588 Comparison of efficacy of electric stimulation and topical EMLA cream in treatment of premature ejaculation: Prospective and comparative study

Mallat, F.; Hmida, Wafa Ben; Hidoussi, A.; Slama, A. Ben; Jaidane, Mehdi; Ben, Sorba N.; Mosbah, A

doi:10.1016/s1569-9056(12)60585-5

Cited by 2 publications

(9 citation statements)

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“…26 Conflicting evidence also exists for TEMPE spray. Evidence from two RCTs 22,27 comparing TEMPE with placebo suggest significant improvements in both sexual satisfaction and ejaculatory control with TEMPE, while anotherRCT suggests no significant difference in sexual quality of life or ejaculatory control.…”

Section: Discussionmentioning

confidence: 99%

“…A statistically significant between-group difference in sexual satisfaction in favour of EMLA cream after 2 months was reported by Busato and Galindo (2004). 19 There appeared to be no difference between EMLA cream and placebo on the International Index of Erectile Dysfunction (IIEF) number of coitus per week and sexual satisfaction values reported by one RCT (Mallat et al 2012). 26 The betweengroup differences on the Index of Ejaculatory Control and Sexual Quality of Life (SQoL) for both men and women were reported as being not statistically significant at 4 weeks in one RCT comparing TEMPE with placebo (Dinsmore et al 2007 23 ).…”

Section: Ielt: Topical Anaesthetics Vs Placebomentioning

confidence: 99%

“…Where reported, the definition of PE was varied and was defined according to: DSM-IV (Diagnostic and Statistical Manual of Mental Disorders) criteria, 19,20,22,23 ISSM (International Society for Sexual Medicine) criteria, 24 an IELT of 2 min or less, 18 1 min or less, 25 or was not reported. 26 The majority of RCTs recruited samples comprising men with lifelong PE and without erectile dysfunction.…”

Section: Characteristics Of Rctsmentioning

confidence: 99%

“…RCTs, 19,20,25,26 whereas three RCT prescribed topical eutectic-like mixture for premature ejaculation (TEMPE) spray containing lidocaine and prilocaine. [22][23][24] One RCT prescribed a lidocaine gel 18 and one a lidocaine spray.…”

Section: A Eutectic Mixture Of Local Anaesthetics Cream Containing LImentioning

confidence: 99%

“…19 There appeared to be no difference between EMLA cream and placebo on the International Index of Erectile Dysfunction (IIEF) number of coitus per week and sexual satisfaction values reported by one RCT (Mallat et al 2012). 26 The betweengroup differences on the Index of Ejaculatory Control and Sexual Quality of Life (SQoL) for both men and women were reported as being not statistically significant at 4 weeks in one RCT comparing TEMPE with placebo (Dinsmore et al 2007 23 ). However, two RCTs reported that the TEMPE spray was significantly more effective than placebo at 12 weeks on the Index of Premature Ejaculation (IPE) measures including ejaculatory control, sexual satisfaction and distress, and on the Premature Ejaculation Profile (PEP) 27 Carson and Wyllie 2010;22 ).…”

Section: Ielt: Topical Anaesthetics Vs Placebomentioning

confidence: 99%

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Topical anaesthetics for premature ejaculation: a systematic review and meta-analysis

Cooper

Kawaguchi

et al. 2016

Sex. Health

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Eutectic Mixture of Local Anaesthetics (EMLA) is recommended for use off-label as a treatment for premature ejaculation (PE). Other topical anaesthetics are available, some of which have been evaluated against oral treatments. The purpose of this systematic review was to evaluate the evidence from randomised controlled trials (RCTs) for topical anaesthetics in the management of PE. Bibliographic databases including MEDLINE were searched to August 2014. The primary outcome was intra-vaginal ejaculatory latency time (IELT).Methodological quality of RCTs was assessed. IELT and other outcomes were pooled across RCTs in a metaanalysis. Between-trial heterogeneity was assessed. Nine RCTs were included. Seven were of unclear methodological quality. Pooled evidence (two RCTs, 43 participants) suggests that EMLA is significantly more effective than placebo at increasing IELT (P < 0.00001). Individual RCT evidence also suggests that Topical Eutectic-like Mixture for Premature Ejaculation (TEMPE) spray and lidocaine gel are both significantly more effective than placebo (P = 0.003; P < 0.00001); and lidocaine gel is significantly more effective than sildenafil or paroxetine (P = 0.01; P = 0.0001). TEMPE spray is associated with significantly more adverse events than placebo (P = 0.003). More systemic adverse events are reported with tramadol, sildenafil and paroxetine than with lidocaine gel. Diverse methods of assessing sexual satisfaction and ejaculatory control with topical anaesthetics are reported and evidence is conflicting. Topical anaesthetics appear more effective than placebo, paroxetine and sildenafil at increasing IELT in men with PE. However, the methodological quality of the existing RCT evidence base is uncertain.Topical anaesthetics were compared with placebo and oral agents for the treatment of premature ejaculation in a systematic review and meta-analysis. Topical anaesthetics are significantly more effective than placebo, sildenafil or paroxetine at increasing intra-vaginal ejaculatory latency time. Topical Eutectic-like Mixture for Premature Ejaculation spray is associated with erectile dysfunction, numbness and burning. More systemic adverse events are reported with tramadol, sildenafil and paroxetine than with lidocaine gel.

