The Experts below are selected from a list of 6639 Experts worldwide ranked by ideXlab platform

Marcel D. Waldinger - One of the best experts on this subject based on the ideXlab platform.

  • The neurobiological approach to Premature Ejaculation.
    The Journal of urology, 2020
    Co-Authors: Marcel D. Waldinger
    Abstract:

    Data showing the neurobiological background of rapid Ejaculation was reviewed. In addition, new hypotheses to integrate clinical symptomatology, psychopharmacotherapy and psychotherapy of rapid Ejaculation with brain function are provided. A computerized MEDLINE search, and manual bibliographic review of cross-references and neurobiological animal studies were performed. These reports were analyzed, summarized and compared with the studies performed by the author. The literature on Premature Ejaculation published between 1887 and 2001 was reviewed. It appeared that the various psychological hypotheses and psychotherapies have not adequately been investigated. In contrast, psychopharmacological treatment studies, animal research data and stopwatch assessments in men with rapid (Premature) Ejaculation indicate that lifelong rapid Ejaculation is a neurobiological phenomenon related to central serotonergic neurotransmission and likely influenced by hereditary factors. Basic and clinical psychopharmacological studies suggest that Premature Ejaculation is a not a psychological disturbance but a neurobiological phenomenon.

  • Pharmacotherapy for Premature Ejaculation
    Current Opinion in Psychiatry, 2014
    Co-Authors: Marcel D. Waldinger
    Abstract:

    PURPOSE OF REVIEW: As there are various drugs and different treatment strategies to delay Ejaculation, a review of the current drug treatments for Premature Ejaculation is relevant for daily clinical practice. RECENT FINDINGS: There are four Premature Ejaculation subtypes: lifelong Premature Ejaculation, acquired Premature Ejaculation, variable Premature Ejaculation and subjective Premature Ejaculation. These Premature Ejaculation subtypes vary in the duration of the intravaginal Ejaculation latency time, their course in life and frequency of early Ejaculations. Drug treatment is mainly required for lifelong and acquired Premature Ejaculation. On the other hand, counseling, psychoeducation and local anesthetics are particularly indicated for variable Premature Ejaculation and subjective Premature Ejaculation. Apart from the efficacy of various drugs, drugs against Premature Ejaculation can be taken on-demand or on a daily basis. However, apart from the on-demand use of dapoxetine, all other Premature Ejaculation treatments are off-label. SUMMARY: Drug treatment is the first choice of treatment for lifelong Premature Ejaculation and may also be indicated for acquired Premature Ejaculation. Together with the patient, the clinician can choose which drug and which treatment strategy is most suitable for the patient and his partner.

  • Practice guideline 'Premature Ejaculation'
    Nederlands Tijdschrift voor Geneeskunde, 2012
    Co-Authors: Peter Leusink, Marcel D. Waldinger, Ellen Laan, Van Lankveld J, Eric J.h. Meuleman, C. Reisman, Luca Incrocci
    Abstract:

    In 2010 the International Society of Sexual Medicine published its practice guideline for the diagnosis and treatment of Premature Ejaculation. This guideline was translated and adapted on a number of points by a committee consisting of members of two Dutch sexological societies, the 'WVSD' and the 'NVVS'. The most important subjects in this guideline are: (a) the case history is the most important diagnostic tool; (b) a physical examination is usually not necessary; (c) determination of the subtype of Premature Ejaculation can guide treatment; (d) pharmacotherapy alone is only applicable for primary Premature Ejaculation; (e) combination therapy is preferable for the secondary form of Premature Ejaculation, and pharmacotherapy is contraindicated for the other 2 subtypes.

