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Premature ejaculation: do we have effective therapy?

Ege Can Serefoglu1, Theodore R Saitz1, Landon Trost1

  • 11 Tulane University, School of Medicine, Department of Urology, New Orleans, LA, USA ; 2 Medicana International Hospital, Ankara, Turkey.

Translational Andrology and Urology
|January 28, 2016
PubMed
Summary

Premature ejaculation (PE) is a common sexual dysfunction with limited treatment data. Current options include behavioral, topical, and oral therapies, but more research is needed for optimal management.

Keywords:
Premature ejaculationsexual dysfunctiontreatment

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Area of Science:

  • Urology
  • Sexual Medicine
  • Pharmacology

Background:

  • Premature ejaculation (PE) is the most prevalent male sexual dysfunction.
  • A significant number of PE cases remain undiagnosed and undertreated.
  • Limited data exists on treatment options and underlying mechanisms for PE.

Purpose of the Study:

  • To review and summarize existing literature on therapeutic options for PE.
  • To explore various treatment modalities, including behavioral, pharmacologic, and surgical approaches.
  • To identify gaps in knowledge regarding PE pathophysiology and management.

Main Methods:

  • Conducted a PubMed search for articles on PE treatment options and mechanisms.
  • Prioritized randomized controlled trials for review.
  • Included studies detailing potential mechanisms of action for treatments.

Main Results:

  • Behavioral therapies (stop-start, squeeze, pelvic floor) show short-term efficacy.
  • Topical therapies prolong intravaginal ejaculatory latency time (IELT) but may cause hypoesthesia.
  • Oral therapies (SSRIs, PDE5 inhibitors, tramadol) improve IELT with variable side effects.
  • Acupuncture shows promise in limited studies; surgery is not recommended.

Conclusions:

  • PE is common, yet its pathophysiology and optimal treatments are not well-defined.
  • Current treatments include topical, oral, and behavioral therapies.
  • Further research is essential to establish optimal treatment strategies and elucidate PE mechanisms.