patients who had a transperitoneal surgical exposure. This difference is statistically significant according to Fisher's exact test (P = 0.017). At 12 months after surgery, 2 patients had resolution of their symptoms: 1 in the retroperitoneal approach group and 1 in the transperitoneal group. At the final 2-year follow-up, no changes in symptoms were reported. One patient in the retroperitoneal approach group (0.86%) and three patients in

  14. Cultivating Lifelong Learning Skills During Graduate Medical Training.

    PubMed

    Mahajan, Rajiv; Badyal, Dinesh Kumar; Gupta, Piyush; Singh, Tejinder

    2016-09-08

    Lifelong learning is referred to as learning practiced by the individual for the whole life, is flexible, and is accessible at all times. Medical Council of India has included lifelong learning as a competency in its new regulations for graduate medical training. Acquisition of metacognitive skills, self-directed learning, self-monitoring, and reflective attitude are the main attributes of lifelong learning; and all of these can be inculcated in the students by using appropriate instructional methodologies. It is time to deliberate upon the instructional designs to foster the lifelong learning skills and behaviors in medical graduates. In this communication, we aim to debrief the concept of lifelong learning, particularly in context with medical training and detailing the process that can be explicitly used to cultivate the attitude of lifelong learning in medical graduates.

  15. Measuring medical students' orientation toward lifelong learning: a psychometric evaluation.

    PubMed

    Wetzel, Angela P; Mazmanian, Paul E; Hojat, Mohammadreza; Kreutzer, Kathleen O; Carrico, Robert J; Carr, Caroline; Veloski, Jon; Rafiq, Azhar

    2010-10-01

    The principle of lifelong learning is pervasive in regulations governing medical education and medical practice; yet, tools to measure lifelong learning are lagging in development. This study evaluates the Jefferson Scale of Physician Lifelong Learning (JeffSPLL) adapted for administration to medical students. The Jefferson Scale of Physician Lifelong Learning-Medical Students (JeffSPLL-MS) was administered to 732 medical students in four classes. Factor analysis and t tests were performed to investigate its construct validity. Maximum likelihood factor analysis identified a three-factor solution explaining 46% of total variance. Mean scores of clinical and preclinical students were compared; clinical students scored significantly higher in orientation toward lifelong learning (P < .001). The JeffSPLL-MS presents findings consistent with key concepts of lifelong learning. Results from use of the JeffSPLL-MS may reliably inform curriculum design and education policy decisions that shape the careers of physicians.

  16. Morphometric and kinematic sperm subpopulations in split ejaculates of normozoospermic men

    PubMed Central

    Santolaria, Pilar; Soler, Carles; Recreo, Pilar; Carretero, Teresa; Bono, Araceli; Berné, José M; Yániz, Jesús L

    2016-01-01

    This study was designed to analyze the sperm kinematic and morphometric subpopulations in the different fractions of the ejaculate in normozoospermic men. Ejaculates from eight normozoospermic men were collected by masturbation in three fractions after 3–5 days of sexual abstinence. Analyses of sperm motility by computer-assisted sperm analysis (CASA-Mot), and of sperm morphometry by computer-assisted sperm morphometry analysis (CASA-Morph) using fluorescence were performed. Clustering and discriminant procedures were performed to identify sperm subpopulations in the kinematic and morphometric data obtained. Clustering procedures resulted in the classification of spermatozoa into three kinematic subpopulations (slow with low ALH [35.6% of all motile spermatozoa], with circular trajectories [32.0%], and rapid with high ALH [32.4%]), and three morphometric subpopulations (large-round [33.9% of all spermatozoa], elongated [32.0%], and small [34.10%]). The distribution of kinematic sperm subpopulations was different among ejaculate fractions (P < 0.001), with higher percentages of spermatozoa exhibiting slow movements with low ALH in the second and third portions, and with a more homogeneous distribution of kinematic sperm subpopulations in the first portion. The distribution of morphometric sperm subpopulations was also different among ejaculate fractions (P < 0.001), with more elongated spermatozoa in the first, and of small spermatozoa in the third, portion. It is concluded that important variations in the distribution of kinematic and morphometric sperm subpopulations exist between ejaculate fractions, with possible functional implications. PMID:27624985

  17. Identification and sequencing of remnant messenger RNAs found in domestic swine (Sus scrofa) fresh ejaculated spermatozoa.

    PubMed

    Yang, C C; Lin, Y S; Hsu, C C; Wu, S C; Lin, E C; Cheng, W T K

    2009-07-01

    The existence of specific messenger RNA remnants contained within freshly ejaculated spermatozoa was described in several species. Those investigations, using high-throughput techniques to screen the population of transcripts in ejaculated spermatozoa, were limited to the probes which mostly derived from nucleic acids of testicular tissues of either human or mice. The objective of this study was to investigate mRNA remnants from ejaculated spermatozoa of the domestic swine (Sus scrofa), a valuable model for biomedical research. A non-redundant 5'-end complementary DNA library was generated from swine ejaculated spermatozoa. After sequence quality verification, 4562 clones remained. These clones were then clustered and assembled into 514 unique sequences including 188 contigs (36.58%) and 326 singletons (63.42%), representing those clusters containing at least two clones and those clusters without having enough similarity with other clones. These unique gene sequences were annotated in Gene Ontology (GO) hierarchy; they included biological processes (38.7%), molecular functions (39.1%) and cellular components (40.3%). Based on the analysis, a broad spectrum of messenger RNAs existed in swine ejaculated spermatozoa and was closely correlated with nucleic acid binding, structural modifications, and transcriptional regulation. All of these categories are considered to have profound effects on the male reproductive system. Therefore, our work provides initial results on potential spermatozoal gene expression for future studies regarding the tightly regulated spermiogenic processes and later fertilization events.

