Arabic Index Of Premature Ejaculation Research Articles

Daily intake of 30 mg duloxetine is effective in decreasing premature ejaculation severity: a prospective randomized placebo-controlled cross over clinical trial

BackgroundPremature ejaculation (PE) is considered to be the most common male sexual disorder affecting 20% to 66% of sexually active men. Most of the patients had already tried on demand dapoxitine with no improvement. We aimed in the current study to assert the efficacy and safety profile of daily intake of 30 mg duloxetine in treating patients with lifelong premature ejaculation (LPE) as well as patients with acquired premature ejaculation (APE).ResultsThe current study showed significant improvement in intravaginal ejaculatory latency time (IELT) after intake of duloxetine. All participants had a median Arabic index of premature ejaculation (AIPE) of 26, median IELT of 180 s, median male sexual quality of life (SQOL) of 43 after being treated with duloxetine (p value < 0.001 for all). While median AIPE after placebo was 19, median IELT after placebo was 60 s and median male SQOL after placebo was 21. Paired comparison of AIPE, IELT (Secs), inter quartile range (IQR) and male SQOL in group (A) patients at baseline and after duloxetine intake showed statistically significant improvement among treated patients (p values < 0.001 for all). Paired comparison of AIPE, IELT (Secs), IQR and male SQOL in group (A) patients at baseline and after placebo treatment showed no significant improvement of male SQOL. Furthermore, AIPE and IELT returned to baseline scores after discontinuation of duloxetine (p values 0.729; 0.892, respectively). Paired comparison of AIPE, IELT (Secs), IQR and male SQOL in group (B) patients at baseline and after placebo treatment showed almost same scores of patients in group (A) who received placebo for 2 months after a 2 month washout period (p values 1.000 for all).Paired comparison of AIPE, IELT (Secs), IQR and male SQOL in group (B) patients at baseline and after duloxetine treatment showed statistically significant improvement among all treated patients (p values < 0.001 for all).ConclusionDuloxetine is an effective drug for treatment of LPE and APE patients. Further, larger studies are needed to compare duloxetine to different known therapeutic modalities for PE to assert it’s efficacy and superiority.

Lifelong Premature Ejaculation and Attention-Deficit Hyperactivity Disorder: A Controlled Study.

In males, one of the most common sexual dysfunction is lifelong premature ejaculation. Sexual dysfunctions, including premature ejaculation, are highly prevalent in adults with attention-deficit hyperactivity disorder. This study aimed to examine the prevalence and symptoms of attention-deficit hyperactivity disorder in patients with lifelong premature ejaculation. In this study, 48 patients diagnosed with lifelong premature ejaculation and 40 controls were included. All patients and controls were asked to fill out Wender-Utah Rating Scale-25 and Adult Attention-Deficit Hyperactivity Disorder Self-Report Scale. Patients also filled out the Arabic Index of Premature Ejaculation and Premature Ejaculation Diagnostic Tool. Totally 20 patients (41.66%) with lifelong premature ejaculation and 2 (5%) controls were diagnosed with attention-deficit hyperactivity disorder. The mean scores of the Wender-Utah Rating Scale-25, Adult Attention-Deficit Hyperactivity Disorder Self-Report Scale, and Adult Attention-Deficit Hyperactivity Disorder Self-Report Scale-hyperactivity-impulsivity subscale were higher in the case group (P = .001, P = .001, and P < .001, respectively). No difference was found between the 2 groups in terms of the Adult Attention-Deficit Hyperactivity Disorder Self-Report Scale-Inattention subtype (P = .492). In the lifelong premature ejaculation group, 13 patients (65%) diagnosed with attention-deficit hyperactivity disorder were found to be attention-deficit hyperactivity disorder-predominantly hyperactivity/impulsivity subtype. The findings of the current study reveal that patients with lifelong premature ejaculation should be assessed carefully in terms of attention-deficit hyperactivity disorder, especially hyperactive and impulsive characteristics, and the relationship between lifelong premature ejaculation and attention-deficit hyperactivity disorder should be examined by further studies with large samples.

