Pharmacological/dynamic rehabilitative behavioural therapy for premature ejaculation: Results of a pilot study

Premature ejaculation (PE) is a sexual disorder characterised by excessive rapidity of orgasm. It is defined as either primary (60%), present since the onset of sexual activity, or secondary (40%), manifesting later in life. To date, dapoxetine is the only preparation approved for the on-demand treatment of PE. However, side effects, costs associated with the treatment of chronic PE, drug dependence and its variable effectiveness leads to a not insignificant drop-out rate. Dynamic rehabilitative/behavioural therapy may be a viable therapeutic option, working alongside pharmacological treatment, as long as the participation and involvement of both the individual and the couple is optimal.

18 patients were enrolled, aged between 25 and 55 (mean: 40), all with primary PE, free of comorbidities and with their partners involved. Six patients were prescribed 30 mg dapoxetine two hours before sexual relations for 3 months (group A); 6 patients began the dynamic rehabilitative treatment (group B); 6 other couples were assigned to pharmacological treatment in association with dynamic rehabilitative behavioural treatment for 3 months (group C). Division of subjects was carried out by simple randomisation, excluding patients with a short frenulum, phimosis, ED, chronic prostatitis or experiencing results from previous treatment.

Outcomes of treatment were evaluated at the end of the 3 months of treatment and 3 months after discontinuing treatment. In Group A 75% of patients were cured at 3 months and 25% at 6 months. In Group B 25% patients were cured at 3 months and 25% at 6 months. In Group C 75% of patients were cured 3 months and 50% at 6 months. "Cured" means a Premature Ejaculation Diagnostic Tool (PEDT) score reduced from an average of 12 to an average of 6 and Intravaginal Ejaculation Latency Time (IELT) values from < 1 to > 6 minutes.

the integration of pharmacological treatment with dynamic behavioural rehabilitation has the specific aim of optimising and stabilising the results, supporting a more efficient recovery of ejaculatory control. The close involvement of the partner is extremely useful for all results.