Aua Guideline on the Pharmacologic Management of Premature Ejaculation

Montague, Drogo K.; Jarow, Jonathan P.; Broderick, Gregory A.; Dmochowski, Roger R.; Heaton, Jeremy P.W.; Lue, Tom F.; Nehra, Ajay; Sharlip, Ira D.

doi:10.1097/01.ju.0000132159.61156.ea

Cited by 267 publications

(261 citation statements)

References 22 publications

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“…This is compatible with the reports about PE being the most common sexual dysfunction in men. [30][31][32] In this study, educational level was significantly lower in patients with AS. The educational status might be an indirect forecaster of PE in this study because there has been some evidence suggesting a negative correlation between the level of education and PE.…”

Section: Discussionmentioning

confidence: 81%

Sexual function in male patients with ankylosing spondylitis

et al. 2011

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Section: Discussionmentioning

confidence: 81%

Sexual function in male patients with ankylosing spondylitis

et al. 2011

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“…This is, in part, due to the lack of knowledge about PE, the absence of performing a careful history, and the nonexistence of diagnostic tools for PE. 23 The diagnostic criterion for many authors is the time between penetration and ejaculation, and this time is agreed to be 1 min. 24 Rowland et al 4 suggested that an IELT of 2 min or less may serve as an adequately sensitive criterion for defining PE.…”

Section: Discussionmentioning

confidence: 99%

“…According to the US FDA, the rate of addiction was low and mostly reported in patients with a prior history of substance abuse. 49,50 Although the mechanism by which tramadol delays ejaculation has not been elucidated, numerous laboratory studies have shown that tramadol acts as a mild m-opioid agonist, 23 N-methyl-D-aspartate receptor antagonist. 53 5-hydroxytryptamine type 2C receptor antagonist, 54 5-nicotinic acetylcholine receptor antagonist, 55 M1 and M3 muscarinic acetylcholine receptor antagonist, 56 and a serotonin and norepinephrine modulator.…”

Section: Discussionmentioning

confidence: 99%

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Safety and efficacy of tramadol hydrochloride on treatment of premature ejaculation

Eassa¹,

El-Shazly²

2012

Asian J Androl

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Premature ejaculation (PE) is the most common sexual disorder. It affects 20%-30% of adult men; the aetiology of this condition has not yet been elucidated. The aim of this study is to evaluate the efficacy, safety, tolerability, undesirable effects and improved satisfaction with sexual intercourse with tramadol hydrochloride at different dosages for the treatment of PE. A total of 300 patients who presented with lifelong (primary) PE were included in this study. The study was performed for 28 weeks, in which placebo (starch tablet) was given for 4 weeks, and active ingredient (tramadol hydrochloride) was administered at different therapeutic dosages for 24 weeks. Patients were divided into three equal groups, each consisting of 100 patients. The first group (A) was given tramadol hydrochloride capsule 25 mg. The second group (B) was given tramadol hydrochloride capsule 50 mg. The third group (C) was given tramadol hydrochloride capsule 100 mg. All of the 300 participants included completed the study voluntarily. The age of the patients varied from 25 to 50 years. After the treatment period, the recorded data were collected for each group and analysed. The results showed a highly significant increase in the mean intravaginal ejaculatory latency time (IELT) in all groups compared to baseline data (P,0.0001). We concluded that using tramadol hydrochloride at different doses on demand for the treatment of PE is effective, safe and tolerable, with minimal undesirable effects, and approval for this indication should be sought.

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“…Other SSRIs, specifically fluvoxamine 28 and venlafaxine, 29 have not proven useful for delaying ejaculation. Although none of these agents has been approved for treating PE, the current American Urological Association guidelines 30 and the recommendations of the International Consultation on Sexual Dysfunction 31 suggest the off-label use of SSRIs for managing PE.…”

Section: Antidepressive Agentsmentioning

confidence: 99%

Current therapeutic strategies for premature ejaculation and future perspectives

Xin¹,

Zhu²,

Yuan³

et al. 2011

Asian J Androl

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Premature ejaculation (PE) is a common sexual disorder in men that is mediated by disturbances in the peripheral and central nervous systems. Although all pharmaceutical treatments for PE are currently used 'off-label', some novel oral agents and some newer methods of drug administration now provide important relief to PE patients. However, the aetiology of this condition has still not been unified, primarily because of the lack of a standard animal model for basic research and the absence of a widely accepted definition and assessment tool for evidence-based clinical studies in patients with PE. In this review, we focus on the current therapeutic strategies and future treatment perspectives for PE. Ejaculation is a tightly coordinated activity with different ejaculatory organs and a spinal reflex initiated by genital and/or brain stimulation through the peripheral sensory receptors and regions, afferent pathways, the central nervous system ejaculatory centre of the brain (namely, sensory and motor areas located in the para-ventricular nucleus of the hypothalamus and the medial preoptic area). The spinal ejaculatory centre, located at the T 12 -L 1-2 spinal cord level (paragigantocellular), and its efferent pathway modulate the function of the ejaculatory organs. Ejaculation is also mediated by a complex interaction of central serotonergic and dopaminergic neurons with the secondary involvement of cholinergic, adrenergic, oxytocinergic and GABAergic neurons.Ejaculation consists of two main phases, the emission phase and the expulsion phase. The emissions include seminal fluid and secretions of the prostate and bulbourethral glands. In this phase, the contraction of accessory ejaculatory organs induces the accumulation of semen in the posterior urethra. Expansion of the posterior urethra creates a feeling of emission and sensory information that is transmitted to the spine via dorsal nerve sensory pathway and along the spinal cord up to the brain ejaculatory centre during the sexual arousal phase. The expulsion phase consists of the highly regular rhythmic contraction of striated muscles and the relaxation of smooth muscles in the ejaculatory ducts. The ejaculated semen can be divided into a number of components by serial biochemical analysis. 1 These include secretions from the seminal vesicles, prostate and bulbourethral (Cowper's) glands and spermatozoa.

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Aua Guideline on the Pharmacologic Management of Premature Ejaculation

Cited by 267 publications

References 22 publications

Sexual function in male patients with ankylosing spondylitis

Sexual function in male patients with ankylosing spondylitis

Safety and efficacy of tramadol hydrochloride on treatment of premature ejaculation

Current therapeutic strategies for premature ejaculation and future perspectives

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