Evidence for the Association between Chronotype and Lifelong Premature Ejaculation

Purpose: This study aimed to investigate the relationships between intravaginal ejaculatory latency time (IELT), severity of disease, and chronotype in lifelong premature ejaculation (PE). Materials and Methods: Evaluation was made of 114 males with PE and 103 healthy individuals, and comparisons were made of self-estimated IELT, Arabic Index of Premature Ejaculation (AIPE), Pittsburg Sleep Quality Index (PSQI), and Morningness-Eveningness Questionnaire (MEQ). Results: The frequency of morningness chronotype (78.1%) was significantly higher, and Morningness-Eveningness Questionnaire (MEQ) scores were negatively correlated with both IELT (r = −0.490, p < 0.001) and Arabic Index of Premature Ejaculation (AIPE) scores (r = −0.639, p < 0.001) in the PE group. MEQ scores significantly predicted IELT (t = −2.465, p = 0.015) and AIPE scores (t = −4.003, p = 0.000) in the PE group but not in the control group. Conclusion: It can be asserted that morningness chronotype is more common, and ejaculatory latency time and PE severity are associated with chronotype in males with PE.

Premature ejaculation: An investigative study into assumptions, facts and perceptions of patients from the Middle East (PEAP STUDY)

ABSTRACT Objective: To determine the prevalence of premature ejaculation (PE) in Qatar as a representative of the Middle East region and the population perception of normal ejaculation. Subjects and methods: This study was a cross-sectional, observational, non-interventional, epidemiological study, conducted from February 2012 to February 2013. Randomly selected married males were asked to answer two questionnaires in a direct interview. The first questionnaire assessed the PE complaint, the time between ejaculation and intromission (actual intravaginal ejaculatory latency time [IELT-a]), and the perceived normal average time between intromission and ejaculation (IELT-p). The second questionnaire used was the Arabic Index of Premature Ejaculation (AIPE). Results: A total of 3042 subjects were included. The mean (SD) age was 37.09 (9.1) years. The prevalence of PE in Qatar using the self-report and AIPE score was 38.5% and 36.2%, respectively. The median (interquartile range) IELT-a and IELT-p were 5 (3–13.5) and 15 (5–15) min. In the AIPE-confirmed PE group, and according to the AIPE severity classification, the differences in IELT-a and IELT-p between the severity groups were highly significant, with the duration of both IELT-a and ILET-p being higher in AIPE-No-PE and mild-PE groups (P < 0.001 for both). A negative correlation was found between AIPE score and age in the PE group. Conclusion: The prevalence of PE in Qatar is high. PE prevalence was found to increase with age. The IELT and perception of normal IELT were both correlated with the severity of PE.

New approach to patients with premature ejaculation: Do social cognition and attachment profiles play a role in premature ejaculation?

Premature ejaculation is the most prevalent male sexual dysfunction and causes significant individual and relational distress in subjects. This study aimed to investigate the underlying psychopathologies of premature ejaculation using theory of mind, empathy and attachment parameters and included 91 participants: 46 with lifelong premature ejaculation and 45 without any ejaculatory complaints. Arabic index of premature ejaculation and stopwatch intravaginal ejaculatory latency times were recorded from all subjects in order to evaluate ejaculatory function. We used reading mind in the eyes, empathy quotient and experiences in close relationships-revised tasks to evaluate social cognitive and attachment profiles of the participants. We compared differences between groups in terms of task performances and symptom severity. Premature ejaculation patients showed significantly low levels of theory of mind abilities as well as empathic skills compared to controls. Although groups did not differ significantly in means of attachment avoidance parameters, premature ejaculation patients had significantly higher levels of attachment anxiety parameters. There was no correlation between symptom severity and social cognition and attachment scores in premature ejaculation patients. These results suggest that patients with premature ejaculations may suffer from significant social cognitive deficits and have anxious but not avoidant pattern of attachment. These results may implicate insights in terms of pharmacological and psychotherapeutic treatments of premature ejaculation.

Comparison of the safety and efficacy of the on-demand use of sertraline, dapoxetine, and daily use of sertraline in the treatment of patients with lifelong premature ejaculation: A prospective randomised study.