  18. Male age and strain affect ejaculate quality in the Mexican fruit fly.

    PubMed

    Herrera-Cruz, Mariana; Abraham, Solana; Nuñez-Beverido, Nicolas; Flores-Estévez, Norma; Reyes-Hernández, Martha; Alvarado, Mayvi; Pérez-Staples, Diana

    2017-02-19

    Aging in all organisms is inevitable. Male age can have profound effects on mating success and female reproduction, yet relatively little is known on the effects of male age on different components of the ejaculate. Furthermore, in mass-reared insects used for the Sterile Insect Technique, there are often behavioral differences between mass-reared and wild males, while differences in the ejaculate have been less studied. The ejaculate in insects is composed mainly of sperm and accessory gland proteins. Here, we studied how male age and strain affected (i) protein quantity of testes and accessory glands, (ii) the biological activity of accessory gland products injected into females, (iii) sperm viability and (iv) sperm quantity stored by females in wild and mass-reared Anastrepha ludens (Diptera: Tephritidae). We found lower protein content in testes of old wild males and lower sperm viability in females mated with old wild males. Females stored more sperm when mated to young wild males than with young mass-reared males. Accessory gland injections of old or young males did not inhibit female remating. Knowledge of how male age affects different ejaculate components will aid our understanding on investment of the ejaculate and possible post-copulatory consequences on female behaviour. This article is protected by copyright. All rights reserved.

  19. A comparison of ejaculated and testicular spermatozoa aneuploidy rates in patients with high sperm DNA damage.

    PubMed

    Moskovtsev, Sergey I; Alladin, Naazish; Lo, Kirk C; Jarvi, Keith; Mullen, J Brendan M; Librach, Clifford L

    2012-06-01

    Testicular spermatozoa are utilized to achieve pregnancy in couples with severe male factor infertility. Several studies suggest that aneuploidy rates in spermatozoa are elevated at the testicular level in infertile patients compared to ejaculates of normal controls. However, essential data regarding aneuploidy rates between ejaculated and testicular spermatozoa in the same individuals is lacking. The purpose of our study was to compare aneuploidy rates at the testicular and post-testicular level from the same patients with persistently high sperm DNA damage. Ejaculates and testicular biopsies were obtained from eight patients with persistently high DNA damage (>30%). Both ejaculated and testicular samples were analyzed for sperm DNA damage and sperm aneuploidy for chromosomes 13, 18, 21, X, and Y. In addition, semen samples from ten normozoospermic men presenting for fertility evaluation served as a control group. A strong correlation between the alteration of spermatogenesis and chromatin deterioration was observed in our study. In the same individuals, testicular samples showed a significantly lower DNA damage compared to ejaculated spermatozoa (14.9% ± 5.0 vs. 40.6% ± 14.8, P<0.05), but significantly higher aneuploidy rates for the five analyzed chromosomes (12.41% ± 3.7 vs. 5.77% ± 1.2, P<0.05). While testicular spermatozoa appear favourable for ICSI in terms of lower DNA damage, this potential advantage could be offset by the higher aneuploidy rates in testicular spermatozoa.

  20. [Treatment of ejaculation disorders by midodrine (Gutron) per os. Retrospective study of about 16 subjects].

    PubMed

    Blanchard-Dauphin, A; Rigot, J M; Thevenon, A

    2005-02-01

    We evaluate the efficiency and side effects of midodrine in the treatment of sperm transport disturbances. This retrospective study concerned patients addressed in Andrologia Department between 1995 and 2002 for treatment of sperm transport disturbances by administration of Midodrine per os (from 2.5 to 20 mg). Anterograde and retrogrades ejaculates (in urine sample) were examined. Sixteen patients (middle age of 36 years) were included: 12 neurologic lesions (central or peripheral, with 3 diabetes), four post-surgical (urologic and digestive) ejaculatory incompetence. One patient obtained anterior and retrograde ejaculation, two patients obtained anterior ejaculation and six retrograde ejaculations by midodrine per os. This treatment was inefficient in eight subjects. Side effects were exceptional. We obtained anterior or retrograde ejaculation in half of our population. The success was more important in patients with central neurologic injuries, diabetes or post-surgical troubles. In peripheral neurologic injuries, midodrine per os (maximal dose of 20 mg) was ineffective. Our study demonstrates the efficiency and good tolerance of midodrine per os for treatment of sperm transport disturbances.

