Treatment Of Premature Ejaculation Research Articles

Promising selective alpha-1 blocker silodosin as a new therapeutic strategy for premature ejaculation and its drug adverse effect: A systematic review and meta-analysis of randomized controlled trials

Introduction and Objectives: Premature ejaculation (PE) occurs in 31% of productive men aged 18-59 years, leading to disappointment and avoidance of sexual relations. The current guideline of treatment for PE is Dapoxetine, which possesses several adverse effects causing the limitation of long-term use. Silodosin, an alpha-1 blocker, has been proposed as a new option for treating PE due to its minimal side effects. Therefore, our study aims to assess the efficacy of silodosin in treating PE.Materials and Methods: This systematic review and meta-analysis was in accordance with Cochrane Handbook guidelines. Comprehensive literature search was conducted in several databases including PubMed, ScienceDirect, and Cochrane Central Register of Controlled Trials. The studies were included if they met the following criteria: (1) Involving premature ejaculation patients; (2) Intervention using silodosin; (3) Comparing placebo or other therapies for PE (4) Outcome includes the Intravaginal Ejaculation Latency Time (IELT) and reported adverse events related to the therapy. Study quality was assessed using Cochrane risk-of-bias criteria. Statistical analysis in this study was performed using Review Manager 5.4 Results: A total of four studies were included in this meta-analysis. Our study showed that patients who received silodosin had a significantly longer IELT compared to control (MD: 132.54, 95% CI 51.51-213.57, p<0.001). However, patient treated with silodosin also possessed significantly higher risk of adverse event for developing reduced semen ejaculation (OR 10.79, 95% CI 3.46 – 33.67, p<0.0001).Conclusion: Silodosin significantly increased IELT. However, it also reduced semen ejaculation as its drug adverse effect. This result supports the clinical use of silodosin as an alternative treatment for premature ejaculation.

Cognitive behavioral therapy combined with selective serotonin reuptake inhibitors for premature ejaculation: A systematic review and meta-analysis.

Premature ejaculation (PE) remains one of the most common male disorders. Many clinical trials have shown that cognitive behavioral therapy (CBT) has significant efficacy in the treatment of PE. The purpose of this article is to review the current evidence regarding the efficacy and safety of CBT combined with selective serotonin reuptake inhibitors (SSRIs) for treating PE. We selected eligible randomized controlled trials (RCTs) from databases including Chinese National Knowledge Infrastructure (CNKI), Wanfang, VIP, China Biology Medicine (CBM), Pubmed, Embase, and Cochrane Library. All data in this paper were analyzed using STATA 17.1 software. Cochrane Evaluator's Manual 5.3 was used to assess the quality of the included literature. Data collection was conducted up until May 2024. Finally, 15 high-quality randomized controlled trials were included, with 1243 patients, 653 experimental groups and 590 control groups. The meta-analysis showed that, compared with SSRIs alone, behavioral therapy combined with SSRIs can significantly prolong the IELT of PE patients, and improve perceived control over ejaculation, Chinese Index of Premature ejaculation-5 (CIPE-5), sexual life satisfaction, and spouses' sexual life satisfaction. Furthermore, there were no significant differences in side effects between the two groups. In addition, the published bias test results showed no significant bias. CBT combined with SSRIs could be a viable alternative for the treatment of PE. Both cognitive and behavioral training or behavioral training alone as a supplement to SSRIs are effective, with no significant increase in adverse reactions.

A Linear and Stereoselective Approach for the Synthesis of Dapoxetine from Benzaldehyde

Abstract: In addition to providing a succinct pathway for the stereoselective synthesis of dapoxetine, a potent SSRI employed in the treatment of premature ejaculation, this study highlights the strategic use of Ellman's sulfinamide as a chiral auxiliary. The key method involves the diastereoselective allylation of (S,E)-N-Benzylidenesulfinamide, resulting in the desired S-configuration critical for the pharmacological activity of dapoxetine. The utilization of readily available benzaldehyde as the starting material and 1-naphthol as a late-stage coupling partner contributes to the economic feasibility of the synthesis. Especially, the linear synthetic approach adopted in this study employs simplified and more efficient protocols for various transformations, culminating in an overall yield of 26%. This research not only presents a practical synthetic route for dapoxetine, but also underscores the importance of cost-effective and streamlined methodologies in drug development processes.