This study compared the safety and efficacy of the on-demand (OD) use of sertraline (50mg), sertraline (100mg) and dapoxetine (30mg), and the daily use of sertraline (50mg) in the treatment of patients with premature ejaculation (PE). This prospective randomised study involved 120 lifelong PE patients (intravaginal ejaculatory latency time [IELT]: <1min; Arabic Index of Premature Ejaculation [AIPE] score: < 30) without secondary causes of PE, identified between March 2018 and May 2020. Patients were divided into 4 groups (30 patients per group) and treated for 8weeks. Assessments were conducted using the AIPE form as a diagnostic tool. Sertraline (50mg, daily; 196.7±115.5s) and sertraline (100mg, OD; 173.3±97.0s) had similar IELT and AIPE scores. The latter groups had better results in comparison with sertraline (50mg, OD; 100.5±54.4s) and dapoxetine (93.7±53.5s; p<0.01). Sertraline (100mg, OD) had a similar efficacy to that of sertraline (50mg, daily) and was more effective than sertraline (50mg, OD) and dapoxetine (30mg, OD). Sertraline (100mg, OD) can be considered in the treatment of lifelong PE treatment, having tolerable side effects.

Evaluation of Drug Abuse in Patients With Lifelong Premature Ejaculation: A Cross-Sectional Study.

IntroductionMost studies investigate sexual dysfunction in drug abusers; however, there are no data available about the pattern of drug abuse in patients with lifelong premature ejaculation (PE).AimTo assess the pattern of drug abuse in patients with lifelong PE and to evaluate its potential effect on their hormonal profile.MethodsA cross-sectional study included patients with lifelong PE (n = 76) with no prescribed medications for 1 month and age-matched control without PE (n = 48). Participants were evaluated by history, examination, Arabic index of PE, and hormonal profile. A urine sample was screened by dipstick kits for the following drug abuse tramadol, opiate, tetrahydrocannabinol (cannabis), amphetamine, barbiturate, cocaine, and benzodiazepines. Positive results were confirmed with a immunoassay drug analyzer.Main outcome measuresThe outcomes of this study are positive and negative drug abuse and hormonal profile changes.ResultsControl patients and patients with PE showed median (interquartile range) of age 43 (33–46.8) and 38.5 (31–45) years, respectively. Drug abuse testing results showed significantly high positive drug abuse in patients with PE, 26 of 76 (34.2%), in comparison with control, 9 of 48 (19.1%) (P = .05). The most commonly abused drug was tetrahydrocannabinol in control, 3 of 9 (33.3%), and tramadol, 12 of 26 (46.2%), in patients with PE. Control patients and patients with PE with positive drug abuse had significantly higher smoking percent (P < .0001) and higher positive drug abuse history (P < .0001). However, there was no relationship between drug abuse and PE severity, and there were no significant changes in their hormonal profile.ConclusionsDrug abuse is high among patients with lifelong PE in Upper Egypt, with tramadol being the comment drug. Drug abuse is common among smokers. However, no hormonal disturbance could be shown in drug abuse patients. Drug abuse might be considered in the evaluation of patients with PE.Mohammed SA, Abdelhamed A, El Sayed RM. Evaluation of Drug Abuse in Patients With Lifelong Premature Ejaculation: A Cross-Sectional Study. Sex Med 2020;8:608–614.

The impact of transcutaneous posterior tibial nerve stimulation in patients with premature ejaculation

Objectives: Approximately 30-40% of men worldwide are affected by premature ejaculation. Despite much research on this subject, there is still little information about the cause and treatment of premature ejaculation. The aim of this study was to evaluate the therapeutic aspect of transcutaneous posterior tibial nerve stimulation (PTNS) in patients with premature ejaculation. Methods: The study included 60 PE patients, aged 20-50 years, divided into 2 groups as the treatment group (n = 30) and the control group (n = 30). Transcutaneous PTNS was applied to patients in the treatment group for 30 minutes once a week for 12 weeks. In the control group, a stimulation probe was placed on the posterior tibial nerve without giving any stimulation, to provide a placebo effect. The Arabic Index of Premature Ejaculation (AIPE) scale and Intravaginal Ejaculation Latency Time (IELT) measurements were used before and after the procedure. Results: In both groups, the mean IELT duration and AIPE scale scores were statistically significantly increased after the procedure (p &amp;lt; 0.05). The percentage change in the AIPE scale scores after the procedure was found to be higher in the treatment group than in the control group (p = 0.007). Conclusions: The results of the study showed a statistically significant increase in the duration of the time to ejaculation with PTNS, and a significant improvement was obtained in the post-treatment AIPE scale scores. There is a need for further research to achieve more robust results to contribute to premature ejaculation treatment.

Effectiveness and tolerability of lidocaine 5% spray in the treatment of lifelong premature ejaculation patients: a randomized single-blind placebo-controlled clinical trial.

