Der Urologe

, Volume 48, Issue 6, pp 663–674 | Cite as

Der vorzeitige Samenerguss (Ejaculatio praecox)

CME Weiterbildung • Zertifizierte Fortbildung

Zusammenfassung

Die Ejaculatio praecox (EP) ist mit Prävalenzraten von 20–25% die häufigste Sexualstörung des Mannes. Während für die lebenslange EP genetisch determinierte Veränderungen im Serotoninrezeptor-/-transportermechanismus verantwortlich zu sein scheinen, ist die erworbene EP oftmals mit anderen konditionierenden Erkrankungen wie erektile Dysfunktion, Prostatitis oder Schilddrüsenstörungen assoziiert. Die EP ist gekennzeichnet durch eine kurze intravaginale Ejakulationslatenzzeit (IELT) von <1–2 min, eine mangelnde Kontrolle über die Ejakulation, einen hohen persönlichen Leidensdruck sowie partnerschaftliche Probleme. Die Therapie der EP unterteilt sich in sexualtherapeutische Ansätze sowie in medikamentöse Therapiemöglichkeiten, wobei hier die orale Therapie mit selektiven Serotoninwiederaufnahmehemmern (SSRI), mit Dapoxetin als dem ersten für die EP zugelassenen Medikament und die Lokaltherapie mit Lidocain/Prilocain im Vordergrund stehen.

Schlüsselwörter

Ejaculatio praecox Vorzeitiger Samenerguss IELT Serotonin Dapoxetin Lidocain/Prilocain 

Premature ejaculation

Abstract

With prevalence rates of 20%–25% premature ejaculation (PE) represents the most frequent sexual dysfunction in men. Whereas genetically determined changes in the serotonin receptor-/transporter mechanism seem to be responsible for lifelong PE, acquired PE is often associated with other conditioning diseases such as erectile dysfunction, prostatitis or thyroid dysfunctions. Typical features of PE are a short intravaginal ejaculatory latency time (IELT) <1–2 min, lack of control over ejaculation, personal distress and partner problems. Treatment of PE subdivides into sexual therapy as well as drug therapy. Among the medications considered for PE, oral therapy with selective serotonin re-uptake inhibitors (SSRI), Dapoxetine (the first officially approved medication for PE) and topical therapy with lidocaine/prilocaine-containing medications are given priority.

