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Annals of Internal Medicine Aug 2021Sathianathen NJ, Hwang EC, Mian R, et al. Cochrane Database Syst Rev. 2021;3:CD012799. 33745183.
Sathianathen NJ, Hwang EC, Mian R, et al. Cochrane Database Syst Rev. 2021;3:CD012799. 33745183.
Topics: Adult; Ejaculation; Humans; Male; Personal Satisfaction; Premature Ejaculation; Selective Serotonin Reuptake Inhibitors; Treatment Outcome
PubMed: 34339221
DOI: 10.7326/ACPJ202108170-090 -
Urology Apr 2013To evaluate the efficacy and safety of topical anesthetic agents for patients with premature ejaculation (PE). (Meta-Analysis)
Meta-Analysis Review
OBJECTIVE
To evaluate the efficacy and safety of topical anesthetic agents for patients with premature ejaculation (PE).
METHODS
Eligible randomized controlled trials (RCTs) were identified from electronic databases (Cochrane Central Register of Controlled Trials, Medline, and EMBASE) without language restrictions. The database search, quality assessment, and data extraction were performed independently by 2 reviewers. The main outcome for the efficacy of topical anesthetic agents was intravaginal ejaculatory latency time (IELT). Efficacy and safety were explored using Review Manager, version 5.1.0 (Cochrane Collaboration, Oxford, UK).
RESULTS
Eight trials met the inclusion criteria. Our pooled analysis showed that IELT in the topical anesthetic agent group was significantly improved compared to the placebo group (random-effect model; mean difference [MD] 5.82, 95% confidence interval [CI] 3.50-8.14, P <.00001). According to the subgroup analysis, a significant improvement was obtained in the domains of ejaculatory control, sexual satisfaction, and distress in the Index of Premature Ejaculation (IPE) questionnaire (random-effect model, MD 4.53, 95% CI 3.05-6.01, P <.00001). In terms of adverse events (AEs), the pooling outcome showed that the overall incidence of AEs was significantly higher in the topical anesthetic agent group than in the placebo group (random-effect model, relative risk [RR] 4.28, 95% CI 1.63-11.24, P = .003). However, nearly all of the AEs were mild and transient.
CONCLUSION
Topical anesthetic agents have been shown to be effective and well tolerated for patients with primary PE, providing a significant improvement in IELT with a higher incidence of AEs that were not long-lasting or severe. High-quality RCTs are necessary to confirm the efficacy and safety of topical anesthetics for PE.
Topics: Anesthetics, Local; Humans; Male; Premature Ejaculation; Randomized Controlled Trials as Topic
PubMed: 23434101
DOI: 10.1016/j.urology.2012.12.028 -
World Journal of Urology Dec 2017To clarify the efficacy of phosphodiesterase-5 inhibitors (PDE5Is) and selective serotonin reuptake inhibitors (SSRIs) in men with premature ejaculation (PE). (Review)
Review
PURPOSE
To clarify the efficacy of phosphodiesterase-5 inhibitors (PDE5Is) and selective serotonin reuptake inhibitors (SSRIs) in men with premature ejaculation (PE).
METHODS
We searched the PubMed, Embase, and Cochrane Library databases to identify all randomized, controlled trials (RCTs) and compared the results, including intravaginal ejaculation latency time, satisfaction, intercourse per-week and side effects after treatment with PDE5I or SSRIs versus placebo, combined use of PDE5I with SSRIs versus PDE5I or SSRIs alone, and PDE5I versus SSRIs for treating PE.
RESULTS
The study inclusion criteria were met by 23 studies (ten RCTs with five crossover studies) involving 6145 patients. The data synthesized from these studies indicated that the efficacy of PDE5Is and SSRIs was better than that of placebo (p < 0.00001; p < 0.00001); however, more patients had side effects while taking PDE5Is and SSRIs (p < 0.00001; p < 0.00001). The efficacy of the combined treatment was significantly better than that of PDE5Is or SSRIs alone (p < 0.00001; p < 0.00001); however, more patients had side effects from the combined treatment than from SSRIs (p = 0.0002), with no significant difference in PDE5Is (p = 0.5). The efficacy of PDE5Is was better than that of SSRIs (p = 0.006), and no significant difference was observed in the frequency of side effects (p = 0.93).
CONCLUSIONS
PDE5Is were significantly more effective than placebo or SSRIs for treating PE, while SSRIs were better than placebo. The combined treatment had better efficacy than PDE5Is or SSRIs alone.
