[Recommendations for the treatment of premature ejaculation]

Area of Science:

• Sexology
• Urology
• Psychiatry

Background:

• Premature ejaculation (PE) is a common male sexual dysfunction.
• Current management strategies lack standardized, evidence-based guidelines in France.
• The Post-University Interdisciplinary Association of Sexology (AIUS) convened experts to address this gap.

Approach:

• A systematic literature review was conducted from January 1995 to February 2022.
• The clinical practice guidelines (CPR) methodology was employed.
• Recommendations were developed for the comprehensive management of PE.

Key Points:

• Psychosexological counseling and partner involvement are recommended for all PE patients.
• First-line pharmacotherapy includes on-demand oral dapoxetine for primary and acquired PE.
• Topical lidocaine/prilocaine spray is recommended for primary PE; combination therapy or off-label SSRIs (e.g., paroxetine) may be considered for refractory cases.
• Erectile dysfunction (ED) should be treated before PE.
• Certain treatments like alpha-1 blockers, tramadol, posthectomy, and frenulum surgery are not recommended for PE.

Conclusions:

• These French guidelines provide a structured approach to PE management.
• Implementation is expected to enhance treatment outcomes and patient quality of life.
• The recommendations emphasize a multimodal and individualized treatment strategy.