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Disorders of Ejaculation: An AUA/SMSNA Guideline
Alan W Shindel1, Stanley E Althof2, Serge Carrier3
1University of California San Francisco, San Francisco, California.
The Journal of Urology
|December 28, 2021
Summary
Premature ejaculation (PE) and delayed ejaculation (DE) affect many men, causing distress. Management involves investigation, education, and shared decision-making for optimal outcomes, with off-label pharmacotherapy options available.
Area of Science:
- Urology
- Sexual Health
- Evidence-Based Medicine
Background:
- Premature ejaculation (PE) and delayed ejaculation (DE) are common conditions causing significant distress and dissatisfaction.
- Clinicians play a vital role in investigating, educating, and treating these ejaculatory disorders.
Purpose of the Study:
- To provide a comprehensive overview of premature ejaculation and delayed ejaculation management.
- To inform clinical practice with evidence-based recommendations for ejaculatory disorders.
Main Methods:
- A systematic review of medical literature was conducted.
- Searches included MEDLINE, Cochrane Central Register, and Cochrane Database of Systematic Reviews.
- 223 systematic reviews and individual studies were initially selected, with 8 systematic reviews and 59 individual studies meeting inclusion criteria.
Main Results:
- Various psychological, behavioral, and pharmacotherapy treatments are available for PE and DE.
- No pharmacotherapy options are FDA-approved for PE or DE; their use is off-label.
Conclusions:
- Ejaculatory timing disturbances significantly impact sexual enjoyment for men and their partners.
- Shared decision-making, involving partners when possible, is recommended for optimizing treatment outcomes.
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