Quantitative sensory testing of peripheral thresholds in patients with lifelong premature ejaculation: a case-controlled study.
BACKGROUND
The main functional factors related to lifelong premature ejaculation (PE) etiology have been suggested to be penile hypersensitivity, greater cortical penile representation, and disturbance of central serotoninergic neurotransmission.


OBJECTIVE
To quantitatively assess penile sensory thresholds in European Caucasian patients with lifelong PE using the Genito-Sensory Analyzer (GSA, Medoc, Ramat Yishai, Israel) as compared with those of an age-comparable sample of volunteers without any ejaculatory compliant.


METHODS
Forty-two consecutive right-handed, fully potent patients with lifelong PE and 41 right-handed, fully potent, age-comparable volunteers with normal ejaculatory function were enrolled. Each man was assessed via comprehensive medical and sexual history; detailed physical examination; subjective scoring of sexual symptoms with the International Index of Erectile Function; and four consecutive measurements of intravaginal ejaculatory latency time with the stopwatch method. All men completed a detailed genital sensory evaluation using the GSA; thermal and vibratory sensation thresholds were computed at the pulp of the right index finger, and lateral aspect of penile shaft and glans, bilaterally.


METHODS
Comparing quantitatively assessed penile thermal and vibratory sensory thresholds between men with lifelong PE and controls without any ejaculatory compliant.


RESULTS
Patients showed significantly higher (P < 0.001) thresholds at the right index finger but similar penile and glans thresholds for warm sensation as compared with controls. Cold sensation thresholds were not significantly different between groups at the right index finger or penile shaft, but glans thresholds for cold sensation were bilaterally significantly lower (P = 0.01) in patients. Patients showed significantly higher (all P < or = 0.04) vibratory sensation thresholds for right index finger, penile shaft, and glans, bilaterally, as compared with controls.


CONCLUSIONS
Quantitative sensory testing analysis suggests that patients with lifelong PE might have a hypo- rather than hypersensitivity profile in terms of peripheral sensory thresholds. The peripheral neuropathophysiology of lifelong PE remains to be clarified.
Salonia
Andrea
A
University Vita-Salute San Raffaele-Department of Urology, Milan, Italy;. Electronic address: saloniaandrea@yahoo.com.
Saccà
Antonino
A
University Vita-Salute San Raffaele-Department of Urology, Milan, Italy.
Briganti
Alberto
A
University Vita-Salute San Raffaele-Department of Urology, Milan, Italy.
Del Carro
Ubaldo
U
University Vita-Salute San Raffaele-Department of Neurology, Milan, Italy.
Dehò
Federico
F
University Vita-Salute San Raffaele-Department of Urology, Milan, Italy.
Zanni
Giuseppe
G
University Vita-Salute San Raffaele-Department of Urology, Milan, Italy.
Rocchini
Lorenzo
L
University Vita-Salute San Raffaele-Department of Urology, Milan, Italy.
Raber
Marco
M
University Vita-Salute San Raffaele-Department of Urology, Milan, Italy.
Guazzoni
Giorgio
G
University Vita-Salute San Raffaele-Department of Urology, Milan, Italy.
Rigatti
Patrizio
P
University Vita-Salute San Raffaele-Department of Urology, Milan, Italy.
Montorsi
Francesco
F
University Vita-Salute San Raffaele-Department of Urology, Milan, Italy.
D000328:Adult; D016022:Case-Control Studies; D039721:Diagnostic and Statistical Manual of Mental Disorders; D004056:Differential Threshold / Q000502:physiology; D004542:Ejaculation / Q000502:physiology*; D006801:Humans; D008297:Male; D012701:Serotonin / Q000378:metabolism; D012720:Severity of Illness Index; D012735:Sexual Dysfunction, Physiological / Q000175:diagnosis / Q000378:metabolism / Q000503:physiopathology*; D009435:Synaptic Transmission / Q000502:physiology
D012701:Serotonin