Are Urology Residents Ready to Treat Premature Ejaculation After Their Training?

Abstract

Introduction The management of premature ejaculation (PE) among urology residents (URs) in the era of standard definition and new treatments is unknown. Aim To determine how future urologists currently address PE and to review their adherence to guidelines. Methods A specifically designed survey on the preferred approaches to the treatment of PE was given to residents during the Eighth European Urology Education Programme. The results were tabled, and descriptive statistics were used to analyze differences in practice patterns. Main Outcomes Measures The responses are compared with clinical guidelines and recommendations. Results A total of 360 URs attended the recommendation course, and 140 answered the survey (response rate: 38.8%). Seventeen (12.1%) of the respondents considered PE to be a very common sexual dysfunction, 62 (44.3%) considered PE to be frequent, 33 (23.6%) considered this condition uncommon, and 28 (20%) did not consider PE to be a dysfunction. Regarding incidents, 67 residents (47.9%) treated one patient per week. To assess PE, 132 (94.3%) used sexual history, 37 (26.4%) used physical examination, 38 (27.1%) used questionnaires, and 4 (2.9%) used laboratory testing. The preferred initial management strategy for PE was psychological/behavioral therapy for 65 (46.4%) residents. Topical anesthetic, andrological referral, and prescription of selective serotonin reuptake inhibitors (SSRIs) on demand were favored by 34 (24.3%), 19 (13.6%), and 8 (12.9%) of the respondents, respectively. Other options were psychiatric referral, which was preferred by two (1.4%) respondents, and prescription of daily SSRIs, which was preferred by two (1.4%) respondents. The preferred secondary treatment for patients who did not improve initially was prescription of SSRIs for on demand, which was 46 (32.9%) respondents. In cases where patients had concomitant erectile dysfunction (ED), 16 (11.4%) URs treated only the ED and 60 (42.9%) treated both conditions. Conclusions The majority of URs follow the established guidelines for diagnosis of PE, but not for treatment. The URs have an insufficient medical education in sexual medicine.

Education in sexual medicine - a nationwide study among German urologists/andrologists and urology residents

“…As in other studies, the need for further education and training in sexual health topics was reported by most respondents at all times (medical school, residency, urologist). Swiss general practitioners and urologists expressed their need for continuing education on sexual issues (Platano et al ., ) as well as Spanish urology residents showed an insufficient training in sexual health topics (Lujan et al ., ). Insufficient training was often reported to be a barrier in addressing sexual health issues, which is in accordance with previous studies (Haboubi & Lincoln, ; Ahrendt & Friedrich, ; Alarcão et al ., ).…”

New insights on premature ejaculation: a review of definition, classification, prevalence and treatment

“…A recent survey of urology residents demonstrated that even though approximately 15% of patients presenting to clinics complain of PE, residents still fail to follow the recommendations of current treatment guidelines; this incongruence indicates insufficient training about PE during urology residency programs. 44 It is evident that the needs of PE treatment remain unmet; however, there are many potentially effective management options. 45 Topical anaesthetic creams, selective serotonin reuptake inhibitors (SSRIs) and phosphodiesterase type-5 (PDE-5) inhibitors have been fairly well studied, while newer modalities, such as tramadol and metered-dose aerosol containing topical anaesthetics, require further evidence to support their efficacy.…”

Combination or alone ? Which one is best in premature ejaculation treatment?

“…No consensus was reached on the treatment of the disease. In a study conducted by Lujan et al, [8] 15% of the patients who were consulting for premature ejaculation were found to have received incorrect treatment and prescription when evaluated according to the guidelines.…”