Effectiveness of masturbation Premature ejaculation diagnostic tool in diagnosing premature ejaculation in men without vaginal intercourse over the past six months: an observational study

Background Premature ejaculation (PE) is a common concern for men and their partners, but current diagnostic tools mainly focus on men who have vaginal intercourse. The Masturbation Premature Ejaculation Diagnostic Tool (MPEDT) was created to address this gap, but its effectiveness for men who only engage in self-masturbation has not been studied. This research aimed to determine the frequency of self-reported PE patients who do not have vaginal intercourse and to evaluate the diagnostic accuracy of MPEDT for this group. Method The study involved 446 male patients aged 18 to 40, and 40 non-self-reported-PE and non-vaginal-intercourse healthy males. Participants completed the MPEDT questionnaire and reported their recent six-months sex frequency. Result Among the patients seeking treatment for PE, 21.75% had not engaged in vaginal intercourse in the past six months. Of the PE patients who completed the MPEDT questionnaire (86 patients), 90.7% were diagnosed with masturbatory-PE (MPE). The sensitivity for self-reported MPE and specificity for self-reported non-MPE were 93.02% and 72.5%, respectively. Discussion For patients who have not had vaginal intercourse in the past six months but engage in masturbation and seek treatment for PE, the PEDT may not effectively assess their ejaculatory function. The MPEDT, however, can effectively evaluate their ejaculatory function. This study also emphasizes the need for diagnostic tools tailored to this population.

Exploring the impact of sexual positions on ejaculation: Insights from a survey study by the Andrology Working Group of the Society of Urological Surgery in Turkey.

Sexual position is one of the several aspects that affects ejaculation control, which is essential for sexual pleasure. Still little is known, nevertheless, about the connection between sexual positions and ejaculation duration. To investigate the impact of various sexual positions on the duration of ejaculation and gain a deeper understanding of the elements that influence the ability to control ejaculation. An online survey was carried out on a sample of 1904 heterosexual men between the ages of 18-65 years. Premature ejaculation (PE) diagnostic tool was used to define PE. Demographic, behavioral, and physiological traits that are linked to PE and non-PE groups were collected. The participants listed their preferred sexual positions and the ones they changed to during ejaculating. Also, analyses were performed between male/female active or deep/shallow thrust positions and PE status. Although there were no appreciable variations in age or circumcision between PE and non-PE groups, the age of first sexual experience was associated with PE status. Groups also varied in the number of weekly ejaculations, the duration of the favored ejaculations, and the characteristics of the erection. The most preferred sexual posture was the doggy style regardless of the group. When the non-PE group felt to ejaculate, they preferred to change the position significantly more than the PE group (74%vs 67.2%; p<0.05). However, when participants felt ejaculate, non-PE participants tended to switch to shallow thrusting positions significantly more than PE participants, who preferred deeper positions (27.1%vs. 18%; p<0.05). This study underlines the relevance of considering sexual positions in controlling PE. Modifying positions during sexual intercourse may offer a non-pharmacological therapeutic alternative for improving ejaculation control. Future studies in this field might help to create tailored PE treatment strategies.

197 - Multicentre study on premature ejaculation treatment with pelvic floor muscle rehabilitation: analysis of 5 years follow-up outcomes

197 - Multicentre study on premature ejaculation treatment with pelvic floor muscle rehabilitation: analysis of 5 years follow-up outcomes

The correlation between premature ejaculation and a high incidence of erectile dysfunction and its research progress: a narrative review.

