The misunderstanding and Countermeasures of premature ejaculation self diagnosis (family medicine)

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The day before, a male patient came to the clinic in our hospital, said he suffered from premature ejaculation, toothpaste glans method usin


The day before, a male patient came to the clinic in our hospital, said he suffered from premature ejaculation, toothpaste glans method using popular online therapy for a period of time, the general effect, and the heart and feel at ease, requires a detailed examination. After a detailed medical history and physical examination, we found that the concept of premature ejaculation is not clear, only a one-time relationship with his girlfriend and ejaculation faster, simply can not talk about premature ejaculation. In fact, this situation is more common, some people worried about premature ejaculation, ejaculation will be worried about a quick, everywhere, there are people with premature ejaculation and erectile dysfunction.

From a biological point of view, those who are able to ejaculate during intercourse are classified as excellent. But human beings are higher animals, have thought, emotion, need to enjoy the pleasure of sex. Ejaculation time is one of the most important factors that affect the quality of life. Studies show that the incidence of premature ejaculation is about 30%, the problem is small, but it can seriously affect the quality of sexual life, but also may further cause erectile dysfunction, need to pay attention to and early treatment. So, what kind of situation is premature ejaculation?

The exact definition of premature ejaculation in medicine is still controversial, according to the 2007 International Society (The International Society for Sexual Medicine, ISSM) the latest definition of premature ejaculation, premature ejaculation is a kind of sexual dysfunction, has the following three characteristics: (1) or almost always in the vagina for 1 minutes or so of ejaculation;

(2) the ability to prolong or control ejaculation;

(3) resulting in negative consequences, such as distress, pain, depression, or / or avoidance of sexual contact.

Clinicians through these characteristics, combined with the patient's sexual life, ejaculation latency (ie, the time after the vagina into the vagina) and the score scale, and finally make the diagnosis of premature ejaculation. Commonly used in clinical scoring scale "premature ejaculation diagnostic tool scale (PEDT)" and "Chinese patients with premature ejaculation sexual function evaluation form (CIPE-10, CIPE-5)". Spread in the network of "premature ejaculation self test table is CIPE-10 (10 questions), but the ejaculation time were tampered with, and with CIPE-5 (5 questions) as the evaluation standard for evaluation, can not be self testing, but misleading. More self testing methods of mild premature ejaculation is defined as the insertion of the penis into the vagina after 6 ~ 15 minutes ejaculation, which will enable many male compatriots with premature ejaculation "hat" ah! In addition, if starting from the first life that premature ejaculation, the diagnosis of primary premature ejaculation. If it is normal, and later due to some problems leading to rapid ejaculation, that is, secondary premature ejaculation.

Cause a lot of premature ejaculation causes, such as emotional problems, urogenital sense, and may cause various perplexing, the relationship between the reciprocal causation. If you suspect that you have premature ejaculation, as soon as possible to the hospital to communicate with the specialist and the corresponding inspection. But there are also some male compatriots ashamed to see a doctor, find their own way of looking at the treatment of the network, so there is the beginning of the scene.

When it comes to the treatment of premature ejaculation, the medical profession has not yet a good solution, you can choose the method of drug treatment, psychological and behavioral therapy and surgical treatment. Among them, the first choice is drug therapy, including five SSRI reuptake inhibitor and surface anesthetic. Dapoxetine is a kind of SSRI, as the United States FDA only recognized for the treatment of premature ejaculation antidepressant, can effectively inhibit the central nervous system, prolong the time of ejaculation. The surface anesthetic spray in the glans, through the nerve to play a role in delaying ejaculation ejaculation, the use of more convenient, but need to use condoms to avoid vaginal mucosa. At present, it is true that the toothpaste is used to clean the glans penis on the Internet. It is said that the nerve can be prolonged, and there is no side effect. But what about the facts? As we all know, the formula of toothpaste is mainly friction agent, foaming agent, binder, sweetener, fragrance (mint, amine leaf, etc.). Which is the role of the inside of the mint. In theory, the mint does have inhibitory and paralysis of the peripheral nerves, the role of the glans penis can delay ejaculation. On the surface, this method can replace the surface anesthetic, and economical, easy to use. But there are some risks and side effects. In addition to the paralysis of the mint at the same time, but also irritating, repeated smear, may lead to congestion of the glans penis, some people may also have allergic reactions. If it is not clean, that is, sexual life, may stimulate the vaginal mucosa, causing the woman unwell. At the same time, the composition of toothpaste friction agent (talc powder, etc.), with a certain degree of friction, repeated friction may cause minor abrasions glans. Some of the chemical composition of toothpaste (such as fluoride, etc.), may affect the male semen and female fertility, resulting in low pregnancy rate or infertility. Therefore, clinicians do not recommend this approach, it is recommended that the patient to the hospital after treatment options.