This study aimed to appraise the effectiveness and tolerability of lidocaine 5% spray in the treatment of patients with premature ejaculation (PE). The current study has been designed as a randomized single-blind placebo-controlled clinical trial. It was done on 150 lifelong PE patients with normal erection. They were randomized evenly categorized into two treatment groups. Group 1 (n = 75); was given on demand lidocaine 5% spray for 8 weeks. Group 2 (n = 75); was given placebo in the form on demand alcohol spray for 8 weeks. All medications were applied on the glans penis for 10-20 min, and then cleaned before planned sexual intercourse. Patients were evaluated with the Arabic Index of Premature Ejaculation (AIPE) scores, intravaginal ejaculatory latency times (IELTs), and frequency of sexual intercourse before and after treatments. The mean values of the AIPE scores, IELTs, and sexual intercourse frequency in the lidocaine 5% spray group were statistically significant increased than the group of placebo after treatment (P value 0.0001). The present study deduced that local use of lidocaine 5% spray on glans penis 10-20 min prior to sexual intercourse could significantly improve PE patients, with tolerated local adverse effects.

Effectiveness and safety of fluoxetine for premature ejaculation

Background:Premature ejaculation (PE) is one of the most common male sexual dysfunctions, which can directly harm men's self-esteem and affect the stability of the relationship between husband and wife. To some extent, PE even affects the harmony and stability of society. So, men's health has gained more and more attention. As one of the long-acting selective serotonin reuptake inhibitors (SSRIs), fluoxetine has been proven to be effective in the treatment of PE by many trails. In this study, we aim to evaluate the effectiveness and safety of fluoxetine for PE to provide the newest evidence for clinical use.Methods and analysis:Literature research will be divided into 2 parts: electronic search and manual search. We will search PubMed, EMBASE, The Cochrane Library, the China National Knowledge Infrastructure (CNKI), China Biology Medicine disc (CBMdisc), the China Science and Technology Journal database (VIP), and the Wanfang database online. We will select the eligible studies published up to December 31, 2018. Manual searches mainly retrieve dissertations, ongoing trails, internal reports, and so on. We use intravaginal ejaculatory latency time (IELT) as the primary outcome of PE and we also care about the following indexes: PE Diagnostic Tool (PEDT); Arabic index of PE (AIPE); Index of PE (IPE). In addition, we will carefully observe the patient's adverse reactions during the medication. Two reviewers will read the articles, extract the data information, and assess the risk of bias independently. Data analysis will be used the software such as RevMan V.5.3.5; EndNote X7 and Stata 13.0.Results:This study will provide a high-quality synthesis of current evidence of fluoxetine for PE from several aspects, including IELT, PEDT, AIPE, IPE, and adverse events.Conclusion:This systematic review will provide evidence to assess the effectiveness and safety of fluoxetine in the treatment of PE.Trial registration number:PROSPERO CRD42018109722.

Efficacy and safety of behavioral therapy for premature ejaculation: Protocol for a systematic review.

Background:Premature ejaculation (PE) is the one of the most prevalent male sexual dysfunction, there has not been specific medicine or therapy for the disease. As an effective treatment for premature ejaculation is a behavioral therapy and is widely used worldwide. The purpose of this study is to evaluate the efficacy and safety of behavioral therapy in patients who suffer from PE.Method:We will search all randomized controlled trials (RCTs) from the following electronic databases, by September 30, 2018, such as PubMed, EMBASE, the Cochrane Library, Web of Science database, China Biology Medicine disc (CBM), China National Knowledge Infrastructure (CNKI), China Science and Technology Journal database (VIP), and Wanfang Database. We will also collect clinical trial registries, dissertations, grey literature, reference lists of studies, systematic reviews, and conference abstracts. The primary outcomes include the Intravaginal Ejaculatory Latency Time (IELT). Besides, Premature Ejaculation Diagnostic Tool (PEDT), Arabic index of Premature Ejaculation (AIPE), Index of Premature Ejaculation (IPE) will be the secondary outcomes. Two people will review these articles, extract the data information, and assess the quality of studies separately. RevMan (version 5.3) and EndNote X7 will be used for meta-analysis.Results:This study will generate a comprehensive review of current evidence of behavioral therapy for premature ejaculation.Conclusion:The study will provide updated evidence to evaluate the efficacy and safety of behavioral therapy for premature ejaculation.Ethics and dissemination:It is not necessary for this systematic review to acquire an ethical approval. This review will be reported in a peer-reviewed journal.PROSPERO registration number:PROSPERO CRD42018111339.