  1. Patterns of genetic variation and covariation in ejaculate traits reveal potential evolutionary constraints in guppies.

    PubMed

    Evans, J P

    2011-05-01

    Ejaculates comprise multiple and potentially interacting traits that determine male fertility and sperm competitiveness. Consequently, selection on these traits is likely to be intense, but the efficacy of selection will depend critically on patterns of genetic variation and covariation underlying their expression. In this study, I provide a prospective quantitative genetic analysis of ejaculate traits in the guppy Poecilia reticulata, a highly promiscuous live-bearing fish. I used a standard paternal half-sibling breeding design to characterize patterns of genetic (co)variation in components of sperm length and in vitro sperm performance. All traits exhibited high levels of phenotypic and additive genetic variation, and in several cases, patterns of genetic variation was consistent with Y-linkage. There were also highly significant negative genetic correlations between the various measures of sperm length and sperm performance. In particular, the length of the sperm's midpiece was strongly, negatively and genetically correlated with sperm's swimming velocity-an important determinant of sperm competitiveness in this and other species. Other components of sperm length, including the flagellum and head, were independently and negatively genetically correlated with the proportion of live sperm in the ejaculate (sperm viability). Whether these relationships represent evolutionary trade-offs depends on the precise relationships between these traits and competitive fertilization rates, which have yet to be fully resolved in this (and indeed most) species. Nevertheless, these prospective analyses point to potential constraints on ejaculate evolution and may explain the high level of phenotypic variability in ejaculate traits in this species.

  2. Direct costs and benefits of multiple mating: Are high female mating rates due to ejaculate replenishment?

    PubMed

    Worthington, Amy M; Kelly, Clint D

    2016-03-01

    Females often mate more than is necessary to ensure reproductive success even when they incur significant costs from doing so. Direct benefits are hypothesized to be the driving force of high female mating rates, yet species in which females only receive an ejaculate from their mate still realize increased fitness from multiple mating. Using the Texas field cricket, Gryllus texensis, we experimentally test the hypothesis that multiple mating via monandry or polyandry increases female fitness by replenishing ejaculates, thereby allowing females to produce more offspring for a longer period of time. We found that higher rates of female mating significantly increased lifetime fecundity and oviposition independent of whether females mated with one or two males. Further, although interactions with males significantly increased rates of injury or death, females that replenished ejaculates experienced an increased rate and duration of oviposition, demonstrating that the immediate benefits of multiple mating may greatly outweigh the long-term costs that mating poses to female condition and survival. We suggest that ejaculate replenishment is a driving factor of high mating rates in females that do not receive external direct benefits from mating and that a comparative study across taxa will provide additional insight into the role that ejaculate size plays in the evolution of female mating rates.

  3. Lifelong Exercise Patterns and Cardiovascular Health.

    PubMed

    Maessen, Martijn F H; Verbeek, André L M; Bakker, Esmée A; Thompson, Paul D; Hopman, Maria T E; Eijsvogels, Thijs M H

    2016-06-01

    To determine the relationship between lifelong exercise dose and the prevalence of cardiovascular morbidity. From June 1, 2011, through December 31, 2014, 21,266 individuals completed an online questionnaire regarding their lifelong exercise patterns and cardiovascular health status. Cardiovascular disease (CVD) was defined as a diagnosis of myocardial infarction, stroke, or heart failure, and cardiovascular risk factors (CVRFs) were defined as hypertension, hypercholesterolemia, or type 2 diabetes. Lifelong exercise patterns were measured over a median of 32 years for 405 patients with CVD, 1379 patients with CVRFs, and 10,656 controls. Participants were categorized into nonexercisers and quintiles (Q1-Q5) of exercise dose (metabolic equivalent task [MET] minutes per week). The CVD/CVRF prevalence was lower for each exercise quintile compared with nonexercisers (CVD: nonexercisers, 9.6% vs Q1: 4.4%, Q2: 2.8%, Q3: 2.4%, Q4: 3.6%, Q5: 3.9%; P<.001; CVRF: nonexercisers, 24.6% vs Q1: 13.8%, Q2: 10.2%, Q3: 9.0%, Q4: 9.4%, Q5: 12.0%; P<.001). The lowest exercise dose (Q1) significantly reduced CVD and CVRF prevalence, but the largest reductions were found at 764 to 1091 MET-min/wk for CVD (adjusted odds ratio=0.31; 95% CI, 0.20-0.48) and CVRFs (adjusted odds ratio=0.36; 95% CI, 0.28-0.47). The CVD/CVRF prevalence did not further decrease in higher exercise dose groups. Exercise intensity did not influence the relationship between exercise patterns and CVD or CVRFs. These findings demonstrate a curvilinear relationship between lifelong exercise patterns and cardiovascular morbidity. Low exercise doses can effectively reduce CVD/CVRF prevalence, but engagement in exercise for 764 to 1091 MET-min/wk is associated with the lowest CVD/CVRF prevalence. Higher exercise doses do not yield additional benefits. Copyright © 2016 Mayo Foundation for Medical Education and Research. Published by Elsevier Inc. All rights reserved.

