The link between penile hypersensitivity and premature ejaculation.

Area of Science:

• Urology
• Sexual Medicine
• Neuroscience

Background:

• Premature ejaculation (PE) is a common sexual dysfunction.
• The International Society of Sexual Medicine (ISSM) provides diagnostic criteria for PE.
• Penile hypersensitivity is a proposed contributing factor to PE, supported by neurophysiological data.

Purpose of the Study:

• To examine the relationship between penile hypersensitivity and premature ejaculation (PE).
• To evaluate the efficacy of PSD502, a topical anesthetic, in treating PE.
• To assess the role of sensory afferents in the ejaculatory reflex.

Main Methods:

• Review of historical neurophysiological data.
• Analysis of data from clinical trials of PSD502, including a double-blind study.
• Utilizing PSD502's local anesthetic properties as an indicator of sensory afferent involvement in ejaculation.

Main Results:

• Published data does not definitively confirm penile hypersensitivity as the sole cause of PE.
• Variability in PE population definitions across studies complicates interpretation.
• PSD502 significantly increased ejaculatory latency and improved control and satisfaction in men with PE compared to placebo.

Conclusions:

• The effectiveness of PSD502 supports the penile hypersensitivity hypothesis for PE.
• PSD502's mechanism, reducing neuronal firing in sensory afferents, suggests hypersensitivity in PE patients.
• Improved ejaculatory function with PSD502, without generalized penile desensitization, points to underlying hypersensitivity.