Effect of premature ejaculation on depression and sexual functions in female partners: A report from Eastern Turkey.

Premature ejaculation (PE) is a sexual dysfunction causing female sexual dissatisfaction that eventually leads to poor quality of life in both partners. To show the presence of depression, anxiety, sexual function disorders and their prevalence in spouses of males with PE living in Eastern Turkey. Ninety male patients suffering from PE who referred to the andrology clinic between January 2016 and March 2017 and diagnosed with PE (Acquired Premature ejaculation) according to the DSM-IV criteria and their partners were included in the study. Male patients answered the PE Profile, Arabic Index of PE, PE Diagnostic Tool, and Arizona Sexual Experiences Scale (ASEX) Questionnaires. Spouses of male patients with PE answered the Arizona Sexual Experiences Scale, Beck Depression Inventory, and Beck Anxiety Inventory Questionnaires. SPSS software version 21.0 was used for statistical analysis. Our study revealed a positive correlation between the PE profile and partners' depression levels (P = 0.03). Also, the average ASEX Scale score of the both genders suggest that patients and partners believe they did not have a severe sexual function disorder. PE can cause psychological problems in both males and females. However, reflection of this pathology can vary from one society to another.

Acupuncture for premature ejaculation: Protocol for a systematic review.

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.

Causative Relationship Between Drug Abuse And Sexual Dysfunction in Males

Objectives: Most studies investigate sexual dysfunction in drug abusers. However, no data is available about drug abuse in patients with sexual dysfunction especially in Upper Egypt. Therefore, this study aims to assess the pattern of drug abuse in patients with sexual dysfunction, and its potential impact on hormonal profile. Material and Methods: The study included 100 male patients with history of sexual dysfunction for at least 6 months. Initial evaluation with history, general & local examinations were done. Sexual dysfunction was evaluated with the Arabic version of Sexual health inventory for men (SHIM), Erection hardness score (EHS), and the Arabic Index of Premature Ejaculation (AIPE). Morning blood sample was used for assessment of Total Testosterone (TT), Luteinizing Hormone (LH), and Follicle Stimulating Hormone (FSH). Urine sample was screened by (ABON™ Multi-Drug) dipstick kits for the following drug abuse tramadol, opiate, THC (Cannabis), amphetamine, barbiturate, cocaine and benzodiazepines. Positive results were confirmed by the Immunoassay drug analyzer through the use of specific antibodies. Results: Patients' characteristics showed age 39 (31-45) years with 52% were smoker. Sexual dysfunction complaints included PE (76%), ED (57%), and combined (43%), with average duration of 11 (8-18) months. Patients' hormonal profile showed TT 6.3 (2.67-7.55) ng/ml, FSH 3.5(1.86-5.01) mIU/ml, and LH 3.1(2.1-5) mIU/ml. SHIM, EHS, and AIPE were 15 (12-19), 3 (2-3), and 19(16-24) respectively. Urine screening was positive in 39 % (39/100). Confirmation by drug analyzer revealed 4 patients were false positive. Therefore, the final result for drug abuse was 35% (35/100); with the most common drug was tramadol 19% (19/100) followed by THC (Cannabis) 12% (12/100). Patients with positive drug abuse had significantly higher smoking percent (p=<0.0001), higher driver occupation (p=0.018), and higher positive drug abuse history (p=<0.0001). There were no significant changes in both the sexual dysfunction severity and hormonal profile between positive and negative drug abuse groups. Through binary logistic regression, both smoking (OR=22.39, 95% CI: 4.20- 119.19, p=<0.0001), and history of drug abuse (OR=20.26, 95% CI: 5.21- 78.76, p=<0.0001) are significantly independent predictors for positive drug abuse test. Conclusions: Drug abuse is prevalent among Egyptian male patients with sexual dysfunction, especially tramadol. The drug abuse is common among smoker, and driver occupation. However, no hormonal disturbance could be shown in drug abuse patients. More patient awareness and legal regulations should be considered to reduce drug abuse in Egypt.

