| Objective:To evaluate the electrophysiological characteristics of premature ejaculation in patients with premature ejaculation and analyze the changes of penile sensory threshold,GPSEP,DNSEP and PSSR in premature ejaculation patients and their clinical value in the diagnosis and treatment of premature ejaculation.Methods:The subjects were divided into seven groups.All were patients who visited the male outpatient department in our hospital from February 2016 to November 2017.Among them,group A:a total of 100 patients with primary premature ejaculation;group B:50 Cases(control group)are male patients with male sexual infertility and normal sexual function of asthenospermia patients;group C:10 cases of pelvic fractures with urethral disruption patients;group D:50 cases of premature ejaculation with chronic prostatitis Patient.Physiological electrophysiological examinations were performed on the four groups A,B,C,and D.The GPSEP,DNSEP,and PSSR waveforms of each group were observed and recorded.Their latency was analyzed and their penile sensory thresholds were recorded.The patients in groups A,C and D were compared with those in group B(control group).In the study,we had a latency of GPSEP and DNSEP greater than 40.83ms in 100 patients with primary premature ejaculation and 34 patients(group E)with an oral PSSR latency less than 1184.6ms(oral E)given oral SSIR drugs(Dapacusine hydrochloride 60mg/day)Three months and three months later,patients were evaluated for IELT,CIPE-5,and IIEF-5 before and after medication,and neurophysiological examinations were performed again to compare the changes of PSSR latency.Group F:Patients with primary premature ejaculation in 100 patients with DNSEP latency and GPSEP latency less than 40.83ms and PSSR latency greater than 1184.6ms were treated with topical compound lidocaine cream and evaluated for IELT after treatment.CIPE-5,?EF-5,and determination of the latency of GPSEP,DNSEP,and PSSR after their administration;Group G:Randomly selected 20 patients from 100 patients with primary premature ejaculation for the same treatment,and evaluated the IELT of patients after treatment.CIPE-5,IIEF-5,once again measured GPSEP,DNSEP and PSSR latency.A comparative analysis of the treatment effects in patients in the F and G groups.Results:Group A:100 cases of primary premature ejaculation patients with penile sensory threshold,GPSEP latency,DNSEP latency,PSSR latency were 4.04±1.10mA,38.50±1.26ms,38.12 + 1.09ms,1231.86 + 112.27ms.In group B,penile sensory thresholds were detected in 50 control groups.The latency periods of GPSEP,DNSEP,and PSSR were 4.91±1.38mA,41.31±1.86ms,40.29±1.36ms,and 1520.18±135.76ms.There was no significant difference between the four test results and the normal reference values in group B(5.0±1.2mA,40.83±1.36ms,39.89±1.28ms,1184.0±248ms)(P<0.05).The penile sensory threshold of PPE patients was lower than that of the control group.At the low 0.87 mA,the GPSEP latency of PPE patients was 2.81 ms lower than that of the control group,the DNSEP latency of PPE patients was 2.17 ms lower than that of the control group,and the PSSR latency of PPE patients was significantly shorter than that of the control group by 284.0 ms,with significant differences(P<0.05).<0.05).Group C:In 10 patients with pelvic fracture complicated with urethral injury,penile sensory threshold,GPSEP,DNSEP,and PSRR latency were 4.80±1.70 mA,40.90±1.30 ms,37.02±0.83 ms,and 538.08±696.56 ms,respectively.The penile sensory threshold(4.80±1.70mA)was not statistically different from the control group(4.89±1.38mA)(P>0.05).There was no significant difference between the GPSEP incubation period(39.90±1.30)and the control group(41±1.23)(P>0.05).The incubation period of DNSEP(37.02±0.83ms)was lower than that of the control group(40.27±1.36ms).The difference was statistically significant(P<0.05).The latency of PSSR(538.08±696.56ms)was lower than that of the control group(1521.48±134.72ms),and the difference was statistically significant(P<0.05).Group D:Perception threshold of penis in patients with premature ejaculation combined with prostatitis,GPSEP,DNSEP,and PSSR latency were 5.08±1.24mA,41.34±1.41ms,39.51±1.34ms,1509.54±127.14ms,respectively,compared with the four test results of the control group.The difference was not statistically significant(P>0.05).Group E:34 patients with primary premature ejaculation after oral administration of dupoxetine hydrochloride for three months,8 cases of IELT prolonged significantly(5min),improved(? 2min)18 cases,8 cases(<2min),total The effective rate is 76.47%.The latency of PSSR increased after taking the drug(P<0.05),CIPE-5 and IELT increased(P<0.05),and the adverse reactions occurred during medication:1 case of nausea,1 case of headache dizziness,1 case of insomnia,Diarrhea in 2 cases,1 case of nasopharyngitis,the total adverse reactions were lighter.The ?EF-5 scores of patients in group F and group G were 23.46±1.03 and 22.86±1.47,respectively.There was no significant difference between the two groups(P>0.05).CIPE-5 scores were 18.46±2.06 and 10.271±2.87,respectively.The difference was statistically significant(P<0.05);the IELT scores were 4.5±1.45 and 3.0±0.84,respectively,and the difference was statistically significant(P<0.05).The latency of GPSEP and DNSEP in group F was significantly longer,and the treatment effect of group F was significantly better than that of group G.Conclusion:The penile sensory threshold,GPSEP,DNSEP and PSSR latency detected by penile electrophysiology can be used as an objective detection index for primary premature ejaculation.This index is of little significance for patients with secondary premature ejaculation.Through the electrophysiological examination of penile nerves,ED patients with pelvic fractures have abnormalities of the pudendal nerve reflex pathway.The occurrence of premature ejaculation may be related to high penis sensitivity(periphery)and penile sympathetic excitability(centrality).In premature ejaculation patients with prostatitis,penile sensory threshold,GPSEP,DNSEP,PSSR incubation period and the normal group had no significant statistical difference,suggesting that penile nerve electrophysiological examination has little significance in the diagnosis of patients with secondary premature ejaculation.Dapoxetine hydrochloride has significantly improved IELT and CIPE-5 in patients with primary premature ejaculation with PSSR less than normal.Therefore,the latency of PSSR can be used to objectively determine whether patients with increased sympathetic excitability of the penis(central type).Patients with primary premature ejaculation whose screened GPSEP and DNSEP latency was less than normal had localized penis used to reduce penis sensitivity.Patients with premature ejaculation,improved CIPE-5 scores,and prolonged latent period of ejaculation in the vagina were significantly better than those without screening.For patients with premature ejaculation treated,similarly,DNSEP and GPSEP latency can be used as an objective detection method to distinguish penis hypersensitivity patients(peripheral type).Therefore,the electrophysiology of the penis nerve can be used not only for the diagnosis of primary premature ejaculation,but also for its simple classification,individualized sensitive treatment options for premature ejaculation treatment. |
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