| BackgroundPremature ejaculation(PE)is one of the most common sexual dysfunction in adult males.The pathogenesis of premature ejaculation has not been fully clarified,which is summarized by researchers.Primary premature ejaculation is mainly genetically related,and the cause of secondary premature ejaculation may be derived largely from nerve,endocrine,urinary system,psychological factors or these combination of factors.The thyroid gland is an important gland in human body.The thyroid hormones secreted by the thyroid gland,including thyroxine(T4)and triiodothyronine(T3),play an important physiological role in free form.They are widely involved in regulating the growth and development of the body,the metabolism of three major substances and other functional activities.Many previous studies have shown that thyroid function played an important role in the stability of hypothalamus-pituitary-gonad axis.It has also been reported that hyperthyroidism might lead to gonad injury or premature ejaculation,but its mechanism is still unclear.Researchers have found that the majority of premature ejaculation patients had shorten penis evoked potential latency and reduced penile sensory threshold.Penile sympathetic skin response(PSSR)is one of the important projects in penile nerve electrophysiological examination,it has been reported that the latency of PS SR in patients with premature ejaculation was significantly shorter than that in the healthy control group.According to the previous narration,hyperthyroidism could induce premature ejaculation,but its mechanism is not clear,and sympathetic nerve is one of the important nerves in controlling ejaculation process,thyroid hormone might induce premature ejaculation by affecting sympathetic pathway,so we discussed the correlations and mechanisms between thyroid hormones and penile neuro-electrophysiology in premature ejaculation patients.PurposeTo analyze the relationship between thyroid hormone and penile electrophysiology in premature ejaculation patients and explore the mechanism.MethodBetween October 2015 and December 2016,52 secondary premature ejaculation patients from our andrology clinics were included in our study,they all underwent a complete andrological and the penis sympathetic skin responseexamination.Our study excluded those patients as follows:lifelong PE,erectile dysfunction,hyperprolactinemia,genitourinary tract infection,any drug or condition that might alter hormonal values,sympathetic and sexual activities(serotonin reuptake inhibitors,phosphodiesterase5inhibitors)and so on,.According to the length of PSSR latency,the premature ejaculation group was divided into normal PSSR group(P1)and abnormal PSSR group(P2).ResultCompared with group P1,the levels of total tetraiodothyronine and free tetraiodothyronine FT4 in group P2 were significantly higher than those in group P2[113.28 ±20.89 nmol/L vs 95.72 ± 12.42 nmol/L,P<0.001]and[12.02 ±0.88 nmol/L vs 10.81 ±1.63 nmol/L,P=0.003].There was a negative correlation between FT4 and PSSR latency(r =-0.363,P = 0.008),and a positive correlation with PEDT(r =0.455,P = 0.001).The ROC analysis showed a significant relationship for FT4 and abnormal PSSR in APE patients,the optimal FT4 cutoff level was 11.25 pmol/L for abnormal latency of PSSR,the latency of PSSR was significantly shorter and the PEDT score was significantly higher in patients with FT4>11.25 pmol/L.(PE2)compared with patients with FT4<11.25 pmol/L(PEI).ConclusionThere was a significant correlation between thyroid hormone and penile sympathetic reflex in patients with secondary premature ejaculation.On the premise of excluding other secondary factors,if there is FT4>11.25 mmol/L andthe latency of penile sympathetic reflex is shortened in patients with secondary premature ejaculation,the etiology of premature ejaculation might be related to thyroid hormones,and its mechanism might result from the influence of thyroid hormone on sympathetic reflex activity. |
