Abstract
ABSTRACTIntroduction:Tramadol has been used for the treatment of premature ejaculation, however, the studies published for the same are not well designed. The primary objective of this study was to explore the literature pertaining to the use of tramadol in patients with PE to determine its safety and efficacy in this population.Materials ande methods:Systematic literature search of various electronic databases was conducted to include all the randomized studies and quasi-randomized studies. Standard PRISMA (Preferred reporting Items for Systematic reviews and Meta-analysis) guidelines were pursued for this review and study protocol was registered with PROSPERO (CRD42019123381).Results:Out of 9 studies included in this review, 5 were randomized controlled trials, and rests of the 4 studies were quasi-randomized studies. Tramadol resulted in significantly higher improvement of IELT with the mean difference (MD) of 139.6 seconds and confidence interval (CI) 106.5-172.6 seconds with a p-value of p <0.00001. All dosages except 25mg fared well as compared to placebo. Tramadol fared better than placebo at 1 month, 2 months, and 3 months after initiation of therapy as compared to the placebo. Tramadol group had reported a significantly higher number of adverse events with treatment as compared to placebo but none of them were serious.Conclusion:Tramadol appears to be an effective drug for the management of PE with a low propensity for serious adverse events. However, evidence obtained from this study is of low to moderate quality. Furthermore, effective dose and duration of therapy remain elusive.
Highlights
Tramadol has been used for the treatment of premature ejaculation, the studies published for the same are not well designed
Premature ejaculation (PE) is one of the most commonly encountered sexual dysfunction in males. It has been defined by the International society of sexual medicine (ISSM) guidelines as “male sexual dysfunction characterized by ejaculation within about one minute of vaginal penetration or a reduction in latency time to
A total of 512 citations were retrieved into a citation manager. 249 duplicate citations were removed and 263 articles were screened for eligibility
Summary
Tramadol has been used for the treatment of premature ejaculation, the studies published for the same are not well designed. Tramadol group had reported a significantly higher number of adverse events with treatment as compared to placebo but none of them were serious. The treatment of PE varies including behavioral and pharmacological therapies. Various off-label pharmacological treatments for PE include use of local anesthetic sprays, selective serotonin uptake inhibitors (SSRI’s) such as paroxetine [2], dapoxetine [3], citalopram, sertraline, trazodone, fluvoxamine and fluoxetine, tricyclic antidepressants such as clomipramine [4], opioid analgesics such as tramadol. SSRIs and clomipramine have been studied in both daily and on-demand settings and has been proven to be more effective than the placebo or control group [5]. On-demand use of a particular pharmacological agent is more convenient for the patients; it reduces tachyphylaxis and adverse effects associated with daily use [5]
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