Topical anaesthetic use for treating premature ejaculation: a double‐blind, randomized, placebo‐controlled study

Busato, Wilson Francisco Schreiner; Galindo, Carles

doi:10.1111/j.1464-410x.2003.04773.x

Cited by 159 publications

(109 citation statements)

References 22 publications

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“…In one RCT, numbers withdrawing were imbalanced across groups [placebo 44%, Eutectic Mixture of Local Anaesthetics (EMLA), 28%] and data were analysed per-protocol (withdrawals exclude). 19 One reported that 30% of participants withdrew overall but did not reported how many withdrew by treatment group. 21 Both RCTs were considered to be at an overall high risk due to attrition bias.…”

Section: Risk Of Bias Assessment Of Rctsmentioning

confidence: 99%

“…Only one RCT reported that a random sequence generation method, 18 and only one reported that treatment allocation was concealed. 19 One RCT prescribed either an oral or a topical treatment to treatment groups and as such, participants and caregivers would not have been blinded. 20…”

Section: Risk Of Bias Assessment Of Rctsmentioning

confidence: 99%

“…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%

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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: Risk Of Bias Assessment Of Rctsmentioning

confidence: 99%

Section: Risk Of Bias Assessment Of Rctsmentioning

confidence: 99%

Section: Characteristics Of Rctsmentioning

confidence: 99%

Section: A Eutectic Mixture Of Local Anaesthetics Cream Containing LImentioning

confidence: 99%

See 2 more Smart Citations

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

Cooper

Kawaguchi

et al. 2016

Sex. Health

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“…73 Another placebo-controlled study reported the optimal application time to be 20 min prior to intercourse. 74 Lidocaine spray.…”

Section: A1-adrenoceptor Antagonistmentioning

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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Ejaculatory Disorders

McMahon¹,

Waldinger²,

Rowland³

et al. 2006

Standard Practice in Sexual Medicine

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Topical anaesthetic use for treating premature ejaculation: a double‐blind, randomized, placebo‐controlled study

Cited by 159 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

Current therapeutic strategies for premature ejaculation and future perspectives

Ejaculatory Disorders

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