Premature ejaculation (PE) - sexual dysfunction in which ejaculation occurs within 1 min after injection of the penis into the vagina or even before that. PE is not only the most common form of male sexual dysfunction , but also in comparison with other types of sexual disorders function (erectile dysfunction, decreased sex drive), occurs to a much younger age.
The prevalence of PE is very high and is, according to different authors, from about 25 to 35% in the general population, ie, almost every third man has problems with ejaculation. PE not only affects the quality of life of men and affects self-esteem, but also leads to disharmony of sexual relations, often causing conflicts. Such a sexual failure, as PE, is traumatic and causes a feeling of great anxiety, and further attempts of sexual intercourse there is a "fear of failure expectations."
The diagnosis of PE is placed in the following cases:
- onset of ejaculation with minimal excitation, immediately or shortly after the introduction of the penis into the vagina;
- onset of ejaculation prior to the introduction of the penis into the vagina
- at different times of orgasm with partners (relative ET).
Uniform classification of PE exists. At the time of PE is divided into primary and secondary. to primary PE include those cases where a patient with early sexual activity is never able to control the duration of sexual intercourse or ejaculation occurred before the introduction of the penis into the vagina, while the development of PE in secondary disorders preceded by a period of satisfactory sexual activity.
By etiological (causal) principle produce n sihogennuyu (anxiety, depression, differences between the partners, or other situational factors) and the organic PE (increased sensitivity of the penis, inflammatory diseases of the reproductive system, etc.) .
When diagnosing PE is first necessary to clarify the duration of sexual intercourse, and then collect the medical history (medical history): Premarital and extramarital sexual experience, the individual rate of the rhythm of sexual activity, duration of sex acts with the introduction of the penis into the vagina and changed there for the duration of the life is dependent on the particular partner, which technique was used sex. It is important to determine the presence of unfavorable internal and external factors affecting sexual function - a possible emotional tensions (in the relationship with his wife, acute and / or chronic stress), information on the admission of various drugs and alcohol.Necessary to clarify the structural features of the genital organs of the partners, the presence of inflammatory diseases (especially prostate), the organic pathology of the nervous system.
In the treatment of PE apply an individual approach that includes therapy, local therapy and systemic therapy drugs. The goal of therapy is to establish control over the process of the patient's ejaculation, desensitize the penis and to normalize the processes of the nervous system. If a patient of inflammatory diseases of the genital organs should carry out a complex of therapeutic measures aimed at their removal, and only then proceed to the treatment of PE.
In the treatment of PE is important to achieve long-term positive effect, so local or drug therapy should always be combined with psychotherapy in the treatment of any scheme.alternative for patients is the application of gels with anesthetics to the glans of the penis before intercourse.
In addition, the widely used medicines - the special agents from the group of antidepressants that act on the central ejaculatory reflex and are very effective in the treatment of PE.
In the case of polyethylene, resistant to conservative treatment, surgery is recommended methods of treatment.
The operation is a partial crossing of the dorsal sensory branches of nerve trunks that innervate the penis.
The operation is performed, usually an outpatient basis under local anesthesia in 1-2 small incision at the edge of the glans penis, through which by means of microscopic loops are identified and then crossed branches of sensory nerves. As a result, the patient has a normal ejaculatory reflex is formed and subsequently woman can control the duration of sexual intercourse.
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