Nyanzvi dzinoti Botox yekusvitsa kusati kwatanga, asi haisati yabvumidzwa
Mumakore makumi matatu adarika, kurapwa kwejeri kusati yasvika kwawedzera kubva pane zvepfungwa kunosanganisira mishonga uye pharmacotherapy. Zvinogona kuuya sezvisingashamisi kuti Botox, iyo inokonzerwa nebhakitiriya Clostridium botulinum uye inowanzoshandiswa kubvisa chiso kumakimbani , inogona kubatsira nekumhanya kusati kwatanga. Zvisinei, zvizhinji zvekutsvakurudza zvinoratidzirwa semuongorori, uye kushandiswa kweBotox kwekutanga kusati kwamboita kusati kwatenderwa neDFA.
Kufananidza Kudengana Kwepamberi
Kurapa kwekusarudzwa kwemazuva mashoma kunobva maitiro aya anotsanangurwa.
Kakawanda, kusvibiswa kwenguva refu kunoparadzaniswa kuva mapoka maviri: hupenyu hwose kana hunowanikwa.
Mazuva ose ejaculation isati yasvika anotanga nehutano hwekutanga hwepabonde. Kudonhedzera kunoitika nokukurumidza-kana usati wapinda mukati kana mumaminitsi maviri kana maviri ekupinda.
Kuwana nguva isati yasvika ejaculation inogona kuratidzira kamwe kamwe kana kuti zvishoma nezvishoma kutevera nhoroondo yekugara yakasununguka. Uyezve, izvi zvinogona kunge zvakadzika muurorogical, thyroid, kana mupfungwa.
Kwemakore, tsanangudzo yekusarudzwa kwenguva refu isati yasanduka. Nzvimbo yekutanga yezvidzidzo zvakawanda zvekusarudzwa kwemazuva mashoma ndeye tsanangudzo inotevera kubva ku DSM-IV-TR:
- Kuenderera mberi kana kuramba kuchidzoka nekunonoka kwepabonde kusati kwaitika, kana kana nguva pfupi mushure mokupinda mukati uye munhu asati achida. Chiremba anofanira kufunga nezvezvinhu zvinopedza nguva yechifaro chechikamu, chakadai sezera, ruzivo rwehutano hwepabonde kana mamiriro ehuwandu hwehuwandu hwepabonde
- Kuvhiringidzika kunokonzera kushungurudzika kunetseka kana kunetseka kwakaoma
- PE haisi yega inokonzerwa nemigumisiro yakananga yezvinhu (semuenzaniso kubvisa maopioid).
Muna 2014, International Society for Sexual Medicine yakapa uchapupu hunotevera-hunotsanangurwa hwehupenyu hwose husati hwasvika.
- Chirume chepabonde chisingaoneki chinoratidzirwa nekugadzirisa kuti nguva dzose kana kuti nguva dzose inowanzoitika zvisati zvaitika, kana mukati meminiti imwe chete, yepakati yepakati
- Kushaya kukwanisa kunonoka kugoverwa kune vose, kana kuti zvinenge zvose, zviratidzo zvepabonde
- Migumisiro yakaipa yemunhu pachake sekutambudzika, kushungurudzika, kushungurudzika, uye / kana kudzivisa kusangana pabonde.
Muchikamu makumi mapfumbamwe nezana zvevarume vane upenyu hwusingaperi husati hwasvika, kuwedzerwa kunoitika mukati memaminitsi makumi matatu nemakumi matanhatu ekubatana kwepabonde. Vakasara makumi maviri kubva muzana zvevarume ava vanoona kuwedzerwa kunopera pakati pemaminitsi maviri nemaminetsi.
Kusarudzwa kwepakutanga kunofungidzirwa kuchinja pakati pe30 kubva muzana uye 70 muzana yevarume veAmerica. Maererano nemigumisiro yeNational Health and Social Life Survey, kupararira kwemajeri asati asvika muUnited States iri 30 muzana uye inokanganisa varume vezera rose. Kupera kwemazuva ekutanga kunowanzoonekwa kune varume vechidiki vane makore gumi nemasere kubva pakati pe18 ne30.
Nekucherechedza, vamwe varume pane dzimwe nguva vanoona kusununguka kusati kwasvika, uye izvi zvingave zvisingaitiki. Uyezve, kunyange zvazvo tsanangudzo dzomusangano dzisina kufanira kujekesa dzinorondedzera sezviri kuitika pamwe nekusangana kwose kwepabonde, kana zvikaitika pakati pe10 kubva muzana uye 20 muzana yenguva iyo zvepabonde inoshandiswa, ipapo kurapwa kungave kwakakodzera.
