Zheng Lei, Wei Le-Tian, Liu Wen-Rong, Jiang Hui, Jiang Tao
Department of Andrology and Sexual Medicine, The Second Hospital of Dalian Medical University, Dalian 116023, China.
Institution of Sexual Medicine, The Second Hospital of Dalian Medical University, Dalian 116023, China.
Sex Med. 2024 Apr 5;12(2):qfae020. doi: 10.1093/sexmed/qfae020. eCollection 2024 Apr.
Penile hypersensitivity is not the whole penis, but rather only a part of the penis. Though local anesthetic can prolong intravaginal ejaculation latency time by reducing penile hypersensitivity, the effect on the hypersensitive and nonsensitive areas of penis is still unclear.
The study aimed to explore whether the effect of local anesthetic on the hypersensitive and nonsensitive areas of the penis is different in premature ejaculation.
Penile neurophysiological tests were performed on 290 patients with primary premature ejaculation. The sensory threshold, latency, and amplitude were recorded before and after the topical application of a local anesthetic (lidocaine cream) on the penis.
Local anesthetics increased the sensory thresholds of hypersensitive and nonsensitive areas of the penis without difference but only prolonged the latency of the hypersensitive areas.
According to the neurophysiological results, 149 of 290 patients with primary premature ejaculation had normal penile sensitivity and 141 had penile hypersensitivity. While penile hypersensitivity does not necessarily mean that the whole penis is hypersensitive, and may be that only a part of the penis is hypersensitive, and we examined the following hypersensitivities: glans hypersensitivity only (14 cases), shaft hypersensitivity only (77 cases), and whole penis hypersensitivity (50 cases). Local anesthetics (lidocaine cream) increased the sensory thresholds of hypersensitive and nonsensitive areas of the penis without difference ( < .001) but only prolonged the latency of the hypersensitive areas ( < .001), and the latency of the nonsensitive areas was not different ( > .05).
The present discovery implies that it is possible to improve ejaculation by applying local anesthetics externally to the hypersensitive areas of the penis to reduce the afferent local sensory signals, and improve intravaginal ejaculation latency time through accurately decreasing penile sensibility.
STRENGTHS & LIMITATIONS: This is the first large-sample study to explore the difference of local anesthetics' effects on the hypersensitive and nonsensitive areas of the penis by means of neurophysiological methods in premature ejaculation. Our study exclusively examines alterations in penile evoked potential following electrical stimulation, which may not entirely encompass shifts in penile receptivity during sexual activity.
The effects of local anesthetics on the same penis varied with penile sensitivity, and can only prolong the latency of hypersensitive area of the penis. The effect of local anesthetic on the hypersensitive and nonsensitive areas of the penis is different in premature ejaculation.
阴茎超敏反应并非整个阴茎，而只是阴茎的一部分。虽然局部麻醉剂可通过降低阴茎超敏反应来延长阴道内射精潜伏期，但对阴茎超敏和非超敏区域的影响仍不明确。
本研究旨在探讨在早泄患者中，局部麻醉剂对阴茎超敏和非超敏区域的影响是否存在差异。
对290例原发性早泄患者进行阴茎神经生理学检测。在阴茎局部涂抹局部麻醉剂（利多卡因乳膏）前后，记录感觉阈值、潜伏期和振幅。
局部麻醉剂可提高阴茎超敏和非超敏区域的感觉阈值，但无差异（P<0.001），仅延长超敏区域的潜伏期（P<0.001），而非超敏区域的潜伏期无差异（P>0.05）。
本研究结果提示，通过在阴茎超敏区域外用局部麻醉剂以减少局部传入感觉信号，从而准确降低阴茎敏感性，有可能改善射精并延长阴道内射精潜伏期。
这是第一项通过神经生理学方法探讨局部麻醉剂对早泄患者阴茎超敏和非超敏区域影响差异的大样本研究。我们的研究仅检测了电刺激后阴茎诱发电位的变化，这可能无法完全涵盖性活动期间阴茎感受性的变化。
局部麻醉剂对同一阴茎的作用因阴茎敏感性而异，且仅能延长阴茎超敏区域的潜伏期。在早泄患者中，局部麻醉剂对阴茎超敏和非超敏区域的影响不同。