A lot of patients with secondary premature ejaculation in the emergence of fast ejaculation, will be attributed to their own young masturbation, to create a huge psychological burden, and even subsequent erectile dysfunction. Frequent masturbation in adolescence, the formation of rapid ejaculation habits, is indeed an important cause of premature ejaculation after marriage. However, with the patient's understanding of the problem and the spread of the network, has been expanded, and even demonized, for a lot of rapid ejaculation without the habit of premature ejaculation patients cause psychological distress. Imagine if it is premature ejaculation caused by masturbation, then these patients can not be the case before the normal ejaculation. As for secondary premature ejaculation, cause is urinary tract infection or sex mental disorder, need to normal hospital, due to an antidote against the disease by the doctor, give some psychological and behavioral therapy, patients with heart doubts and solve the conflict inside. For patients with primary premature ejaculation, in addition to the use of first-line drug treatment, but also through psychological and behavioral therapy to further improve the ejaculation time.

The network has introduced the "pinch method" to control ejaculation, this method is two kinds of behavior recognized one of the treatment methods, but the need to master certain skills, otherwise it may damage the patient's penis, may also cause the penis weak and unable to continue life. This paper introduces a "stop and move 2 step training method", which is improved by Semens in 1956. After the erection of the penis, open the foreskin to reveal the entire glans, smear the right amount of vaginal lubricant. With the right index finger by coronary sulcus to urethral mouth spiral stimulation glans, occurrence ejaculation feeling after immediate cessation of stimulation, and about 10 minutes; second groups of actions by the right hand thumb and index finger buckle into the ring, from the urethra to the coronal direction, extrusion friction glans, extrusion pressure rate and friction speed from slow to fast, appear after ejaculation feeling the same, about 10 minutes after the increase of stimulus intensity, the last ejaculation. Weekly training 2 ~ 4 times, can be carried out by the patient himself for the first time for 2 ~ 4 weeks, some patients can obviously feel ejaculation control ability. To stop after training by wife instead of patients, patients feel after ejaculation, which told the woman to stop stimulation, training frequency and cycle the previous stage. This method is often used in clinical work, but also can be combined with drug treatment. There are patients who will doubt that this approach is a disguised form of masturbation, will hurt the vitality of men. In fact, sexual life is too little, or ejaculation is also one of the reasons leading to premature ejaculation.

In addition, with the development of selective penile dorsal neurotomy for the treatment of premature ejaculation, many private hospitals as a gimmick to attract patients. There are also a number of patients to our hospital outpatient surgery strongly require surgery. There are a lot of misunderstanding, first of all, this surgery is only applied to married primary premature ejaculation, and must accept the long-term drug and psychological behavior after treatment, there is still minimal stimulation of ejaculation. At the same time, also need to determine the threshold value of the penis, to obtain objective data after a comprehensive judgment, I have carried out the relevant examination before the subject. For drugs that can improve ejaculation time or secondary premature ejaculation patients do not consider surgical treatment. At the same time, the operation has a certain risk, including postoperative poor results, postoperative psychological disorders, postoperative penile numbness, as well as the unknown impact on erectile function. Therefore, physicians in the selection of surgery is also very cautious. Suggested that patients do not have to go to the private hospital because the normal hospital surgery will be convenient".

Finally, we put forward some precautions to avoid and treat premature ejaculation:

1 avoid the use of repeated sexual intercourse to extend the second sexual intercourse time, which is detrimental to health, not long-term use;

2 sexual life before the mood has a great influence on the speed of ejaculation, should avoid anxiety, excitement and tension, to establish self-confidence;

3 foreplay should make, make the woman advanced into the excitement and the platform, is easier to satisfy the requirements of;

4 insert the vagina, reduce the amplitude and speed of the tic, reduce the stimulation of the penis, through the "nine shallow deep" method to extend the ejaculation time;

5 in the presence of ejaculation feeling, the dispersion of the attention of sexual stimulation, the penis will be transferred to other issues of thinking, will help to delay ejaculation;

6 can take the female sexual intercourse method, in order to ease the tension of sexual life, and increase the adaptability of vaginal stimulation;

7 to strengthen the exchange of ideas and feelings of the couple, to eliminate barriers and misunderstandings, to understand her husband premature ejaculation and actively cooperate with the treatment, will help overcome the bad psychology;

8 the woman to be considerate, comfort, not blame, threat, or not, is not conducive to the rehabilitation of premature ejaculation.

The last thing you need to remember is that there is no uniform standard of sexual life ejaculation time, do not deliberately pursue the length of time, as long as the two sides are satisfied with your success.

With disease counseling can add Dr. Wang Hongxiang public micro signal: Dr_WHX (add please explain what disease and have seen the real name, treatment time and the number of visits, or will not sign. Because Doctor Wang is usually busy, WeChat can't reply for the first time, please be patient

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