  4. Lifelong Learning for the Hand Surgeon.

    PubMed

    Adkinson, Joshua M; Chung, Kevin C

    2015-09-01

    Hand surgeons are faced with the impossible task of mastering a rapidly expanding pool of knowledge and surgical techniques. Dedication to lifelong learning is, therefore, an essential component of delivering the best, most up-to-date care for patients. Board certification, participation in continuing medical education and maintenance of certification activities, and attendance at national meetings are essential mechanisms by which hand surgeons may foster the acquisition of essential knowledge and clinical skills, This article highlights the history, current status, and emerging needs in continuing medical education for the hand surgeon. Copyright © 2015 American Society for Surgery of the Hand. Published by Elsevier Inc. All rights reserved.

  5. Lifelong Literacy: Some Trends and Issues in Conceptualising and Operationalising Literacy from a Lifelong Learning Perspective

    ERIC Educational Resources Information Center

    Hanemann, Ulrike

    2015-01-01

    In a fast-changing and highly inequitable world, lifelong learning is becoming increasingly important, not only as a key organising principle for all forms of education and learning but also as an absolute necessity for everyone. It is particularly important for disadvantaged individuals and groups who have been excluded from or failed to acquire…

  6. Confucian Educational Philosophy and Its Implication for Lifelong Learning and Lifelong Education

    ERIC Educational Resources Information Center

    Sun, Qi

    2008-01-01

    This paper, from historical and philosophical perspectives, presents Confucian education philosophy, a philosophy that is argued is a philosophy of lifelong learning. Examined and illustrated are the Confucian concepts of "Sage", a Confucian ideal human model, and "Jun Zi", a Confucian realistic educational result. Through "Sage", Confucius…

  7. Lifelong Literacy: Some Trends and Issues in Conceptualising and Operationalising Literacy from a Lifelong Learning Perspective

    ERIC Educational Resources Information Center

    Hanemann, Ulrike

    2015-01-01

    In a fast-changing and highly inequitable world, lifelong learning is becoming increasingly important, not only as a key organising principle for all forms of education and learning but also as an absolute necessity for everyone. It is particularly important for disadvantaged individuals and groups who have been excluded from or failed to acquire…

  8. Easing Access for Lifelong Learners: A Comparison of European Models for University Lifelong Learning

    ERIC Educational Resources Information Center

    Müller, Romina; Remdisch, Sabine; Köhler, Katharina; Marr, Liz; Repo, Saara; Yndigegn, Carsten

    2015-01-01

    Easing access to higher education (HE) for those engaging in lifelong learning has been a common policy objective across the European Union since the late 1990s. To reach this goal, the transition between vocational and academic routes must be simplified, but European countries are at different developmental stages. This article maps the…

  9. Learning to Live: The Relationship between Lifelong Learning and Lifelong Illness

    ERIC Educational Resources Information Center

    Jackson, Sue

    2006-01-01

    This paper explores the ways in which people with lifelong chronic illness engage with learning, and how learning impacts on the ways in which they learn to live with their illness. It considers their engagement with and changing focus of learning at different stages: prior to diagnosis, at about the time of diagnosis, and as their understanding…

  10. Easing Access for Lifelong Learners: A Comparison of European Models for University Lifelong Learning

    ERIC Educational Resources Information Center

    Müller, Romina; Remdisch, Sabine; Köhler, Katharina; Marr, Liz; Repo, Saara; Yndigegn, Carsten

    2015-01-01

    Easing access to higher education (HE) for those engaging in lifelong learning has been a common policy objective across the European Union since the late 1990s. To reach this goal, the transition between vocational and academic routes must be simplified, but European countries are at different developmental stages. This article maps the…

  11. Learning to Live: The Relationship between Lifelong Learning and Lifelong Illness

    ERIC Educational Resources Information Center

    Jackson, Sue

    2006-01-01

    This paper explores the ways in which people with lifelong chronic illness engage with learning, and how learning impacts on the ways in which they learn to live with their illness. It considers their engagement with and changing focus of learning at different stages: prior to diagnosis, at about the time of diagnosis, and as their understanding…

  12. Strategic ejaculation in simultaneously hermaphroditic land snails: more sperm into virgin mates.

    PubMed

    Kimura, Kazuki; Chiba, Satoshi

    2013-12-05

    It has been theorised that sperm competition promotes the strategic usage of costly sperm. Although sperm competition is thought to be an important driving force of reproductive traits in simultaneous hermaphrodites as well as in species with separate sexes, empirical studies on strategic ejaculation in simultaneous hermaphrodites are scarce. In the present study, we tested whether the simultaneously hermaphroditic land snail Euhadra quaesita adjusts the number of sperm donated according to the condition of the mate and whether the pattern of strategic ejaculation is in line with previously suggested theories. We found that individuals donated much more sperm when they copulated with a virgin mate than when they copulated with a non-virgin. The virgin-biased pattern of ejaculation matches the theoretical prediction and suggests that sperm competition significantly influence the reproductive traits of simultaneously hermaphroditic land snails.

