Aerobic exercise improves ejaculatory behaviors and complements dapoxetine treatment by upregulating the BDNF-5-HT duo: a pilot study in rats.

Accumulating evidence has revealed many clues that regular aerobic exercise benefits brain health and behaviors. The aims of this study were to explore the effect of aerobic exercise on ejaculatory behaviors, as well as to make a preliminary assessment of aerobic exercise as a complementary strategy to dapoxetine treatment in rapid ejaculators. Copulatory tests of rats and a treadmill training protocol were performed in this study. In total, 12 rapid ejaculators were selected on the basis of ejaculation distribution theory and randomly assigned to 4 groups: control (Ctrol) group, aerobic exercise (Ex) group, dapoxetine (Dapo) group, and Ex+Dapo group. We evaluated the changes in ejaculatory parameters in the 4 groups. Variations in biological markers, including serum corticosterone, serotonin (5-HT), and brain-derived neurotrophic factor (BDNF) of the raphe nucleus, were determined by enzyme-linked immunosorbent assay (ELISA). The primary finding of our study was that both aerobic exercise and acute dapoxetine could enhance ejaculation control and prolong ejaculation latency in rapid ejaculator rats. The ejaculation delay effect of aerobic exercise was nearly equivalent to that of acute dapoxetine. In addition, both aerobic exercise and dapoxetine treatment could lead to increased expression of BDNF and 5-HT in the raphe nucleus of rapid ejaculators. Moreover, the two interventions, when applied together, may further upregulate the expression of BDNF-5-HT duo in a complementary manner. This study highlights the positive effects of aerobic exercise on ejaculation control. Regular aerobic exercise might be a promising complementary treatment to dapoxetine in rats.

[Correlation between the phenotypic domains of the UPOINT system and sexual dysfunction in men with chronic prostatitis/chronic pelvic pain syndrome].

OBJECTIVE: To investigate the correlation of the six phenotypic domains of the UPOINT (urinary, psychosocial, organ-specific, infection, neurologic/systemic, and tenderness) system with premature ejaculation (PE) and ED in male patients with chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS). METHODS: We collected the clinical data on 453 cases of CP/CPPS from December 2016 to December 2017, including the general information, CP symptoms, sexual life history, intravaginal ejaculatory latency time (IELT), NIH-CPSI, and IIEF-5 scores. We classified the patients according to the UPOINT system. RESULTS: The CP/CPPS patients were aged 32.75 ± 6.85 years, of whom 45.03% (204/453) were diagnosed with ED and 43.27% (196/453) with PE. The positive rates of the six phenotypic domains of the UPOINT system were 68.78% (U), 60.21% (P), 77.45% (O), 20.34% (I), 46.83% (N), and 65.12% (T), respectively. Multivariate logistic regression analysis showed psychosocial (P) abnormality to be an independent risk factor for PE (OR = 4.55, 95% CI: 2.75－8.06, P < 0.05) and ED (OR = 3.35, 95% CI: 2.02－6.25, P < 0.05). CONCLUSIONS: The psychosocial (P) factor in the UPOINT system plays an important role in the pathogenesis of PE and ED in patients with CP/CPPS.

Validity of premature ejaculation diagnostic tool and its association with International Index of Erectile Function-15 in Chinese men with evidence-based-defined premature ejaculation.

The premature ejaculation diagnostic tool (PEDT) is a brief diagnostic measure to assess premature ejaculation (PE). However, there is insufficient evidence regarding its validity in the new evidence-based-defined PE. This study was performed to evaluate the validity of PEDT and its association with IIEF-15 in different types of evidence-based-defined PE. From June 2015 to January 2016, a total of 260 men complaining of PE and defined as lifelong PE (LPE)/acquired PE (APE) according to the evidence-based definition from Andrology Clinic of the First Affiliated Hospital of Anhui Medical University, along with 104 male healthy controls without PE from a medical examination center, were enrolled in this study. All individuals completed questionnaires including demographics, medical and sexual history, as well as PEDT and IIEF-15. After statistical analysis, it was found that men with PE reported higher PEDT scores (14.28 ± 3.05) and lower IIEF-15 (41.26 ± 8.20) than men without PE (PEDT: 5.32 ± 3.42, IIEF-15: 52.66 ± 6.86, P < 0.001 for both). It was suggested that a score of ≥9 indicated PE in both LPE and APE by sensitivity and specificity analyses (sensitivity: 0.875, 0.913; specificity: 0.865, 0.865, respectively). In addition, IIEF-15 were higher in men with LPE (42.64 ± 8.11) than APE (39.43 ± 7.84, P < 0.001). After adjusting for age, IIEF-15 was negatively related to PEDT in men with LPE (adjust r = -0.225, P < 0.001) and APE (adjust r = -0.378, P < 0.001). In this study, we concluded that PEDT was valid in the diagnosis of evidenced-based-defined PE. Furthermore, IIEF-15 was negatively related to PEDT in men with different types of PE.