The role of diallyl thiosulfinate associated with nuciferine and diosgenin in the treatment of premature ejaculation: a pilot study

Objective: To assess the efficacy and safety of an association of diallyl thiosulfinate with nuciferine and diosgenin in the treatment of a group of patients suffering from premature ejaculation (PE), primary or secondary to erectile dysfunction (ED). Materials and methods: From July 2015 to October 2016, 143 patients (mean age 25.3; range 18-39) affected by PE completed the study and were finally analyzed in this phase I study. All patients, after clinical assessment and laboratory evaluation were asked to take an association of diallyl thiosulfinate with nuciferine and diosgenin as oral tablet, once a day, on alternate days, for three months. At the baseline and after three months of treatment, each patient was asked to complete the following questionnaires: International Index of Erectile Function (IIEF-5), Premature Ejaculation Diagnostic Tool (PEDT), Male Sexual Health Questionnaire (MSHQ). Results: A statistical significant improvement in terms of erectile function, comparing the IIEF-5 value at baseline and follow-up visit was found (respectively IIEF-5: 8.7 vs 14.01; p < 0.001). Moreover, at follow-up visit, 97/143 men (67.8%) referred a subjective improvement of the erection quality and a better control of the ejaculation (PROs). The IELT improved too between the baseline evaluation and the follow-up visit (p < 0.001). Conclusion: In conclusion, our study, even if supported by preliminary results, showed how Diallyl Thiosulfinate, Nuciferine and Diosgenin is able to improve the control of ejaculation in patients suffering from PE, primary or secondary to ED without any significant adverse effects

Etiology and Management of Sexual Dysfunction

Sexual dysfunction is the impairment or disruption of any of the three phases of normal sexual functioning, including loss of libido, impairment of physiological arousal and loss, delay or alteration of orgasm. Each one of these can be affected by an orchestra of factors like senility, medical and surgical illnesses, medications and drugs of abuse. Non-pharmacological therapy is the main stay in the treatment of sexual dysfunction and drugs are used as adjuncts for a quicker and better result. Management in many of the cases depends on the primary cause. Here is a review of the major etiological factors of sexual dysfunction and its managemen

Flouxetine Improved Intravaginal Ejaculatory Latency TIME Through Decreased Levels of Interferon-gamma and Increased Levels of Serotonin in Patient with Premature Ejaculation

Pathophysiology of premature ejaculation (PE) is very complex because it is associated with many factors, which can be grouped into biological factors and psychological factors. Various diseases have been found correlate between psychological factors and biological factors through cytokines, one of which is IFN-g (IFN-g). IFN-g affect indolamine dioxygenase enzyme (IDO) and decrease levels of serotonin. Low levels of serotonin leads to PE. The purpose of this study was to prove the relationship of serotonin and IFN-g in pathophysiology of PE. This study was designed as a pretest-posttest double-blind cross-over control group design. Patients with PE were divided into 2 groups: control group and treatment group. Treatment group received flouxetine 20 mg for 30 days. Then the control and treatment groups were crossed after passing a 14-days washout period. Previously as a control group to treatment group and received flouxetine 20 mg per day for 30 days. Before and after treatment in each group was examined the levels of serotonin and IFN-g. Of the 26 subjects, each group there was 13 subjects. Flouxetine 20 mg per day for 30 days increased serotonin levels were significantly (p < 0.05), and decreased levels of IFN-g were significantly (p < 0.05). Increased levels of serotonin and decreased levels of IFN-g was significantly associated with improvements (intravaginal ejaculatory latency time) ejaculation in PE patient. From these results it can be concluded that PE occurs because decreased levels of serotonin. Decreased levels of serotonin are associated with increased levels of IFN-g

The sentiment analysis of tweets as a new tool to measure public perception of male erectile and ejaculatory dysfunctions

Twitter is a social network based on "tweets," short messages of up to 280 characters. Social media has been investigated in health care research to ascertain positive or negative feelings associated with several conditions but never in sexual medicin

Thyroid hormone receptors and ligand, tissue distribution and sexual behavior

The thyroid hormones (THs) triiodothyronine (T3) and tetraiodothyronine, or thyroxine (T4), not only dramatically impact on development and differentiation, but also on the sexual and reproductive function. There is large body of literature, in fact, on the effects of THs on the reproductive function in both humans (Poppe and Velkeniers, 2004; Wajner et al., 2009) and animals (Hapon et al., 2010; Nelson et al., 2011). For a long time the gonads were thought to be unresponsive to THs, but TH receptors (TR) were discovered in rat (Jannini et al., 1990; Palmero et al., 1988) and then in human testis (Jannini et al., 2000). In women, the association of menstrual disturbance with thyroid disease was described as early as 1840 by von Basedow, but the discovery of TRs in the ovary was carried out at the end of last century (Wakim et al., 1994b). Therefore, the link between thyroid and reproductive function was well established. Since then, research has shown that thyroid dysfunction is associated with an adverse effect on fertility, both in men (Wagner et al., 2009) and women (Dittrich et al., 2011). There is also evidence that THs can affect the sex steroid hormone axis (Bagamasbad and Denver, 2011), consequently sexual hormones and the pituitary gland can mediate the action of THs on the reproductive physiology. While the effects of THs on fertility have been widely studied, little is known about their influence on sexual function. In the last few years, an increasing number of evidences have shown the influence of THs on male sexual function, particularly on ejaculation control as well on desire and erectile function (Carani et al., 2005; Corona et al., 2012b; Di Sante et al., 2016). The female sexual function and the relationship with thyroid function is still less studied. Furthermore, studies conducted on animals have shown the presence of TRs in the male (Carosa et al., 2010) and female genitalia (Rodriguez-Castelan et al., 2017). Moreover, knockout mice for TRs showed alterations in sexual behavior (Dellovade et al., 2000). The purpose of this review is to summarize and discuss the available data on the influence of THs on male and female sexual function to understand the molecular mechanisms of the influence of the thyroid gland on sexual behavior and function

