Pharmacotherapy of premature ejaculation: a systematic review and network meta-analysis

Jian, Zhongyu; Wei, Xin; Ye, Donghui; Wang, Kunjie

doi:10.1007/s11255-018-1984-9

Cited by 20 publications

(19 citation statements)

References 64 publications

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“…Therefore, we assumed that patients with severe PE who ejaculate within a few seconds might not gain satisfactory results with oral dapoxetine treatment. Similar observations were stated by Waldinger and Schweitzer two successive studies (2008a,2008b) and are also supported by a close figure of 38.5% as a total success rate using oral dapoxetine 60 mg (Jian et al, 2018).…”

Section: Discussionsupporting

confidence: 82%

“…This corresponds to 2.5 and 3 folds increase of IELT, while the administered placebo increased IELT to 1.3 min, or 1.6 folds (McMahon et al, 2011). In their meta‐analysis, JianWei, Ye, Li, and Wang (2018) reported an overall success rate of 30 mg and 60 mg oral dapoxetine of 24.2% and 38.5% respectively with no withdrawal symptoms after its stoppage. The common side effects reported with dapoxetine were nausea, headache and dizziness (Abu El‐Hamd & Abdelhamed, 2018).…”

Section: Introductionmentioning

confidence: 99%

“…Among these formulas are eutectic mixtures of local anaesthetic cream containing lidocaine and prilocaine (Atikeler, Gecit, & Senol, 2002; Busato & Galindo, 2004; Xia et al, 2014), topical eutectic‐like mixture spray containing lidocaine and prilocaine (Carson & Wyllie, 2010; Dinsmore et al, 2007; Dinsmore & Wyllie, 2009), lidocaine gel (Gameel et al, 2013), lidocaine spray (Dell’Atti, Galosi, & Ippolito, 2017; Steggall, Fowler, & Pryce, 2008) and fortacin (Porst & Burri, 2017, 2019). In their meta‐analysis, Jian et al (2018) showed a success rate of 90% of using topical anaesthetics in improving the IELT in PE cases. However, in the available literature, no reachable studies compared the efficacy of oral dapoxetine versus topical anaesthetics on‐demand basis for PE treatment.…”

Section: Introductionmentioning

confidence: 99%

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Oral dapoxetine versus topical lidocaine as on‐demand treatment for lifelong premature ejaculation: A randomised controlled trial

et al. 2020

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This trial aimed to assess the efficacy of on‐demand oral dapoxetine versus topical lidocaine treatments for lifelong PE. Cases with lifelong PE were randomised to start treatment by oral dapoxetine 60 mg or topical lidocaine 10% spray. The intravaginal ejaculatory latency time (ILET), validated Arabic Index for PE (AIPE), Sexual Health Inventory for Men (SHIM) and frequency of intercourse/week were recorded at the baseline and after 12 weeks treatment period of the first medication before two weeks washout period and then crossing over to the other one for another 12 weeks. Results showed that both medications significantly increased both IELT and AIPE scores compared with the baseline being significantly better with topical lidocaine (63.44 s, 179.4 s versus 21.87 s, p < .05). Significant decrease of SHIM score was recorded with lidocaine but not with dapoxetine. Global Efficacy Question for the patient's assessment of the effectiveness of drugs showed that lidocaine was described as being effective by 43 cases and ineffective by 12 cases, oral dapoxetine was described as being effective by 16 cases and ineffective by 39 cases. From these accumulated data, it is concluded that topical lidocaine is more effective on‐demand therapy for lifelong PE compared with oral dapoxetine.

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Section: Discussionsupporting

confidence: 82%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Oral dapoxetine versus topical lidocaine as on‐demand treatment for lifelong premature ejaculation: A randomised controlled trial

et al. 2020

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“…Pharmacological investigations had found that selective serotonin reuptake inhibitors (SSRIs), acting at the brain level, could increase intravaginal ejaculatory latency time (IELT) and had been recognized as an effective treatment for PE (Saitz & Serefoglu, ; Castiglione et al ., ; Jian et al ., ). The medial pre‐optic area, paraventricular hypothalamic nucleus and the lateral hypothalamus were identified as the excitatory cerebrospinal pathways, while the ventral medulla was considered as the inhibitory structure for ejaculation (Clement & Giuliano, ; Xia et al ., ).…”

Section: Introductionmentioning

confidence: 97%

Graph analysis of DTI‐based connectome: decreased local efficiency of subcortical regions in PE patients with high sympathetic activity