Premature ejaculation (PE) and erectile dysfunction (ED) are two common sexual symptoms of male sexual dysfunction that can strongly affect men's mental health and quality of life, and they often coexist. This aim of this study was to explore the causes and relationships between PE and ED, with a focus on the progression of PE accompanied by high-frequency ED. A deeper understanding of the causes and treatments for PE combined with ED will help improve clinical diagnosis and treatment. We conducted a literature review of the most relevant articles related to the outlined topic in the PubMed, Google Scholar, and Web of Science databases. We did not limit language, covering both English and non-English publications, and include Chinese and English papers published between January 1996 and March 2024. The incidence of PE and ED increases with age. Approximately one-third of patients who complain of ED suffer from PE. Similarly, in a large-scale survey in the Asia-Pacific region, more than 30% of patients with PE reported concurrent ED. Various research findings indicate a strong correlation between PE and ED. Some scholars speculate that there is a vicious cycle between PE and ED. Men who attempt to control ejaculation can reduce the level of arousal, leading to ED, whereas men who try to achieve an erection will attempt to increase the level of arousal, which can lead to PE. This cycle of mutual influence may lead to reciprocal aggravation and persistence of sexual dysfunction in both parties. Although some studies have explored the relationship between PE and ED, the specific determinants and underlying factors have not yet been clarified. There is a close interrelationship between PE and ED, and a vicious cycle may exist between the two. This cycle of mutual influence may lead to the mutual aggravation and persistence of both sexual dysfunctions. However, the specific determining factors and potential factors underlying the correlation between the two have not been clearly identified and require further exploration.

Sexual dysfunctions (SD) and selective serotonin reuptake inhibitors (SSRIs): from preclinical studies to intervention strategies

In the light of existing literature, we reviewed the causes, management and potential therapeutic benefits of SSRI (Selective serotonin reuptake inhibitor) agents regarding sexual functions. (SSRIs) are the most commonly used medications for the treatment of depression, based on their effectiveness and safety profile. Sexual dysfunctions (SD) caused by SSRIs are one of the most important reasons for discontinuation of treatment in both genders. Knowing the intervention strategies in patients who develop SD is pivotal for the proper management of sexual side effects and the treatment adherence of patients. The effects of SSRIs on sexual functions can also be used to treat certain disorders. SSRIs have a high success rate in the treatment of premature ejaculation and their off-label use for this purpose is widely recognized.

Perception of normal and treatment level ejaculatory latency times in men with premature ejaculation

Abstract Background Although the normal intravaginal ejaculation latency time (NIELT) as subjectively perceived by patients with premature ejaculation (PE) and expected IELT (EIELT), which represents the individual’s expectations of what treatment for PE would achieve, are critically influential in the treatment of patients with PE, there is a significant dearth of exploratory research on NIELT and EIELT among patients with PE. Aim To explore the NIELT and EIELT of patients with PE, understand why patients with PE perceive such a long IELT as normal, and identify factors associated with EIELT. Methods We recruited both patients with PE and control subjects, and analyzed the parameters related to IELT using detailed interviews and questionnaires. Outcomes Parameters related to IELT. Results A total of 592 individuals (mean age 29.6 ± 6.2) were included in the study, comprising 466 patients with PE (mean age 28.3 ± 5.4) and 126 non-PE individuals (mean age 34.6 ± 6.5). The actual perceived intravaginal ejaculation latency time (PIELT), referring to the patient’s self-assessed IELT at baseline, as well as NIELT, and EIELT of patients with PE, were 1.0 (1.0 − 2.0), 14.0 (10.0 − 15.0), and 15.0 (10.0 − 20.0), respectively. The control group’s PIELT and EIELT were 15.0 (10.0 − 20.0) and 20.0 (15.0 − 24.3), respectively, showing statistical differences compared with the PIELT and EIELT in the PE group. In the PE group and the control group, 31.5% and 57.9% of individuals, respectively, have an EIELT greater than the average actual normal ejaculatory latency time of 15.0 minutes. Among patients with PE, 51.3% expressed a NIELT &amp;gt;10 minutes, identical to the EIELT in a higher percentage (59.4%). The control group’s EIELT is 5 minutes longer than the PE group’s EIELT. Multivariable linear regression analysis showed that age, marital status, education level, BMI, satisfaction evaluation of PIELT, PEDT score, and IIEF-6 score were not associated with EIELT; only NIELT (beta = 0.817, P &amp;lt; 0.001) and PIELT (beta = 0.056, P = 0.044) were related to EIELT. Clinical implications Sexual health care providers should be aware that patients with PE have excessively high expectations for IELT. Strengths and limitation The first study explores why patients with clinically diagnosed PE perceive long IELT as normal and examines factors associated with EIELT. Further validation is needed in different cultural contexts. Conclusion Patients with PE often have excessively high expectations regarding IELT, primarily due to their insufficient understanding of IELT.

