Efficacy of sildenafil as adjuvant therapy to selective serotonin reuptake inhibitor in alleviating premature ejaculation

Chen, Juza; Mabjeesh, Nicola J.; Matzkin, Haim; Greenstein, Alexander

doi:10.1016/s0090-4295(02)02075-7

Cited by 108 publications

(108 citation statements)

References 14 publications

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“…Interestingly, since this study was carried out, three papers have suggested that PDE5 inhibitors may have such a role. [13][14][15] However, we stress again that sildenafil has no place in improving normal erections. We think it unlikely that many authorities would consider its use ethical in healthy men who simply wish to reduce their latency time.…”

Section: Discussionmentioning

confidence: 94%

Sildenafil does not improve sexual function in men without erectile dysfunction but does reduce the postorgasmic refractory time

et al. 2003

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Section: Discussionmentioning

confidence: 94%

Sildenafil does not improve sexual function in men without erectile dysfunction but does reduce the postorgasmic refractory time

et al. 2003

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“…34,42,48,53,54 Potential new treatments for premature ejaculation to be explored are sildenafil and tramadol (SSRI-like effect). 34,42,48,55 However, a valid pharmaceutical option for inducing antegrade ejaculation or treating anejaculation does not exist. Alphamimetic drugs have been tried to treat retrograde ejaculation in these patients, but no evidence of effect exists.…”

Section: Discussionmentioning

confidence: 99%

Neuroanatomy and neurophysiology related to sexual dysfunction in male neurogenic patients with lesions to the spinal cord or peripheral nerves

et al. 2010

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Study design: Review article. Objectives: The neuroanatomy and physiology of psychogenic erection, cholinergic versus adrenergic innervation of emission and the predictability of outcome of vibration and electroejaculation require a review and synthesis. Setting: University Hospital Belgium. Methods: We reviewed the literature with PubMed 1973PubMed -2008. Results: Erection, emission and ejaculation are separate phenomena and have different innervations. It is important to realize, which are the afferents and efferents and where the motor neuron of the end organ is located. When interpreting a specific lesion it is important to understand if postsynaptic fibres are intact or not. Afferents of erection, emission and ejaculation are the pudendal nerve and descending pathways from the brain. Erection is cholinergic and NO-mediated. Emission starts cholinergically (as a secretion) and ends sympathetically (as a contraction). Ejaculation is mainly adrenergic and somatic. For vibratory-evoked ejaculation, the reflex arch must be complete; for electroejaculation, the postsynaptic neurons (paravertebral ganglia) must be intact. Conclusion: Afferents of erection, emission and ejaculation are the pudendal nerve and descending pathways from the brain. Erection is cholinergic and NO-mediated. Emission starts cholinergically (as a secretion) and ends sympathetically (as a contraction). Ejaculation is mainly adrenergic and somatic. In neurogenic disease, a good knowledge of neuroanatomy and physiology makes understanding of sexual dysfunction possible and predictable. The minimal requirement for the success of penile vibration is a preserved reflex arch and the minimal requirement for the success of electroejaculation is the existence of intact post-ganglionic fibres.

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“…Four reports assessed therapy with sildenafil as monotherapy and two as combination therapy with an SSRI. 15 Only three studies yielded encouraging results to support the use of PDE5i in the treatment of patients with LL-PE with or without additional SSRIs. In a randomized, 8-week, double-blind, placebo-controlled multicenter study, McMahon et al 16 assessed the efficacy of 50-100 mg as needed sildenafil in 157 potent men with LL-PE, defined in 75% of intercourse attempts.…”

Section: Discussionmentioning

confidence: 99%

Effects of vardenafil administration on intravaginal ejaculatory latency time in men with lifelong premature ejaculation

et al. 2009

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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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Efficacy of sildenafil as adjuvant therapy to selective serotonin reuptake inhibitor in alleviating premature ejaculation

Cited by 108 publications

References 14 publications

Sildenafil does not improve sexual function in men without erectile dysfunction but does reduce the postorgasmic refractory time

Sildenafil does not improve sexual function in men without erectile dysfunction but does reduce the postorgasmic refractory time

Neuroanatomy and neurophysiology related to sexual dysfunction in male neurogenic patients with lesions to the spinal cord or peripheral nerves

Effects of vardenafil administration on intravaginal ejaculatory latency time in men with lifelong premature ejaculation

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