Ejaculation is regulated by the central nervous system.However,the central pathophysiology of primary intravaginal anejaculation(PIAJ)is unclear.The present study aimed to examine the changes in regional brain activit...Ejaculation is regulated by the central nervous system.However,the central pathophysiology of primary intravaginal anejaculation(PIAJ)is unclear.The present study aimed to examine the changes in regional brain activity and functional connectivity underlying PIAJ.A total of 20 PIAJ patients and 16 healthy controls(HCs)were enrolled from September 2020 to September 2022 in the Department of Andrology,Nanjing Drum Tower Hospital(Nanjing,China).Magnetic resonance imaging data were acquired from all participants and then were preprocessed.The measures of fractional amplitude of low-frequency fluctuation(fALFF),regional homogeneity(ReHo),and functional connectivity(FC)were calculated and compared between the groups.PIAJ patients showed increased fALFF values in the left precuneus compared with HCs.Additionally,PIAJ patients showed increased ReHo values in the left precuneus,left postcentral gyrus,left superior occipital gyrus,left calcarine fissure,right precuneus,and right middle temporal gyrus,and decreased ReHo values in the left inferior parietal gyrus,compared with HCs.Finally,brain regions with altered fALFF and ReHo values in PIAJ patients showed increased FC with widespread cortical regions,which included the frontal,parietal,temporal,and occipital regions,compared with HCs.In conclusion,increased regional brain activity in the parietal,temporal,and occipital regions,and increased FC between these brain regions,may be associated with PIAJ occurrence.展开更多
Ejaculatory dysfunction is a highly prevalent clinical condition that may be classified along a continuum that ranges from premature ejaculation （PE）, through retarded or delayed ejaculation （DE）, to complete anej...Ejaculatory dysfunction is a highly prevalent clinical condition that may be classified along a continuum that ranges from premature ejaculation （PE）, through retarded or delayed ejaculation （DE）, to complete anejaculation （AE）. Retrograde ejaculation （RE） represents a distinct entity in which ejaculate is expelled either partially or completely into the bladder. While DE and PE are significant sources of sexual dissatisfaction among men and their partners, patients with these disorders retain normal fertility in most cases. Conversely, men with AE and RE are unable to deliver sperm into the female genital tract and are therefore rendered subfertile. Therefore, in reviewing ejaculatory disorders as they relate to fertility, this paper will primarily focus on the diagnosis and management of AE and RE. Physiology, diagnostic strategies, pharmacological treatments, and procedural interventions relevant to AE and RE are discussed.展开更多
Diabetes mellitus(DM)is a metabolic disorder that is characterized by elevated blood glucose levels due to absolute or relative insulin deficiency,in the background ofβ-cell dysfunction,insulin resistance,or both.Suc...Diabetes mellitus(DM)is a metabolic disorder that is characterized by elevated blood glucose levels due to absolute or relative insulin deficiency,in the background ofβ-cell dysfunction,insulin resistance,or both.Such chronic hyperglycemia is linked to long-term damage to blood vessels,nerves,and various organs.Currently,the worldwide burden of DM and its complications is in increase.Male sexual dysfunction is one of the famous complications of DM,including abnormal orgasmic/ejaculatory functions,desire/libido,and erection.Ejaculatory dysfunction encompasses several disorders related to DM and its complications,such as premature ejaculation,anejaculation(AE),delayed ejaculation,retrograde ejaculation(RE),ejaculatory pain,anesthetic ejaculation,decreased ejaculate volume,and decreased force of ejaculation.The problems linked to ejaculatory dysfunction may extend beyond the poor quality of life in diabetics as both AE and RE are alleged to alter the fertility potential of these patients.However,although both diabetes patients and their physicians are increasingly aware of diabetic ejaculatory dysfunction,this awareness still lags behind that of other diabetes complications.Therefore,all these disorders should be looked for thoroughly during the clinical evaluation of diabetic men.Besides,introducing the suitable option and/or maneuvers to treat these disorders should be tailored according to each case.This review aimed to explore the most important findings regarding ejaculatory dysfunction in diabetes from pre-clinical and clinical perspectives.展开更多
For decades the field of male sexual dysfunction has remained controversial in terms of both diagnosis and management. There is a clear lack of rational, scientific and evidence-based practice in the field. Treatment ...For decades the field of male sexual dysfunction has remained controversial in terms of both diagnosis and management. There is a clear lack of rational, scientific and evidence-based practice in the field. Treatment remains arbitrary. This brief review tries to summarize concisely the etiology, diagnosis and management of the four categories of Ejaculatory dysfunction (EjD). This review also challenges the role of pharmacotherapy in the management of Ejaculatory dysfunction (EjD).展开更多
