Waldinger Marcel D
Division of Pharmacology, Utrecht Institute for Pharmaceutical Sciences, Faculty of BetaSciences, Utrecht University, Utrecht, The Netherlands; Private Practice, Amstelveen, The Netherlands; Outpatient Department of Neurosexology, HagaZiekenhuis, Den Haag, The Netherlands.
Pharmacol Biochem Behav. 2014 Jun;121:189-94. doi: 10.1016/j.pbb.2013.12.004. Epub 2013 Dec 11.
In the last two decades, in vivo animal research and human neurobiological, genetic and pharmacological research of lifelong premature ejaculation (PE) have much contributed to a better understanding of the role of the central and peripheral nervous systems in mediating ejaculation. Research of genetic polymorphisms in men with lifelong PE and clinical research of the validity of the classification into four PE subtypes have provided a better insight into lifelong PE and its distinction from the three other PE subtypes. Nevertheless, a number of symptoms of lifelong PE and its treatment by SSRIs are still not well understood. In the current article, it will be argued that lifelong PE is characterized not only by early ejaculations (ejaculatio praecox), a diminished control over ejaculation, and negative personal consequences, but also by early erections (erectio praecox) and an immediately occurring detumescence of the penis after ejaculation (detumescentia praecox) as symptoms of an (sub)acute hypertonic or hypererotic physical state when making love. Based on animal research it is postulated that the facilitated erection, facilitated ejaculation and facilitated penile detumescence are associated with centrally and peripherally increased oxytocin release. In addition, it is postulated that mechano- and thermosensory activity of transient receptor potential (TRP) ion channels, located in skin receptors of the glans penis, are associated with lifelong PE. Research into the three characteristics of the (sub)acute hypererotic state will presumably contribute to a better phenomenological description of and better neurobiological understanding of lifelong PE and its delineation to the three other PE subtypes.
在过去二十年中，对终生性早泄（PE）的体内动物研究以及人类神经生物学、遗传学和药理学研究，为更好地理解中枢和外周神经系统在射精调节中的作用做出了很大贡献。对终生性早泄男性的基因多态性研究以及将其分为四种PE亚型的分类有效性的临床研究，为终生性早泄及其与其他三种PE亚型的区别提供了更好的见解。然而，终生性早泄的一些症状及其通过5-羟色胺再摄取抑制剂（SSRI）的治疗仍未得到充分理解。在当前文章中，将论证终生性早泄不仅以早泄（射精过早）、对射精控制减弱以及负面个人后果为特征，还以早期勃起（勃起过早）以及射精后阴茎立即出现消肿（消肿过早）为特征，这些是做爱时（亚）急性高渗或性欲亢进身体状态的症状。基于动物研究推测，勃起促进、射精促进和阴茎消肿促进与中枢和外周催产素释放增加有关。此外，推测位于阴茎头皮肤感受器中的瞬时受体电位（TRP）离子通道的机械和热感觉活动与终生性早泄有关。对（亚）急性性欲亢进状态的三个特征的研究可能有助于对终生性早泄进行更好的现象学描述和更好的神经生物学理解，并将其与其他三种PE亚型区分开来