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Section: Discussionmentioning

confidence: 99%

Section: Ielt: Topical Anaesthetics Vs Placebomentioning

confidence: 99%

Section: Characteristics Of Rctsmentioning

confidence: 99%

Section: A Eutectic Mixture Of Local Anaesthetics Cream Containing LImentioning

confidence: 99%

Section: Ielt: Topical Anaesthetics Vs Placebomentioning

confidence: 99%

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Topical anaesthetics for premature ejaculation: a systematic review and meta-analysis

Cooper

Kawaguchi

et al. 2016

Sex. Health

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Interventions to treat premature ejaculation: a systematic review short report

Cooper

James

Kaltenthaler

et al. 2015

Health Technology Assessment

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BackgroundPremature ejaculation (PE) is commonly defined as ejaculation with minimal sexual stimulation before, on or shortly after penetration and before the person wishes it. PE can be either lifelong and present since first sexual experiences (primary), or acquired (secondary), beginning later (Godpodinoff ML. Premature ejaculation: clinical subgroups and etiology.J Sex Marital Ther1989;15:130–4). Treatments include behavioural and pharmacological interventions.ObjectiveTo systematically review evidence for clinical effectiveness of behavioural, topical and systemic treatments for PE.Data sourcesThe following databases were searched from inception to 6 August 2013 for published and unpublished research evidence: MEDLINE; EMBASE; Cumulative Index to Nursing and Allied Health Literature; The Cochrane Library including the Cochrane Systematic Reviews Database, Cochrane Controlled Trials Register, Database of Abstracts of Reviews of Effects and theHealth Technology Assessmentdatabase; ISI Web of Science, including Science Citation Index, and the Conference Proceedings Citation Index-Science. The US Food and Drug Administration website and the European Medicines Agency (EMA) website were also searched.MethodsRandomised controlled trials (RCTs) in adult men with PE were eligible (or non-RCTs in the absence of RCTs). RCT data were extrapolated from review articles when available. The primary outcome was intravaginal ejaculatory latency time (IELT). Data were meta-analysed when possible. Other outcomes included sexual satisfaction, control over ejaculation, relationship satisfaction, self-esteem, quality of life, treatment acceptability and adverse events (AEs).ResultsA total of 103 studies (102 RCTs, 65 from reviews) were included. RCTs were available for all interventions except yoga. The following interventions demonstrated significant improvements (p < 0.05) in arithmetic mean difference in IELT compared with placebo:topical anaesthetics– eutectic mixture of local anaesthetics (EMLA®, AstraZeneca), topical eutectic mixture for PE (Plethora Solutions Ltd) spray;selective serotonin reuptake inhibitors(SSRIs) – citalopram (Cipramil®, Lundbeck), escitalopram (Cipralex®, Lundbeck), fluoxetine, paroxetine, sertraline, dapoxetine (Priligy®, Menarini), 30 mg or 60 mg;serotonin–noradrenaline reuptake inhibitors– duloxetine (Cymbalta®, Eli Lilly & Co Ltd);tricyclic antidepressants– inhaled clomipramine 4 mg;phosphodiesterase-5(PDE5)inhibitors– vardenafil (Levitra®, Bayer), tadalafil (Cialis®, Eli Lilly & Co Ltd);opioid analgesics– tramadol (Zydol SR®, Grünenthal). Improvements in sexual satisfaction and other outcomes compared with placebo were evident for SSRIs, PDE5 inhibitors and tramadol. Outcomes for interventions not compared with placebo were as follows:behavioural therapies– improvements over wait list control in IELT and other outcomes, behavioural therapy plus pharmacotherapy better than either therapy alone;alpha blockers– terazosin (Hytrin®, AMCO) not significantly different to antidepressants in ejaculation control;acupuncture– improvements over sham acupuncture in IELT, conflicting results for comparisons with SSRIs;Chinese medicine– improvements over treatment as usual;delay device– improvements in IELT when added to stop–start technique;yoga– improved IELT over baseline, fluoxetine better than yoga. Treatment-related AEs were evident with most pharmacological interventions.LimitationsAlthough data extraction from reviews was optimised when more than one review reported data for the same RCT, the reliability of the data extraction within these reviews cannot be guaranteed by this assessment report.ConclusionsSeveral interventions significantly improved IELT. Many interventions also improved sexual satisfaction and other outcomes. However, assessment of longer-term safety and effectiveness is required to evaluate whether or not initial treatment effects are maintained long term, whether or not dose escalation is required, how soon treatment effects end following treatment cessation and whether or not treatments can be stopped and resumed at a later time. In addition, assessment of the AEs associated with long-term treatment and whether or not different doses have differing AE profiles is required.Study registrationThis study is registered as PROSPERO CRD42013005289.FundingThe National Institute for Health Research Health Technology Assessment programme.

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588 Comparison of efficacy of electric stimulation and topical EMLA cream in treatment of premature ejaculation: Prospective and comparative study

Cited by 2 publications

References 0 publications

Topical anaesthetics for premature ejaculation: a systematic review and meta-analysis

Topical anaesthetics for premature ejaculation: a systematic review and meta-analysis

Interventions to treat premature ejaculation: a systematic review short report

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