Can sildenafil treat primary premature ejaculation? A prospective clinical study

Area of Science:

• Urology
• Sexual Medicine
• Pharmacology

Background:

• Previous studies showed sildenafil's efficacy for premature ejaculation (PE).
• These studies overlooked female factors and potential drug interactions with paroxetine.
• This research addresses these limitations by evaluating sildenafil monotherapy for primary PE.

Purpose of the Study:

• To assess the efficacy and safety of sildenafil monotherapy in treating primary premature ejaculation (PE).
• To consider female factors in the treatment of PE.
• To compare sildenafil with paroxetine and the squeeze technique.

Main Methods:

• 180 men with primary PE were randomized into three groups: sildenafil (50 mg), paroxetine (20 mg daily), or squeeze technique.
• Follow-up duration was 6 months, with data collected at baseline, 3 months, and 6 months.
• Outcome measures included intravaginal ejaculatory latency time (IELT), PE grade, intercourse satisfaction, intercourse frequency, and adverse effects.

Main Results:

• All treatment groups showed significant improvements in measured parameters compared to baseline (P = 0.00).
• Sildenafil demonstrated significantly higher efficacy than both paroxetine and the squeeze technique across all parameters (P = 0.00).
• Patient withdrawal rates were lowest with sildenafil (1.7%) compared to paroxetine (18.3%) and squeeze technique (36.7%), with significantly more patients preferring continued sildenafil treatment.

Conclusions:

• Sildenafil is a highly effective and safe monotherapy for treating primary premature ejaculation (PE).
• Sildenafil exhibits superior efficacy compared to paroxetine and the squeeze technique.
• The findings support sildenafil as a primary treatment option for PE, considering its safety and effectiveness.