New Concepts in the Diagnosis and Treatment of Premature Ejaculation
- 168 Downloads
Premature ejaculation is the most common male sexual dysfunction. The International Society of Sexual Medicine recently defined premature ejaculation as ejaculation less than about 1 min after penetration, inability to control ejaculation, and resulting negative personal consequences. Evolving treatments target the modulation of the neurobiological causes of the disorder. Current pharmaceuticals focus on aerosolized topical agents, selective serotonin reuptake inhibitors, 5-hydroxytryptamine receptor modulators, and opioid agonists. These emerging medications and the ability to tailor treatments based on genetic information likely will change the paradigm of this disorder and how it will be treated by clinicians.
KeywordsPremature ejaculation SSRI PSD 502 Neurotomy Nerve ligation Genetic Topical treatment Phosphodiesterase 5 inhibitor
No potential conflicts of interest related to this article were reported.
Papers of particular interest, published recently, have been highlighted as: •• Of major importance
- 7.•• McMahon CG, Althof SE, Waldinger MD, et al.: An evidence-based definition of lifelong premature ejaculation: report of the International Society of Sexual Medicine (ISSM) ad hoc committee for the definition of premature ejaculation. J Sex Med 2008, 5:1590–1606. We feel that this paper will prove to be a landmark in the field of sexual medicine as the first to definitively characterize the disorder as well as provide leadership for the field. CrossRefPubMedGoogle Scholar
- 16.Masters WH, Johnson VE: Human Sexual Inadequacy. London: Bantam; 1970:463.Google Scholar
- 17.•• Waldinger MD: Premature ejaculation: different pathophysiologies and etiologies determine its treatment. J Sex Marital Ther 2008, 34:1–13. This paper is a major contributor showing us that even though we are moving toward concrete definitions of this disorder, its cause remains complex. The author describes what eventually may be delineated into psychological PE versus organic. CrossRefPubMedGoogle Scholar
- 22.•• Dinsmore WW, Wyllie MG: PSD502 improves ejaculatory latency, control and sexual satisfaction when applied topically 5 min before intercourse in men with premature ejaculation: results of a phase III, multicentre, double-blind, placebo-controlled study. BJU Int 2009, 103:940–949. PSD502, as described in this article, is currently in phase 3 trials. Once approved, it will be the first FDA-approved medication for the sole purpose of treating PE. CrossRefPubMedGoogle Scholar
- 24.Leaker B: A double blind, placebo-controlled, randomized crossover study to investigate the effect of inhaled doses of VR776 on intravaginal ejaculatory latency in patients with premature ejaculation (abstract P-05-048). J Sex Med 2008, 5(Suppl 2):60.Google Scholar
- 28.•• Aversa A, Pili M, Francomano D, et al.: Effects of vardenafil administration on intravaginal ejaculatory latency time in men with lifelong premature ejaculation. Int J Impot Res 2009, 21:221–227. This article has adopted a new role for the PDE5Is, demonstrating favorable results in patients with PE. CrossRefPubMedGoogle Scholar
- 31.Alghobary M, El-Bayoumy Y, Mostafa Y, et al.: Evaluation of tramadol on demand vs. daily paroxetine as a long-term treatment of lifelong premature ejaculation. J Sex Med 2010 Mar 30 (Epub ahead of press).Google Scholar
- 41.Schapiro B: Premature Ejaculation: A review of 1130 cases. J Urol 1943, 50:374–379.Google Scholar