Comparison of efficacy of sildenafil-only, sildenafil plus topical EMLA cream, and topical EMLA-cream-only in treatment of premature ejaculation

Atan, Ali; Başar, M. Murad; Tuncel, Altuğ; Ferhat, Mehmet; Agras, Koray; Tekdoğan, Ümit Yener

doi:10.1016/j.urology.2005.09.002

Cited by 73 publications

(103 citation statements)

References 22 publications

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“…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%

“…[21][22][23][24] The remainder were undertaken in Brazil,19 Egypt, 18 Tunisia 26 and Turkey. 20,25 Outcome data reported by RCTs…”

Section: A Eutectic Mixture Of Local Anaesthetics Cream Containing LImentioning

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: Characteristics Of Rctsmentioning

confidence: 99%

Section: A Eutectic Mixture Of Local Anaesthetics Cream Containing LImentioning

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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“…Another study of a lidocaine/prilocaine cream found that EMLA cream produced a 65% improvement or cure rate in PE patients. 16 Unfortunately, the patient numbers were small, IELT was not documented and patient selfassessments were the evaluating tools. Also of note is that placebo cream alone produced a 40% rate of cure or improvement.…”

Section: Topical Anesthetic Ointmentsmentioning

confidence: 99%

“…The sildenafil groups did not have any statistically significant improvements over the EMLA only group. 16 Another randomized, double-blind crossover study of 31 patients found that sildenafil was superior to SSRIs and the squeeze technique. IELT was measured with a stopwatch, and improved from 1 min at baseline to 3 or 4 min with SSRIs, and to 15 min with sildenafil.…”

Section: Pde5 Inhibitorsmentioning

confidence: 99%

‘Off-label’ drug use in sexual medicine treatment

Fallon

2007

Int J Impot Res

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Phosphodiesterase type 5 inhibitors are the only drugs approved for a specific sexual function disorder. All other drugs used in the treatment of sexual disorders are used 'off-label.' This paper reviews the use of drugs in the treatment of premature ejaculation, Peyronie's disease and female hypoactive sexual desire disorder (HSDD). While the treatment of premature ejaculation is quite well documented and supported by evidence of good quality in the medical literature, there is little evidence for the use of the variety of medications in use for the treatment of Peyronie's disease. In particular, the use of verapamil is not supported by any double-blind studies whatsoever. The use of testosterone patch for treatment of HSDD in postmenopausal women is well documented, but not in premenopausal women.

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Premature Ejaculation

and¹,

McMahon²

2008

Handbook of Sexual and Gender Identity Disorders

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Comparison of efficacy of sildenafil-only, sildenafil plus topical EMLA cream, and topical EMLA-cream-only in treatment of premature ejaculation

Cited by 73 publications

References 22 publications

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

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

‘Off-label’ drug use in sexual medicine treatment

Premature Ejaculation

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