A Review of Studies on the Treatment of Premature Ejaculation with Traditional Chinese Medicine

By combing the literature and analyzing the current status of traditional Chinese medicine (TCM) treatment for premature ejaculation (PE), the strengths and shortcomings of the existing studies were identified. Building upon this assessment, we put forward a prospect for the establishment of TCM-specific strategies for PE, including more targeted and individualized comprehensive diagnosis and treatment approaches for PE, the establishment of a TCM hierarchical management program, and the exploration of the most effective entry points for collaborative treatment of PE using both TCM and Western medicine. Indeed, integrating therapeutical strategies from the two perspectives in a multifaceted and complex symptom such as PE, would enhance the possibility of success, possibly also reducing side effects. Moreover, with the help of well-established and new scientific and technological tools, we can explore the key links and targets in treating PE by TCM. At the same time, the mechanism of TCM treatment for PE could and should be examined in depth to lay the foundation for widespread clinical application. Finally, we suggest conducting multicenter, nationwide standardized clinical studies on treating PE with TCM. These studies should employ high-quality randomized controlled trial designs to obtain robust evidence-based medical data.

Clinical efficacy and safety of hyaluronic acid gel injection in the glans penis for treatment of premature ejaculation: systematic review and meta-analysis.

In recent years, there has been growing interest in the use of hyaluronic acid (HA) for the treatment of premature ejaculation (PE). The efficacy of this treatment is quite controversial. This study intended to evaluate the efficacy and safety of glans penis augmentation with HA gel for PE. This systematic review includes randomized controlled trials (RCTs), primary clinical trials, prospective and retrospective studies, case series, and case reports. Searches in Embase, PubMed, Cochrane, Web of Knowledge, and ClinicalTrials.gov were performed blindly by 2 reviewers. Intravaginal ejaculation latency time (IELT), questionnaires about PE, glans circumference (millimeters), and adverse events. Thirteen studies were included in the evaluation: 4 RCTs, 8 prospective observational studies, and 1 restrospective study. The number of patients who received HA gel on the glans penis was 706. According to the results of 2 placebo-controlled RCTs, HA gel treatment significantly improved IELT at the end of the first month (mean difference [MD], 65.44 seconds). In the first month after the HA gel injection procedure, IELT increased vs before the procedure (MD, 176.18 [95% CI, 146.89-205.48]; P < .001, I2 = 83%). When the IELT values ​​were compared at 6 months after HA gel application, IELT improved vs before the procedure (MD, 143.93 [95% CI, 124.78-163.09]; P < .001, I2 = 82). The glans circumference expanded by approximately 1.5 cm after the procedure (MD, 14.82 mm [95% CI, 12.75-16.90]; P < .001, I2 = 65%). When the side effect profile of other studies was examined, side effects were observed in 91 patients after HA gel injection applied to 598 patients (15.22%). Among these side effects, the most common were pain (n = 46, 7.69%), bulla/nodule formation (n = 25, 4.18%), and ecchymosis (n = 20, 3.34%). While HA shows promise as a therapeutic option for PE, ongoing research is essential to elucidate its clinical utility, mechanisms of action, and comparative efficacy.

Which SSRI is the most effective for treatment of premature ejaculation?

Which SSRI is the most effective for treatment of premature ejaculation?

Evaluation of efficacy and safety of Botulinum toxin-A injection at three deferent sites in treatment of premature ejaculation.

Premature ejaculation (PE) is a common sexual problem, resulting in adverse effects on the quality of life, of both the patient and the partner. The idea of muscular contraction inhibition during the ejection phase of ejaculation by Botulinum toxin-A injection may delay ejaculation. This study was performed to assess the efficacy and safety of Botulinum toxin-A injection in PE treatment. This study included 45 married male patients diagnosed with primary PE. All included patients were injected with 75 units of Dysport equal efficacy of 25 units of Botulinum toxin-A (Botox) into three sites: the root of the penis (Group 1), glans penis (Group 2), and each side of the ischiocavernosus muscle (Group 3). All patients were subjected to an assessment of intravaginal ejaculation latency time (IELT) using a stopwatch and answering the Premature Ejaculation Diagnostic Tool (PEDT) Questionnaire before and after treatment. There was a statistically significant improvement in IELT after treatment in all groups. The most significant improvement was shown in Group 3 (average 108% increase), followed by Group 1 (74%) and Group 2 (40%), respectively. There was a positive correlation between age and the improvement in improved IELT. There was a statistically significant improvement in PEDTq scores in Group 1 and Group 3. Botulinum toxin-A injection into the root of the penis and ischiocavernosus muscle could be recommended in the treatment of premature ejaculation.

