Department of Urology, Tulane University School of Medicine, New Orleans, LA, USA; Department of Urology, Bagcilar Training & Research Hospital, Istanbul, Turkey.
J Sex Med. 2014 Jul;11(7):1657-63. doi: 10.1111/jsm.12553. Epub 2014 Apr 29.
INTRODUCTION: Premature ejaculation (PE) is the most common male sexual dysfunction. A variety of pharmacotherapeutic strategies have been employed to treat men suffering with lifelong PE. However, there are currently no pharmaceuticals approved by the U.S. Food and Drug Administration specifically designed for PE treatment. AIM: Given that the bulbospongiosus muscle is involved in the ejaculatory reflex in both humans and rodents and that local administration of botulinum-A can abolish muscle contractions, the current study examined the effect of injection of botulinum-A toxin into the bulbospongiosus muscle on the ejaculatory latency of male rats. METHODS: After screening for normal sexual activity with sexually receptive female rats, 33 sexually experienced male Long-Evans rats (Harlan Laboratories, Indianapolis, IN, USA) underwent an additional four pretreatment sexual exposures over the course of the following week, during which all components of sexual behavior were video recorded by trained observers. On the day after their fourth experience, rats were anesthetized and received a single injection of either 0.5 unit (n = 11) or 1 unit (n = 11) of botulinum-A toxin or saline vehicle (n = 11). Botulinum-A toxin was dissolved in 0.1 mL of saline vehicle and injected bilaterally into the bulbospongiosus muscle by the percutaneous route. Beginning 2 days after treatment, sexual behaviors were reexamined over the course of the following week on four separate occasions. MAIN OUTCOME MEASURES: The latency to achieve ejaculation, and the frequencies and latencies of mounts and intromissions were video recorded by trained observers in a blinded fashion. RESULTS: Relative to pretreatment measurements, bilateral injection of saline vehicle into the bulbospongiosus muscle did not affect ejaculation latencies. However, rats treated with either 0.5 or 1 unit of botulinum-A toxin exhibited significantly longer latencies to achieve ejaculation relative to pretreatment performance. Of note, botulinum-A toxin did not affect the ability to achieve mounts, intromissions, or ejaculation. CONCLUSIONS: These results demonstrate that botulinum-A toxin injection into the bulbospongiosus muscle is a safe and effective treatment that extends ejaculatory latency in rats without affecting the ability to engage in sexual activity or achieve ejaculation. Further studies are required to evaluate this therapeutic concept in PE patients.
引言:早泄(PE)是最常见的男性性功能障碍。为了治疗患有终身 PE 的男性,已经采用了多种药物治疗策略。然而,目前尚无美国食品和药物管理局批准的专门用于治疗 PE 的药物。
目的:鉴于球海绵体肌在人类和啮齿动物的射精反射中都有涉及,并且局部给予肉毒杆菌-A 可以消除肌肉收缩,因此本研究检查了将肉毒杆菌-A 毒素注射到球海绵体肌中对雄性大鼠射精潜伏期的影响。
方法:在与有接受能力的雌性大鼠进行正常性行为筛选后,33 只有性经验的雄性长耳大白鼠(印第安纳波利斯哈兰实验室,美国)在接下来的一周内进行了另外四次预处理性暴露,在此期间,所有性行为的组成部分都由经过训练的观察者进行视频记录。在他们第四次体验后的第二天,大鼠被麻醉,并接受单侧或双侧 0.5 单位(n=11)或 1 单位(n=11)肉毒杆菌-A 毒素或生理盐水载体(n=11)的单次注射。肉毒杆菌-A 毒素溶解在 0.1mL 的生理盐水载体中,通过经皮途径双侧注射到球海绵体肌中。治疗后 2 天开始,在接下来的一周内,分四次在不同时间重新检查性行为。
主要观察指标:射精潜伏期,以及交配和插入的频率和潜伏期,均由经过训练的观察者以盲法进行视频记录。
结果:与预处理测量值相比,将生理盐水载体单侧注射到球海绵体肌中不会影响射精潜伏期。然而,接受 0.5 或 1 单位肉毒杆菌-A 毒素治疗的大鼠的射精潜伏期明显长于预处理时的表现。值得注意的是,肉毒杆菌-A 毒素不会影响交配、插入或射精的能力。
结论:这些结果表明,将肉毒杆菌-A 毒素注射到球海绵体肌中是一种安全有效的治疗方法,可以延长大鼠的射精潜伏期,而不会影响进行性行为或达到射精的能力。需要进一步的研究来评估这种治疗概念在 PE 患者中的应用。
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