早泄诊断客观指标的研究进展
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摘要
早泄是男性最常见的性功能障碍性疾病,属于射精障碍。对于早泄的定义还有许多争议。随着对早泄病因及病理机制研究的不断深入,越来越多的辅助检查用于早泄的诊断、预后判定及治疗。如经直肠超声检测精囊,血清5-羟色胺浓度、血清生殖激素水平、阴茎敏感度、脑功能检查及基因检测等。本文就早泄辅助检查的最新研究进展做一综述,为广大临床医师提供一个可供参考的早泄诊断指标或方法。
Premature ejaculation is a common male sexual dysfunction disorder, and there are many controversies over its definition. With deeper insights into the etiology and pathogenesis of premature ejaculation, more and more auxiliary examinations are used in its diagnosis, prognostic evaluation and treatment, such as transrectal ultrasonography of seminal vesicles, determination of serum 5-hydroxytryptamine(5-HT) concentration, serum hormone levels, penile sensitivity detection, brain function tests, and genetic sequencing. This review outlines the latest advances in the auxiliary examination of premature ejaculation and provides clinicians with some diagnostic indexes or methods of premature ejaculation for reference.
Premature ejaculation is a common male sexual dysfunction disorder, and there are many controversies over its definition. With deeper insights into the etiology and pathogenesis of premature ejaculation, more and more auxiliary examinations are used in its diagnosis, prognostic evaluation and treatment, such as transrectal ultrasonography of seminal vesicles, determination of serum 5-hydroxytryptamine(5-HT) concentration, serum hormone levels, penile sensitivity detection, brain function tests, and genetic sequencing. This review outlines the latest advances in the auxiliary examination of premature ejaculation and provides clinicians with some diagnostic indexes or methods of premature ejaculation for reference.
引文
[1] Montorsi F. Prevalence of premature ejaculation: A global and regional perspective. J Sex Med, 2005, 2(s2): 96-102.
[2] Hatzimouratidis K, Amar E, Eardley I, et al. Guidelines on male sexual dysfunction: Erectile dysfunction and premature ejaculation. Eur Urol, 2010, 57(5): 804-814.
[3] Segraves RT. Considerations for an evidence-based definition of premature ejaculation in the DSM-Ⅴ. J Sex Med, 2010, 7(2 Pt 1): 672-679.
[4] Serefoglu EC, McMahon CG, Waldinger MD, et al. 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. Sex Med, 2014, 2(2): 41-59.
[5] Waldinger MD. 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. J Sex Med, 2006, 3(4): 693-705
[6] Hsieh JT, Chang HC, Law HS, et al. In vivo evaluation of serotonergic agents and alpha-adrenergic blockers on premature ejaculation by inhibiting the seminal vesicle pressure response to electrical nerve stimulation. Br J Urol, 1998, 82(2): 237-240.
[7] Kim SW, Paick JS. Peripheral effects of serotonin on the contractile responses of rat seminal vesicles and vasa deferentia. J Androl, 2004, 25(6): 893-899.
[8] Kang KK, Ahn GJ, Ji HS, et al. Ejaculatory responses are inhibited by a new chemical entity, DA-8031, in preclinical rodent models of ejaculation. Urology, 2013, 81(4): 920. e13-e18.
[9] La Vignera S, Condorelli RA, Vicari E, et al. Acquired premature ejaculation and male accessory gland infection: Relevance of ultrasound examination. Asian J Androl, 2016, 18(5): 769-772.
[10] Hong ZW, Feng YM, Ge YF, et al. Relation of size of seminal vesicles on ultrasound to premature ejaculation. Asian J Androl, 2017, 19(5): 554-560.
[11] La Vignera S, Condorelli R, Vicari E, et al. High frequency of sexual dysfunction in patients with male accessory gland infections. Andrologia, 2012, 44(s1): 438-446.
[12] Lee JH, Lee SW. Relationship between premature ejaculation and chronic prostatitis/chronic pelvic pain syndrome. J Sex Med, 2015, 12(3): 697-704.
[13] Yang C, Tang K, Wang B. Clinical value of serum 5-HT level in diagnosis and treatment of premature ejaculation. Urol Int, 2013, 90(2): 214-218.
[14] Guo Y, Wang Y, Wang X, et al. Association between changes in serum 5-hydroxy-tryptamine concentrations and improvement in clinical symptoms in primary premature ejaculation with paroxetine treatment. Med Sci Monit, 2015, 21: 2521-2527.
[15] Corona G, Jannini EA, Mannucci E, et al. Different testosterone levels are associated with ejaculatory dysfunction. J Sex Med, 2008, 5(8): 1991-1998.
[16] Sakamoto H, Takanami K, Zuloaga DG, et al. Androgen regulates the sexually dimorphic gastrin-releasing peptide system in the lumbar spinal cord that mediates male sexual function. Endocrinology, 2009, 150(8): 3672-3679.
[17] 柳建明, 邓军洪, 石华,等. 血清睾酮与早泄相关性的初步探讨. 中国性科学, 2016, 25(8): 32-34.