Topics: Humans; Male; Phosphodiesterase 5 Inhibitors; Premature Ejaculation; Selective Serotonin Reuptake Inhibitors; Treatment Outcome
PubMed: 28913588
DOI: 10.1007/s00345-017-2086-5 -
European Urology Sep 2021The present summary of the European Association of Urology (EAU) guidelines is based on the latest guidelines on male sexual health published in March 2021, with a last...
CONTEXT
The present summary of the European Association of Urology (EAU) guidelines is based on the latest guidelines on male sexual health published in March 2021, with a last comprehensive update in January 2021.
OBJECTIVE
To present a summary of the 2021 version of the EAU guidelines on sexual and reproductive health.
EVIDENCE ACQUISITION
A literature review was performed up to January 2021. The guidelines were updated, and a strength rating for each recommendation was included based on either a systematic review of the evidence or a consensus opinion from the expert panel.
EVIDENCE SYNTHESIS
Late-onset hypogonadism is a clinical condition in the ageing male combining low levels of circulating testosterone and specific symptoms associated with impaired hormone production and/or action. A comprehensive diagnostic and therapeutic work-up, along with screening recommendations and contraindications, is provided. Erectile dysfunction (ED) is the persistent inability to attain and maintain an erection sufficient to permit satisfactory sexual performance. Along with a detailed basic and advanced diagnostic approach, a novel decision-making algorithm for treating ED in order to better tailor therapy to individual patients is provided. The EAU guidelines have adopted the definition of premature ejaculation (PE), which has been developed by the International Society for Sexual Medicine. After the subtype of PE has been defined, patient's expectations should be discussed thoroughly and pharmacotherapy must be considered as the first-line treatment for patients with lifelong PE, whereas treating the underlying cause must be the initial goal for patients with acquired PE. Haemospermia is defined as the appearance of blood in the ejaculate. Several reasons of haemospermia have been acknowledged; the primary goal over the management work-up is to exclude malignant conditions and treat any other underlying cause.
CONCLUSIONS
The 2021 guidelines on sexual and reproductive health summarise the most recent findings, and advise in terms of diagnosis and treatment of male hypogonadism and sexual dysfunction for their use in clinical practice. These guidelines reflect the multidisciplinary nature of their management.
PATIENT SUMMARY
Updated European Association of Urology guidelines on sexual and reproductive health are presented, addressing the diagnosis and treatment of the most prevalent conditions in men. Patients must be fully informed of all relevant diagnostic and therapeutic options and, together with their treating physicians, decide on optimal personalised management strategies.
Topics: Erectile Dysfunction; Europe; Hemospermia; Humans; Hypogonadism; Male; Practice Guidelines as Topic; Premature Ejaculation
PubMed: 34183196
DOI: 10.1016/j.eururo.2021.06.007 -
Archivio Italiano Di Urologia,... Mar 2021The aim of the study is to extrapolate clinical features of Premature Ejaculation (PE) patients and female partners of men affected with PE, in order to get a profile... (Observational Study)
Observational Study
The aim of the study is to extrapolate clinical features of Premature Ejaculation (PE) patients and female partners of men affected with PE, in order to get a profile that can be of assistance for physicians within the dynamics of a couple, one of which is a PE patient. An observational, non-interventional, cross-sectional epidemiological study entitled IPER (Italian Premature Ejaculation Research) was conducted and included two different cohorts of subjects that were randomly sampled from a patient dataset of selected General Practitioners: 1. IPER-M sub-cohort (1.104 subjects) was made of male subjects in which they were then distinguished patients with or without PE based on the score of the PEDT questionnaire; IPER-F sub-cohort (1.109 subjects) was made of female subjects from an independent sample of women (therefore not the partners of the IPER-M males) in which they then distinguished those partners of a male subject with PE or not. In addition to an identical general questionnaire to explore demographic aspects and habits, each subcohort was then evaluated using validated questionnaires. No differences were noted between PE+/PE- patients in terms of alcohol consumption, smoking habits, physical activity nor stress condition in everyday life, employment, socio-economic class and marital status. While the prevalence of PE proportionally increased with age, excluding the 50-59 and 70-80 years decades, in the IPER-M group an overall statistically significant difference for the mean age between the PE+ and PE- groups (p = 0.002) was detected, but without reaching any difference amongst the different age classes in the IPER-F group. The PE+ patients reported a significantly lower frequency rate of sexual intercourse, worse QoL (p = 0.006 and p < 0.0001, respectively), and increased anxiety status (p < 0.0001 for both subgroups). This study shows that, rather than talking with a patient affected by PE it would be advisable to introduce the concept of couple counseling with the person patient and his partner, because it is only through classification of both partners as one couple and a full understanding of their mutual sexual experience that PE treatment can be optimized and its results measured accurately.
