THE TRIBUNE
Tuesday, February 8, 2022, PAGE 9
A wearable patch controlled by an app to treat premature ejaculation Premature ejaculation is the most common male sexual dysfunction, with 30 to 40 percent of adult men suffering from this frustrating and often depressing sexual disorder. Premature ejaculation is defined as a man ejaculating before or very soon after vaginal penetration or the inability to delay ejaculation. A new single use, square inch in size skin patch applied to the male’s perineum and controlled by an app has shown promising evidence for treating premature ejaculation. The perineum is the area of skin beneath the scrotal sac and above the anus. The patch developed by the Israeli company Virility Medical painlessly delivers a neuromuscular stimulation that can potentially delay the onset of ejaculation. This device represents the first innovation in the treatment of premature ejaculation in more than 20 years. The patch contains a tiny battery and a wireless transdermal electric neuromodulation unit and is controlled by an app so the male or female partner can activate the device on their phone or android device and determine the intensity of the stimulation. The nerve stimulation created by this painless device, essentially dampens the transmission of nerve signals so that ejaculation is delayed. Studies involving this Virility patch have shown that with its use, that the time to ejaculation can be prolonged by a factor of four. This wearable perineum patch technology is still in the trial phase with hopeful FDA approval during 2021.
Two types of premature ejaculation There are two classifications of premature ejaculation: primary and secondary premature ejaculation. Primary, or lifelong premature ejaculation, involves every sexual experience ending too soon.
worldwide that a quantitative measurement tool was developed to assess premature ejaculation, so as to assess the severity.
The Premature Ejaculation Diagnostic Tool
DELAY ejaculation using an app-controlled electrical stimulation patch. Secondary, or acquired premature ejaculation, is suffered by men who only sparingly suffer from premature ejaculation and have a history of sexual episodes without the disorder.
THE UROLOGY DOCTOR IS IN...
Medical treatment premature ejaculation
How does the body control ejaculation? The physiological control of a man’s ejaculation is dictated by two neurological domains; the central and the peripheral nervous systems. Peripheral tactile stimulation can trigger the spinal cord driven ejaculatory reflex. The central nervous system of the brain can be stimulated by visual or emotional stimuli that leads to a physiological climax. The physiological basis for the peripheral and central nervous system driven ejaculatory response, differs widely. Tens of thousands of Bahamian men and residents last one, two or three minutes and they have profound disappointment in their sexual lives. This affliction often provides frustration and anguish to both partners. Men often suffer from low self-esteem and even depression due to their unsatisfactory sexual experiences. Every sexual escapade that ends too soon, leaves the men involved often feeling like a failure.
(PEDT) is a self-evaluation of a man’s various aspects of sexual dysfunction. The questionnaire includes a man’s ability to control the timing of ejaculation, the length of the sexual episode and the degree to which the premature ejaculation affects their sexual life. The total score on the PEDT questionnaire predicts the likelihood of a man experiencing premature ejaculation.
Dr Greggory Pinto Mammals in general experience very short sexual interludes, whether it be lions, tigers, monkeys or bears. Men are the only mammals on earth that attempt to prolong the sexual experience. Multiple studies have estimated that American men last on average thirteen minutes and European men last ten minutes, whereby German men last on average seven minutes. A United Kingdom study involving five hundred couples, found that men in this study lasted on average five and a half minutes during sexual intercourse.