Kurapa Kusarudzwa Kwakaitika Kare NeBotox
Botox injections inoshanda kuburikidza nekuora simba kana kupera simba uye pamwe nekudzivirira mitsipa. Migumisiro yeBotox inopera pakati pemwedzi mitatu nemumiviri.
Migumisiro inowanzovhiringidza yeBotox inosanganisira kupfugama, kupwanya, uye kurwadziwa panzvimbo yejojo.
Mukuwedzera kunotsvedza kubwinya kwepiso, heano zvimwe zvimwe zvinoshandiswa zveBotox:
- Zvinokurudzira kupfutidza sweti (kureva, hyperhidrosis)
- Meso akayambuka (kureva, strabismus)
- Chronic migraines
- Kudzora kusingadzorwi (kureva, blepharospasm)
- Chirwere chinoputika
Izvozvo zvinonzi bulbospongiosus uye ischiocavernosus zvikamu zvepenile shaft, uye mutsara iyi inonyanya kukosha muhupenyu. Munguva yekushandura, masimba aya anowanikwa zvakajeka zvinyorwa zvezvinyorwa.
Botox inosarudza kusunungurwa kweacetylcholine kubva mumagumo ekupedzisira, uye inofungidzirwa kuti iyi nzira inogona kudzivisa maitiro akasiyana-siyana ezvinyorwa zve bulbospongiosus uye ischiocavernosus uye nokudaro anobatsira kunonoka kubuda.
Pakave nekumwe kunetseka kwakataurwa pamusoro pekushandiswa kweBotox kuporesa kusvibiswa kwemajeri. Kutanga, dzimwe nyanzvi dzinonetseka kuti Botox ichavhara ejaculation zvachose uye inoguma nekusajulation. Izvo zvave zvichinetseka pamusoro pekudhura-kubudirira kwekushandisa Botox kubata chirwere chisati chasvika.
Muchipatent chakabudiswa neEllergan muna 2012, nzira dzakasiyana-siyana dzeBotox hutungamiri hwekurapwa kusati kwasvika ejaculation dzinoratidzwa, kusanganisira zvinotevera:
Imwe nzira yekurapa kupererwa kwemajeri kusati kwasvika mumurwere inoshaiwa iyo inopa, apo iyo nzira inosanganisira danho rekugadza kwekune imwe nzvimbo, neripi, chirwere, botulinum neurotoxin kuchirwere chemurwere, nokudaro kurapa kusati kwasvika kwejeri mumurwere. Kunyanya kuratidza, botulinum neurotoxin inoshandiswa muzvikamu zviviri zvepenile, uye mune dzimwe mienzaniso kunenge nzvimbo nhatu dzepenile.
Vanyori vepa patent vanoti Botox inogona kuiswa mu glans kana frenulum yepenis (pedyo nechepakati pepenis). Uyezve, Botox inogona kushandiswa pachikonzero chinodiwa, nemigumisiro inosvika kumwedzi mitanhatu. Kupindira kunotanga kushanda mukati maawa 48 kusvika ku 72, uye hakufaniri kuva neavo kana kukanganisa migumisiro yakaipa.
Zvizhinji zvekutsvakurudza zvakabudiswa pamusoro pekushandiswa kweBotox zvinoratidzirwa semafungiro uye kujekesa. Sezviri pachena, Botox inofanira kushanda kurapwa kwemajeri asati asvika asi tsvakurudzo dzakawanda dzinofanira kuitwa kuitira kuti ibudirire. Musi waAugust 15, 2017, Allergan yakagumisa chikamu chechipiri mishonga yemakiriniki ichiongorora kushandiswa kweBotox kuporesa ejaculation isati yasvika, asi migumisiro iyi inenge isipo.
Mimwe Mishonga yeChembera Yokutanga
Kunyange zvazvo pasina mushonga unogamuchirwa neDAA wekugadzirira kusati kwavapo, mamwe maitiro akashandiswa kurapa chirwere ichi.
Kusarura serotonin-reuptake inhibitors (SSRIs) uye tricyclic vanodzvinyirira zvakaratidza kuti zvakakosha mukurapa kusati kwasvika. Kunyanya, paroxetine, sertraline, fluoxetine, citalopram, uye clomipramine zvose zvakashandiswa kurapa kusvibiswa kusati kwatanga. Kushandiswa kwemishonga iyi yekurapa kusati kwasvika ejaculation isina-label.
