| Objective To investigate the correlations of premature ejaculation type,cooperation of sexual partner in the treatment,drug side effects,the levels of sex hormone,thyroid hormone,and efficacy,so as to provide a reference for predicting the efficacy before clinic treatment of premature ejaculation by SSRIs,and enhancing the efficacy in the treatment.Method With reference to the guidelines for the diagnosis and treatment of premature ejaculation issued by the International Society for Sexual Medicine(ISSM)and the European Association of Urology(EAU),the outpatients with premature ejaculation at the Urology Surgery and Andrology of the hospital were selected from January 2017 to December 2019.Before the treatment,the premature ejaculation type,and the levels of total testosterone,estrogen,prolactin and thyroxine were measured;the intra-vaginal ejaculation latency time(IELT)was assessed by the patients,and the premature ejaculation diagnostic tool(PDET)was used for scoring,followed by oral administration of sertraline hydrochloride tablets(50mg,qd);IELT and PDET score were evaluated again after four weeks of oral administration of the drug,and the sexual partner cooperation and side effects were assessed in the treatment period.Eligible subjects were selected according to the inclusion criteria and exclusion criteria,and the data were processed by SPSS19.0,for purposes of analysis of the changes of IELT and PDET score before and after taking sertraline,and correlation of premature ejaculation type,cooperation of sexual partner in the treatment,drug side effects,and the levels of sex hormone and thyroid hormone.Results In this study,130 subjects with premature ejaculation cases met the criteria of inclusion and exclusion.Statistical analysis:(1)No significant difference was found in PEDT score between primary premature ejaculation group(70 cases)and secondary premature ejaculation group(60 cases)before treatment with sertraline(P=0.693);however,the PEDT score in secondary premature ejaculation group was significantly lower than that in primary premature ejaculation group after treatment(P=0.001),and the decrease of PEDT score in secondary premature ejaculation group was significantly higher than that in primary premature ejaculation group after treatment(P=0.047);in addition,the improvement of IELT in the secondary premature ejaculation group was significantly better than that in the primary premature ejaculation group(P=0.012);(2)A total of 58 cases(44.6%)had obvious side effects after taking sertraline.No significant difference was found in PEDT score between the side-effect group and noside-effect group before treatment(P=0.087);however,the PEDT score in the sideeffect group was significantly lower than that in the no-side-effect group after treatment(P =0.016),and the decrease of PEDT score in side-effect group was significantly higher than that in no-side-effect group after treatment(P=0.014);no significant difference was found in the improvement of IELT between the two groups after treatment(P=0.080);(3)No significant difference was found in PEDT score between sexual partner cooperation treatment group(53 cases)and sexual partner non-cooperation treatment group(77 cases)before treatment with sertraline(P=0.500);however,the PEDT score in sexual partner cooperation treatment group was significantly lower than that of sexual partner non-cooperation treatment group after treatment(P<0.001),and the decrease of PEDT score in sexual partner cooperation treatment group was significantly higher than that in sexual partner non-cooperation treatment group after treatment(P<0.001);in addition,the improvement of IELT in the sexual partner cooperation treatment group was significantly better than that in sexual partner non-cooperation treatment group after treatment(P<0.001);(4)No significant correlation was found in PEDT score after treatment,PEDT score difference before and after treatment,levels of testosterone and estradiol before treatment(all P>0.05);significant negative correlation was found between PEDT score after treatment and the testosterone-to-estradiol ratio before treatment(r=-0.308,P<0.001);significant positive correlation was found between PEDT score difference(score before treatment-score after treatment),and the testosterone-to-estradiol ratio before treatment(r=0.384,P<0.001);significant positive correlation was found between PEDT score after treatment and prolactin level before treatment(r=0.493,P<0.001);significant negative correlation was found between PEDT score difference(before and after treatment)and prolactin level before treatment(r=-0.568,P<0.001);no significant correlation was found in PEDT scores before and after treatment,PEDT score difference(before and after treatment),and levels of FT3 and FT4 before treatment(all P>0.05);Conclusion In the treatment of premature ejaculation by sertraline hydrochloride,secondary premature ejaculation,sexual partner cooperation treatment and drug side effects are the favorable factors for enhancing efficacy;When patient's sex hormone levels are basically in the normal range,the levels of testosterone and estrogen in the patients before treatment are not related to the efficacy,but the higher testosterone-to-estradiol ratio is a favorable factor for the improving efficacy;besides,and the lower prolactin level is also a favorable factor for the efficacy improvement. |
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