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Medicine Aug 2018Premature ejaculation is a common sexual dysfunction disease in adult males. It can be divided into primary and secondary premature ejaculation. Acupuncture is widely...
BACKGROUND
Premature ejaculation is a common sexual dysfunction disease in adult males. It can be divided into primary and secondary premature ejaculation. Acupuncture is widely used in the treatment of premature ejaculation in China. There are many clinical trials confirmed that acupuncture can prolong the ejaculation latency in the vagina. We aim to use a meta-analysis to evaluate the efficacy and safety of acupuncture for premature ejaculation.
METHOD
We will systematically search all randomized controlled trials (RCTs) by electronic and manual search, until June 31, 2018. Electronic retrieval of the database includes Medline, EMBASE, the Cumulative Index to Nursing and Allied Health Literature, Allied and Complementary Medicine Database, the Cochrane Library, the Chinese BioMedical Literature Database, the China National Knowledge Infrastructure (CNKI), the China Science and Technology Journal database (VIP), and the Wanfang database. Manual search will retrieve gray literature, including unpublished conference articles. The primary outcomes include the Intravaginal Ejaculatory Latency Time (IELT). At the same time, Premature Ejaculation Diagnostic Tool (PEDT), Arabic index of Premature Ejaculation (AIPE), Index of Premature Ejaculation (IPE) will be the secondary outcomes. Two reviewers will independently read the articles, extract the data information, and give the assessment of risk of bias. Data analysis will be used the special software like RevMan (version 5.3) and EndNote X7.
ETHICS AND DISSEMINATION
This systematic review will evaluate the efficacy and safety of acupuncture for premature ejaculation. This review does not require ethical approval and will be reported in a peer-reviewed journal.
PROSPERO REGISTRATION NUMBER
PROSPERO CRD42018092783.
Topics: Acupuncture Therapy; Adult; Clinical Protocols; Humans; Male; Premature Ejaculation; Randomized Controlled Trials as Topic; Systematic Reviews as Topic; Treatment Outcome
PubMed: 30170398
DOI: 10.1097/MD.0000000000011980 -
Actas Urologicas Espanolas Jun 2017
Topics: Humans; Male; Premature Ejaculation; Sociological Factors; Terminology as Topic
PubMed: 27908635
DOI: 10.1016/j.acuro.2016.09.010 -
Sexual Medicine Reviews Jan 2019Besides erectile dysfunction, premature ejaculation (PE) is the most frequent male sexual disorder and shows a high level of bother and distress. The negative...
INTRODUCTION
Besides erectile dysfunction, premature ejaculation (PE) is the most frequent male sexual disorder and shows a high level of bother and distress. The negative consequences of long-term and unsuccessfully treated PE on both patient and partner are well established in the literature and include personal distress, impairment of the partner's sexual function, and interpersonal difficulties.
AIM
To outline the consequences of untreated PE and the advantages and disadvantages of currently available treatment options with a special focus on a new topical eutectic lidocaine/prilocaine metered dose spray (Fortacin; Lidocaine/Prilocaine, Recordati, Milan, Italy) which represents the second officially approved drug in this indication.
METHODS
Narrative overview of the literature synthesizing the findings of literature retrieved from searches of computerized databases such as Web of Science, Medline, PubMed, and Google Scholar, hand searches, and authoritative texts. Combinations of keywords including premature ejaculation, ejaculatory control, intravaginal ejaculation latency time, IELT, PE, PDE5 inhibitors (PDE5i), SSRIs, topical anesthetics, lidocaine, prilocaine, and treatment were used. In the end, 59 studies published between 2000 and 2018 were considered relevant for this review.
MAIN OUTCOME MEASURES
Published studies on PE-related negative psychosocial outcomes, as well as advantages and disadvantages of currently available off-label and officially approved treatment options.
RESULTS
Although a variety of treatment options for PE have shown marked improvements in stopwatch-measured intravaginal ejaculation latency time (IELT) and patient-reported outcomes as assessed by the Premature Ejaculation Profile (PEP), none of the investigated drugs has reached market approval. The only so far officially approved medication-dapoxetine-is characterized by high discontinuation rates of up to 90%, mostly because of high side effects, cost issues, efficacy below expectations, and the need for scheduling sexual intercourse.
