Prematür Ejakülasyona Güncel Yaklaşım

Prematür ejakülasyon, erkeklerde seksüel tatmin, duygusal stres ve ilişki durumlarını negatifyönde etkileyen erkeklerde sık görülen bir seksüel disfonksiyondur. Prematür ejakülasyon,kişilerin seksüel tatmin, duygusal stres ve ilişki durumlarını negatif yönde etkilemektedir. Sıkgörülen ve psikososyal durumda bozulmaya yol açan bu hastalığın iyi anlaşılması gerekmektedir.Prematür ejakülasyon primer (yaşam boyu) ve sekonder (sonradan kazanılmış) olarak ikiyeayrılmaktadır. Primer şeklinin yıllarca psikolojik temelli olduğu düşünülmüş ve anksiyeteninetiyolojideki rolü üzerinde durulmuştur. Sonradan kazanılan prematür ejakülasyon etiyolojisindeise özellikle prostatitler üzerinde durulmakla birlikte hipertiroidizm ve intervertebral diskherniasyonunun da prevalansı artırdığı düşünülmektedir.Tedavi yöntemleri incelendiğinde psikoseksüel davranışsal yöntemlerin önceden daha sıkkullanıldığı görülmektedir. Özellikle tedavide selektif serotonin geri alım inhibitörlerinin (SSRI)kullanılması devrim niteliğindedir. Son yıllarda da daha kısa etkili ve selektif ilaçlar üzerindeçalışmalar devam etmektedir. Prematür ejakülasyon yaşamı tehdit etmeyen ancak hasta vepartnerlerinde psikolojik problemlere yol açabilecek bir hastalıktır. Sık görüldüğünden dolayıüzerinde önemle durulması gerekmektedir. Halen daha etkin ve selektif tedavi yöntemlerininaraştırılmasına ihtiyaç duyulmaktadır

Anahtar Kelimeler:

Prematür ejekülasyon, Erkek seksüel disfonksiyonu, Seratonin reuptakeinhibitörleri (SSRİ)

Current Approach To Premature Ejaculation

Premature ejaculation is a common sexual dysfonction in men. Premature ejaculation negativelyaffects sexual satisfaction, emotional stress and relationship status of the people. This commondisease cause of deterioration in the psychosocial status needs to be well understood. It is dividedas primary (lifelong) and secondary (acquired later). It was thought to be psychological foryears, and focused on role of anxiety for etiology. In the etiology of aquired prematureejaculation, although especially focused on prostatitis, it is thought that the hyperthyroidismand the intervertebral disc herniation are increase the prevalance of premature ejaculation.When the treatment methods are examined, the psychosexual behavioral methods previouslyhave been used more frequently. Especially use of selective serotonin reuptake inhibitors intreatment (SSRI) is revolutionary. The current studies about shorter effective and selective drugshave continue. Premature ejaculation is non-life-threatening, but it may be cause psychologicalproblems in the patients and their partners. Because of the frequency, it must be emphasized.Currently, more effective and selective treatment methods are needed to be investigated

Keywords:

Premature ejaculation, Male sexual dysfonction, Serotonin reuptake inhibitors(SSRI),

