The Diagnostic Role of Neurophysiological Tests for Premature Ejaculation: A Prospective Multicenter Study.
The Diagnostic Role of Neurophysiological Tests for Premature Ejaculation: A Prospective Multicenter Study.
复制标题
DOI：
10.1097/ju.0000000000002198
复制
发表时间：
2022-01
期刊：
影响因子：
--
通讯作者：
Xia J
中科院分区：
文献类型：
--
作者：
Yang B;Hong Z;Luse DC;Han Y;Sun G;Feng Y;Zhang C;Sun C;Xu Z;Chen H;Yao B;Liu K;Zhu W;Chen Y;Wang R;Dai Y;Xia J
早泄是男性最常见的性功能障碍之一。局部麻醉剂（LAs）和达泊昔布经常用于治疗PE;然而，先前的研究显示了不同的疗效。本研究旨在使用基于神经生理学测试的新分类来确定LA和达泊沙星的疗效。这项多中心队列研究入组了阴道内射精潜伏期（IELT）≤2分钟的成年男性（568例）。根据神经生理学检查结果将患者分为4组，并分配12周的不同治疗：1）阴茎感觉兴奋过度型（Sens）-LAs; 2）阴茎交感兴奋过度型（Symp）-达泊洛酮; 3）混合型（Mixed）-LAs和达泊洛酮; 4）正常型（Norm）-LAs和达泊洛酮。记录自我评估的IELT和患者报告的结局。治疗后达到IELT >2分钟和≥5分钟的男性总百分比分别为82.7%和76.7%。在神经生理学检查异常的男性中，401例（86.6%）在12周疗程后IELT改善>2 min，其中375例（81.0%）达到IELT ≥5 min。治疗12周后，各组患者报告的所有结局指标均有所改善，其中神经生理学检查异常的患者改善更大。神经电生理检查结果异常的PE患者，LAs和达泊昔单抗的疗效增加。这种使用神经生理学测试的PE新分类可以帮助指导和提高PE治疗的疗效。
Premature ejaculation (PE) is one of the most common male sexual dysfunctions. Local anesthetics (LAs) and dapoxetine are frequently used to treat PE; however, previous studies show variable efficacy. This study aims to determine the efficacy of LAs and dapoxetine using a novel classification based on neurophysiological tests. This multicenter cohort study enrolled adult men (568) with an intravaginal ejaculatory latency time (IELT) ≤2 minutes. Patients were divided into 4 groups according to the results of neurophysiological tests and assigned different treatments for 12 weeks: 1) penile sensory hyperexcitability type (Sens)—LAs; 2) penile sympathetic hyperexcitability type (Symp)—dapoxetine; 3) mixed type (Mixed)—both LAs and dapoxetine; 4) normal type (Norm)—both LAs and dapoxetine. Self-estimated IELT and patient-reported outcomes were recorded. The total percentage of men achieving IELT >2 minutes and ≥5 minutes after treatment were 82.7% and 76.7%, respectively. For men with abnormal results of neurophysiological tests, 401 (86.6%) had improved IELT >2 minutes after the 12-week treatment course, in which 375 (81.0%) achieved IELT ≥5 minutes. All patient-reported outcome measures improved in each group after 12 weeks of treatment, with greater improvements among those with abnormal neurophysiological tests. The efficacy of LAs and dapoxetine increased in PE patients with abnormal results of neurophysiological tests. This novel classification of PE using neurophysiological tests could help guide and improve efficacy of PE therapies.