The Impediment of Impotency and the Condition of Male Impotence: A Canonical-Medical Study: Part II, Medical Considerations

To present the problems involved in the matter of male impotence as related to the validity of marriage, the canonical considerations, as prepared by Rev. Paul v. Harrington, J.C.L., were published in the August and November 1958 issues of The Linacre Quarterly. The Medical study as set forth by Dr. Charles J. E. Kickham appears in this issue. Dr. Kickham is a graduate of Holy Cross College and Harvard medical School. He is Associate Professor of Urology at Tufts medical School and is Surgeon-in-Chief, Department of Urology, St. Elizabeth\u27s Hospital, Brighton; Carney Hospital, Boston, and Pondville Cancer Hospital at Norfolk, Mass. He is a diplomate of the American Board of Urology

Sex Differences in Attributions to Positive and Negative Sexual Scenarios in Men and Women With and Without Sexual Problems: Reconsidering Stereotypes

People with sexual problems are more likely to attribute negative sexual experiences to themselves, in contrast to sexually functional individuals who attribute negative sexual experiences to external factors such as the circumstance or partner. We investigated attribution patterns in 820 men and 753 women, some of whom reported an orgasmic problem, to assess differences between the sexes and those with and without an orgasmic difficulty. Specifically, using an Internet-based approach, we compared attribution responses to four sexual scenarios, one representing a positive sexual experience and three representing negative sexual experiences. Women were more likely to attribute positive outcomes to their partner than men. Women were also more likely to attribute negative outcomes to themselves than men, but they more readily blamed their partner and circumstances for negative outcomes than men as well. Those with orgasmic problems were less willing to take credit for positive outcomes and more willing to accept blame for negative outcomes. Interaction effects between sex and orgasmic problems further highlighted differences between men’s and women’s attribution patterns. These results are interpreted in the context of traditional notions that men’s attributions tend to be more self-serving and women’s attributions more self-derogatory

Outcome of anterior lumbar interbody fusion : a retrospective study of clinical and radiologic parameters

Objective. This study aims to critically evaluate the long-term results of stand-alone anterior lumbar interbody fusion (ALIF), without use of rhBMP-2, as a therapeutic option for symptomatic patients with degenerative disc disease (DDD). Furthermore this study intends to identify predictive parameters for anterior lumbar interbody fusion outcome. Methods. A retrospective cohort study with additional telephone interview to obtain missing data was performed. All patients who underwent a L4-L5 and/or L5-S1 ALIF-procedure in the period between 2006 and 2011 were identified. The medical files of 123 patients with 154 fusion levels were reviewed. All patients were contacted by phone to gather supplementary and missing information. Pain and functionality scores (Visual Analogue Scale [VAS] and Oswestry Disability Index [ODI]), radiological (intervertebral disc height, Modic and Pfirrmann classifications) and different clinical parameters were gathered. Results. The mean age at surgery of the population was 46.2 years. Overall, 59 female and 64 male patients were included in the study. The mean visual analogue scales (VAS) for back and leg pain improved significantly (P<0.001) with 5 and 4.4 points respectively at 3 years follow-up. Modic-type I changes are associated with a better improvement in VAS-score for back pain (P=0.026), Pfirrmann-grades IV and V and an intervertebral disc height of less than 5 mm are associated with a better improvement in leg pain (respective P-values: 0.045 and 0.033). Overall, 89% of patients would reconsider the surgical intervention. Conclusions. The ALIF-technique is a durable treatment option for patients with DDD. This study suggests different predictive parameters for treatment outcome

Readability and understandability of andrology questionnaires

Objective: Medical questionnaires, which enable collection, comparison and analysis of appropriate data as a means of written communication between a patient and a doctor, must be easily readable, and understandable. Here, we measure the readability and understandability of questionnaires used in andrology and examine the relationship between the educational status of the patients and the understandability of the forms. Material and methods: Seven questionnaires used to diagnose andological diseases were selected from the European Association of Urology guidelines. The number of syllables per word, the number of words in a sentence, and the average word and sentence lengths were calculated for each Turkish validated form. Readability scores were calculated, and closet tests were used to measure the understandability of the texts. Results: Three hundred and twenty-seven male volunteers participated in the study. Two hundred and sixteen of the participants (66%) had a high school or college education. The readability level of the seven forms was determined to be ''Difficult'' or ''Very Difficult,'' and at least a high school education level was required to understand the forms. As education level and monthly income increased, the understandability of the forms increased; as the readability of the forms became more difficult, their understandability decreased (p<0.001). Conclusion: The readability levels of questionnaires used in andrology are well above the reading level of Turkey. Health providers can help patients to fill out forms to increase doctor-patient communication

The Impediment of Impotency and the Condition of Male Impotence: A Canonical-Medical Study: Medical Considerations

To present the problems involved in the matter of male impotence as related to the validity of marriage, the canonical considerations, as prepared by Rev. Paul v. Harrington, J.C.L., were published in the August and November 1958 issues of The Linacre Quarterly. The Medical study as set forth by Dr. Charles J. E. Kickham appears in this issue. Dr. Kickham is a graduate of Holy Cross College and Harvard medical School. He is Associate Professor of Urology at Tufts medical School and is Surgeon-in-Chief, Department of Urology, St. Elizabeth\u27s Hospital, Brighton; Carney Hospital, Boston, and Pondville Cancer Hospital at Norfolk, Mass. He is a diplomate of the American Board of Urology