Nanjing Drum Tower Hospital Clinical College of Nanjing Medical University, Nanjing, China.
Department of Andrology, Jiangsu Province Hospital of Chinese Medicine, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, China.
Andrology. 2024 Nov;12(8):1822-1829. doi: 10.1111/andr.13622. Epub 2024 Mar 4.
Primary intravaginal anejaculation (PIAJ) is a relatively uncommon male sexual dysfunction characterized by an inability to achieve intravaginal ejaculation during all sexual intercourse. Effective treatment options for this condition are lacking. We aimed to explore the clinical effect of the sexual therapy combined with vacuum negative pressure hydropneumatic/pneumatic bubble massage (VNPHP/PBM) on primary intravaginal anejaculation, and its possible mechanism.
A total of 95 PIAJ patients were randomly divided into three groups, including group A with 32 patients treated with the sexual therapy combined with VNPHP/PBM, group B with 32 patients treated with the sexual therapy and group C with 31 patients treated with VNPHP/PBM. The efficacy of therapeutic regimes, latency of the somatosensory evoked potentials of dorsal nerve (DNSEP), glans penis (GPSEP) and penile shaft sensory threshold (PSST), measures of sexual behavior of patients, as well as the self-rating anxiety scale (SAS) sores of patients and their partners, were compared before and after treatment among three groups.
The total effective rate of group A (84.38%) was higher than those of groups B and C (53.13% and 41.94%), however, no differences were found between groups B and C. The ratios of patients and their partners with anxiety, frequency of observing erotic films of patients, ratios of patients with special self-masturbation and frequency of masturbation decreased significantly in the three groups after the treatment. The decrease in the ratios of patients and their partners with anxiety, frequency of observing erotic films of patients in groups A and B were higher than those of group C, however, no differences were identified between groups A and B. The decrease in the ratios of patients with special self-masturbation and frequency of masturbation in group A were higher than those of group B, however, no differences were found between groups A and C, B and C. There were no differences in the latency of DNSEP, GPSEP, and PSST among the three groups before and after treatment.
The sexual therapy combined with VNPHP/PBM has good therapeutic effects on PIAJ, which might be achieved by reducing the anxiety level of patients and their partners, improving sexual behavioral patterns, rather than increasing the sensitivity of penis including dorsal nerve and glans penis.
原发性阴道内射精障碍（PIAJ）是一种相对罕见的男性性功能障碍，其特征是在所有性行为中无法实现阴道内射精。这种情况下有效的治疗选择方法缺乏。我们旨在探讨性治疗联合真空负压水力/气动气泡按摩（VNPHP/PBM）对原发性阴道内射精障碍的临床疗效及其可能的机制。
将 95 例 PIAJ 患者随机分为三组，A 组 32 例患者采用性治疗联合 VNPHP/PBM 治疗，B 组 32 例患者采用性治疗，C 组 31 例患者采用 VNPHP/PBM 治疗。比较三组患者治疗前后的疗效、感觉诱发电位潜伏期（DNSEP）、龟头（GPSEP）和阴茎体感觉阈值（PSST）、患者性行为测量、患者及其伴侣的焦虑自评量表（SAS）评分。
A 组总有效率（84.38%）高于 B 组和 C 组（53.13%和 41.94%），但 B 组与 C 组之间无差异。治疗后三组患者及其伴侣焦虑比例、患者观看色情电影频率、患者特殊自慰比例、自慰频率均明显下降。A 组和 B 组患者及其伴侣焦虑比例、患者观看色情电影频率下降均高于 C 组，但 A 组与 B 组之间无差异。A 组患者特殊自慰比例和自慰频率下降高于 B 组，但 A 组与 C 组、B 组与 C 组之间无差异。三组患者治疗前后 DNSEP、GPSEP 和 PSST 潜伏期无差异。
性治疗联合 VNPHP/PBM 对 PIAJ 有较好的治疗效果，可能是通过降低患者及其伴侣的焦虑水平，改善性行为模式，而不是增加阴茎包括背神经和龟头的敏感性来实现的。