CONCLUSION
With the official approval in Europe the new dose-metered lidocaine-prilocaine spray (Fortacin) may become a real first-line therapy option for PE and may offer a satisfactory and affordable solution, especially because of its unique galenic preparation, making its handling easy and customer friendly. In addition, it has the potential to significantly increase the currently low patients' acceptance of available monotherapies and become an established second-line therapy for the severe PE patients with IELTs <1 to 2 minutes or with ante-portal ejaculation in combination with oral therapy. Porst H, Burri A. Novel treatment for premature ejaculation in the light of currently used therapies: A review. Sex Med Rev 2019; 7:129-140.
Topics: Benzylamines; Coitus; Ejaculation; Humans; Male; Naphthalenes; Patient Satisfaction; Penile Erection; Phosphodiesterase 5 Inhibitors; Premature Ejaculation; Randomized Controlled Trials as Topic; Treatment Outcome
PubMed: 30057136
DOI: 10.1016/j.sxmr.2018.05.001 -
Journal of the College of Physicians... Mar 2024To assess the impact of vitamin B12 levels in the failure of the dapoxetine used in premature ejaculation (PE) treatment.
OBJECTIVE
To assess the impact of vitamin B12 levels in the failure of the dapoxetine used in premature ejaculation (PE) treatment.
STUDY DESIGN
Experimental study. Place and Duration of the Study: Andrology Clinic, between May and December 2020.
METHODOLOGY
Patients with premature ejaculation complaints completed the Premature Ejaculation Diagnostic Tool (PEDT) questionnaire. Patients were also asked to fill in the Premature Ejaculation Profile (PEP) surveys. Intravaginal ejaculation latency time (IELT) were recorded based on the estimates of patients. Serum vitamin B12 levels were evaluated based on blood samples. All patients were advised to use dapoxetine 30 mg, 1-3 hours prior to intercourse. After four weeks, patients were asked to complete the PEP questionnaire again. IELT times were recorded.
RESULTS
A total of 62 patients were included in the study. A total of 39 patients (62.90%) were satisfied with the treatment of the dapoxetine. In comparison to patients who benefited from dapoxetine treatment and those who did not, vitamin B12 levels of patients who did not benefit from dapoxetine were found to be significantly lower (p=0.005).
CONCLUSION
Vitamin B12 deficiency can reduce the effectiveness of dapoxetine treatment in patients with PE. It is important to evaluate serum vitamin B12 levels for the evaluation of patients with PE.
KEY WORDS
Premature ejaculation, Dapoxetine, Vitamin B12, Serotonin, Treatment.
Topics: Male; Humans; Premature Ejaculation; Treatment Outcome; Ejaculation; Vitamin B 12; Benzylamines; Naphthalenes
PubMed: 38462874
DOI: 10.29271/jcpsp.2024.03.351 -
Expert Opinion on Pharmacotherapy Jun 2022Premature ejaculation (PE) is a sexual dysfunction of unknown etiology affecting a substantial number of males and deteriorating sexual health and quality of life of the...
INTRODUCTION
Premature ejaculation (PE) is a sexual dysfunction of unknown etiology affecting a substantial number of males and deteriorating sexual health and quality of life of the patient and his partner. Treatment still remains challenging; however, pharmacotherapy is considered the mainstay of therapy with behavioral and psychosexual interventions being particularly important as adjudicate procedures, within the context of a holistic approach.
AREAS COVERED
The authors review the literature on the available medications for PE, both officially registered and non-registered. Currently, only dapoxetine and an anesthetic spray containing lidocaine and prilocaine (Fortacin™) are officially approved, with the rest being used off-label. Herein, updated data regarding the efficacy and safety of the pharmaceutical agents are presented.
EXPERT OPINION
On-demand dapoxetine is reportedly efficacious and safe in treating lifelong PE and is the first medication to be approved for this purpose. Fortacin has also shown considerable efficacy and may be reliably used on-demand. Phosphodiesterase type 5 inhibitors (PDE5Is) have been found to be effective in the treatment of PE and are therefore recommended either as monotherapy or combined with other therapies (i.e. dapoxetine). Adverse events of any therapy should be taken under consideration. Physicians should encourage patients to discuss their needs and expectations and grade any improvement of their condition with treatment.