593 Evaluation of drug abuse in male patients with sexual dysfunction in Upper Egypt: a cross sectional study

Most studies investigate sexual dysfunction in drug abusers. However, no data is available about drug abuse in patients with sexual dysfunction in Upper Egypt. Therefore, this study aims to assess the pattern of drug abuse in patients with sexual dysfunction, and its potential hormonal impact. The study included 50 male patients with history of sexual dysfunction for at least 6 months. Initial evaluation with history, general & local examinations were done. Sexual dysfunction was evaluated with the Arabic version of Sexual health inventory for men (SHIM), Erection hardness score (EHS), and the Arabic Index of Premature Ejaculation (AIPE). Morning blood sample was used for assessment of Total Testosterone (TT), LH, and FSH. Urine sample was screened by (ABON™ Multi-Drug) dipstick kits for the following drug abuse tramadol, opiate, THC (Marijuana), amphetamine, barbiturate, cocaine and benzodiazepines. Positive results were confirmed by drug analyzer (CDX90) (Thermo fisher scientific co, Supplier AMG Company).

Efficacy and safety of daily use of tadalafil in treatment of patients with premature ejaculation: A randomised placebo‐controlled clinical trial

The study aimed to evaluate the efficacy and safety of the once-daily use of 5mg tadalafil in the treatment of patients with premature ejaculation (PE). In a single-blind placebo-controlled clinical study, it was carried out on 100 patients with PE. All patients were randomised equally divided into two groups (50 patients each). Group 1 was given placebo in the form of oral multivitamin tablet once a day for 6weeks. Group 2 was given 5mg tadalafil once a day for 6weeks. All patients were asked to complete Arabic Index of Premature Ejaculation (AIPE) before and after the treatment. This study showed that there were no statistically significant differences between patients in the placebo and tadalafil groups regarding the mean values of the seven questions and total scores of the AIPE questionnaire before treatment (p value >.05). The mean values of the seven questions and total scores of AIPE questionnaire in the tadalafil group were significantly higher than the placebo group after treatment (p value=.001). This study concluded that once-daily use of 5mg tadalafil for 6weeks was effective and well tolerated in the treatment of patients with PE.

Premature ejaculation in type II diabetes mellitus patients: association with glycemic control.

BackgroundPremature ejaculation (PE) is a highly prevalent sexual dysfunction among patients with diabetes mellitus (DM). Despite this, the underlying mechanism of this association is poorly understood. In this study, we aimed to investigate the prevalence of PE in a group of patients with DM and explore possible associations linking both conditions together.MethodsThis was a prospective study of subjects recruited with advertisement pamphlets and whose sexual function was assessed using the international index of erectile function-5 (IIEF-5) and the Arabic index of premature ejaculation (AIPE) questionnaires together with stopwatch measured intravaginal ejaculatory latency time (ELT). Participants were divided into two groups; group A subjects had DM and group B were healthy adult males.ResultsA total of 488 subjects were recruited. Group A included 199 (40.8%) subjects, while group B included 289 (59.2%). The prevalence of PE and ED was significantly higher in group A subjects (P<0.001). Mean ELT ± standard deviation (SD) was 3.6±2.7 in group A versus 4.3±2.8 in group B (P<0.014). Diabetic patients with erectile dysfunction (ED) showed a significantly higher incidence of PE with significantly shorter ELT.ConclusionsPE is more prevalent in diabetic patients. DM is a multi-systemic disorder with complications that could help explain the pathophysiology of PE.

Evaluation of dapoxetine hydrochloride in treatment of primary premature ejaculation

Objective: The aim of the study was to evaluate the role of dapoxetine in treatment of primary premature ejaculation (PE). Background: PE is regarded as the most common male sexual disorder. To date, there is no accurate and objective diagnostic test or specific treatment for PE. Dapoxetine hydrochloride is recently developed for treatment of primary PE. It is a short-acting selective serotonin reuptake inhibitor. Although it was refused by the food and drug administration (FDA) in 2005, it is now available in many countries, including Egypt, for treatment of PE. Its efficacy and side effects are not fully studied and few studies exist in this regard with controversial results. Materials and methods: This was a double-blind, placebo-controlled, cross-over study. It included 24 patients with primary PE, selected according to the International Society of Sexual Medicine definition of primary PE with intravaginal ejaculatory latency time (IELT) less than 1 min. The patients received dapoxetine 60 mg and placebo for 6 weeks, each with 2 weeks in between as a washout period. The drug and placebo were received on demand 1–3 h before the sexual activity. Efficacy and tolerability were evaluated by IELT and Arabic index of premature ejaculation (AIPE) mean score changes, and the side effects were reported upon at baseline and at 1, 3, and 6 weeks. Results: Dapoxetine significantly increased IELT by first, third, and sixth week and the geometric mean by 5.15 ± 0.17 folds, and with dapoxetine (60 mg) the AIPE became normal in 88.9% of patients by the sixth week, whereas placebo failed to give any change. Conclusion: Dapoxetine is a promise drug for PE as on-demand treatment. Dapoxetine significantly improved the IELT and AIPE, and it is well tolerated.

