Ochwepheshe basikisela i-Botox ukuthi i-ejaculation engakafiki, kodwa ayikakamukelwa
Phakathi neminyaka engama-30 eyedlule, ukwelashwa kwe-ejaculation ngaphambi kwesikhathi kuye kwanda kusuka kwengqondo ye-psychotherapy ukufaka imithi kanye ne-pharmacotherapy. Kungase kusimangaze ukuthi i-Botox, okuyi-toxin eyenziwe yi-bacterium Clostridium botulinum futhi evame ukusetshenziselwa ukubhebhezela imibuso ebusweni , ingasiza nge-ejaculation ngaphambi kwesikhathi. Kodwa-ke, ucwaningo oluthe xaxa lunikezwa njengengqondo, futhi ukusetshenziswa kweBotox ye-ejaculation engakafiki kusakaze kuvunywe yi-FDA.
Ukuchaza ukujula kokuqala
Ukwelashwa kwe-ejaculation ngaphambi kwesikhathi kuncike ekutheni lesi simo sichazwa kanjani.
Ngokuvamile, i-ejaculation engakafiki ihlukaniswe ngezigaba ezimbili: impilo yonke noma itholakele.
I-ejaculation engakapheli isikhathi eside iqala ngesipiliyoni sokuqala socansi. Ukujula kuvele ngokushesha-noma ngaphambi kokungena noma kungakapheli imizuzu eyodwa noma emibili yokungena.
Ukutholakala kwe-ejaculation ngaphambi kwesikhathi kungabonakalisa ngokuzumayo noma ngokulandela kancane umlando wokujula okuvamile. Ngaphezu kwalokho, lesi simo singase sigxile ezinkingeni ezingenangqondo, ze-thyroid, noma ezingokwengqondo.
Kule minyaka, incazelo ye-ejaculation engakafiki ishintshiwe. Isiqalo seziningi zezifundo ze-ejaculation engakabi yisikhathi incazelo elandelayo evela ku-DSM-IV-TR:
- I-ejaculation ephikisanayo noma ephindaphindiwe ene-stimulation encane yokucansi ngaphambi, ngemuva noma ngemva nje kokungena futhi ngaphambi kokuba umuntu afise lokhu. Umtholampilo kumele acabangele izici ezithinta ubude besigaba sokujabula, njengokudala, ubuhle bomlingani wesimo socansi noma isimo kanye nemvamisa yamuva yocansi
- Ukuphazanyiswa kubangelwa ukucindezeleka okuphawulekayo noma ukukhathazeka kwabantu
- I-PE ayiyona nje imiphumela yemiphumela eqondile yento (isb. Ukuhoxiswa kwama-opioid).
Ngo-2014, iNhlangano Yomhlaba Wonke Yokwelapha Ngokwezocansi inikeze incazelo elandelayo efakazela ubufakazi ejaculation engakapheli isikhathi eside.
- Ukungasebenzi komuntu wesilisa ngokobulili okubonakala nge-ejaculation ukuthi njalo noma ehlala ihlala njalo ngaphambi, noma kungakapheli umzuzu owodwa, ukungena kwesisu
- Ukungakwazi ukulibazisa ukujula ku-wonke, noma cishe konke, ukungena kwamagciwane
- Imiphumela emibi yomuntu siqu njengokucindezeleka, ukukhathazeka, ukukhungatheka, kanye / noma ukugwema ukuthandana ngokobulili.
Ezingamaphesenti angu-80 zamadoda ane-ejaculation engakapheli isikhathi eside, ukujula kwe-ejaculation kwenzeka ngaphakathi kwamasekhondi angu-30 kuya kwangu-60 okuhlangana kocansi. Amaphesenti angama-20 asele ala madoda abhekana ne-ejaculation ehlala phakathi komzuzu owodwa nambili.
Ukujula kwe-prejature kunomthelela ophakathi kwamaphesenti angu-30 namaphesenti angama-70 amadoda aseMelika. Ngokomphumela we-National Health and Social Life Survey, ukusabalalisa kwe-ejaculation ngaphambi kwesikhathi e-United States kungamaphesenti angu-30 futhi kuthinta amadoda abo bonke ubudala. Ukujula kwe-premature kuvame kakhulu ezinsizweni ezineminyaka ephakathi kuka-18 no-30. I-ejaculation yangaphambi kwesikhathi isithinta nabesilisa abangenamandla okuqala abangama-45 no-60 ubudala.
Ngolwazi, amanye amadoda athola i-ejaculation ngaphambi kwesikhathi, futhi lokhu kungase kungabhekiseki. Ngaphezu kwalokho, nakuba izincazelo ezisemthethweni ze-ejaculation ngaphambi kwesikhathi zichaza ukuthi zenzeke cishe cishe konke ukuhlangana kocansi, uma kwenzeka phakathi kwamaphesenti ayishumi namaphesenti angu-20 ngesikhathi sokuzama ucansi, khona-ke ukwelashwa kungagunyazwa.