Iyi mishonga inogona kutorwa zuva roga roga kana sezvinodiwa. Kunyange zvazvo kurapwa kwemazuva mazhinji nemishonga inodzvinyirira yakagadzikana kupfuura inoshandiswa-kushandiswa, nguva yakareba hutongi inokonzera mimwe migumisiro yakaipa. Nehurongwa hunogara huripo, SSRI inonyanya kubudirira mushure mokunge ichisvika mumamiriro ezvinhu akasimba, izvo zvingatora mavhiki. Zvisinei, kubatsirwa kunogona kuitika kare.
Imwe SSRI inonyanya kukodzera kurapwa kwejeri isati yasvika dapoxetine (Priligy). Iyi SSRI shoma-yakagadzirwa yakanyatsogadzirirwa kurapwa kwemajeri asati asvika uye inogona kushandiswa sezvinodiwa. Dapoxetine inogona kutorwa maawa mashomanana mushure mekuita zvepabonde.
Imwe nzira inogona kubatsira kudzivirira kupera kusati kwatanga kunosanganisira kushandiswa kwemashoko aneshetitics kunoderedza kunzwa mukati mepenisheni uye nokudaro kunokanganisa kukwira. Mukuwedzera kune anesthesia, kondomu inogona kushandiswa kuti iwedzere kuderedza kunzwa. Nyaya dzinofanirwa kunyanya kushandisa anesthetics yakashandiswa nokuda kweizvi ndeye lidocaine uye prilocaine.
Pakupedzisira, nhamba shomanana yevarume vane jeri risati rapera vanogona kubatsirwa nekuita pasi pepelvic kana Kegel maitiro.
Ko Zvakadini Nehutano Hwakanaka?
Parizvino, nyanzvi dzakawanda dzinofungidzira kuti nguva isati yakwana ejaculation inonzi neurobiological uye genetic. Somugumisiro, kurapwa kwemazuva kwenguva refu kunofungidzirwa kusingabatsiri kwoupenyu hwese husati hwasvika. Uyezve, zvidzidzo zvemazuva mazhinji zvakaratidza kuti kurapwa kwehutano hakubatsiri mukurapa upenyu hwese husati hwasvika.
Mutsara wegore ra2014 unonzi "Premature ejaculation: tsanangudzo, epidemiology, uye kurapwa," Kirby anonyora zvinotevera maererano nehutano hwepfungwa uye hwepfungwa dzekugadzirira kusati kwapera: "Zvirwere zvave zvichinyorwa kwemakore akawanda, asi kuongororwa kwakawanda kunoratidza kubatsirwa hakusi kuitika. Kunyange zvakadaro, varwere vazhinji vanonzwisisika vane hanya uye vanogona kuonga psychotherapy. "
Nokuda kwekuwana nguva isati yakwana ejaculation, nzira yekubatanidza yekurapa inogona kushanda. Iyi nzira inosanganisira nzira yekumisa-kutanga, kugadzirisa maitiro ekurapa, uye zvinodhaka. Nenzira yekutanga-kumisa, murume anoziva kufara pakati pepakati pepabonde panguva yepabonde uye anonoka zvepabonde kwemaminitsi. Kana murume wacho akadzoka zvakare, hutano hwakatanga zvakare. Zvimwewo, nemhando yekufambisa, murume anoomesa peni vasati vashandura kuti vadzikise kukonzera uye kumira kudii.
> Sources:
> Ashburn TT, Thor KB. Zvinodhaka Kuisa: Kuziva uye Kuvandudza Mashandisiro Matsva Emishonga Inoshandiswa. Nat Rev Drug Discov. 2004; 3: 673-83. https://doi.org/10.1038/nrd1468
> Gastiola, Gustavo M. Nzira Yokurapa Kutanga Kupera Kwemajeri neBotulinum Neurotoxin. 11 Dec. 2012.
> Kirby M. Premature ejaculation: tsanangudzo, epidemiology uye kurapwa. Trends muUrology & Men's Health. 2014; 5: 23-28. https://doi.org/10.1002/tre.406
> Serefoglu EC, Silay MS. Botulinum toxin-A injection inogona kubatsira mukurapa kwehupenyu-nguva refu isati yasvika. Med Hypotheses. 2010; 74: 83-4. https://doi.org/10.1016/j.mehy.2009.07.038