The use of phenoxybenzamine treatment in premature ejaculation

Shilon, Michael; Paz, Gedalia; Homonnai, Z. T.

doi:10.1016/s0015-0282(16)48157-4

Cited by 40 publications

(19 citation statements)

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“…These reports comprised the use of anesthetic ointments, 12,26,27,[29][30][31][32][33][34][35][36][37] neuroleptics, 20,22,[38][39][40][41][42] monoamine-oxidase inhibitors, 16,43 sympatholytic drugs, 18,19,[44][45][46] antibiotics, 47,48 and a group of miscellaneous agents 13,14,21,[49][50][51] (Table 1). Between 1973 and 2003, there have been 35 studies 15,17,23-25,60-79,80,81 on daily treatment with clomipramine, a tricyclic antidepressant, and on SSRIs (Table 2).…”

Section: General Results Of Reviewmentioning

confidence: 99%

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Relevance of methodological design for the interpretation of efficacy of drug treatment of premature ejaculation: a systematic review and meta-analysis

et al. 2004

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The aim of this systematic review and meta-analysis is to evaluate whether the design and methodology of drug-treatment studies of premature ejaculation affect the efficacy outcome differently. Therefore, methodological, design and efficacy data from 79 studies (3034 males), published between 1943 and 2003, are reviewed. A meta-analysis is performed on 43 selective serotonin reuptake inhibitors (SSRIs) and clomipramine studies (1514 males), published between 1973 and 2003; these studies were pooled to provide a summary variance-weighted effect size. The antidepressant-induced percentage increase of the intravaginal ejaculation latency time (IELT) was calculated and examined against various methodological items. A significant difference in efficacy between SSRIs was observed. Using daily treatment, paroxetine appeared more effective than the other SSRIs. Retrospective use of a questionnaire, subjective reports, single-blind and open study designs generate far greater variability of ejaculation time both at baseline and during active drug treatment than real time assessment by stopwatch. In conclusion, at daily treatment, the overall efficacy of paroxetine, clomipramine, sertraline and fluoxetine is comparable, but paroxetine exerts the strongest ejaculation delay. Only eight (18.5%) studies on antidepressant treatment fulfilled all criteria used in evidence-based medicine, for example, randomised, double-blind studies with prospective real time (stopwatch) assessment of the IELT at each intercourse. Single-blind studies, open designs, retrospective reporting, or the use of a questionnaire to assess ejaculation time should be avoided.

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Section: General Results Of Reviewmentioning

confidence: 99%

“…Six studies used the DSM classification. With the exception of six publications, 29,90,44,20,21,72 all studies that mentioned a definition of premature ejaculation used the ejaculation time as outcome measure.…”

Section: Operational Definitionmentioning

confidence: 99%

Relevance of methodological design for the interpretation of efficacy of drug treatment of premature ejaculation: a systematic review and meta-analysis

et al. 2004

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“…injection of vasoactive drugs (to be considered as the last resort) [4]; lorazépam [5]; propranolol [6]; clomipramine [7]; phenoxibenzamine [8], and metoclopramide [9]. These drugs can be divided into three groups; (a) drugs causing a persistent erection thus overcoming ejaculationinduced detumescence (intracavemous injectable drugs); (b) drugs acting on the central nervous system (i.e.…”

Section: Introductionmentioning

confidence: 99%

“…phenoxybenzamine, propranolol). With the sole exception of clomipramine and phenoxybenzamine, which proved ac tive in approximately 50% of the cases [7,8], the other drugs were active episodically [5], seldom [9] or never Primitive psychogenic premature ejaculation is re garded as the most common sexual disorder in males. The therapy of choice for this disorder has been psychological, i.e.…”

Section: Introductionmentioning

confidence: 99%

Alpha-1 Blockade Pharmacotherapy in Primitive Psychogenic Premature Ejaculation Resistant to Psychotherapy

Cavallini¹

1995

Eur Urol

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“…Treatments for PE can be directed at any component of this complex mechanism and include psychoanalytic therapy, behavioral therapy ('stopstart' and 'squeeze' techniques), centrally acting pharmacological therapy (suppress stimulating or increase the inhibiting neurotransmitters) and topical local anesthetics to the penis. Although sympathetic blockade with the alpha receptor antagonist phenoxybenzamine 13 and dopamine 2 receptor blockade with known antipsychotic agents such as the phenothiazines 14 do delay ejaculation, the frequency and severity of side effects prevent widespread use of these drugs. Interestingly, dopamine 2 receptor agonists L-dopamine and apomorphine have been shown to decrease the number of penile intromissions to achieve ejaculation.…”

Section: Discussionmentioning

confidence: 99%

Topical lidocaine–prilocaine spray for the treatment of premature ejaculation: a proof of concept study

Henry

Morales

2003

Int J Impot Res

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Premature ejaculation (PE) is the most common sexual dysfunction in men. Since heightened sensitivity of the glans is implicated in PE, it seems reasonable that reducing this sensitivity could have a delaying effect on intravaginal ejaculation latency time (IVELT) without adversely affecting the sensation of ejaculation. We have developed a local anesthetic combination, in a metered-dose aerosol delivery system, that delivers lidocaine and prilocaine in base form without organic solvents. The drug can be easily removed prior to vaginal penetration, circumventing the need for a condom that most patients find undesirable. Herein, we report on a prospective open-label pilot study investigating the safety and efficacy of this novel delivery system for topical local anesthetic to the glans penis aimed at prolonging the IVELT in patients who self-reported having PE. This was an open-label prospective pilot study. The lidocaine-prilocaine (LP) aerosol delivered 7.5 mg lidocaine and 2.5 mg prilocaine, both in base form, per actuation. A total of 14 men who had been referred to urology clinics with the problem of PE were recruited. Consent was obtained from both subjects and their partners. Couples were asked to time their IVELT without treatment on one encounter, and then on five subsequent encounters were asked to apply the spray to the glans penis, leave on for 10-15 min, wipe off carefully before intercourse. The IVELT was timed with a stopwatch and then both partners were asked to rate their individual satisfaction relative to baseline without treatment. They were also asked to document any adverse events or comments. In all, 11 patients completed the study. The average IVELT increased from 1 min:24 s to 11 min:21 s (P ¼ 0.008) representing an average eight-fold increase. No subjects experienced a decrease in IVELT. The average satisfaction score for both subjects and partners was 1.0; on a scale where À1 was worse, 0 the same, +1 better and +2 much better. Topical LP spray, applied to the glans penis 15 min before intercourse, prolongs ejaculation time significantly and improves sexual satisfaction in both men with PE and their partners. The glandular numbness, noticed in only two cases, did not adversely affect the quality of the orgasm. Occasionally, a patient reported difficulty maintaining an erection while waiting the required 15 min between application of the spray and the initiation of intercourse.

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The use of phenoxybenzamine treatment in premature ejaculation

Cited by 40 publications

References 1 publication

Relevance of methodological design for the interpretation of efficacy of drug treatment of premature ejaculation: a systematic review and meta-analysis

Relevance of methodological design for the interpretation of efficacy of drug treatment of premature ejaculation: a systematic review and meta-analysis

Alpha-1 Blockade Pharmacotherapy in Primitive Psychogenic Premature Ejaculation Resistant to Psychotherapy

Topical lidocaine–prilocaine spray for the treatment of premature ejaculation: a proof of concept study

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