Abnormal White Matter Microstructure in Lifelong Premature Ejaculation Patients Identified by Tract–Based Spatial Statistical Analysis

Objective Different mechanisms such as psychological, neurobiological, autonomic, and genetic factors might be involved in the etiology of lifelong Premature Ejaculation (PE). Albeit cortical activity changes have been reported, the relationship between PE and impulsivity/decision-making is minimally studied to date. The present study aimed to assess impulsivity and risky decision-making in individuals with lifelong PE for the first time. Method 26 lifelong PE patients were diagnosed by the International Society for Sexual Medicine (ISSM-2014) criteria and 26 healthy volunteers were recruited. The Premature Ejaculation Diagnostic Tool (PEDT), International Erectile Function Index (IIEF), Barratt Impulsiveness Scale-11 (BIS-11), Patient Health Questionnaire-9 (PHQ-9), Balloon Analogue Risk Task (BART), and Monetary Choice Questionnaire-27 (MCQ-27) were administered. Results The mean age was 37.28 (18-55). No differences were found between groups in risky decision-making and impulsivity. Conclusion No alterations of impulsivity and risky decision-making were found in lifelong PE patients. Impulsivity may only exist in a subset of individuals with lifelong PE or may only be evident in neural levels or specific subtypes of impulsivity.

1140 ASSESSMENT OF INTRAVAGINAL EJACULATORY TIME IN LIFELONG PREMATURE EJACULATION PATIENTS WITH AND WITHOUT MONOSYMPTOMATIC ENURESIS

We aimed to evaluate the effectiveness of paroxetine and tadalafil combination in the treatment of premature ejaculation (PE). A total of 150 primary (lifelong)PE patients were randomly distributed into three groups of 50 patients each. Group 1 received 20mg paroxetine every day for 1month, Group 2 received 20mg tadalafil on demand 2h before intercourse, and Group 3 received paroxetine and tadalafil on demand 2h before intercourse. Intravaginal ejaculatory latency times (IELT) scores were evaluated at baseline, at the end of the first month of therapy and 1month after discontinuation of the treatment, while International Index of Erectile Function (IIEF) questionnaire scores were evaluated both prior to and after the treatment. At the end of the first month of therapy, IELT scores were compared with the basal values and statistically significant changes were detected (60.6±30.2-117.3±67.3, 68.5±21.4-110.2±37.3, 71.56±40.23-175.2±60.2)(P<0.01). IELT scores after discontinuation of treatment were found to be close to the baseline IELT scores (P>0.05). IIEF scores were evaluated both prior to and after the treatment, and no statistically significant difference was detected (P>0.05). It is concluded that utilisation of selective serotonin reuptake inhibitors (SSRI) and phosphodiesterase-5 inhibitors (PDE5i) combination before intercourse seems to provide significantly longer ejaculatory latency times as compared with SSRI alone for a long time in patients with PE.

MP84-15 LOSS-OF-FUNCTION MISSENSE MUTATIONS IN <i>DCC</i> IDENTIFIED FROM LIFELONG PREMATURE EJACULATION BY TRIO-BASED GENOME SEQUENCING

BackgroundTo investigate the white matter microstructural changes association between untreated life-long premature ejaculation (LPE) patients and controls by tract-based spatial statistical analysis. As well, to investigate how the depression and anxiety influence the result.MethodsThe sample consisted with 32 medication-naive adult men with clinical diagnosed LPE and matched 32 healthy controls. Tract-based spatial statistical (TBSS) were implemented to perform between-group analysis. The regions of white matter microstructural significant changes were detected.ResultsThe LPE group had higher mean FA and mean AD in widespread regions. Moreover, the depression and anxiety is negatively correlated with the mean FA of the right posterior thalamic radiation (PTR).ConclusionsOur study will be helpful for improving our understanding of the mechanism of LPE. Larger and possibly longitudinal studies will be required to confirm these findings and to better specify the link between structural abnormalities and functional data.