Topics: Benzylamines; Ejaculation; Humans; Male; Phosphodiesterase 5 Inhibitors; Premature Ejaculation; Quality of Life; Selective Serotonin Reuptake Inhibitors; Treatment Outcome
PubMed: 35108136
DOI: 10.1080/14656566.2022.2035361 -
Urology Apr 2016
Topics: History, Medieval; Humans; Male; Persia; Premature Ejaculation
PubMed: 26827844
DOI: 10.1016/j.urology.2016.01.007 -
Asian Journal of Andrology Nov 2012There are ongoing debates about the definition, classification and prevalence of premature ejaculation (PE). The first evidence-based definition of PE was limited to... (Review)
Review
There are ongoing debates about the definition, classification and prevalence of premature ejaculation (PE). The first evidence-based definition of PE was limited to heterosexual men with lifelong PE who engage in vaginal intercourse. Unfortunately, many patients with the complaint of PE do not meet these criteria. However, these men can be diagnosed as one of the PE subtypes, namely acquired PE, natural variable PE or premature-like ejaculatory dysfunction. Nevertheless, the validity of these subtypes has not yet been supported by evidence. The absence of a universally accepted PE definition and lack of standards for data acquisition have resulted in prevalence studies that have reported conflicting rates. The very high prevalence of 20%-30% is probably due to the vague terminology used in the definitions at the time when such surveys were conducted. Although many men may complain of PE when questioned for a population-based prevalence study, only a few of them will actively seek treatment for their complaint, even though most of these patients would define symptoms congruent with PE. The complaints of acquired PE patients may be more severe, whereas complaints of patients experiencing premature-like ejaculatory dysfunction seem to be least severe among men with various forms of PE. Although numerous treatment modalities have been proposed for management of PE, only antidepressants and topical anaesthetic creams have currently been proven to be effective. However, as none of the treatment modalities have been approved by the regulatory agencies, further studies must be carried to develop a beneficial treatment strategy for PE.
Topics: Animals; Benzylamines; Coitus; Humans; Lidocaine; Male; Naphthalenes; Piperazines; Premature Ejaculation; Prevalence; Prilocaine; Purines; Selective Serotonin Reuptake Inhibitors; Sexual Dysfunction, Physiological; Sildenafil Citrate; Sulfones
PubMed: 23064688
DOI: 10.1038/aja.2012.108 -
Archivio Italiano Di Urologia,... Jun 2017Premature Ejaculation (PE), the commonest sexual dysfunction in males, is generally treated with local anesthetic and SSRI (Dapoxetine). The aim of our study was... (Randomized Controlled Trial)
Randomized Controlled Trial
OBJECTIVES
Premature Ejaculation (PE), the commonest sexual dysfunction in males, is generally treated with local anesthetic and SSRI (Dapoxetine). The aim of our study was investigate Group Psychotherapy as an alternative treatment for PE and compare the efficacy of pharmacological treatment and psychotherapy, either alone or in combination, in terms of response and improved Quality of Life (QoL). From a male outpatient population screened for PE, those who received a diagnosis of PE were proposed for the study, enrolled and divided into 3 groups (A, B and C). Each group was treated with Dapoxetine, Group Psychotherapy alone and Dapoxetine and Group Psychotherapy, respectively.
MATERIALS AND METHODS
Out of 1237 male outpatients, 353 received a diagnosis of Premature Ejaculation. Of them, 279 were enrolled in the study and randomized into 3 groups (A, B and C). Only 157 patients were evaluable. Before and after treatments all participants completed two questionnaires to evaluate PE status and anxiety and referred their IELT.
RESULTS
GROUP A: The mean post-treatment Premature Ejaculation Diagnostic Tool (PEDT) score decreased from 12.95 to 8.26, while the mean Intra-vaginal Ejaculation Latency Time (IELT) increased from 50.77 sec to 203 sec. (p < 0.05); GROUP B: Reduction in the mean PEDT from 13.44 to 5.11 and an increased IELT from 48.33 to 431.11 sec (p < 0.001); GROUP C: The mean post-treatment PEDT score decreased from 12.29 to 5.57, while the mean IELT increased from 46.86 to 412.14 sec (p < 0.001). All groups recorded an improvement in anxiety.
CONCLUSIONS
According to our results Group Psychotherapy is an alternative method of treatment for PE. Group Psychotherapy plays a significant role in the treatment of PE, determining a better improvement of symptoms than Dapoxetine alone even if not statistically significant.
