Paediatrics Urology Unit
Prostate Growth And Greenlight Method
Premature Ejaculation (Early-Fast-Rapid Ejaculation)
Penile Prosthesis İmplantation
Sexually Transmitted Diseases (Venereal Diseases)
Testicle And Epididymis İnfection
• Assoc. Prof. Ömer ÖGE, MD
• Işık H. ÖZGÜ, MD
• Uğur SARAÇOĞLU, MD
PREMATURE EJACULATION (EARLY-FAST-RAPID EJACULATION)
Ejaculation can be used for defining throwing out and spurting (ejaculation) semen (ejaculate, semen) together with orgasm experienced at the end of sexual intercourse in men. Ejaculation disorders may arise either based on organic or psychological causes and a number of drugs may lead to ejaculation dysfunction.
In urbanized society, approximately one of three men experiences this dysfunction and it is considered that it is the most frequently seen sexual dysfunction among men. Premature ejaculation is not to be compared with erection insufficiency. (erectile dysfunction, impotence). After ejaculation, penis becomes soft, it is a normal situation and for a while and penis does get hard again. This case is called "refractory period" and men perceive this as erectile insufficiency.
Definition of premature ejaculation and what normal-abnormal limit is may not be easily based on conclusive objective criteria. For this reason, some criteria have been strived to be found out for definition of premature ejaculation.
• Occurrence of ejaculation before 15 in-out movements made for vagina, lack of women orgasm or ejaculation of male in at least half of sexual intercourse before women.
• Ejaculation when male sexual organ enters into vagina or ejaculation just before it, ejaculation within 7 minutes after male sexual organ enters into vagina.
Furthermore, according to another view; what is important here is not how men delay ejaculation but to what extent man and his partner are satisfied from sexual intercourse process.
Causes of Premature Ejaculation
Some factors identified in very few patients are Medulla spinalis tumours and traumas, multiple sclerosis, urinary tract infection, prostate infection.
In our time, some controversial disorders considered to be underlying causes in at least a group of patient detected with special analyses in very few patients are nervous system dysfunction characterized by over sensitivity of penis skin, excess of sensory nerve cells, failure to delay ejaculation due to insufficiency in autonomous nervous system control mechanism and extreme active of smooth muscles around penis contracted during ejaculation.
It has been claimed that extreme excitement or tension may cause over stimulation of ejaculation central centre located at brain. According to another view, tension stimulates adrenaline discharge in body and contractions during ejaculation stimulate and accelerate rhythmic contractions of smooth muscles on genital area. Problems in relationships may cause ejaculation. In man was to ejaculate in a short time all the time in his previous sexual experiences or was forced so, this case may have become a habit. Young men ejaculate more quickly than adults; this case is an indicator of the fact that control of man over ejaculation increases when his sexual experience increases.
Purpose in this treatment is to try to reduce over sensitivity in penis and to enhance control of a person during ejaculation process with behaviour treatment and in this way, to increase satisfaction obtained from sexual stimulus. Since permanent success in treatment is of high importance, both methods are endeavored to be applied at the same time.
Behaviour Treatment: Feeling and being aware of ejaculation time is of utmost important for patient. In this way, satisfaction and sense of control may be improved. For this end, exercise program is applied on 6-20 weeks to patients and their spouses. In this method, patients become aware of extended systematic relaxation techniques wherein (15 minutes) this is applied with the patient himself or his spouse. That a person's perception of the incident, whether he has sexual spouse or not and his attempt to apply treatment together with her in the treatment is of influential significance.
Condom Use: A condom acts by reducing direct stimulation of penile skin. Some men have reported that they get stimulated less than with condom and they involve with longer sexual activity. In addition to this condom protects you against sexually transmitted diseases and is an effective method of birth control.
Creams Reducing Penile Sensitivity: This treatment method is based on applying creams containing drug with anesthesia content over penis skin before sexual intercourse. It is recommended to wash penis just before the intercourse for avoiding numbness of penis and vagina likely to occur during sexual intercourse.
Drug Treatment: The most frequently used drugs for preventing premature ejaculation are anti-depressants. One of the side effects of these drugs is to delay ejaculation and for this reason, anti-depressants are used for making use of this side effect. In recent times, publications relating to the fact that drugs used in treatment of erectile dysfunction and alpha-adrenergic blocking drugs are effective in premature ejaculation treatment have been made and they have been started to be used as treatment alternative.