  13. The outcome of intracytoplasmic sperm injection in patients with retrograde ejaculation.

    PubMed

    Nikolettos, N; Al-Hasani, S; Baukloh, V; Schöpper, B; Demirel, L C; Baban, N; Sturm, R; Rudolf, K; Tomalak, K; Tinneberg, H R; Diedrich, K

    1999-09-01

    The objective of this retrospective clinical study was to assess the benefit of assisted fertilization in cases of anejaculatory infertility due to retrograde ejaculation. We report the outcome of intracytoplasmic sperm injection (ICSI) treatment. In 16 couples in which the men suffered from retrograde ejaculation. We performed 35 cycles of ICSI with spermatozoa retrieved from post-ejaculatory urine. The patients had been instructed to alkalinize the urine by ingesting sodium bicarbonate before the procedure. The fertilization rate averaged 51.2%. Seven clinical pregnancies were achieved. Three spontaneous first trimester abortions occurred, but three live offspring were delivered and one pregnancy is ongoing. In conclusion, the use of ICSI may be feasible for patients with retrograde ejaculation who are resistant to medical treatment and whose sperm quality is so low or unpredictable that intrauterine insemination or conventional methods of in-vitro fertilization are not possible.

  14. Healthy live birth using theophylline in a case of retrograde ejaculation and absolute asthenozoospermia.

    PubMed

    Ebner, Thomas; Shebl, Omar; Mayer, Richard Bernhard; Moser, Marianne; Costamoling, Walter; Oppelt, Peter

    2014-02-01

    To analyze whether the use of ready-to-use theophylline is a feasible option in a case of retrograde ejaculation and absolute asthenozoospermia. Case report. In vitro fertilization unit of a public hospital. Thirty-one-year-old nulliparous woman, and 39-year-old male with retrograde ejaculation and absolute asthenozoospermia. Retrieval of postejaculatory urine, restoration of motility using a methylxanthine, intracytoplasmic sperm injection, single-embryo transfer. Sperm motility, fertilization, embryo quality, live birth. Successful fertilization and a single-embryo transfer resulted in a healthy live birth. Theophylline turned out to be a safe, efficient agent for stimulating immotile spermatozoa in patients with retrograde ejaculation. Copyright © 2014 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.

  15. Retrograde ejaculation and abnormal hormonal profile in a subject under treatment with valproate and phenytoin.

    PubMed

    Elia, Jlenia; Imbrogno, Norina; Delfino, Michele; Mazzilli, Fernando

    2010-12-01

    Anti-epileptic drugs may have negative effects on sexual function and hormonal profile. The exact mechanisms involved, however, have yet to be completely understood. We report a case of ejaculation failure and abnormal hormonal profile in a patient affected by epilepsy. A 59-year-old man, under treatment with valproate and phenytoin for 15 years, complained of orgasmic an ejaculation over the previous 6 months. He was not affected by other relevant pathologies and he had not undergone pelvic surgery. We found spermatozoa in post-orgasmic urine, which confirmed our suspicion of retrograde ejaculation. The hormonal profile showed high levels of FSH, LH and, surprisingly, increased levels of total testosterone and SHBG. We hypothesized bladder sphincter inhibition and receptor alterations due to the anti-epileptic drugs.

  16. Identification, RNAi Knockdown and Functional Analysis of an Ejaculate Protein that Mediates a Postmating, Prezgotic Phenotype in a cricket

    USDA-ARS?s Scientific Manuscript database

    Male ejaculate proteins, including both sperm and seminal fluid proteins, play an important role in mediating reproductive biology. The function of ejaculate proteins can include enabling sperm-egg interactions, enhancing sperm storage, mediating female attractiveness, and even regulating female lif...

  17. Ejaculate and type of freezing extender affect rates of fertilization of horse oocytes in vitro.

    PubMed

    Roasa, L M; Choi, Y H; Love, C C; Romo, S; Varner, D D; Hinrichs, K

    2007-09-01

    In vitro fertilization (IVF) was performed on in vitro-matured equine oocytes in three experiments. Frozen-thawed sperm were prepared using swim-up separation and heparin treatment. In Experiment 1, fertilization was achieved with sperm from only one frozen ejaculate of four obtained from the same stallion. Within this ejaculate, fertilization rates were higher with fresh media, as compared to media held for 6-8 days before use (39.6% versus 7.3%, respectively; P<0.001). The type of bovine serum albumin used affected fertilization rates (4% versus 39.6%; P<0.001). To determine if IVF rates were influenced by factors associated with the freezing process (Experiment 2), a single ejaculate from a second stallion was frozen using eight variations in timing of steps in the freezing protocol. There were no differences among treatments in fertilization rates (range, 0-3%). In Experiment 3, fertilization rates of semen frozen in an extender containing 21.5% egg yolk were lower than fertilization rates of semen from the same ejaculate but frozen with a 3% egg-yolk extender (0% versus 15%, respectively; P<0.01). We inferred that rates of equine IVF with frozen-thawed sperm were influenced by ejaculate, the composition and age of the media used, and freezing extender. To our knowledge, this is the first report of ejaculate or extender differences affecting in vitro fertilization in this species. These factors may help to explain the great variability in fertilization rates reported with equine IVF, both among and within laboratories.