  • proposal for a definition of lifelong Premature Ejaculation based on epidemiological stopwatch data
    The Journal of Sexual Medicine, 2005
    Co-Authors: Marcel D. Waldinger, Aeilko H Zwinderman, Berend Olivier, Dave H Schweitzer
    Abstract:

    ABSTRACT Introduction Consensus on a definition of Premature Ejaculation has not yet been reached because of debates based on subjective authority opinions and nonstandardized assessment methods to measure Ejaculation time and Ejaculation control. Aim To provide a definition for lifelong Premature Ejaculation that is based on epidemiological evidence including the neurobiological and psychological approach. Methods We used the 0.5 and 2.5 percentiles as accepted standards of disease definition in a skewed distribution. We applied these percentiles in a stopwatch‐determined intravaginal Ejaculation latency time (IELT) distribution of 491 nonselected men from five different countries. The practical consequences of 0.5% and 2.5% cutoff points for disease definition were taken into consideration by reviewing current knowledge of feelings of control and satisfaction in relation to ejaculatory performance of the general male population. Main Outcome Measures Literature arguments to be used in a proposed consensus on a definition of Premature Ejaculation. Results The stopwatch‐determined IELT distribution is positively skewed. The 0.5 percentile equates to an IELT of 0.9 minute and the 2.5 percentile an IELT of 1.3 minutes. However, there are no available data in the literature on feelings of control or satisfaction in relation to ejaculatory latency time in the general male population. Random male cohort studies are needed to end all speculation on this subject. Exact stopwatch time assessment of IELT in a multinational study led us to propose that all men with an IELT of less than 1 minute (belonging to the 0.5 percentile) have “definite” Premature Ejaculation, while men with IELTs between 1 and 1.5 minutes (between 0.5 and 2.5 percentile) have “probable” Premature Ejaculation. Severity of Premature Ejaculation (nonsymptomatic, mild, moderate, severe) should be defined in terms of associated psychological problems. Conclusion We define lifelong Premature Ejaculation as a neurobiological dysfunction with an unacceptable increase of risk to develop sexual and psychological problems anywhere in a lifetime. By defining Premature Ejaculation from an authority‐defined disorder into a dysfunction based on epidemiological evidence it is possible to establish consensus based on epidemiological evidence. Additional epidemiological stopwatch studies are needed for a final decision of IELT values at both percentile cutoff points.

  • lifelong Premature Ejaculation from authority based to evidence based medicine
    BJUI, 2004
    Co-Authors: Marcel D. Waldinger
    Abstract:

    SUMMARY Historically, four periods can be distinguished in the approach to and treatment of lifelong Premature Ejaculation. Although drug treatment has been an option for many decades, psychotherapy prevailed as the first choice of treatment. However, the application of the principles of evidence-based medicine shows that there is little evidence to support the psychological approach and behavioural treatment. In contrast, controlled trials with selective serotonin reuptake inhibitors, clomipramine and anaesthetic ointments have repeatedly shown the efficacy of both daily and ‘as-needed’ drug treatment to delay Ejaculation. Currently, an evidence-based approach is gradually replacing the authority-based psychological attitude that characterized the view of Premature Ejaculation. Based on psychopharmacological studies there is evidence that Premature Ejaculation is related to a diminished serotonergic neurotransmission, and 5-HT2C or 5-HT1A receptor disturbances. Moreover, animal studies show the presence of a distinct Ejaculation-related neural circuit in the central nervous system; its role in Premature Ejaculation remains to be elucidated.

Emmanuele A. Jannini - One of the best experts on this subject based on the ideXlab platform.

  • the pathophysiology of acquired Premature Ejaculation
    Translational Andrology and Urology, 2016
    Co-Authors: Chris G. Mcmahon, Emmanuele A. Jannini, Ege Can Şerefoğlu, Wayne J.g. Hellstrom
    Abstract:

    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.

