title: A reassessment of penile sensory pathways and effects of prilocaine-lidocaine cream in primary premature ejaculation.
abstract: To assess the penile sensory pathway abnormalities of the patients with primary premature ejaculation (PPE) and effects of prilocaine-lidocaine (PLA) cream, we enrolled 82 PPE patients and 34 normal potent male volunteers. Somatosensory evoked potentials of dorsal nerve (DNSEP) and glans penis (GPSEP) were performed in each subject. In addition, among the 82 patients, 60 were selected and randomly divided into PLA and placebo subgroups, each with 30 patients. Cream was applied evenly on the glans penis for 10 min and washed off just before DNSEP and GPSEP were repeatedly measured. Mean latencies of DNSEP and GPSPE were both remarkably shorter in the patients than those in the normal potent men (P<0.001, both). Compared with the control group, the mean amplitudes of GPSEP were significantly greater in the patient group (P<0.001), but not considerably on the amplitudes of DNSEP (P=0.229). After cream application, the latencies and amplitudes of both DNSEP and GPSEP were significantly prolonged and reduced, respectively, in the PLA cream subgroup (P<0.001, all). These results showed that hyperexcitable ejaculatory reflex neurological factor was linked to PPE, because of hypersensitivity of the penile, accelerated conduction and cortical amplification of the genital stimuli. The PLA cream could delay sensory latency and decrease glans penile hyperexcitability, which may be the mechanism for PPE treatment.
authors.affiliation: Department of Andrology, Nanjing Drum Tower Hospital, Nanjing Medical University, Nanjing, China.
authors.forename: J-D
authors.initials: JD
authors.lastname: Xia
authors.affiliation: Department of Andrology, The Affiliated Drum Tower Hospital of Nanjing University, School of Medicine, Nanjing, China.
authors.forename: L-H
authors.initials: LH
authors.lastname: Zhou
authors.affiliation: Department of Andrology, Nanjing Drum Tower Hospital, Nanjing Medical University, Nanjing, China.
authors.forename: Y-F
authors.initials: YF
authors.lastname: Han
authors.affiliation: 1] Department of Andrology, Nanjing Drum Tower Hospital, Nanjing Medical University, Nanjing, China [2] Department of Andrology, The Affiliated Drum Tower Hospital of Nanjing University, School of Medicine, Nanjing, China.
authors.forename: Y
authors.initials: Y
authors.lastname: Chen
authors.affiliation: Department of Urology, University of Texas Medical School at Houston and M.D. Anderson Cancer Center, Houston, TX, USA.
authors.forename: R
authors.initials: R
authors.lastname: Wang
authors.affiliation: 1] Department of Andrology, Nanjing Drum Tower Hospital, Nanjing Medical University, Nanjing, China [2] Department of Andrology, The Affiliated Drum Tower Hospital of Nanjing University, School of Medicine, Nanjing, China.
authors.forename: Y-T
authors.initials: YT
authors.lastname: Dai
mesh_terms: D000287:Administration, Topical; D000328:Adult; D000779:Anesthetics, Local / Q000008:administration & dosage / Q000627:therapeutic use*; D004576:Electromyography; D005073:Evoked Potentials, Somatosensory / Q000187:drug effects; D006801:Humans; D008012:Lidocaine / Q000008:administration & dosage / Q000627:therapeutic use*; D008297:Male; D009434:Neural Pathways / Q000187:drug effects*; D009824:Ointments; D010413:Penis / Q000294:innervation*; D061686:Premature Ejaculation / Q000188:drug therapy*; D011318:Prilocaine / Q000008:administration & dosage / Q000627:therapeutic use*
chemical_list: D000779:Anesthetics, Local; D009824:Ointments; D011318:Prilocaine; D008012:Lidocaine