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McMahon CG, Althof SE, Waldinger MD, et al. An evidence- based definition of lifelong premature ejaculation: report of the International Society for Sexual Medicine (ISSM) ad hoc committee for the definition of premature ejaculation. J Sex Med. 5(7):1590-1606, 2008.
Rosenberg MT, Sailor N, Tallman CT, Ohl DA. Premature ejaculation as reported by female partners: survey results from a community practice. Poster presented at: American Urological Association Annual Meeting, May 20–25, Atlanta, GA. Abstract 1332, 2006.
Waldinger MD, Zwinderman AH, Olivier B, Schweitzer DH. Proposal for a definition of lifelong premature ejaculation based on epidemiological stopwatch data. J Sex Med. 2:498- 507, 2005
McMahon CG. Long term results of treatment of premature ejaculation with selective serotonin re-uptake inhibitors Int J Impot Res 14(Suppl 3):S19, 2002
Patrick DL, Althof SE, Pryor JL, et al. Premature ejaculation: an observational study of men and their partners. J Sex Med. 2:358-367, 2005.
American Psychiatric Association. The diagnostic and statistical manual of mental disorders. 4th ed. Washington, DC: American Psychiatric Association; 2000.
McMahon CG. Treatment of premature ejaculation with sertraline hydrochloride. Int J Impot Res, 10:181–185, 1998.
Nicolosi A, Laumann EO, Glasser DB, et al. Sexual behavior and sexual dysfunctions after age 40: the global study of sexual attitudes and behaviors. Urology. 64:991-997, 2004.
Laumann EO, Paik A, Rosen RC. Sexual dysfunction in the United States:prevalence and predictors. JAMA, 281:537–44, 1998.
Corona G, Petrone L, Mannucci E, et al. Psycho-biological correlates of rapid ejaculation in patients attending an andrologic unit for sexual dysfunctions.Eur Urol. 46(5):615- 622, 2004.
Corona G, Mannucci E, Petrone L, et al. Psycho-biological correlates of free-floating anxiety symptoms in male patients with sexual dysfunctions.J Urol. 27(1):86-93, 2006.
Waldinger MD. The neurobiological approach to premature ejaculation. J Urol 168:2359-67, 2002.
McMahon CG, Abdo C, Incrocci L, et al. Disorders of orgasm and ejaculation. J Sex Med, 1:58–65, 2004.
Waldinger MD, Rietschel M, Nöthen MM, Hengeveld MW, Olivier B. Familial occurrence of primary premature ejaculation. Psychiatr Genet. 8(1):37-40.1998.
Carani C, Isidori AM, Granata A, Carosa E, Maggi M, Lenzi A, Jannini EA. Multicenter study on the prevalence of sexual symptoms in male hypo- and hyperthyroid patients. J Clin Endocrinol Metab. 90(12):6472-6479, 2005.
Lotti F, Corona G, Mancini M, et al. The association between varicocele, premature ejaculation and prostatitis symptoms: possible mechanisms. J Sex Med. 6(10):2878-2887, 2009.
Jin BF, Zhang XD, Huang YF, et al. Correlation of premature ejaculation with central lumber intervertebral disc herniation. Zhonghua Nan Ke Xue. 15(3): 244-247, 2009.
Zohdy W. Clinical parameters that predict successful outcome in men with premature ejaculation and inflammatory prostatitis. J Sex Med. 2009 Sep 14. [Epub ahead of print].
El-Nashaar A, Shamloul R. Antibiotic treatment can delay ejaculation in patients with premature ejaculation and chronic bacterial prostatitis. J Sex Med. ;4(2):491-496, 2007.
Shamloul R, el-Nashaar A. Chronic prostatitis in premature ejaculation: a cohort study in 153 men. J Sex Med. 3(1):150- 154, 2006.
Semans JH. Premature ejaculation: a new approach. South Med J. 49: 353–358, 1956.
Masters WM, Johnson VE. Human Sexual Inadequacy. Boston: Little, Brown; 1970.
Hawton K, Catalan J, Martin P, Fagg J. Long-term outcome of sex therapy. Behav Res Ther 24: 665–675, 1986.
Waldinger MD. Towards evidenced based drug treatment research on premature ejaculation: A critical evaluation of methodology. J Impotence Res. 15:309-313, 2003.
Waldinger MD, Hengeveld MW, Zwinderman AH, Olivier B. Effect of SSRI antidepressants on ejaculation: A double- blind,randomized, placebo-controlled study with fluoxetine,fluvoxamine, paroxetine and sertraline. J Clin Psychopharmacol. 18:274-81, 1998.
Waldinger MD, Berendsen HH, Blok BF, Olivier B, Holstege G. Premature ejaculation and serotonergic antidepressants- induced delayed ejaculation: The involvement of the serotonergic system. Behav Brain Res 92:111-118, 1998.
Waldinger MD. Premature ejaculation: definition and drug treatment. Drugs 67:547–568, 2007.
Hellstrom WJ, Heintz JW. Treatment of premature ejaculation: new drugs and treatment strategies. Curr Urol Rep 7: 473–478, 2006.
Pryor JL, Althof SE, Steidle C, et al. Effi cacy and tolerability of dapoxetine in the treatment of premature ejaculation. Lancet. 9:368(9539):929-937, 2006.
Safarinejad MR, Hosseini SY. Safety and efficacy of tramadol in the treatment of premature ejaculation: a double-blind, placebocontrolled, fixed-dose, randomized study. J Clin Psychopharmacol. 26:27–31, 2006.
McMahon CG, Stuckey B, Andersen ML, et al. Efficacy of viagra: Sildenafil citrate in men with premature ejaculation. J Sex Med. 2:368-75, 2005.
Vanden Broucke H, Everaert K, et al. Ejaculation latency timesand their relationship to penile sensitivity in men with normal sexual function. J Urol 177: 237–40, 2007.