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Biomedical subjects

David Rowland

Publications and source records attributed to David Rowland.

4 recordsLinked to original sources

Psychosexual factors that differentiate men with inhibited ejaculation from men with no dysfunction or another sexual dysfunction.

AIM: Inhibited or retarded ejaculation (IE) is an uncommon male sexual dysfunction that may result in a lack of sexual fulfillment for both the man and his partner. In this study, we attempted to identify factors that differentiate men with IE from sexually functional controls or from men with other sexual dysfunctions and to specify whether such factors predict self-reported sexual arousal during psychophysiological assessment. METHODS: Each patient underwent psychophysiological assessment and a structured clinical interview based on a standardized questionnaire that included demographic information, psychosexual and medical history, and assessment of current sexual, erectile, and ejaculatory function, including relationship quality and characteristics. RESULTS: Men with IE resemble men with other dysfunctions but are differentiated from controls, in their lower level of relationship satisfaction, greater level of distress, and higher level of health-related problems. Men with IE were further characterized by lower levels of self-reported subjective sexual arousal, despite exhibiting strong penile response during psychophysiological testing and reporting high quality erections across a variety of situations. Also notable, however, were the many factors on which men with IE did not differ from controls. CONCLUSIONS: Taken together, this research helps specify directions for future investigations of men with IE.

Adult↗

Self-reported premature ejaculation and aspects of sexual functioning and satisfaction.

BACKGROUND: Although premature ejaculation (PE) is a common male sexual dysfunction, its relevant parameters have not been adequately studied in large community-based samples. OBJECTIVE: To examine the diagnostic utility of two self-report questions based on the DSM-IV-TR definition of PE and to investigate the relationship between self-identified PE, sexual functioning, and sexual satisfaction in men. METHODS: An Internet survey of general health and aspects of sexual functioning and satisfaction was conducted in 2,056 males. Subjects were classified as having "probable" or "possible" PE, or as "non-PE" by survey responses. RESULTS: A total of 1158 men met the selection criteria (sexually active in a stable heterosexual relationship), and 189 (16.3%) were classified as having probable PE by reporting they ejaculated before they wished and indicating it was "very much" or "somewhat" a problem. Another 188 (16.2%) men reported ejaculating before they wished but rated their distress lower and were classified as having possible PE. Compared to non-PE men, those with probable and possible PE reported significantly worse sexual functioning in 6 of 8 study measures. Concern about partner satisfaction was high in all groups. The importance of ejaculatory control and the ability to have intercourse for the desired time was significantly higher in men with PE as compared to non-PE men (P < 0.01). CONCLUSIONS: PE was a common problem, was characterized by a lack of ejaculatory control, and was associated with significant effects on sexual functioning and satisfaction. Additional research on the sensitivity and specificity of these self-report questions should be pursued.

Adult↗

Disorders of orgasm and ejaculation in men.

INTRODUCTION: Ejaculatory/orgasmic disorders, common male sexual dysfunctions, include premature ejaculation, inhibited ejaculation, anejaculation, retrograde ejaculation and anorgasmia. AIM: To provide recommendations/guidelines concerning state-of-the-art knowledge for management of ejaculation/orgasmic disorders in men. METHODS: An International Consultation in collaboration with the major urology and sexual medicine associations assembled over 200 multidisciplinary experts from 60 countries into 17 committees. Committee members established specific objectives and scopes for various male and female sexual medicine topics. The recommendations concerning state-of-the-art knowledge in the respective sexual medicine topic represent the opinion of experts from five continents developed in a process over a 2-year period. Concerning the Disorders of Ejaculation/Orgasm in Men Committee, there were nine experts from six countries. MAIN OUTCOME MEASURE: Expert opinion was based on grading of evidence-based medical literature, widespread internal committee discussion, public presentation and debate. RESULTS: Premature ejaculation management is dependent upon etiology. When secondary to ED, etiology-specific treatment is employed. When lifelong, initial pharmacotherapy (SSRI, topical anesthesia, PDE5 inhibitors) is appropriate. When associated with psychogenic/relationship factors, behavioral therapy is indicated. When acquired, pharmacotherapy and/or behavioral therapies are preferred. Retrograde ejaculation, diagnosed with spermatozoa and fructose in centrifuged post-ejaculatory voided urine, is managed by education, patient reassurance, pharmacotherapy or bladder neck reconstruction. Men with anejaculation or anorgasmia have a biologic failure of emission and/or psychogenic inhibited ejaculation. Men with age-related penile hypoanesthesia should be educated, reassured and be instructed in revised sexual techniques which maximize arousal. CONCLUSIONS: More research is needed in understanding management of men with ejaculation/orgasmic dysfunction.

Anesthetics, Local↗