Diagnostic tool for premature ejaculation Premature ejaculation is such a common issue seen by urologists
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Medication can be prescribed to dampen either the central or peripheral nervous system’s input in the ejaculatory response and therefore prolong the period before ejaculation. Medications such as selective serotonin reuptake inhibitors (SSRIs), such as Dapoxetine or Prozac, Paxil used primarily to treat depression or anxiety, increase neurotransmitters sent to the brain and have the wanted side effect of delaying ejaculation and prolonging a man’s sexual experience. Modafinil (Provigil) is a medication used to treat the sleeping disorder narcolepsy but it has the wanted side effect of delaying ejaculation. Silodosin (Rapaflo) is used in the medical management of urinary symptoms associated with benign prostate hyperplasia and it also leads to delayed ejaculation. Certain analgesics such as Tramadol can also potentially prolong the period before ejaculation, but Tramadol can be habit forming and have side effects such as nausea, headaches and vomiting. Some men who suffer from premature ejaculation benefit from
the use of phosphodiesterase 5 inhibitors such as Viagra or Cialis. The peripheral nerve endings of the penis can be dampened by local anaesthesia sprays or applied creams that reduce the tactile stimulation and delay the ejaculatory response. These local anaesthesia agents unfortunately could potentially reduce the pleasure of the sexual experience for the man and possibly be transferred to the female and reduce her level of tactile stimulation and lower the pleasure of sexual intercourse. The use of condoms, particularly thick, desensitising condoms can reduce the tactile stimulation of the penis. Pelvic floor physiotherapy with Kegel exercises have shown to aid a man’s ability to delay ejaculation. Behavioural therapy can also provide beneficial results regarding premature ejaculation. Men are usually very reluctant to seek the consult of an urologist for their often deeply disturbing premature ejaculation, due to embarrassment. One in three men experience premature ejaculation, thus if you unfortunately have this frustrating and potentially devastating issue then take comfort in the fact that you are far from alone. Seek compassionate and comprehensive urology care to solve your erectile dysfunction, whether it is premature ejaculation or difficulty achieving a strong erection or maintaining an erection. The real tragedy is continuing to live with a correctable sexual problem. You can always rise again. • Dr Greggory Pinto is a boardcertified Bahamian urologist and laparoscopic surgeon. He can be contacted at OakTree Medical Center, #2 Fifth Terrace & Mount Royal Avenue, Nassau, Telephone (242) 322-1145-7; email: welcome@urologycarebahamas. com, or visit the website:www. urologycarebahamas.com
Pregnant women encouraged to get the jab Research says COVID-19 vaccines are safe for pregnant women or those trying to conceive, according to OB-GYN Dr Shamanique Bodie-Williams. She encouraged individuals in this group to speak to their healthcare provider and get the jab, joining the other 150,000 plus people in the country who are fully vaccinated. “Through the course of the pandemic, I’ve seen mothers die. I’ve seen babies born to COVID mothers and I’ve seen babies lost in utero because of COVID. One loss is too much and with that in mind if we have some way to mitigate or prevent the damage in the form of handwashing, sanitising, vaccination and social distancing then I don’t think that’s a lot to ask,” said the obstetrician/ gynaecologist. “We do have studies now that tell us vaccination does not create problems within pregnancies. Vaccinations have been shown to be effective. They are not 100
Dr Shamanique Bodie percent, meaning that they will not prevent you from getting the illness 100 percent of the time, but we do know that it will decrease your risk of death and it will decrease your risk of complications if you get COVID while you are expecting.” According to the American College of Obstetricians and
Gynecologists (ACOG), “Data from tens of thousands of individuals indicate the vaccines are safe for pregnancy and can even build and pass antibodies along to the baby.” Developing COVID-19 during pregnancy, however, has been linked to severe disease, along with an increased risk of preterm birth and stillbirth. Consequently, ACOG and the US Centres for Disease Control and Prevention (CDC) both recommend COVID19 vaccination “for anyone who’s pregnant or trying to become pregnant.” Another study found vaccination did not impair fertility in either partner. Rather, couples in the study had slightly lower chances of conception, 18 percent, if the male partner was infected with coronavirus within 60 days. Researchers say that’s even more reason to get vaccinated against COVID-19, since the illness could affect male fertility in the short term, according to the study,