Many diseases have been associated with anogenital distance, as an indicator of intrauterine androgen exposure. The aim of this study was to investigate the association between lifelong premature ejaculation and anogenital distance. The study included 140 participants: 70 with lifelong premature ejaculation (group 1) and 70 without any ejaculatory complaints (group 2). Premature Ejaculation Diagnostic Tool and stopwatch intravaginal ejaculatory latency time were recorded from all participants in order to evaluate ejaculatory function. Two variants of anogenital distance were measured: anogenital distance (from anus to the posterior base of the scrotum) from anus to the posterior base of the scrotum and anogenital distance (from anus to the cephalad insertion of the penis) to the cephalad insertion of the penis. We compared differences between groups and correlations between anogenital distance variants and patients' characteristics. The groups were similar in terms of age, BMI, and total testosterone levels. The mean anogenital distance (from anus to the posterior base of the scrotum) scores were 59.45±10.76 vs. 55.02±10.13 (p=0.01), and anogenital distance (from anus to the cephalad insertion of the penis) scores were 128.37±22.2 vs. 126.78±16.21 (p=0.63) in groups 1 and 2, respectively. Significant correlation was observed between anogenital distance (from anus to the posterior base of the scrotum) and Premature Ejaculation Diagnostic Tool scores (r=0.199, p=0.019) and intravaginal ejaculatory latency time (r=-0.185, p=0.028). There were no statistically significant differences between anogenital distance (from anus to the posterior base of the scrotum) scores and total testosterone levels and between anogenital distance (from anus to the cephalad insertion of the penis) and Premature Ejaculation Diagnostic Tool scores or intravaginal ejaculatory latency time. These results suggest that longer anogenital distance is associated with higher possibility of lifelong premature ejaculation. However, further studies are needed to confirm our results.

Stress is a powerful moderator of brain plasticity and may affect several physiological functions such as the endocrine and the immune system. The impact of stress can be protective or detrimental according to several factors such as level of the stressor and age of occurrence. Also, the impact may differ in males and females. We aim to analyze the effect of mild levels of early and recent stress on white matter microstructure in healthy volunteers. MRI acquisition of diffusion tensor images with a 3.0 T scanner was performed on 130 healthy subjects (71 males and 59 females). Severity of early and recent stress was rated, respectively, on the Risky Families Questionnaire and on the Schedule of Recent Experiences; subjects were divided into low stress and mild stress groups. Mild early stress associated with lower fractional anisotropy (FA) in the cingulate gyrus compared to low early stress. Females reported reduced FA compared to males in the low-stress group in the internal capsule, posterior corona radiata, posterior thalamic radiation, superior longitudinal fasciculus, and sagittal stratum whereas no difference was observed in the mild stress group. An additive effect of early and recent stress was observed in posterior corona radiata, retrolenticular part of the internal capsule, and superior longitudinal fasciculus. The impact of early stress on WM microstructure in healthy subjects is different in males and females. While males seem to be more sensitive to early stress, an additive effect of early and recent stress manifests itself in females.Layman summaryMild levels of early stress associate with lower white matter integrity measured by fractional anisotropy.Females and males show differences in white matter integrity when exposed to low levels of early stress with females showing lower white matter integrity compared to males.No difference in white matter integrity was observed for males and females exposed to mild levels of stress.Mild stress in females is associated with higher white matter integrity.Males seem to be more sensitive to early stress while females are more affected when early stress is followed by stress in adult life.

We aimed to determine the level of miRNAs 16 and 135a in lifelong premature ejaculation (LPE) patients versus controls. Moreover, we evaluated the potential interplay between the studied miRNAs and fluoxetine in these patients after utilizing fluoxetine daily for 3months. The study involved 60 consecutive LPE patients and 20 healthy age matched individuals as controls. The median miRNA16 was significantly higher in the controls (1.02) compared to the patients (0.31) (p <0.001). Moreover, the median miRNA-135a was significantly higher in the controls compared to the patients 1.02 and 0.35, p <0.001, respectively. In addition, the median pre-treatment miRNA16 in the responders was 0.29 that significantly increased to 0.66 (p <0.001). The median pre-treatment miRNA-135a in the responders was 0.27 that significantly increased to 0.65 (p <0.001). Furthermore, considering EXP(β) for the odds ratio evaluation, with a 95% degree of confidence, a 1 fold increase in pre-treatment miRNA 135a fold change decreases the odds for being responsive to SSRI by 0.028. Meanwhile, there was non-significant association between fluoxetine responsiveness and age, pre-treatment miRNA 16, pre-treatment PEDT and pre-treatment IELT. The current study had shown that a lower pre-treatment miRNA 135a was significantly associated with response to fluoxetine.

