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Premature ejaculation (PE) is thought to be the most common male sexual dysfunction; however, the prevalence of lifelong (LL)-PE is relatively low. The aim of this study was to investigate the effects of on-demand vardenafil (10 mg) to modify the intravaginal ejaculatory latency time (IELT) in men with LL-PE without erectile dysfunction. Forty-two men (18-35 years) were enrolled in a 16-week, double-blind, placebo-controlled, cross-over study. Primary end point was the modification from baseline of IELT assessed by stopwatch technique; secondary end points were post-ejaculatory refractory time (PERT) and variations of scores at the Index of Premature Ejaculation questionnaire. The changes in geometric mean IELT were superior after taking vardenafil (0.6±0.3 vs 4.5 ± 1.1 min, Po0.01), compared with placebo (0.7 ± 0.3 vs 0.9 ± 1.0 min, ns). PERT dropped significantly after vardenafil (16.7 ± 2.0 vs 4.3 ± 0.9 min, Po0.001), compared with placebo (15.3±2.2 vs 15.8±2.3 min). Patients who took vardenafil (vs placebo) reported significantly (Po0.01) increased ejaculatory control (6±2 vs 16±2), improved overall sexual satisfaction (7±2 vs 15 ± 1) and distress (4 ± 1 vs 8 ± 1) scores, respectively. Multiple regression analysis (r 2 ¼ 0.86) for IELT by the number of attempts at sexual intercourse showed significant differences between the slopes of lines for placebo and vardenafil (Po0.0001). The most common adverse events for vardenafil (vs placebo) were headache (10 vs 3%), flushing (12 vs 0%) and dyspepsia (10 vs 0%), which tended to disappear over the time. In conclusion, in our study, vardenafil increased IELT and reduced PERT in men with LL-PE. Besides, improvements in confidence, perception of ejaculatory control and overall sexual satisfaction were reported.

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This study evaluated pelvic floor rehabilitation as a possible treatment for premature ejaculation. In this treatment it is assumed that the pelvic muscles are involved in the control of the ejaculatory reflex. The treatment avails itself of a method already used for fecal and urinary incontinence. Eighteen patients with premature ejaculation were recruited. Fifteen (83%) of them had suffered from this disturbance for at least five years. Most of them had experienced other therapies without success. After 15-20 sessions of pelvic floor rehabilitation, 11 (61%) patients were cured and are able to control the ejaculatory reflex; seven (39%) patients had no improvement. All patients were followed for a minimum of 6 months to a maximum of 14 months. This therapy is easy to perform, has no side effects, and can be included among the therapuetic options for patients with premature ejaculation.

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