Chen

Xiao-hong

et al. 2019

Andrology

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Introduction Hyperactivity of the sympathetic nervous system was considered as one of the factors involved in the pathological mechanisms of premature ejaculation (PE). Sympathetic skin response of the penis (PSSR) was used to evaluate the activity of sympathetic innervations in the penis, which was controlled by the central nervous system (brain). Shorter PSSR was found in PE patients; however, little was known regarding the central neural mechanisms of PE patients with high sympathetic activity. Methods PSSR of PE patients was evaluated, and diffusion tensor images of participants were collected. Graph theoretical analysis was employed to examine the differences of the topological properties of structural brain connectome between PE patients with high sympathetic activity and healthy controls (HCs). Moreover, the relationships between topological characteristics and clinical features in PE patients were also explored. Results Decreased local efficacy was found in the left amygdala, right pallidum and thalamus in the white matter brain networks of PE when compared with HC (survived false discovery rate (FDR) correction). In addition, PE patients showed decreased global efficacy in the left amygdala and right rolandic operculum, supramarginal gyrus, heschl gyrus, inferior temporal gyrus, pallidum and thalamus; however, these results did not survive FDR correction. Finally, the local efficacy of right thalamus had a positive correlation with the premature ejaculation diagnostic tool (PEDT) scores, while the local efficacy of left amygdala was negatively associated with the state score of the state‐trait anxiety inventory (STAI) and penile shaft sensory threshold. Conclusion The results highlighted the abnormal topological properties of structural brain connectome in PE with high sympathetic activity. We also suggested that the clinical features of PE were related to the abnormality of several brain regions involved in the central control of ejaculation and emotion. This study provided new insights into the central neural mechanisms of PE, which might offer biological markers for understanding the physiopathology of PE.

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“…Wang et al reported different results in their study, the efficacy of available SSRIs was uncertain and there was no consensus on the type and dose of these drugs (26). Jian et al showed that topical delayed creams with PDE5is and SSRIs resulted in the highest IELT (27). Recently, in Europe, the delayed spray [lidocaine--prilocaine (Fortacin®)] is considered a real first line treatment for PE because of its unique preparation, making customer friendly and its easy-handling (28).…”

Section: Discussionmentioning

confidence: 99%

Which of available selective serotonin reuptake inhibitors (SSRIs) is more effective in treatment of premature ejaculation? A randomized clinical trial

Siroosbakht

Rezakhaniha

2019

Int. braz j urol.

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Purpose: To compare the effi cacy and safety of available selective serotonin reuptake inhibitors (SSRIs) in order to fi nd the most effective drug with the least number of side effects in treatment of premature ejaculation (PE). Materials and Methods: This study was a randomized clinical trial. Four hundred and eighty patients with PE in the 4 groups referred to Imam Reza hospital Tehran, Iran from July 2018 to February 2019 were enrolled in the study. The patients received sertraline 50mg, fl uoxetine 20mg, paroxetine 20mg and citalopram 20mg, every 12 hours daily. The intravaginal ejaculatory latency time (IELT) before treatment, fourth and eighth weeks after treatment was recorded by the patient's wife with a stopwatch. Results: Mean IELT before, 4 and 8 weeks after treatment in four groups were: sertraline 69.4±54.3, 353.5±190.4, 376.3±143.5; fl uoxetine 75.5±64.3, 255.4±168.2, 314.8±190.4; paroxetine 71.5±69.1, 320.7±198.3, 379.9±154.3; citalopram 90.39±79.3, 279.9±192.1, 282.5±171.1 seconds, respectively. The ejaculation time signifi cantly increased in all groups (p <0.05), but there was no signifi cant difference between the groups (P=0.75). Also, there was no signifi cant difference in drugs side effects between groups (p >0.05). The most common side effects were drowsiness and dyspepsia, which were not severe enough to cause discontinuation of the drug. Conclusions: All available SSRIs were effective and usually had no serious complications. In patients who did not respond to any of these drugs, other SSRI drugs could be used as a salvage therapy.

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Pharmacotherapy of premature ejaculation: a systematic review and network meta-analysis

Cited by 20 publications

References 64 publications

Oral dapoxetine versus topical lidocaine as on‐demand treatment for lifelong premature ejaculation: A randomised controlled trial

Oral dapoxetine versus topical lidocaine as on‐demand treatment for lifelong premature ejaculation: A randomised controlled trial

Graph analysis of DTI‐based connectome: decreased local efficiency of subcortical regions in PE patients with high sympathetic activity

Which of available selective serotonin reuptake inhibitors (SSRIs) is more effective in treatment of premature ejaculation? A randomized clinical trial

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