Topics: Adult; Cross-Sectional Studies; Female; Humans; Male; Middle Aged; Premature Ejaculation; Sexual Partners
PubMed: 33754608
DOI: 10.4081/aiua.2021.1.42 -
Journal of Magnetic Resonance Imaging :... Sep 20205 TECHNICAL EFFICACY: Stage 3 J. Magn. Reson. Imaging 2020;52:785-786.
5 TECHNICAL EFFICACY: Stage 3 J. Magn. Reson. Imaging 2020;52:785-786.
Topics: Ejaculation; Humans; Hypothalamus; Male; Premature Ejaculation
PubMed: 32142194
DOI: 10.1002/jmri.27128 -
Andrologia Feb 2020There are very few studies that have evaluated premature ejaculation characteristics in regard to subtypes. Additionally, to our knowledge, there are no studies which...
There are very few studies that have evaluated premature ejaculation characteristics in regard to subtypes. Additionally, to our knowledge, there are no studies which have explored testosterone replacement therapy in secondary premature ejaculation patients with testosterone deficiency. Therefore, our aims were as follows: (a) to determine the characteristics of patients with premature ejaculation in regard to the four subtypes of premature ejaculation and (b) to determine the efficacy of testosterone replacement therapy in the treatment of testosterone-deficient patients with secondary premature ejaculation. Patients who applied to our clinic from May 2010 to August 2018 with premature ejaculation were included in this study. The mean age of the study group was 36.42 (min-max: 24-52) years. Those with secondary premature ejaculation were found to have significantly lower testosterone concentration compared to the other groups. Shortest mean intravaginal ejaculation latency time and lowest International Index of Erectile Function-5 score were found among those with secondary PE. In regard to treatment results, recipients of testosterone replacement demonstrated a 4.8-fold increase in mean intravaginal ejaculation latency time, while dapoxetine recipients had a 1.8-fold increase. Our findings demonstrate that testosterone replacement may be a promising treatment for those with secondary PE in the presence of testosterone deficiency.
Topics: Adult; Benzylamines; Ejaculation; Hormone Replacement Therapy; Humans; Male; Middle Aged; Naphthalenes; Patient Satisfaction; Premature Ejaculation; Retrospective Studies; Selective Serotonin Reuptake Inhibitors; Testosterone; Time Factors; Treatment Outcome; Young Adult
PubMed: 31657066
DOI: 10.1111/and.13452 -
Revista Da Associacao Medica Brasileira... Sep 2022The aim of this study was to evaluate the quality of life of patients with lifelong and acquired premature ejaculation and to examine its relationship with depression...
OBJECTIVE
The aim of this study was to evaluate the quality of life of patients with lifelong and acquired premature ejaculation and to examine its relationship with depression and anxiety.
METHODS
Between February 2017 and January 2018, a total of 175 patients with premature ejaculation and 132 control men who applied to the urology department of the training and research hospital with the complaint of Premature Ejaculation were included. Patients were divided into three groups according to International Society for Sexual Medicine (ISSM) criteria as follows: Group 1, lifelong premature ejaculation; Group 2, acquired premature ejaculation, and Group 3, control group without premature ejaculation. A detailed medical history of patients was obtained and physical examinations were performed. Intravaginal ejaculation latency time (IELT) was recorded and patients were administered International Erectile Function Index-5 (IIEF-5), Premature Ejaculation Diagnostic Tool (PEDT), Sexual Health Inventory for Men (SHIM), Beck Depression Inventory (BDI), State-Trait Anxiety Inventory (STAI)-1 and STAI-2, and Short Form-36 (SF-36).
RESULTS
The mean mental component score (MCS) of the SF-36 was 51.65±6.57 in the lifelong premature ejaculation group, 49.33±8.65 in the acquired premature ejaculation group, and 61.12±11.09 in the control group (p<0.0001). The mean physical component score (PCS) was 50.99±7.43 in the lifelong premature ejaculation group, 48.32±11.58 in the acquired premature ejaculation group, and 55.17±8.10 in the control group (p<0.0001). Quality of life of premature ejaculation patients as assessed by SF-36 was lower in the subscales of physical functioning, general health perception, vitality, and role limitations due to emotional functioning, compared to the control group.