Keywords

Premature ejaculation IELT Serotonin Dapoxetine Lidocaine/Prilocaine 

Literatur

  1. 1.
    Althof SE, Rosen R, Symonds T et al (2006) Development and validation of a new questionnaire to assess sexual satisfaction, control and distress associated with premature ejaculation. J Sex Med 3:465–475PubMedCrossRefGoogle Scholar
  2. 2.
    Buvat J, Tesfaye F, Rothman M et al (2009) Dapoxetine for the treatment of premature ejaculation: results from a randomized, double-blind, placebo-controlled phase 3 trial in 22 countries. Eur Urol 55:957–968CrossRefGoogle Scholar
  3. 3.
    De Amicis LA, Goldberg DC, LoPiccolo J et al (1985) Clinical follow-up of couples treated for sexual dysfunction. Arch Sex Behav 14(6):467–489CrossRefGoogle Scholar
  4. 4.
    Dinsmore W, Wyllie MG (2009) PSD 502 improves ejaculatory latency, control and sexual satisfaction when applied topically 5 min. before intercourse in men with premature ejaculation: results of a phase III, multicentre, double-blind, placebo-controlled study. BJU Int 103:940–949PubMedCrossRefGoogle Scholar
  5. 5.
    Giuliano F, Clément P (2006) Serotonin and premature ejaculation: from physiology to patient management. Eur Urol 50:454–466PubMedCrossRefGoogle Scholar
  6. 6.
    Giuliano F, Patrick DL, Porst H et al for the 3004 Study Group (2008) Premature ejaculation: results form a five country European observational study. Eur Urol 53:1048–1057PubMedCrossRefGoogle Scholar
  7. 7.
    Jannini EA, Caros E, Pepe M, Lombardo F (2006) Update on pathophysiology of premature ejaculation: the basis for new pharmacological treatments. Eur Urol EAU EBU Update Series 4:141–149CrossRefGoogle Scholar
  8. 8.
    Janssen PKC, Bakker SC, Réthlevy J et al (2009) Serotonin transporter promoter region (5-httlpr) polymorphism is associated with the intravaginal ejaculation latency time in Dutch men with lifelong premature ejaculation. J Sex Med 6:276–84PubMedCrossRefGoogle Scholar
  9. 9.
    Jearn P, Santtila P, Johansson A et al (2009) Evidence for a genetic etiology to ejaculatory dysfunction. Int J Impot Res 21:62–67CrossRefGoogle Scholar
  10. 10.
    Lindau ST, Schumm LP, Laumann EO et al (2007) A study of sexuality and health among older adults in the United States. N Engl J Med 357:762–774PubMedCrossRefGoogle Scholar
  11. 11.
    McMahon CG, Abdo C, Incrocci L et al (2004) Disorders of orgasm and ejaculation in men. In Sexual medicine: Sexual dysfunctions in men and women. 2nd International Consultation on Sexual Dysfunctions, ParisGoogle Scholar
  12. 12.
    McMahon CG, Althof S, Waldinger M, Porst H et al (2008) An evidence-based definition of lifelong premature ejaculation: report of the International Society for Sexual Medicine (ISSM) Ad Hoc Committee For The Definition of Premature Ejaculation. J Sex Med 5:1590–1606PubMedCrossRefGoogle Scholar
  13. 13.
    McMahon CG (2008) The DSM-IV-TR definition of premature ejaculation and its impact upon the results of epidemiological studies. Eur Urol 53:887–889PubMedCrossRefGoogle Scholar
  14. 14.
    Porst H, Montorsi F, Rosen R et al (2007) The Premature Ejaculation Prevalence and Attitudes (PEPA) Survey: Prevalence, comorbidities and professional help-seeking. Eur Urol 51:816–824PubMedCrossRefGoogle Scholar
  15. 15.
    Pryor JL, Althof SE, Steidle C et al (2006) Efficacy and tolerability of dapoxetine in treatment of premature ejaculation: an integrated analysis of two double-blind, randomized controlled trials. Lancet 368:929–937PubMedCrossRefGoogle Scholar
  16. 16.
    Rosen RC, McMahon CG, Niederberger C et al (2007) Correlates to the diagnosis of premature ejaculation: results from a large observational study of men and their partners. J Urol 177:1059–1064PubMedCrossRefGoogle Scholar
  17. 17.
    Rowland DL, Patrick DL, Rothman M, Gagnon DD (2007) The psychological burden of premature ejaculation. J Sex Med 177:1065–1070Google Scholar
  18. 18.
    Sadeghi-Nejad H, Watson R (2008) Premature ejaculation: current medical treatment and directions. J Sex Med 5:1037–1050PubMedCrossRefGoogle Scholar
  19. 19.
    Steggall MJ, Fowler CG, Pryce A (2008) Combination therapy for premature ejaculation: results of a small-scale study. Sex Relationship Ther 23:365–376CrossRefGoogle Scholar
  20. 20.
    Waldinger MD (2007) Premature ejaculation. Definition and drug treatment. Drugs 67(4):547–568PubMedCrossRefGoogle Scholar
  21. 21.
    Waldinger MD, Zwinderman AH, Oliver B, Schweitzer DK (2005) Proposal fo a definition of lifelong premature ejaculation based on epidemiological stopwatch data. J Sex Med 2:498–507PubMedCrossRefGoogle Scholar

Copyright information

© Springer Medizin Verlag 2009

Authors and Affiliations

  1. 1.Neuer Jungfernstieg 6aHamburgDeutschland

Personalised recommendations