Ukwelapha Ukujula Kwangaphambi Kokuqala Nge-Botox
I-Botox injection isebenza ngokubuthaka noma imisipha ekhubazayo kanye nokuvimbela izinzwa. Imiphumela yeBotox iphelile phakathi kwezinyanga ezintathu nezinyanga eziyishumi nambili.
Imiphumela emibi evamile yeBotox ihlanganisa ukuvuvukala, ukulimaza, nobuhlungu endaweni yokujova.
Ngaphezu kokuphefumula kwesibindi, nansi amanye okusetshenziswa kwe-Botox:
- Ukwenyuka kwe-underarm sweating (okungukuthi, i-hyperhidrosis)
- Amehlo awela (ie, strabismus)
- Migraines engapheli
- Ukukhanyisa okungalawuleki (okungukuthi, i-blepharospasm)
- Isibilini esingasebenzi
Izinhlanzi ze-bulbospongiosus kanye ne-ischiocavernosus ziyingxenye ye-penile shaft, futhi lezi musipha zibaluleke kakhulu ekujuleni. Ngesikhathi sokunyuka kwegazi, lezi zinhlanzi zamathambo zithathwa ngokungahambisani nemigqa.
I-Botox ivimbela ngokukhululekile ukukhululwa kwe-acetylcholine kusukela ekupheleni kwezinzwa, futhi kuthiwa le ndlela ingavimbela ukuphazamiseka okulinganiselwe kwesibalo se-bulbospongiosus ne-ischiocavernosus futhi ngaleyo ndlela kusize ukulibazisa ukujula.
Kube khona ukukhathazeka okukhulunywa ngakho mayelana nokusetshenziswa kwe-Botox ukuphatha i-ejaculation ngaphambi kwesikhathi. Okokuqala, abanye ochwepheshe bakhathazeka ngokuthi iBotox izovimba ukujula ngokuphelele futhi kuholele ekujuleni. Kubuye kube nokukhathazeka mayelana nezindleko-ukusebenza kokusebenzisa i-Botox ukuphatha i-ejaculation ngaphambi kwesikhathi.
Ku-patent efakwe ngu-Allergan ngo-2012, kuphakanyiswa izindlela ezehlukene zokuphatha i-Botox ekwelapheni kwe-ejaculation ngaphambi kwesikhathi, kufaka phakathi okulandelayo:
Indlela yokwelapha i-ejaculation engakafiki ngaphambi kwesiguli esinesidingo sinikezwa, lapho le ndlela ihlanganisa isinyathelo sokuphathwa kwendawo, ngomjovo, i-botulinum neurotoxin eya emgodini wesiguli, ngaleyo ndlela ukwelapha i-ejaculation ngaphambi kwesikhathi esigulini. Ngokwezifiso ezithile, i-botulinum neurotoxin ifakwe okungenani ezindaweni ezimbili ze-penile, futhi kwezinye izibonelo okungenani izindawo ezintathu ze-penile.
Abalobi be-patent basikisela ukuthi i-Botox ingafakwa egameni lika-glans noma i-frenulum ye-penis (eduze nensika yepenisi). Ngaphezu kwalokho, i-Botox ingasetshenziselwa isisekelo esidingekayo, nemiphumela ehlala kuze kube izinyanga eziyisithupha. Ukungenelela kufanele kuqale ukusebenza phakathi kwamahora angu-48 kuya ku-72, futhi akufanele kube nemiphumela emibi noma enganiselwe.
Ucwaningo olwengeziwe olunyathelisiwe mayelana nokusetshenziswa kweBotox luvezwa njengengqondo kanye nokuchazwa. Ngokusobala, i-Botox kufanele isebenze ukwelapha i-ejaculation ngaphambi kwesikhathi kodwa ucwaningo olwengeziwe luzodingeka lwenziwe ukuze kuqinisekiswe ukuthi kusebenza kahle. Ngomhla ka-Agasti 15, 2017, i-Allergan yokuqedwa kwesigaba sesi-2 sokuhlolwa kwemitholampilo ehlola ukusetshenziswa kwe-Botox ukuphatha i-ejaculation ngaphambi kwesikhathi, kodwa imiphumela yalolu cwaningo ayitholakali.
Ezinye Ukwelapha Ukuqanjwa Kwangaphambi Kokuqala
Nakuba kungekho ukwelashwa okuvunyelwe i-FDA ye-ejaculation ngaphambi kwesikhathi, ezinye izindlela zokungenelela zisetshenziselwe ukuphatha lesi simo.
I-serotonin-reuptake inhibitors (i-SSRIs) ekhethiwe kanye nama-anti-depressants we-tricyclic afakazele kakhulu ukusebenza ekwelapheni kwe-ejaculation ngaphambi kwesikhathi. Ngokuqondile, i-paroxetine, i-sertraline, i-fluoxetine, i-citalopram, ne-clomipramine sonke isetshenziselwe ukuphatha i-ejaculation ngaphambi kwesikhathi. Ukusetshenziswa kwala mithi yokwelapha i-ejaculation engakafiki kuphelile.