CONCLUSIONS
Lifelong and acquired premature ejaculation patients deteriorate their quality of life: the deterioration in these patients' quality of life also negatively affects their depression and anxiety states.
Topics: Ejaculation; Erectile Dysfunction; Humans; Male; Penile Erection; Premature Ejaculation; Quality of Life
PubMed: 36228262
DOI: 10.1590/1806-9282.20220421 -
The Journal of Sexual Medicine Sep 2019Patients with premature ejaculation (PE) often complain of difficulty in having second erection, which is not yet investigated using scientific methodology.
INTRODUCTION
Patients with premature ejaculation (PE) often complain of difficulty in having second erection, which is not yet investigated using scientific methodology.
AIM
Evaluation of the association between post-ejaculation refractory time (PERT) with PE by comparing PERT in premature ejaculators with their age-matched control subjects.
METHODS
After ethical committee approval and written informed consent from the participants were obtained, men in a monogamous stable sexual relationship and reporting PE were recruited into the study. Sexually active, matched control subjects were recruited for comparison. Exclusion criteria were erectile dysfunction, diabetes mellitus, cardiovascular diseases, hypogonadism, psychiatric conditions, instrumentation of the genitourinary tract, genitourinary anomalies, and genitourinary infections. Both the premature ejaculators and their control subjects were evaluated with the PE diagnostic tool before initiation of the study. They were asked to record their IELT and PERT over 4 weeks. The statistical analysis was done to obtain descriptive statistics, namely, mean and SD, paired t-tests, and logistic regression analysis. P < .001 was considered significant.
MAIN OUTCOME MEASURE
There was a statistically significant association between prolonged PERT and PE in patients with PE compared with their age-matched control subjects.
RESULTS
102 premature ejaculators and an equal number of matched control subjects were evaluated from January 2016-December 2017. The average PERT in premature ejaculators and control subjects was 330 ± 296.63 minutes and 105.64 ± 98.59 minutes, respectively (P < .0001). Increasing age was associated with increasing PERT. PE was more common in patients when PERT exceeded a threshold of 590 minutes.
CLINICAL IMPLICATIONS
Until now, the association between PE and PERT with matched-pair analysis was not reported. Our study addresses this association, which can add a new paradigm in the evaluation and management of PE.
STRENGTH & LIMITATIONS
The association between PE and prolonged PERT using a statistically appropriate, adequately powered methodology is the strength of the study. The inability to address the causal association between prolonged PERT and PE because of the paucity of evidence at present is the limitation of the study. We believe that the results of this study could trigger further research into such an association, so the mystery of such an association can be unraveled.
CONCLUSIONS
The association between prolonged PERT and PE, as seen in our study, is a finding, that needs further research to establish a causal association. However, reporting such an association is necessary because it is contrary to the present understanding. Bhat GS, Shastry A. Association Between Post-Ejaculatory Refractory Time (PERT) and Premature Ejaculation (PE). J Sex Med 2019;16:1364-1370.
Topics: Adult; Case-Control Studies; Dopamine; Ejaculation; Erectile Dysfunction; Humans; Male; Marriage; Middle Aged; Premature Ejaculation; Time Factors
PubMed: 31405769
DOI: 10.1016/j.jsxm.2019.06.016 -
Zhonghua Nan Ke Xue = National Journal... Sep 2023There is a close relationship between male erectile dysfunction (ED) and premature ejaculation (PE) on the pathogenesis, leading a high comorbidity rate and a need of... (Review)
Review
There is a close relationship between male erectile dysfunction (ED) and premature ejaculation (PE) on the pathogenesis, leading a high comorbidity rate and a need of simultaneous treatment in clinical practice. Phosphodiesterase 5 inhibitors (PDE5i) and selective serotonin reuptake inhibitor (SSRI) Dapoxetine are first-line oral drugs for ED and PE, respectively. In recent years, multi-country clinical guidelines have provided suggestions and guidance for the combination of these two drugs, with the safety and effectiveness being further explored and verified. This review summarized the status of ED and PE comorbidity, treatment principles, and research progress on the safety and effectiveness of Dapoxetine combined with PDE5i, in order to provide reference for the combination therapy of ED and PE comorbidity.
Topics: Humans; Male; Benzylamines; Comorbidity; Ejaculation; Erectile Dysfunction; Naphthalenes; Phosphodiesterase 5 Inhibitors; Premature Ejaculation; Treatment Outcome
PubMed: 38639587
DOI: No ID Found