  • Epidemiology of Premature Ejaculation
    Current Opinion in Urology, 2005
    Co-Authors: Emmanuele A. Jannini, Andrea Lenzi
    Abstract:

    Purpose of reviewAccumulating evidence suggests that Premature Ejaculation is the most common sexual symptom. This review focuses on the epidemiology of Premature Ejaculation from geographical and medical perspectives.Recent findingsIn the past year many articles have been published using the data f

  • prevalence of chronic prostatitis in men with Premature Ejaculation
    Urology, 2001
    Co-Authors: Emiliano Screponi, Eleonora Carosa, Savino M Di Stasi, Mario Pepe, Giuseppe Carruba, Emmanuele A. Jannini
    Abstract:

    Objectives. To investigate the prevalence of chronic prostatitis in men with Premature Ejaculation. The etiology of Premature Ejaculation is currently considered psychological in nature. However, the possibility that urologic, hormonal, or neurologic factors may contribute to this condition should be considered in its management. Methods. We evaluated segmented urine specimens before and after prostatic massage and expressed prostatic secretion specimens from 46 patients with Premature Ejaculation and 30 controls by bacteriologic localization studies. The incidence of Premature Ejaculation in the subjects with chronic prostatitis was also evaluated. Results. Prostatic inflammation was found in 56.5% and chronic bacterial prostatitis in 47.8% of the subjects with Premature Ejaculation, respectively. When compared with the controls, these novel findings were statistically significant (P <0.05). Conclusions. Considering the role of the prostate gland in the mechanism of Ejaculation, we suggest a role for chronic prostate inflammation in the pathogenesis of some cases of Premature Ejaculation. Since chronic prostatitis has been found with a high frequency in men with Premature Ejaculation, we stress the importance of a careful examination of the prostate before any pharmacologic or psychosexual therapy for Premature Ejaculation.

  • Prevalence of chronic prostatitis in men with Premature Ejaculation
    Urology, 2001
    Co-Authors: Emiliano Screponi, Eleonora Carosa, Savino M Di Stasi, Mario Pepe, Giuseppe Carruba, Emmanuele A. Jannini
    Abstract:

    Objectives. To investigate the prevalence of chronic prostatitis in men with Premature Ejaculation. The etiology of Premature Ejaculation is currently considered psychological in nature. However, the possibility that urologic, hormonal, or neurologic factors may contribute to this condition should be considered in its management. Methods. We evaluated segmented urine specimens before and after prostatic massage and expressed prostatic secretion specimens from 46 patients with Premature Ejaculation and 30 controls by bacteriologic localization studies. The incidence of Premature Ejaculation in the subjects with chronic prostatitis was also evaluated. Results. Prostatic inflammation was found in 56.5% and chronic bacterial prostatitis in 47.8% of the subjects with Premature Ejaculation, respectively. When compared with the controls, these novel findings were statistically significant (P

Rany Shamloul - One of the best experts on this subject based on the ideXlab platform.

  • original research ejaculatory disorders chronic prostatitis in Premature Ejaculation a cohort study in 153 men
    The Journal of Sexual Medicine, 2006
    Co-Authors: Rany Shamloul, Abdelrahman El Nashaar
    Abstract:

    ABSTRACT Introduction Premature Ejaculation is a common male sexual dysfunction, affecting 30–40% of sexually active men in an age‐dependent manner. Chronic prostatitis has been suggested as an important organic cause of Premature Ejaculation. Aim The aim of this study was to confirm previous data reported on the incidence of chronic prostatitis in a large cohort of patients with primary and secondary Premature Ejaculation. Methods A total of 153 consecutive heterosexual men aged 29–51 years with Premature Ejaculation and another 100 male healthy subjects were included in this study. Sequential microbiologic specimens were obtained according to the standardized Meares and Stamey protocol. Nonbacterial prostatitis was defined by the evidence of prostatic inflammation but negative cultures of urine and prostatic fluids in men with various genitourinary symptoms. Results There was no significant difference between patients and control subjects regarding age, education, or intercourse frequency. Prostatic inflammation was found in 64% and chronic bacterial prostatitis in 52% of the patients with Premature Ejaculation, respectively, showing statistical significance compared with control subjects ( P Conclusions Results in our study showed a high prevalence of chronic prostatitis in patients with Premature Ejaculation. Examination of the prostate, physically and microbiologically, should be considered during assessment of patients with Premature Ejaculation. Shamloul R, and Nashaar A. Chronic prostatitis in Premature Ejaculation: A cohort study in 153 men. J Sex Med 2006;3:150–154.