Topics: Adult; Aged; Benzylamines; Combined Modality Therapy; Humans; Male; Middle Aged; Naphthalenes; Premature Ejaculation; Psychotherapy, Group; Young Adult
PubMed: 28679182
DOI: 10.4081/aiua.2017.2.114 -
Sexual Medicine Reviews Dec 2023Premature ejaculation is a prevalent male sexual dysfunction that causes significant distress for men and their partners on a global scale. Despite its widespread... (Review)
Review
INTRODUCTION
Premature ejaculation is a prevalent male sexual dysfunction that causes significant distress for men and their partners on a global scale. Despite its widespread impact, effective treatment options without undesirable side effects remain limited.
OBJECTIVES
The present review aimed to provide an overview of experimental studies that analyzed the effects of physical exercise interventions on premature ejaculation.
METHODS
The inclusion criteria for the review included: Population: Adult men. Intervention: An intervention designed to increase physical exercise was delivered in the study. Comparison: Before versus after intervention with or without a comparison group receiving a drug treatment or an active or no control intervention. Outcomes: Self-reported or clinician-rated premature ejaculation or its symptoms. Study type: Experimental designs. We conducted the search process in 9 databases: APA PsycNET, PubMed, Scopus, SPORTDiscus, JSTOR, ScienceDirect, Web of Science, Embase, and CAB Direct. This review included six intervention studies that included 433 participants (307 men with premature ejaculation) ranging from 18 to 50 years of age. All participants had a stable female sexual partner and had not any other physical or mental problems.
RESULTS
The synthesized results indicated that yoga, running, and high-intensity interval training alleviate premature ejaculation symptoms in men with premature ejaculation after varying intervention duration times. The effectiveness of physical exercise for premature ejaculation symptoms was similar to that of drug treatments.
CONCLUSION
Physical exercise can be one of the potential treatment modalities for premature ejaculation. The intensity of physical exercise and the effort of participants during exercise are key factors affecting improvements in ejaculation control. A potential limitation was that the review did not include any literature written in non-English languages.
Topics: Adult; Humans; Male; Female; Ejaculation; Premature Ejaculation; Exercise; Treatment Outcome; Exercise Therapy
PubMed: 37786366
DOI: 10.1093/sxmrev/qead042 -
Andrology Mar 2020Many diseases have been associated with anogenital distance, as an indicator of intrauterine androgen exposure.
BACKGROUND
Many diseases have been associated with anogenital distance, as an indicator of intrauterine androgen exposure.
OBJECTIVES
The aim of this study was to investigate the association between lifelong premature ejaculation and anogenital distance.
MATERIALS AND METHODS
The study included 140 participants: 70 with lifelong premature ejaculation (group 1) and 70 without any ejaculatory complaints (group 2). Premature Ejaculation Diagnostic Tool and stopwatch intravaginal ejaculatory latency time were recorded from all participants in order to evaluate ejaculatory function. Two variants of anogenital distance were measured: anogenital distance (from anus to the posterior base of the scrotum) from anus to the posterior base of the scrotum and anogenital distance (from anus to the cephalad insertion of the penis) to the cephalad insertion of the penis. We compared differences between groups and correlations between anogenital distance variants and patients' characteristics.
RESULTS
The groups were similar in terms of age, BMI, and total testosterone levels. The mean anogenital distance (from anus to the posterior base of the scrotum) scores were 59.45 ± 10.76 vs. 55.02 ± 10.13 (p = 0.01), and anogenital distance (from anus to the cephalad insertion of the penis) scores were 128.37 ± 22.2 vs. 126.78 ± 16.21 (p = 0.63) in groups 1 and 2, respectively. Significant correlation was observed between anogenital distance (from anus to the posterior base of the scrotum) and Premature Ejaculation Diagnostic Tool scores (r = 0.199, p = 0.019) and intravaginal ejaculatory latency time (r = -0.185, p = 0.028). There were no statistically significant differences between anogenital distance (from anus to the posterior base of the scrotum) scores and total testosterone levels and between anogenital distance (from anus to the cephalad insertion of the penis) and Premature Ejaculation Diagnostic Tool scores or intravaginal ejaculatory latency time.
CONCLUSIONS
These results suggest that longer anogenital distance is associated with higher possibility of lifelong premature ejaculation. However, further studies are needed to confirm our results.
Topics: Adult; Anal Canal; Body Weights and Measures; Humans; Male; Penis; Premature Ejaculation
PubMed: 31536679
DOI: 10.1111/andr.12709