  18. Erection- and ejaculation-preserving cystectomy with orthotopic urinary diversion: is it feasible?

    PubMed

    Girgin, Cengiz; Oder, Mehmet; Sahin, M Oguz; Sezer, Akif; Berkmen, Serdar; Aydin, Rusen; Dincel, Cetin

    2006-01-01

    Nerve-sparing techniques to preserve sexual function in men undergoing cystoprostatectomy have been documented by different centers. We evaluated the results of the first 4 erection- and ejaculation-preserving cystectomies performed in our department. The ages of patients ranged between 36 and 43 years. In all cases, patients wished to maintain sexual function. Of the cases, 3 patients had pT1 G3 transitional cell carcinoma (TCC) refractory to treatment and one had pT2a adenocarcinoma of the bladder. Extirpation of the bladder and anterior proximal prostate en bloc with preservation of the vasa deferentia, seminal vesicles, posterior prostate, and neurovascular bundles was performed after pelvic lymphadenectomy. W-ileal neobladder was performed by using 40 cm of ileum. All patients had erections at the third month. Of the cases, 2 patients had antegrade ejaculation. The ejaculate volumes were 0.8 and 1.2 mL in patients with antegrade ejaculation. Patients in the other cases had retrograde ejaculation. All patients were continent day and night. We started clean intermittent catheterization in 1 case because of residual urine. There were no local recurrences. One patient with TCC died because of systemic disease in the postoperative 32nd month. The most important drawback of potent cases in cystectomy decision is erectile dysfunction after radical cystectomy. This drawback causes delay of the operation and sometimes mortality. As was the case in other reports, our limited number of cases in this study demonstrated that erection and ejaculation could be preserved in selected groups of patients.

  19. Premature Needle Loss of Spruce

    Treesearch

    Jennifer Juzwik; Joseph G. O Brien

    1990-01-01

    Premature needle loss on white, black and Norway spruce has been observed in forest plantations in Wisconsin and Minnesota during the past six years. Symptoms vary by species but usually appear first in 2-4-year old needles on lower branches. Infected needles are dropped, resulting in branch mortality that progresses upward through the crown, sometimes killing even...

  20. Music Therapy with Premature Infants

    ERIC Educational Resources Information Center

    Standley, Jayne

    2003-01-01

    Over 20 years of research and clinical practice in music therapy with premature infants has been compiled into this text designed for Board Certified Music Therapists specializing in Neonatal Intensive Care clinical services, for NICU medical staff incorporating research-based music therapy into developmental care plans, and for parents of…

  1. Mothers' Retrospections of Premature Childbirth.

    ERIC Educational Resources Information Center

    Kalmar, Magda; And Others

    This study examined Hungarian mothers' recollections, 8 years after the birth of their premature baby, of their stress at the time of the baby's birth. Interviews were conducted with 30 mothers whose babies had been born between 30 and 37 weeks gestational age. At the time of the follow-up, all children had normal IQs and were attending normal…

  2. Music Therapy with Premature Infants

    ERIC Educational Resources Information Center

    Standley, Jayne

    2003-01-01

    Over 20 years of research and clinical practice in music therapy with premature infants has been compiled into this text designed for Board Certified Music Therapists specializing in Neonatal Intensive Care clinical services, for NICU medical staff incorporating research-based music therapy into developmental care plans, and for parents of…

  3. Lifelong learning: Established concepts and evolving values.

    PubMed

    Talati, Jamsheer Jehangir

    2014-03-01

    To summarise the concepts critical for understanding the content and value of lifelong learning (LL). Ideas generated by personal experience were combined with those of philosophers, social scientists, educational institutions, governments and UNESCO, to facilitate an understanding of the importance of the basic concepts of LL. Autopoietic, continuous, self-determined, informal, vicarious, biographical, lifelong reflexive learning, from and for society, when supported by self-chosen formal courses, can build capacities and portable skills that allow useful responses to challenges and society's new structures of governance. The need for LL is driven by challenges. LL flows continuously in pursuit of one agenda, which could either be citizenship, as is conventional, or as this article proposes, health. LL cannot be wholly centred on vocation. Continuous medical education and continuous professional development, important in their own right, cannot supply all that is needed. LL aids society with its learning, and it requires an awareness of the environment and structures of society. It is heavily vicarious, draws on formal learning and relies for effectiveness on reflection, self-assessment and personal shaping of views of the world from different perspectives. Health is critical to rational thought and peace, and determines society's capacity to govern itself, and improve its health. LL should be reshaped to focus on health not citizenship. Therefore, embedding learning in society and environment is critical. Each urologist must develop an understanding of the numerous concepts in LL, of which 'biographicisation' is the seed that will promote innovative strategies.