David L Rowland - One of the best experts on this subject based on the ideXlab platform.

  • the psychological burden of Premature Ejaculation
    The Journal of Urology, 2007
    Co-Authors: David L Rowland, Donald L Patrick, Margaret Rothman, Dennis D Gagnon
    Abstract:

    Purpose: Premature Ejaculation is characterized by short ejaculatory latency, inability to control Ejaculation and resultant overall decreased sexual satisfaction for the man and his partner. Diagnostic criteria typically include aspects of psychological well-being. To motivate and justify treatment for Premature Ejaculation a more comprehensive understanding of its impact on men, their partners and their overall relationship is needed.Materials and Methods: In a community based, observational study of 1,587 men and their female partners clinicians diagnosed Premature Ejaculation using Diagnostic and Statistical Manual of Mental Disorders, 4th edition, text revision criteria. For purposes of this analysis this group was further restricted to subjects with a stopwatch measured intravaginal ejaculatory latency time of 2 minutes or less. Responses to the Premature Ejaculation Profile, Self-Esteem and Relationship questionnaire, Golombok-Rust Inventory of Sexual Satisfaction and Medical Outcomes Study SF-36® ...

  • Penile sensitivity in men with Premature Ejaculation and erectile dysfunction
    Journal of Sex & Marital Therapy, 1993
    Co-Authors: David L Rowland, Stefan Haensel, J. H. M. Blom, A.k. Slob
    Abstract:

    Abstract Previous research indicates that penile sensitivity is typically lower in men with erectile dysfunction than in age-matched controls. On the assumption that sensitivity might be greater in men with short Ejaculation latency (Premature Ejaculation), the present research investigated penile threshold (sensitivity) to vibrotactile stimulation in men with Premature Ejaculation, erectile dysfunction, or a combination of the two. Premature ejaculators showed thresholds commensurate with controls, while men with erectile dysfunction, or combined erectile dysfunction and Premature Ejaculation, showed significantly elevated thresholds. Although Premature ejaculators did not show penile hypersensitivity, there was a significant correlation in this group between Ejaculation latency and threshold. Overall, these findings argue against a primary role for penile sensitivity in Ejaculation latency, and suggest that other somatic factors or cognitive factors may play the more critical role in Premature Ejaculation.

Abdelrahman El Nashaar - One of the best experts on this subject based on the ideXlab platform.

  • original research ejaculatory disorders chronic prostatitis in Premature Ejaculation a cohort study in 153 men
    The Journal of Sexual Medicine, 2006
    Co-Authors: Rany Shamloul, Abdelrahman El Nashaar
    Abstract:

    ABSTRACT Introduction Premature Ejaculation is a common male sexual dysfunction, affecting 30–40% of sexually active men in an age‐dependent manner. Chronic prostatitis has been suggested as an important organic cause of Premature Ejaculation. Aim The aim of this study was to confirm previous data reported on the incidence of chronic prostatitis in a large cohort of patients with primary and secondary Premature Ejaculation. Methods A total of 153 consecutive heterosexual men aged 29–51 years with Premature Ejaculation and another 100 male healthy subjects were included in this study. Sequential microbiologic specimens were obtained according to the standardized Meares and Stamey protocol. Nonbacterial prostatitis was defined by the evidence of prostatic inflammation but negative cultures of urine and prostatic fluids in men with various genitourinary symptoms. Results There was no significant difference between patients and control subjects regarding age, education, or intercourse frequency. Prostatic inflammation was found in 64% and chronic bacterial prostatitis in 52% of the patients with Premature Ejaculation, respectively, showing statistical significance compared with control subjects ( P Conclusions Results in our study showed a high prevalence of chronic prostatitis in patients with Premature Ejaculation. Examination of the prostate, physically and microbiologically, should be considered during assessment of patients with Premature Ejaculation. Shamloul R, and Nashaar A. Chronic prostatitis in Premature Ejaculation: A cohort study in 153 men. J Sex Med 2006;3:150–154.