The Analysis Study of Efficacy, Effectiveness, and Clinical Risk of Tramadol as Treatment of Premature Ejaculation : A Comprehensive Systematic Review

Background: Premature ejaculation is a common sexual dysfunction affecting 20%-30% of men. Understanding the effectiveness and potential dangers of tramadol in treating premature ejaculation can help develop efficient treatment protocols. Methods: In accordance with the PRISMA 2020 principles, this systematic review focused specifically on comprehensive English literature published from 2013 to 2024. Result: The study examined over 2000 papers from respectable sources such as Science Direct, SagePub, and PubMed. Following the decision to subject eight publications to further scrutiny, a comprehensive examination of the complete body of literature was conducted. Conclusion: Tramadol, an analgesic derived from opioids, effectively suppresses premature ejaculation (PE) and enhances sexual satisfaction during sexual intercourse. Nevertheless, the efficacy and safety of its use in treating PE are still a subject of discussion due to a lack of solid empirical evidence. Additional investigation is required to ascertain the effectiveness of the medication and its possible adverse effects.

The Analysis Study of Efficacy and Safety of Topical Anesthetic Agent for Treatment of Premature Ejaculation: A Comprehensive Systematic Review

Background: Premature ejaculation (PE) affects 20-30% of men globally, with lifelong and acquired types requiring diverse behavioral and pharmacological treatments. This systematic review aims to analyze current evidence on the efficacy and safety of topical anesthetic agent for treatment of premature ejaculation based on literatures of the last 10 years. Methods: The study adhered to PRISMA 2020 standards, examining English literature from 2014 to 2024. PubMed, SagePub, SpringerLink, and Google Scholar were utilized as literature sources. Result: Initially retrieving 360 articles from online databases (PubMed, SagePub, SpringerLink and Google Scholar) six relevant papers were selected after three rounds of screening for full-text analysis. Conclusion: Overall, the evidence suggests that topical anesthetic agents are effective in treating PE. These agents consistently improve IELT and patient satisfaction, with a favorable safety profile. The findings also highlight the importance of individualized treatment approaches, considering patient preferences, sexual habits, and the specific characteristics of PE.

33 - Multicentre study on premature ejaculation treatment with pelvic floor muscle rehabilitation: Analysis of 5 years results

33 - Multicentre study on premature ejaculation treatment with pelvic floor muscle rehabilitation: Analysis of 5 years results

Safūf-i Aslussūs: A time-tested polyherbal formulation for the management of Premature Ejaculation- A comprehensive review

Premature Ejaculation (PE) is the most prevalent male sexual complaint worldwide. The ability to control the timing of ejaculation is very important to get pleasure and to maintain the couple’s sexual health. PE is believed to have a multifactorial etiology which mainly includes psychogenic and biogenic factors. Currently available conventional drugs are based on mere assumptions and their use in PE is considered off-label as they have not been approved by the regulatory bodies. On the other hand, Unani System of Medicine has a holistic approach to the prevention and treatment of diseases and provides a line of treatment for PE which is mainly focused on the internal and external use of specific drugs for the restoration of lost powers, elimination of morbid humor and strengthening of organs, muscles, and nerves. In classical Unani literature, PE/Surʻat-i-Inzāl are described in detail under the heading of Amrāz-i-Bāh. In the series of drug therapy a polyherbal Unani formulation, Safūf-i Aslussūs mentioned in different Unani Pharmacopoeias for the management of PE, and Spermatorrhoea is widely prescribed and recommended for a long time by Unani physicians and it is a time-tested drug. This manuscript is an attempt to summarize scientific studies in support of the claim made by Unani physicians regarding Safūf-i Aslussūs. Keywords: Safoof-i Aslussoos, Surʻat-i-Inzāl, Premature ejaculation, Unani System of Medicine

