The effects of diaphragmatic breathing exercises on individuals with premature ejaculation: a randomized controlled trial.

IF 3.3 3区 医学 Q1 UROLOGY & NEPHROLOGY
Umit Erkut, Dilber Karagozoglu Coskunsu, Kubra Erkut, Ali Veysel Ozden
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引用次数: 0

Abstract

Background: There are no standardized, evidence-based rehabilitation protocols for premature ejaculation (PE) which hinders effective management, the development of validated patient-reported outcomes, regulatory oversight, and the potential benefits of targeted interventions.

Aim: To investigate the effect of diaphragmatic breathing exercises (DBE) on PE.

Methods: Sixty-two participants with PE were randomly assigned to Group I (n = 31) or Group II (n = 31). Both groups received behavioral therapy (BT) and pelvic floor muscle training (PFMT) twice daily, three days a week, for eight weeks. Additionally, Group I recieved DBE twice daily, every day, for eight weeks. Intravaginal ejaculation latency time (IELT) was calculated with a stopwatch, at the end of the 8th week (post-treatment), and at 1-year follow-up. Pelvic floor muscle (PFM) strength and endurance were evaluated with ultrasound, and changes in the in the autonomic nerves system (ANS) parameters (including the root mean square of successive differences [RMSSD], proportion of NN50 [PNN50], low-frequency [LF] power, and high-frequency [HF] power) were evaluated with an Elite HRV device at pre-treatment and post-treatment by a blinded assessor.

Outcomes: Primary outcome measurements were IELT, PFM strength and endurance, and changes in ANS paramaters.

Results: The study was completed by 29 participants (mean age = 31.4 ± 6.5 years) in Group I and 30 (mean age = 31.3 ± 7.6 years) in Group II. At post-treatment, all outcome measures showed significant improvements in both groups (P <.001 for all). Compared to Gropu II, Group I showed significantly greater improvements in IELT(P=0.12), RMSDD (P<.001), PNN50 (P=.003), LF Power (P<.001), HF Power (P=.003), strength(P<.001), and endurance (P<.001). The median IELT increase from baseline to post-treatment was 283 seconds (range: 84-870; 900%) in Group I and 204 seconds (range: 44- 581; 690%) in Group II. While IELT declined significantly from post-treatment to 1-year follow-up in Group II, no statistically significant change was found in Group I.

Clinical implications: The effect of DBE on the ANS may help regulate the ejaculatory reflex.

Strengths and limitations: This is the first study to apply breathing exercises with BT and PFMT in men with PE. Limitations include the lack of exercise adherence records beyond 8 weeks and the estimation-based IELT measurement at baseline.

Conclusion: Adding DBE, to BT and PFMT, yields better results in IELT (at 8 weeks and 1 year) and inreases PFM strength and endurance of PFM (at 8 weeks) in men with PE.

横膈膜呼吸练习对早泄患者的影响:一项随机对照试验。
背景:早泄(PE)没有标准化的、基于证据的康复方案,这阻碍了有效的管理、有效的患者报告结果的发展、监管监督和有针对性干预的潜在益处。目的:探讨横膈膜呼吸练习(DBE)对肺栓塞的影响。方法:62例PE患者随机分为I组(n = 31)和II组(n = 31)。两组均接受行为治疗(BT)和盆底肌肉训练(PFMT),每天两次,每周三天,持续8周。此外,组1每天接受两次DBE治疗,持续8周。在第8周(治疗后)和1年随访时,用秒表计算阴道内射精潜伏期(IELT)。采用超声评估盆底肌(PFM)的力量和耐力,并用Elite HRV仪采用盲法评估治疗前后自主神经系统(ANS)参数的变化(包括连续差的均方根[RMSSD]、NN50的比例[PNN50]、低频[LF]功率和高频[HF]功率)。结果:主要结果测量是雅思,PFM强度和耐力,以及ANS参数的变化。结果:ⅰ组29例(平均年龄31.4±6.5岁),ⅱ组30例(平均年龄31.3±7.6岁)。治疗后,两组患者的预后指标均有显著改善(P)。临床意义:DBE对ANS的影响可能有助于调节射精反射。优势和局限性:这是第一个将BT和PFMT呼吸练习应用于PE患者的研究。局限性包括缺乏超过8周的运动坚持记录和基于基线估计的雅思测量。结论:在BT和PFMT的基础上添加DBE, PE患者的雅思成绩(8周和1年)更好,PFM的强度和耐力(8周)也有所提高。
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来源期刊
Journal of Sexual Medicine
Journal of Sexual Medicine 医学-泌尿学与肾脏学
CiteScore
6.20
自引率
5.70%
发文量
826
审稿时长
2-4 weeks
期刊介绍: The Journal of Sexual Medicine publishes multidisciplinary basic science and clinical research to define and understand the scientific basis of male, female, and couples sexual function and dysfunction. As an official journal of the International Society for Sexual Medicine and the International Society for the Study of Women''s Sexual Health, it provides healthcare professionals in sexual medicine with essential educational content and promotes the exchange of scientific information generated from experimental and clinical research. The Journal of Sexual Medicine includes basic science and clinical research studies in the psychologic and biologic aspects of male, female, and couples sexual function and dysfunction, and highlights new observations and research, results with innovative treatments and all other topics relevant to clinical sexual medicine. The objective of The Journal of Sexual Medicine is to serve as an interdisciplinary forum to integrate the exchange among disciplines concerned with the whole field of human sexuality. The journal accomplishes this objective by publishing original articles, as well as other scientific and educational documents that support the mission of the International Society for Sexual Medicine.
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