Le mithi ingathathwa nsuku zonke noma iyadingeka. Nakuba ukwelashwa isikhathi eside nemithi yokucindezeleka kuyasebenza kakhulu kunalokho okudingekayo, ukuphathwa kwesikhathi eside kubangela imiphumela embi kakhulu. Ngokuphathwa okuqhubekayo, i-SSRI iphumelela kakhulu ngemuva kokuba ifinyelele esimweni esifanele, esingathatha amasonto. Noma kunjalo, inzuzo ingenzeka ngaphambili.
Omunye we-SSRI ofanelwe ngokukhethekile ukwelashwa kwe-ejaculation ngaphambi kwesikhathi i-dapoxetine (Priligy). Le SSRI esheshayo yenzelwe ukwelashwa kwe-ejaculation ngaphambi kwesikhathi futhi ingasetshenziswa njengoba kudingeka. I-Dapoxetine ingathathwa amahora ambalwa ngaphambi kocansi.
Enye indlela engasiza ekuvimbeleni i-ejaculation ngaphambi kwesikhathi kuhilela ukusetshenziswa kwe-anesthetics ye-topical ukuze kunciphise ukuzwa ngaphakathi kwepenisi futhi ngaleyo ndlela kuphephe ukujula. Ngaphezu kwe-anesthesia, ikhondomu ingasetshenziswa ukuqhubeka nokunciphisa ukuzwa. Ama-anesthetics ehlosiwe asetshenziselwa le njongo yi-lidocaine ne-prilocaine.
Okokugcina, inamba encane yamadoda ene-ejaculation engakafiki ingase izuze ekwenzeni i-pelvic floor noma i-Kegel umzimba.
Kuthiwani Ngokwemithi Yokuziphatha?
Njengamanje, ochwepheshe abaningi bakholelwa ukuthi i-ejaculation engakafiki isimo se-neurobiological nezofuzo. Ngenxa yalokho, ukwelashwa kwesikhashana eside kubhekwa njengengasebenzi empilweni yokuphila engakapheli isikhathi eside. Ngaphezu kwalokho, izifundo zesikhathi eside ziye zabonisa ukuthi ukwelashwa kokuziphatha akusebenzi ekuphatheni ukwelashwa okungakapheli isikhathi eside.
Ku-athikili ka-2014 ebizwa ngokuthi "Ukuqanjwa kwe-prejature ejaculation: definition, epidemiology, kanye nokwelashwa," uKirby ubhala okulandelayo mayelana nokuphathwa kokwelashwa nokuziphatha kwengqondo ngaphambi kokuba u-ejaculation ungakapheli isikhathi eside: "Ukwelashwa sekufakwe iminyaka eminingi, kodwa ucwaningo oluningi lukhombisa ukuthi inzuzo ayikho. Noma kunjalo, iziguli eziningi ziyakhathazeka futhi zingase zithande i-psychotherapy. "
Ukuze uthole i-ejaculation ngaphambi kwesikhathi, indlela yokuhlanganiswa yokwelashwa ingasebenza. Le ndlela ihilela uhlelo lokuyeka ukusebenza, ukwelashwa kokuziphatha kwengqondo, kanye nezidakamizwa. Ngendlela yokuqala yokumisa, indoda iyaqaphela injabulo ephakathi kwesikhatsi ngesikhathi sokulala futhi iyeka ukulala ngokocansi. Uma le ndoda ibuye ithole ukulawula, ubulili buyaqala kabusha. Ngaphandle kwalokho, ngendlela yokucindezela, le ndoda iminyanisa ipenisi ngaphambi kokuba i-ejaculation iyanciphisa ukulungiswa nokuyeka ukujula.
> Imithombo:
> Ashburn TT, Thor KB. Ukufakwa kwezidakamizwa: Ukukhomba nokuthuthukisa ukusetshenziswa okusha kwezidakamizwa ezikhona. Nat Rev Drug Discov. 2004; 3: 673-83. https://doi.org/10.1038/nrd1468
> Gastiola, Gustavo M. Indlela Yokuphatha Ukujula Kwemvelo Ngaphambi Kokuqala nge-Botulinum Neurotoxin. 11 Disemba 2012.
> Kirby M. Ejaculation Premature: incazelo, epidemiology kanye nokwelashwa. Amathrendi ku-Urology & Health Men. 2014; 5: 23-28. https://doi.org/10.1002/tre.406
> Serefoglu EC, uSilay MS. I-botulinum ye-toxin-I-A injection ingaba nenzuzo ekwelapheni i-ejaculation engakafiki isikhathi eside. Bonisa ama-hypothetical. 2010; 74: 83-4. https://doi.org/10.1016/j.mehy.2009.07.038