Premature%20ejaculation Signs and Symptoms

Signs and Symptoms

Introduction

A male sexual dysfunction characterized by:
- Short, easily stimulated ejaculation that occurs always or nearly always before or within about 1 minute of vaginal penetration or a clinically significant and bothersome reduction in latency time, often to about 3 minutes or less
- Either present from the first sexual experience or following a new bothersome change in ejaculatory latency
- Involuntarily controlled
- Causes negative personal consequences eg distress, bother, frustration, avoidance of sexual intimacy and interpersonal difficulty

Most common male sexual dysfunction with prevalence not affected by age
- More common in younger men

Etiology

Unknown exact etiology with few data to support the following suggested biological and psychological hypotheses including:
- Anxiety
- Penile hypersensitivity
- 5-HT receptor dysfunction

Risk Factors

Risk factors include:
- Genetic influences (lifelong PE)
- Prostatic inflammation and chronic bacterial prostatitis (acquired PE)
- Hormonal aberrations or thyroid hormone disorders
- Poor overall health status and obesity
- Psychological factors that may precipitate PE are historical factors (eg sexual abuse, attitude towards sex in the home), individual psychological factors (eg body image, depression, performance anxiety) or relationship factors (eg intimacy, anger)

Optimizing metastatic hormone-sensitive prostate cancer treatment in advanced prostate cancer

Assoc Prof. Darren Poon, Assoc Prof. Edmund Chiong, 14 Jan 2021

Metastatic hormone-sensitive prostate cancer (mHSPC) refers to the condition whereby patients have metastatic prostate cancer and no prior hormonal therapy or androgen deprivation therapy (ADT). Typically, patients with mHSPC have been treated with ADT alone, following which, the overwhelming majority develop castration resistance over time and head towards eventual mortality. In recent years, the publication of various landmark trials has prompted dramatic changes in the mHSPC treatment landscape, and had favourably impacted overall survival (OS) in these patients. At a recent webinar, A/Prof Darren Poon, Honorary Consultant in Clinical Oncology, Hong Kong Sanatorium & Hospital, and Honorary Clinical Associate Professor, Department of Clinical Oncology, The Chinese University of Hong Kong, reviewed treatment options in mHSPC, while A/Prof Edmund Chiong, Head and Senior Consultant, Department of Urology, National University Hospital, Singapore, presented a case which was discussed by an esteemed panel of experts. This webinar was jointly organized by the Singapore Society of Oncology and the Singapore Urological Association, and supported by Astellas.