Sexual dysfunction in 2013: Advances in epidemiology, diagnosis and treatment

Peer review under responsibility of Arab Association of Urology.

Abstract

Objectives:

To provide a contemporary review of the epidemiology, diagnosis and treatment of premature ejaculation (PE) and erectile dysfunction (ED).

Methods:

We searched for English-language articles published in the past 12 months using the PubMed database. Relevant articles on the subjects of sexual dysfunction, ED and PE were selected for review.

Conclusions:

Recent studies on male sexual dysfunction have provided new therapeutic possibilities. Tramadol, a well-used analgesic, has a new role in the treatment of PE. Super-selective targeting of dorsal penile nerves by surgery or cryoablative technologies might become a viable treatment option for refractory PE in the future. The role of ED as a harbinger of important comorbidities allows for the early detection and intervention of these conditions, which can optimise therapeutic outcomes. The long-term effect of chronic phosphodiesterase-5 inhibitors on endothelial dysfunction, the angiogenic potential of low-intensity extracorporeal shock wave therapy, and further advances in drug-eluting endovascular stents might in future allow clinicians to treat ED more definitively.

Keywords:

• Sexual dysfunction
• Erectile
• Premature ejaculation
• Endovascular therapy
• Cryoablation
• Epidemiology

Notes

Peer review under responsibility of Arab Association of Urology.

1 Abbrevations: PE, premature ejaculation; ED, erectile dysfunc PE, premature ejaculation; ED, erectile dysfunc-tion; IELT, intravaginal ejaculatory latency time; SSRIs, selective serotonin reuptake inhibitors; TEMPE, topical eutectic mixture for PE; ODT, orally disintegrating tablet; SRDN, selective resection of the dorsal nerves; DPN, dorsal penile nerve; PDE5-I, phosphodiesterase- 5 inhibitor; CV, cardiovascular; GOSS, global online sexuality survey; CAD, coronary artery disease; IIEF, International Index of Erectile Function; LVDD, left ventricular diastolic dysfunction; DT, deceleration time; IVRT, isovolumic relaxation time; E/Em, mitral E velocity/ tissue Doppler imaging E velocity; EjD, ejaculatory disorders; OD, rgasmic isorders; LI-ESWT, low-intensity extracorporeal shock wave therapy; IPA, internal pudendal artery.