基金supported by grants from the Nanjing Medical Technology Development Project(No.YKK19059)Excellent Young Doctor Training Program of Jiangsu Province Hospital of Chinese Medicine(No.2023QB0126)+1 种基金Jiangsu Province Graduate Research and Practice Innovation Program Project-School Assisted General Project(No.SJCX23_0804)the General project of Natural Science Foundat。
文摘Ejaculation is regulated by the central nervous system.However,the central pathophysiology of primary intravaginal anejaculation(PIAJ)is unclear.The present study aimed to examine the changes in regional brain activity and functional connectivity underlying PIAJ.A total of 20 PIAJ patients and 16 healthy controls(HCs)were enrolled from September 2020 to September 2022 in the Department of Andrology,Nanjing Drum Tower Hospital(Nanjing,China).Magnetic resonance imaging data were acquired from all participants and then were preprocessed.The measures of fractional amplitude of low-frequency fluctuation(fALFF),regional homogeneity(ReHo),and functional connectivity(FC)were calculated and compared between the groups.PIAJ patients showed increased fALFF values in the left precuneus compared with HCs.Additionally,PIAJ patients showed increased ReHo values in the left precuneus,left postcentral gyrus,left superior occipital gyrus,left calcarine fissure,right precuneus,and right middle temporal gyrus,and decreased ReHo values in the left inferior parietal gyrus,compared with HCs.Finally,brain regions with altered fALFF and ReHo values in PIAJ patients showed increased FC with widespread cortical regions,which included the frontal,parietal,temporal,and occipital regions,compared with HCs.In conclusion,increased regional brain activity in the parietal,temporal,and occipital regions,and increased FC between these brain regions,may be associated with PIAJ occurrence.
文摘Ejaculatory dysfunction is a highly prevalent clinical condition that may be classified along a continuum that ranges from premature ejaculation （PE）, through retarded or delayed ejaculation （DE）, to complete anejaculation （AE）. Retrograde ejaculation （RE） represents a distinct entity in which ejaculate is expelled either partially or completely into the bladder. While DE and PE are significant sources of sexual dissatisfaction among men and their partners, patients with these disorders retain normal fertility in most cases. Conversely, men with AE and RE are unable to deliver sperm into the female genital tract and are therefore rendered subfertile. Therefore, in reviewing ejaculatory disorders as they relate to fertility, this paper will primarily focus on the diagnosis and management of AE and RE. Physiology, diagnostic strategies, pharmacological treatments, and procedural interventions relevant to AE and RE are discussed.
文摘Diabetes mellitus(DM)is a metabolic disorder that is characterized by elevated blood glucose levels due to absolute or relative insulin deficiency,in the background ofβ-cell dysfunction,insulin resistance,or both.Such chronic hyperglycemia is linked to long-term damage to blood vessels,nerves,and various organs.Currently,the worldwide burden of DM and its complications is in increase.Male sexual dysfunction is one of the famous complications of DM,including abnormal orgasmic/ejaculatory functions,desire/libido,and erection.Ejaculatory dysfunction encompasses several disorders related to DM and its complications,such as premature ejaculation,anejaculation(AE),delayed ejaculation,retrograde ejaculation(RE),ejaculatory pain,anesthetic ejaculation,decreased ejaculate volume,and decreased force of ejaculation.The problems linked to ejaculatory dysfunction may extend beyond the poor quality of life in diabetics as both AE and RE are alleged to alter the fertility potential of these patients.However,although both diabetes patients and their physicians are increasingly aware of diabetic ejaculatory dysfunction,this awareness still lags behind that of other diabetes complications.Therefore,all these disorders should be looked for thoroughly during the clinical evaluation of diabetic men.Besides,introducing the suitable option and/or maneuvers to treat these disorders should be tailored according to each case.This review aimed to explore the most important findings regarding ejaculatory dysfunction in diabetes from pre-clinical and clinical perspectives.
文摘For decades the field of male sexual dysfunction has remained controversial in terms of both diagnosis and management. There is a clear lack of rational, scientific and evidence-based practice in the field. Treatment remains arbitrary. This brief review tries to summarize concisely the etiology, diagnosis and management of the four categories of Ejaculatory dysfunction (EjD). This review also challenges the role of pharmacotherapy in the management of Ejaculatory dysfunction (EjD).