Recovering from a foot fracture In my previous column, I recounted the story of one of my patients to demonstrate the perhaps unexpected value of physiotherapy in recovering from illness rather than injury. This week, I thought I would tell my own personal story to emphasise the necessity of sticking with a series of treatments even if it seems to take a tediously long time. There’s a saying, “Accidents happen” and of course they do to everyone indiscriminately, including to me and they are not all dramatic accidents. Sometimes the simplest and apparently harmless behaviour or action can end in physical damage. Somewhat ironically, as a physiotherapist I never gave much thought that I might need physiotherapy one day,but several years ago, what started out as a pleasant stroll along the beach, precipitated an accident. A simple twist of my foot caused a bone fracture. Under normal circumstances this in itself would not have been a big issue, but unfortunately, I then discovered that I had the more serious and undiagnosed health issue of osteoporosis. Because of the osteoporosis and the type of fracture I had, a Jones fracture, the diagnosis was that healing would be lengthy, therefore surgery was suggested
Hannah FosterMiddleton BSc (Hons) Physiotherapy, MCSP, SRP
to pin the fracture to stabilise it. Following surgery, a cast was applied to my foot which I had to wear for three weeks before a walking boot was prescribed. A walking boot completely immobilises the foot yet allows the patient to have a reasonable but limited form of activity. The boot did its job allowing my fracture to heal but the extended immobilisation caused a different problem by causing the joints in my foot and ankle to stiffen which meant I lost all flexibility in those joints. An added complication was a trapped nerve in my foot which was unbearably painful.
So a series of diverse physiotherapy treatments was initiated, all working in concert with each other to achieve the best positive result. We started with dry needling, a treatment consisting of placing fine needles at anatomically identified areas of the body to relieve pain. A period of manual mobilisation of the stiff joints followed which, over time, restored a normal range of movement and flexibility. Kinesio taping was also applied - this is the tape that you see many athletes wearing in competitions; it reduces swelling and is another resource for alleviating pain. Additionally, I had infrared
light treatment which also assists with reducing swelling and pain. Another part of the therapy process was stretching of the soft tissues of the foot, ankle and calf, to restore normal length prior to rehabilitation because everything in our bodies is connected and each part is dependent on another to work efficiently. It is important to understand that successful therapy is sometimes an extended and lengthy process to achieve maximum benefit and long-lasting results. In my case the next step was a series of rehabilitation exercises aimed at restoring power, proprioception and saving reactions. Proprioception, also referred to as kinaesthesia, is the sense of
published in the American Journal of Epidemiology. Researchers believe the temporary reduction in male fertility could be due to fevers, a common symptom associated with infections and linked to a reduction in sperm count. According to Dr Bodie-Williams, COVID itself has some impact on the gynecological system. “We know it can have some changes that it causes to the menstrual cycle, but those changes so far, anecdotally are temporary and not permanent. More information will become available overtime as we become more familiar with the disease.” She added: “With that in mind, consider all measures. Discuss them with your healthcare provider and they will be able to look at your risks and help you make an informed decision with someone that you trust.” self-movement and body position. It is sometimes described as the “sixth sense”. Proprioception is mediated by proprioceptors, mechano sensory neurons located within our muscles, tendons and joints. In other words, it is how we remain upright and balanced in our movements, not falling over and being able to save ourselves from falls. The rehabilitation exercises were essential as otherwise the ankle would be subjected to repeated sprains and further damage. Following my Osteoporosis diagnosis, I took medication which included vitamin D and vitamin K supplements in a holistic and preventive approach and I then embarked on a series of weight-bearing exercises for strengthening and to reduce the risk of further fractures. All in all, I underwent two months of treatments before full mobility was regained but complete rehabilitation took a total of four months. I was able to achieve an excellent result - with a longterm gain but as you can see from my story, this was not a quick fix nor was it an easy process. All therapy requires patience and a commitment to adhering to the protocol for long-lasting results. • For questions and comments, call Hannah Foster-Middleton at 356 4806, e-mail genesisphysiotherapy@gmail.com, or visit www.physiotherapybahamas. com.