Comparing the Effectiveness of Tramadol versus Paroxetine in the Treatment of Premature Ejaculation

Objective: To conduct a comparative analysis of the effectiveness of tramadol versus paroxetine in managing premature ejaculation (PE). Methodology: This study employs a randomized, double-blind, parallel-group design conducted at the Urology department of Liaquat University of Medical and Health Sciences Jamshoro, Hyderabad, Pakistan. Participants are adult males aged 18–65 years who report persistent PE were included in the study. Premature ejaculation occurs in men when semen leave the body (ejaculate) sooner or just before penetration. Participants meeting the diagnostic criteria for PE are assigned randomly to either the tramadol group or the paroxetine group. Participants in the tramadol group receive oral tramadol hydrochloride at a dose of 50 mg, taken 1–2 hours before anticipated sexual activity. Participants in the paroxetine group receive oral paroxetine hydrochloride (20mg daily), taken continuously for 8 weeks. The primary outcome measure is the change or delay in intravaginal ejaculatory latency time (IELT). Results: The mean baseline IELT and after treatment IELT in tramadol group was statistically significant (p&lt;0.001), 47.83±5.68 seconds and 141.54±4.04 seconds, respectively. Similarly, the mean baseline IELT and after treatment IELT in the paroxetine group was statistically significant (p&lt;0.001), 47.03±5.48 seconds and 98.67±4.68 seconds, respectively. Conclusion: Tramadol is an effective alternative to paroxetine in treating premature ejaculation, with studies showing it significantly delays ejaculation similar to paroxetine, providing patients more options for managing lifelong PE.

High-intensity interval training (HIIT) and slow breathing interventions alleviate premature ejaculation (PE) symptoms

BackgroundPhysical exercise may alleviate premature ejaculation symptoms, a prevalent male sexual dysfunction linked to a series of negative outcomes for men and their partners. ObjectiveWe investigated the effectiveness of high-intensity interval training (HIIT) and slow breathing interventions on premature ejaculation symptoms and their relation to autonomic activity and attention regulation. MethodChinese adult men (N = 76, M = 21.89, SD = 3.32) with premature ejaculation completed one of the two-week interventions in their homes or as participants in a normal breathing control group; they reported their age, height, weight, physical activity level, premature ejaculation symptoms, and attention regulation. In the HIIT group, 26 participants engaged in a 7-minute HIIT each day. In the slow breathing group, 25 participants performed 7-minute slow breathing exercises per day while the 25 participants in the normal breathing group similarly performed normal breathing exercises. All participants measured their heart rate once before and five times (with one-minute intervals) after the intervention. When participants had penile-vaginal sex with their partners, they measured their heart rate once after ejaculation. ResultsTime × Intervention interaction was significant with lower levels of premature ejaculation symptoms on Days 12, 13, and 14 in the HIIT group (M ± SD = 16.19 ± 3.45, 15.96 ± 3.43, and 15.15 ± 3.62) compared to the normal breathing group (M ± SD = 17.68 ± 3.06, 17.68 ± 3.15, and 17.44 ± 3.25). Higher levels of attention regulation were associated with fewer premature ejaculation symptoms. We also found that a larger increase in heart rate from resting to after sex was associated with fewer premature ejaculation symptoms. ConclusionCompared to the control group, the efficacy of two weeks of HIIT exercise in mitigating PE symptoms suggests its potential as a novel treatment for PE.

New technologies developed for treatment of premature ejaculation.

Premature ejaculation (PE), lifelong and acquired, is the most common male sexual disorder, with serious impacts on the patient and his partner's quality of life, sexual well-being, and psychosocial health. The most popular treatment options are on-demand topical anesthetics and off-label daily or on-demand selective serotonin reuptake inhibitors (SSRIs), followed by behavioral therapy. While SSRI treatments are reportedly safe, they are associated with limited efficacy and provide only a temporary delay in ejaculation latency time. The majority of PE patients are dissatisfied with SSRIs; thus, adherence to on-demand or daily SSRI treatments is low. In this article, we review studies on currently available technologies that are not pharmacological, surgical, cognitive or behavioral therapies. Recent data from studies of newly developed medical devices used in PE treatment are encouraging as they provide drug-free spontaneity during coitus, without severe adverse effects.