The Comparison of Premature Ejaculation Assessment Questionnaires and Their Sensitivity for the Four Premature Ejaculation Syndromes: Results from the Turkish Society of Andrology Sexual Health Survey

In addition to the previously defined "lifelong" and "acquired" premature ejaculation (PE), the existence of two more subtypes of PE, namely "natural variable PE" and "premature-like ejaculatory dysfunction," has been proposed. To evaluate the diagnostic value of the Premature Ejaculation Diagnostic Tool (PEDT) and Arabic Index of Premature Ejaculation (AIPE) in a population-based study, in relation to their sensitivity across these four different PE syndromes and to assess the Premature Ejaculation Profile (PEP) scores of patients with lifelong, acquired, natural variable PE and premature-like ejaculatory dysfunction. Between June 2009 and December 2009, couples were randomly selected from 17 provinces of Turkey. Subjects with the complaint of ejaculating prematurely were classified as lifelong, acquired, natural variable PE, and premature-like ejaculatory dysfunction according to the medical and sexual history they described. PE status was also assessed with PEDT, AIPE and PEP. The sensitivity, specificity, positive predictive value and negative predictive value were calculated for PEDT and AIPE in the study population whereas detection rates of these two questionnaires were also compared among the four PE syndromes. Moreover, PEP scores of patients with lifelong, acquired, natural variable PE and premature-like ejaculatory dysfunction were compared. Significance level was considered as P < 0.05. Scores obtained from PEDT, AIPE, and PEP questionnaires. A total of 2,593 couples were enrolled where 512 (20.0%) male subjects reported PE. PEDT, AIPE, and PEP measures of the PE patients indicated worse sexual function (P < 0.001 each). Mean scores obtained from questionnaires were significantly better in patients with premature-like ejaculatory dysfunction and they were the worst in patients with acquired PE (P < 0.001 each). The sensitivity values of PEDT and AIPE were 89.3 and 89.5, whereas their specificity values were 50.5 and 39.1, respectively. There were statistically significant differences in detection rates of PEDT and AIPE among the four PE syndromes (P = 0.006 and P < 0.001). They were higher in acquired and lifelong PE and lower in premature-like ejaculatory dysfunction. PEDT and AIPE can diagnose PE with high sensitivity, especially in patients with lifelong and acquired PE. The complaint of patients with acquired PE seems to be more severe than those complaining of lifelong, natural variable PE and premature-like ejaculatory dysfunction patients.

Evaluation of Tramadol on Demand Vs. Daily Paroxetine as a Long-Term Treatment of Lifelong Premature Ejaculation

Premature ejaculation (PE) is the most common male sexual dysfunction with many lines of treatment that show conflicting results. Paroxetine and tramadol were both reported to be effective in treatment of PE. To investigate the effectiveness of long-term daily paroxetine vs. on-demand tramadol HCl in treatment of PE. Intravaginal ejaculatory latency time (IELT) and Arabic Index of PE (AIPE) were used to assess the efficacy of investigated drugs. Thirty-five cases with lifelong PE were enrolled in this study. Baseline recording of IELT using a stop watch and AIPE was done. Patients were randomized to take tramadol HCl on-demand or daily paroxetine. Reassessment was done after 6 and 12 weeks. A wash-out period for 2 weeks was given before cross-over to the other medication. Assessment of the effect of the second medication after 6 and 12 weeks was done. Tramadol and paroxetine increased IELT significantly after 6 weeks by seven- and 11-folds, respectively, compared with baseline. After 12 weeks, a decline of IELT to fivefolds was recorded with tramadol whereas further increase of IELT to 22-folds was recorded with paroxetine compared with baseline (P < 0.05). Tramadol improved AIPE score significantly after 6 weeks but not after 12 weeks vs. baseline, whereas paroxetine increased the AIPE score after 6 and 12 weeks vs. baseline (P < 0.05). Daily paroxetine is more effective than on-demand tramadol for treatment of lifelong PE. Tramadol is not recommended as a long-term treatment of lifelong PE.