[18] Canat L, Erbin A, Canat M, et al. Assessment of hormonal activity in patients with premature ejaculation. Int Braz J Urol, 2017, 43(2): 311-316.
[19] Wyllie MG, Hellstrom WJ. The link between penile hypersensitivity and premature ejaculation. BJU Int, 2011, 107(3): 452-457.
[20] 夏佳东, 韩友峰, 龚曹科, 等. 阴茎背神经体感诱发电位对早泄的诊断价值. 中国男科学杂志, 2012, 21(12): 17-21.
[21] Xia JD, Zhou LH,Han YF, et al. A reassessment of penile sensory pathways and effects of prilocaine-lidocaine cream in primary premature ejaculation. Int J Impot Res, 2014, 26(5): 186-190.
[22] Xia JD, Han YF, Zhou LH, et al. Sympathetic skin response in patients with primary premature ejaculation. Int J Impot Res, 2014, 26(1): 31-34.
[23] Guo L, Liu Y, Wang X, et al. Significance of penile hypersensitivity in premature ejaculation. Sci Rep, 2017, 7(1): 10441.
[24] 张春影, 李兴华, 袁谭, 等. 阴茎背神经局部解剖学研究及其临床意义. 中华男科学杂志, 2009, 15(2): 130-133.
[25] Mouras H, Stoléru S, Bittoun J, et al. Brain processing of visual sexual stimuli in healthy men: A functional magnetic resonance imaging study. Neuroimage, 2003, 20(2): 855-869.
[26] Kim SW, Sohn DW, Cho YH, et al. Brain activation by visual erotic stimuli in healthy middle aged males. Int J Impot Res, 2006, 18(5): 452-457.
[27] Mallick HN, Tandon S, Jagannathan NR, et al. Brain areas activated after ejaculation in healthy young human subjects. Indian J Physiol Pharmacol, 2007, 51(1): 81-85.
[28] Zhang B, Lu J, Xia J, et al. Functional insights into aberrant brain responses and integration in patients with lifelong premature ejaculation. Sci Rep, 2017, 7(1): 460.
[29] Guo F, Xi YB, Gao M, et al. Alterations in cortical thickness in nonmedicated premature ejaculation patients: A morphometric MRI study. J Magn Reson Imaging, 2018, 47(3): 656-662.
[30] Schapiro B. Potency disorders in the male: A review of 1960 cases of premature ejaculation. Harefuah, 1953, 45(2): 39-41.
[31] Waldinger MD, Rietschel M, N?then MM, et al, Familial occurrence of primary premature ejaculation. Psychiatr Genet, 1998, 8(1): 37-40.
[32] Jern P, Santtila P, Johansson A, et al. Evidence for a genetic etiology toejaculatory dysfunction. Int J Impot Res, 2009, 21(1): 62-67.
[33] Gelernter J, Kranzler H, Cubells JF. Serotonin transporter protein (SLC6A4)allele and haplotype frequencies and linkage disequilibria in African- and European-American and Japanese populations and in alcohol-dependent subjects. Hum Genet,1997, 101(2): 243-246.
[34] Heils A, Teufel A, Petri S. et al. Allelic variation of human serotonin transporter gene expression. J Neurochem, 1996, 66(6): 2621-2624.
[35] Luo S, Lu Y, Wang F, et al. Association between polymorphisms in the serotonin 2C receptor gene and premature ejaculation in Han Chinese subjects. Urol Int, 2010, 85(2): 204-208.
[36] Huang Y, Zhang X, Gao J, et al. 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. Med Sci Monit, 2016, 22: 2066-2074.
[2] Hatzimouratidis K, Amar E, Eardley I, et al. Guidelines on male sexual dysfunction: Erectile dysfunction and premature ejaculation. Eur Urol, 2010, 57(5): 804-814.
[3] Segraves RT. Considerations for an evidence-based definition of premature ejaculation in the DSM-Ⅴ. J Sex Med, 2010, 7(2 Pt 1): 672-679.
[4] Serefoglu EC, McMahon CG, Waldinger MD, et al. 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. Sex Med, 2014, 2(2): 41-59.
[5] Waldinger MD. 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. J Sex Med, 2006, 3(4): 693-705
[6] Hsieh JT, Chang HC, Law HS, et al. In vivo evaluation of serotonergic agents and alpha-adrenergic blockers on premature ejaculation by inhibiting the seminal vesicle pressure response to electrical nerve stimulation. Br J Urol, 1998, 82(2): 237-240.
[7] Kim SW, Paick JS. Peripheral effects of serotonin on the contractile responses of rat seminal vesicles and vasa deferentia. J Androl, 2004, 25(6): 893-899.
[8] Kang KK, Ahn GJ, Ji HS, et al. Ejaculatory responses are inhibited by a new chemical entity, DA-8031, in preclinical rodent models of ejaculation. Urology, 2013, 81(4): 920. e13-e18.
[9] La Vignera S, Condorelli RA, Vicari E, et al. Acquired premature ejaculation and male accessory gland infection: Relevance of ultrasound examination. Asian J Androl, 2016, 18(5): 769-772.
