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Kevan R Wylie

Publications and source records attributed to Kevan R Wylie.

5 recordsLinked to original sources

Evaluation of the Sexual Assessment Monitor, a diagnostic device used to electronically quantify ejaculatory latency time: findings from three studies.

OBJECTIVE: To validate the Sexual Assessment Monitor (SAM), a novel apparatus designed to collect electronic data on ejaculatory latency time (ELT) for diagnosing premature ejaculation (PE), and for accurately measuring treatment outcomes in clinical trials. PATIENTS, SUBJECTS AND METHODS: Men with PE, and healthy volunteers aged 18-75 years, were enrolled in three open-label studies, conducted in the UK. The SAM, which consists of a control box with two front attachments, a vibrator and sensor, was attached to the penis. The vibrator, which provides stimulation, was positioned at the frenulum using a soft cuff; the vibrator intensity was set at 80 units for most subjects. The sensor is an indium-gallium elasticated loop, which was positioned around the base of the penis to detect ejaculatory pulses. These pulses were transmitted to a data recorder in the control box. The data, which are displayed graphically as traces, were automatically classified by a computer-generated algorithm to quantify ELT. RESULTS: In all, 53 healthy volunteers and 58 men with PE provided 213 and 195 evaluable records, respectively. Most were complete records (99% and 96%). The pooled data showed that the ELT was much higher for healthy volunteers than for men with PE (geometric means: 687 vs 169 s, respectively), with a healthy volunteer to PE patient ratio of 2.87 (P < 0.001). Only 6.3% of subjects reported mild adverse events, which were unrelated to the SAM. CONCLUSIONS: These open-label studies show that the SAM can consistently and safely measure times to erection (from the start of vibration) and ejaculation, and ELT in healthy volunteers and men with PE. These findings show that the SAM has the potential to become the 'gold standard' in the diagnosis of PE and in clinical trials design.

Adolescent↗

Sexuality and the menopause.

Sexual problems such as dyspareunia and decreased sexual desire are common after the menopause. Hypoactive sexual desire disorder is the diagnostic category applied to many women with loss or lack of sexual interest or desire. The principal components of assessment for sexual dysfunction in menopausal women are: a general, gynaecological, obstetric, psychiatric, psychosexual and relationship history; use of self-report questionnaires; physical examination; and hormonal evaluation. The use of low-dose vaginal estrogen tablets, rings, creams or pessaries may help to improve local genital response but does not necessarily improve sexual interest or motivation. An improvement in sexual function has been reported with tibolone and a combination of estrogen and androgen therapy, al though it remains unclear which groups of postmenopausal women with sexual problems will benefit most from such treatments. Where there is no response to estrogens or where there is premature or surgical menopause the addition of an androgen may be necessary, particularly if the free testosterone levels are low.

Female↗

Premature ejaculation: the current literature.

PURPOSE OF REVIEW: The recent increase in research with regard to premature ejaculation has led to a significant number of new papers looking at the diagnosis, definition, aetiology and management of this condition. RECENT FINDINGS: The intravaginal ejaculatory latency time remains the primary measure of ejaculatory time although increasing bother and distress require assessment and establishment of quantifiable measures. Biological and psychogenic causes contribute to a multifactorial model of premature ejaculation with some neurobiological vulnerability. The principal treatments are selective serotonin reuptake inhibitors and behavioural cognitive interventions. New treatment interventions are under investigation. SUMMARY: A number of guideline papers confirm that a primary sexual history and a multimodel treatment approach provide the best approach to patients with this common condition.

Adult↗

The potential benefit of vacuum devices augmenting psychosexual therapy for erectile dysfunction: a randomized controlled trial.

A cohort of 45 patients diagnosed with predominant psychogenic erectile disorder (ED) chose couples psychotherapy. We randomized 25 couples to also receive a vacuum constriction device (VCD), also known as a vacuum erectile device, at the second session (group 1), whereas 20 couples had psychotherapy without a VCD. Twenty-one couples (84%) in group 1 reported some improvement after the initial psychotherapy and VCD sessions compared with 12 of the 20 couples (60%) who reported some improvement after couples psychotherapy in group 2. We subsequently found that 3 of the 4 couples in group 1 reporting no improvement had not used the pump provided. Early combination treatment of couples psychotherapy and a physical treatment such as a VCD may lead to a greater beneficial response in men with ED than therapy alone. The delay of demonstrating the capacity and potential benefit from a physical intervention may have a marked effect on the initial and ongoing response to sex therapy.

Adult↗