The ejaculation process is typically subdivided into two distinct successive phases: emission (that is, secretion of the various components of sperm by seminal vesicles, prostate and ampullary vas deferentia contents into the prostatic urethra) and expulsion (that is, forceful propulsion of sperm from the prostatic urethra to the urethral meatus caused by rhythmic contractions of perineal striated muscles), which depends on the automatic nervous tones and the somatomotor system, respectively. 3, 4, 5 In addition, several studies have noted the effects of polymorphism of serotonin transporter promoter gene (5-HTTLPR) on ejaculatory function in spite of inconsistencies on this issue. 2 Over the last two decades, it has been suggested that the etiology of PPE may be somatic disorders and/or neurobiological disturbances, suggesting a hypersensitivity and hyperexcitability of the glans penis that cause uncontrolled ejaculation. Previously, it was believed that PPE was primarily psychologically or interpersonally based. 1 Although many different scientific approaches have been applied to study PPE, until now, the precise pathological mechanisms of PPE have not been well evaluated. Primary premature ejaculation (PPE) is defined as ‘a male sexual dysfunction characterized by ejaculation which always or nearly always occurs before or within about 1 min of vaginal penetration, the inability to delay ejaculation on all or nearly all vaginal penetrations and negative personal consequences, such as distress, bother, frustration and/or the avoidance of sexual intimacy’. Patients with PPE have hyperactivity of the sympathetic nervous system, which may be another factor involved in the pathological mechanisms of PPE, and the PSSR is an objective test to evaluate patients with PPE. Mean amplitude of the PSSR was significantly greater in patients than that in the normal men ( P<0.001). Mean latency of the PSSR was significantly shorter in the patients than that in the normally potent men ( P<0.001). The waveform distribution in the PPE patients was not statistically different from that in the control group ( P=0.609). The PSSR waveforms were classified into P type and N type according to the waveform characteristics. The latencies and amplitudes of PSSR were measured.
We performed sympathetic skin response located in the penis (PSSR) in 52 patients with PPE and 46 normally potent men. To evaluate the possible role of the autonomic (sympathetic) nervous system function among the patients with primary premature ejaculation (PPE) and determine whether there is an etiological basis for this condition.
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