  4. Lifelong sedentary behaviour and femur structure.

    PubMed

    Fonseca, H; Gonçalves, D; Figueiredo, P; Mota, M P; Duarte, J A

    2011-05-01

    The aim of the present study was to analyze the lifelong differences of femur structure in sedentary and physically active animal models. Thirty male C57BL/6 mice, 2 months old, were either: i) housed in cages with running wheel (AA; n=10), ii) housed in cages without running wheel (AS; n=10), iii) or sacrificed without intervention (Y; n=10). AA and AS animals were sacrificed after 23 months of housing. Right femur structure was analyzed in all animals by histomorphometry. Significant differences in several microarchitectural parameters of cancellous and cortical bone were identified between Y mice and both groups of aged mice, as well as between AA and AS groups. Lifelong physically active mice had significantly higher cancellous bone surface (Cn.BS) and trabecular number (Tb.N) and decreased trabecular separation (Tb.Sp) at both epiphyses when compared to AS animals. No differences were observed between Y and AA groups regarding osteocyte number (N.Ot) despite its significant reduction in AS animals, suggesting that age alone was not a cause for decreases in N.Ot. Our results suggest that the reduced bone quality observed in the elderly is not only a consequence of age but also of lack of physical activity since sedentary behaviour significantly aggravated the degenerative age-related bone differences.

  5. Is celiac disease a lifelong disorder?

    PubMed

    Schmitz, J

    1996-10-01

    That celiac disease is a lifelong disorder was suggested by clinical case records and was considered to have been demonstrated through the widespread use of intestinal biopsies by the end of the 1950s. It was clear that the mucosal lesions observed in children and adults were identical and responded similarly to gluten withdrawal. In fact, in 1970 the European Society for Paediatric Gastroenterology and Nutrition instituted the practice of a challenge after diagnosis. A relapse of clinical symptoms and of the intestinal lesions after gluten was reintroduced into the diet demonstrated the "permanent" nature of sensitivity to gluten in children with celiac disease. Twenty-five years later, the permanence of the sensitivity of the intestinal mucosa to gluten is again a matter of debate. Several lines of evidence, gathered during recent years, show that celiac disease is not always a lifelong condition. First, the long-term follow-up of children with proven celiac disease shows that 10% to 20% of them become "tolerant" (defined on clinical, biological and histologic grounds) to gluten during adolescence. Second, it has also been shown, in individual cases, that the mucosal lesions typical of the disease may appear during adulthood. Our increasing knowledge of the long-term evolution of the disease suggests that celiac disease develops and, in some cases, fades in a predisposed group of people with intestinal sensitivity to gluten, which is probably a common condition. The factors leading to the appearance or disappearance of the disease, however, are still unknown.

  6. [Ejaculatory profile: a pressure of 5 meters H2O at the level of the bladder neck during ejaculation].

    PubMed

    Hugonnet, Christophe L; Böhlen, Dominik; Schmid, Hans-Peter

    2002-12-01

    The existence of a pressure gradient in order to prevent retrograde ejaculation in men with no ejaculatory disorders has always been postulated, but without any scientific evidence. The profile of the prostatic urethra was recorded during ejaculation in 5 men with no ejaculatory disorders using a 10 F balloon catheter with 16 pressure channels, situated in pairs every 5 mm, starting just below the balloon in the bladder neck and extending as far as the external urethral sphincter. The pressure in the proximal part of the proximal urethra was 500 cm H2O in the five men, but this pressure did not exceed 400 cm H2O distally as far as the colliculus seminalis. The authors present a new method for recording the urethral pressure profile during ejaculation (ejaculatory profile). This study provides a better understanding of the mechanisms of normal ejaculation and could be useful for the evaluation of disorders of ejaculation.

  7. Understanding the Short- and Long-Term Respiratory Outcomes of Prematurity and Bronchopulmonary Dysplasia

    PubMed Central

    Islam, Jessica Y.; Keller, Roberta L.; Aschner, Judy L.; Hartert, Tina V.

    2015-01-01

    Bronchopulmonary dysplasia (BPD) is a chronic respiratory disease associated with premature birth that primarily affects infants born at less than 28 weeks’ gestational age. BPD is the most common serious complication experienced by premature infants, with more than 8,000 newly diagnosed infants annually in the United States alone. In light of the increasing numbers of preterm survivors with BPD, improving the current state of knowledge of long-term respiratory morbidity for infants with BPD is a priority. We undertook a comprehensive review of the published literature to analyze and consolidate current knowledge of the effects of BPD that are recognized at specific stages of life, including infancy, childhood, and adulthood. In this review, we discuss both the short-term and long-term respiratory outcomes of individuals diagnosed as infants with the disease and highlight the gaps in knowledge needed to improve early and lifelong management of these patients. PMID:26038806

  8. Learners or Participants? The Pros and Cons of "Lifelong Learning"

    ERIC Educational Resources Information Center

    Mantie, Roger

    2012-01-01

    Whereas adult education used to be the preferred concept for those studying adult music-making, there is now an increasing trend away from this and towards lifelong learning. Uncritically adopting government lifelong learning discourses, however, blurs the line between educational ideals and political ones. Although there may be merit in the…

  9. Lifelong Learning in Singapore: Where Are We Now?

    ERIC Educational Resources Information Center

    Kumar, Prem

    2004-01-01

    The term lifelong learning has been used in different contexts and in policy application for a wide variety of purposes and initiatives. Singapore's approach to lifelong learning is pragmatic and rational. It is one of the economic drivers used by policy makers to enhance Singapore's competitiveness and is viewed as an antidote against…

  10. Inequalities in Lifelong Learning and Adult University Education Policies

    ERIC Educational Resources Information Center

    Zmas, Aristotelis; Sipitanou, Athina A.