[10] Hong ZW, Feng YM, Ge YF, et al. Relation of size of seminal vesicles on ultrasound to premature ejaculation. Asian J Androl, 2017, 19(5): 554-560.
[11] La Vignera S, Condorelli R, Vicari E, et al. High frequency of sexual dysfunction in patients with male accessory gland infections. Andrologia, 2012, 44(s1): 438-446.
[12] Lee JH, Lee SW. Relationship between premature ejaculation and chronic prostatitis/chronic pelvic pain syndrome. J Sex Med, 2015, 12(3): 697-704.
[13] Yang C, Tang K, Wang B. Clinical value of serum 5-HT level in diagnosis and treatment of premature ejaculation. Urol Int, 2013, 90(2): 214-218.
[14] Guo Y, Wang Y, Wang X, et al. Association between changes in serum 5-hydroxy-tryptamine concentrations and improvement in clinical symptoms in primary premature ejaculation with paroxetine treatment. Med Sci Monit, 2015, 21: 2521-2527.
[15] Corona G, Jannini EA, Mannucci E, et al. Different testosterone levels are associated with ejaculatory dysfunction. J Sex Med, 2008, 5(8): 1991-1998.
[16] Sakamoto H, Takanami K, Zuloaga DG, et al. Androgen regulates the sexually dimorphic gastrin-releasing peptide system in the lumbar spinal cord that mediates male sexual function. Endocrinology, 2009, 150(8): 3672-3679.
[17] 柳建明, 邓军洪, 石华,等. 血清睾酮与早泄相关性的初步探讨. 中国性科学, 2016, 25(8): 32-34.
[18] Canat L, Erbin A, Canat M, et al. Assessment of hormonal activity in patients with premature ejaculation. Int Braz J Urol, 2017, 43(2): 311-316.
[19] Wyllie MG, Hellstrom WJ. The link between penile hypersensitivity and premature ejaculation. BJU Int, 2011, 107(3): 452-457.
[20] 夏佳东, 韩友峰, 龚曹科, 等. 阴茎背神经体感诱发电位对早泄的诊断价值. 中国男科学杂志, 2012, 21(12): 17-21.
[21] Xia JD, Zhou LH,Han YF, et al. A reassessment of penile sensory pathways and effects of prilocaine-lidocaine cream in primary premature ejaculation. Int J Impot Res, 2014, 26(5): 186-190.
[22] Xia JD, Han YF, Zhou LH, et al. Sympathetic skin response in patients with primary premature ejaculation. Int J Impot Res, 2014, 26(1): 31-34.
[23] Guo L, Liu Y, Wang X, et al. Significance of penile hypersensitivity in premature ejaculation. Sci Rep, 2017, 7(1): 10441.
[24] 张春影, 李兴华, 袁谭, 等. 阴茎背神经局部解剖学研究及其临床意义. 中华男科学杂志, 2009, 15(2): 130-133.
[25] Mouras H, Stoléru S, Bittoun J, et al. Brain processing of visual sexual stimuli in healthy men: A functional magnetic resonance imaging study. Neuroimage, 2003, 20(2): 855-869.
[26] Kim SW, Sohn DW, Cho YH, et al. Brain activation by visual erotic stimuli in healthy middle aged males. Int J Impot Res, 2006, 18(5): 452-457.
[27] Mallick HN, Tandon S, Jagannathan NR, et al. Brain areas activated after ejaculation in healthy young human subjects. Indian J Physiol Pharmacol, 2007, 51(1): 81-85.
[28] Zhang B, Lu J, Xia J, et al. Functional insights into aberrant brain responses and integration in patients with lifelong premature ejaculation. Sci Rep, 2017, 7(1): 460.
[29] Guo F, Xi YB, Gao M, et al. Alterations in cortical thickness in nonmedicated premature ejaculation patients: A morphometric MRI study. J Magn Reson Imaging, 2018, 47(3): 656-662.
[30] Schapiro B. Potency disorders in the male: A review of 1960 cases of premature ejaculation. Harefuah, 1953, 45(2): 39-41.
[31] Waldinger MD, Rietschel M, N?then MM, et al, Familial occurrence of primary premature ejaculation. Psychiatr Genet, 1998, 8(1): 37-40.
[32] Jern P, Santtila P, Johansson A, et al. Evidence for a genetic etiology toejaculatory dysfunction. Int J Impot Res, 2009, 21(1): 62-67.
[33] Gelernter J, Kranzler H, Cubells JF. Serotonin transporter protein (SLC6A4)allele and haplotype frequencies and linkage disequilibria in African- and European-American and Japanese populations and in alcohol-dependent subjects. Hum Genet,1997, 101(2): 243-246.
[34] Heils A, Teufel A, Petri S. et al. Allelic variation of human serotonin transporter gene expression. J Neurochem, 1996, 66(6): 2621-2624.
[35] Luo S, Lu Y, Wang F, et al. Association between polymorphisms in the serotonin 2C receptor gene and premature ejaculation in Han Chinese subjects. Urol Int, 2010, 85(2): 204-208.
[36] Huang Y, Zhang X, Gao J, et al. 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. Med Sci Monit, 2016, 22: 2066-2074.