The aim of this study was to investigate the relationship between metabolic syndrome (MetS) and acquired premature ejaculation (PE). A total of 100 patients with acquired PE and 100 control cases were enrolled in the study. After obtaining a detailed medical history, anthropometric (weight, height and waist circumference) and blood pressure measurements were performed. Ejaculation and erection functions were evaluated by Premature Ejaculation Diagnostic Tool (PEDT) and International Index of Erectile Function-5 (IIEF-5), respectively. Self-estimated intravaginal ejaculatory latency time (IELT) of the participants was recorded. Fasting blood samples were taken for biochemical and hormonal work-up. The median PEDT scores were 16 (9-22) and 4.5 (2-8) in acquired PE and control groups, respectively (P<0.001). The mean estimated IELT values in PE patients and controls were 36.1±46.5 versus 488.2±313.8 s (P<0.001). MetS was diagnosed in 51 patients (51%) in the PE group and 24 (24%) participants in the control group (P<0.001). A significant negative correlation was observed between the components of MetS and estimated IELT, except for diastolic blood pressure. Moreover, there was a significant positive correlation between the all components of MetS and total PEDT score, except for fasting blood glucose and high-density lipoprotein cholesterol (HDL) levels. Logistic regression analysis revealed that, except blood pressure and HDL levels, MetS components were significant risk factors for PE after adjusting for age and total testosterone. In conclusion, MetS is associated with acquired PE.

BackgroundDisrupted white matter (WM) microstructure has been commonly identified in youth at clinical high risk (CHR) for psychosis. Several lines of evidence suggest that fatty acids, especially unsaturated fatty acids...

Abnormal white matter microstructure in children with sensory processing disorders☆

The aim of our study was to compare melatonin levels of patients with lifelong premature ejaculation (LPE) (n:60) with healthy controls (n:30) and to investigate the changes of melatonin levels in the treatment with dapoxetine and sertraline. Age, body mass index, duration of marriage, weekly intercourse number, International Index of Erectile Function scores, Intravaginal Ejaculation Latency Time (IELT) and melatonin levels were recorded. LPE patients were divided into two treatment groups. The first group was included 30 patients, who received 60mg dapoxetine for six weeks, twice a week, an hour before intercourse. The second group received 50mg of sertraline daily, for six weeks. IELT and melatonin measures were repeated after the treatment. IELT (dapoxetine group: 41.22±21.3s, sertraline group: 48±23.11s, control group: 195.54±84.14s; p<.001) and melatonin levels (dapoxetine group: 5.75±2.04pg/mL, sertraline group: 5.49±2.88pg/mL, control group: 13.4±12.09pg/mL; p<.001) of both LPE groups were significantly lower than control group. Following the six-week sertraline (before: 48±23.11s, after: 101.01±59.55s; p<.001) and dapoxetine (before: 41.22±21.3s, after: 97.39±44.1s; p<.001) treatments, IELT increased. The melatonin levels increased in the sertraline group (before: 5.49±2.88pg/mL, after: 10.6±7.37pg/mL; p<.001). Our results indicate that melatonin levels of LPE patients are lower than levels of healthy volunteers. Furthermore, we found a significant increase in melatonin levels following sertraline treatment.

Lifelong premature ejaculation patients had altered structural and functional parameters of the hypothalamus compared with healthy controls. The patients showed increased hypothalamus-related functional connectivity in several regions one hour after dapoxetine administration. The changing trends of the brain functional connectivity after dapoxetine administration possibly provided important information about the selective serotonin reuptake inhibitor effects on the functional neural system.

Premature Ejaculation Among Italian Men: Prevalence and Clinical Correlates From an Observational, Non-Interventional, Cross-Sectional, Epidemiological Study (IPER)

The aim of this study was to investigate whether vitamin B12 levels are associated with premature ejaculation (PE). A total of 109 subjects (56 PE and 53 controls) were included in this study. PE was defined as self-reported intravaginal ejaculatory latency time (IELT) based on the Diagnostic and Statistical Manual of Mental Disorders IV criteria and those who had had an IELT of <2min was considered as PE. All participants were evaluated using premature ejaculation diagnostic tool (PEDT), International Index of Erectile Function (IIEF) and Beck Depression Inventory (BDI). The vitamin 12 levels were measured in all subjects. The mean age between the PE and controls was comparable (p=.084). Mean IIEF and BDI scores between the two groups did not statistically differ. The mean IELT values in the PE group were significantly lower than in the control group (p<.0001). PE patients reported significantly lower vitamin B12 levels compared with the controls (213.14 vs. 265.89ngml-1 ; p<.001). The ROC analysis showed a significant correlation between the diagnosis of PE and lower vitamin B12 levels. This study has demonstrated that lower vitamin B12 levels are associated with the presence of PE. This work also shows a strong correlation between vitamin B12 levels and the PEDT scores as well as the IELT values.