    2009-01-01

    Firstly, the views of the European Union (E.U.) and the Organisation for Economic Co-operation and Development (O.E.C.D.) are examined in relation to the issue of lifelong learning, as well as the challenges that render the reconstruction of the national educational systems essential. Following, it is pointed out that access to lifelong learning…

  11. Lifelong Learning. A Guide to Adult Education in the Church.

    ERIC Educational Resources Information Center

    Grothe, Rebecca, Ed.

    This book contains eight papers about lifelong learning in the Christian church. The preface and foreword are written by Rebecca Groth and H. George Anderson, respectively. (1) "The Gospel Calls Us" (Margaret A. Krych) examines five theological themes of lifelong learning. Adult development and learning styles are considered in (2) "What Teachers…

  12. Researching Lifelong Learning Participation through an Interdisciplinary Lens

    ERIC Educational Resources Information Center

    Boeren, Ellen

    2017-01-01

    This paper explores the interdisciplinary nature of studies in the field of lifelong learning participation. Until recently, participation studies have been presented in a rather fragmented way, often drawing on insights from separate disciplines such as sociology or psychology. The complex nature of lifelong learning participation, however, urges…

  13. Legal Educators' Perceptions of Lifelong Learning: Conceptualisation and Practice

    ERIC Educational Resources Information Center

    Hammer, Sara Jeanne; Chardon, Toni; Collins, Pauline; Hart, Caroline

    2012-01-01

    Lifelong learning appears frequently on university statements of desirable graduate outcomes. It is also referred to as a desirable outcome for Australian law graduates. This paper examines academic staff perceptions of lifelong learning as part of a broader study about assessment practices in a recently established Australian law school. Findings…

  14. Purpose of Lifelong Learning: Analysis from a Single Participant Interview

    ERIC Educational Resources Information Center

    Regmi, Kapil Dev

    2012-01-01

    What should be goal of education in general? What type of education are we practicing in the name of lifelong learning? What perspective of lifelong learning is becoming more dominant? Should the education system of a nation fulfill the demand of the market or the demand of the society? In this short single participant interview research I have…

  15. Development of a Scale to Measure Lifelong Learning

    ERIC Educational Resources Information Center

    Kirby, John R.; Knapper, Christopher; Lamon, Patrick; Egnatoff, William J.

    2010-01-01

    Primary objective: to develop a scale to measure students' disposition to engage in lifelong learning. Research design, methods and procedures: using items that reflected the components of lifelong learning, we constructed a 14-item scale that was completed by 309 university and vocational college students, who also completed a measure of deep and…

  16. Lifelong Learning: Foundational Models, Underlying Assumptions and Critiques

    ERIC Educational Resources Information Center

    Regmi, Kapil Dev

    2015-01-01

    Lifelong learning has become a catchword in almost all countries because of its growing influence on education policies in the globalised world. In the Organisation for Economic Cooperation and Development (OECD) and the European Union (EU), the promotion of lifelong learning has been a strategy to speed up economic growth and become competitive.…

  17. Africa and International Policy Making for Lifelong Learning: Textual Revelations

    ERIC Educational Resources Information Center

    Preece, Julia

    2013-01-01

    This paper discusses the relationship between international agendas for lifelong learning and financial aid for low income countries, especially those on the African continent. It argues that there are subtle differences in terminology written by policymakers respectively in Europe and South Africa for lifelong learning but that international…

  18. The Planner and Lifelong Education. Fundamentals of Educational Planning, 25.

    ERIC Educational Resources Information Center

    Furter, Pierre

    The three sections making up the main body of this publication look at lifelong education from three successive approaches at different levels. An introduction briefly reviews factors influencing the rapid spread of lifelong education--anthropological, socioeconomic, and political. Through a series of questions emerges the idea that lifelong…

  19. Lifelong Learning--Is It Just for the Rich?

    ERIC Educational Resources Information Center

    Duke, Chris

    2008-01-01

    Lifelong learning is a powerful concept and perspective for transforming education systems and enabling learning societies. Developed in the advanced industrialised North, it is now being considered in poor countries where Education for All is a main educational preoccupation. The meaning of lifelong learning is confused and contested, caught up…

  20. Lifelong Learning for All in Asian Communities: ICT Based Initiatives

    ERIC Educational Resources Information Center

    Misra, Pradeep Kumar

    2011-01-01

    The necessity to adjust to the prerequisites of the knowledge based society and economy brought about the need for lifelong learning for all in Asian communities. The concept of lifelong learning stresses that learning and education are related to life as a whole - not just to work - and that learning throughout life is a continuum that should run…