Intracavernous medication for treatmentof premature ejaculation

Fein, Richard L.

doi:10.1016/0090-4295(90)80149-h

Cited by 43 publications

(21 citation statements)

References 6 publications

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“…These advantages of this form of treatment have been utilised in the treatment of premature ejaculation. 15 However, the effect appears to be age-related, older men losing their erections after ejaculation much more often than younger age-groups. This tendency is also seen in the normal, potent population 16 , and presumably re¯ects age-related changes in neural or cavernosal function.…”

Section: Discussionmentioning

confidence: 99%

Intracavernosal therapy for erectile failure—Impact of treatment and reasons for drop-out and dissatisfaction

Purvis¹,

Egdetveit²,

Christiansen³

1999

Int J Impot Res

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Objectives: To examine the impact of intracavernosal therapy on libido, ejaculatory control, quality of life and treatment dependency in men with erectile failure. Furthermore to assess the drop-out rate and reasons for dissatisfaction with the technique. Subjects and methods: Questionnaires were sent to 1116 subjects with erectile failure who had previously elected to use intracavernosal therapy in the period 1995 ± 1997. Results: The response rate was 72.5%. The majority of erections lasted 30 ± 60 min, 10 ± 20% of the erections were considered unsatisfactory for intercourse and 15% of subjects reported erections lasting longer than 5 h on at least 10% of the occasions. Bleeding at the injection site occurred in 60% on at least 10% of the occasions and various degrees of deformation of the penis shaft were reported by 10%. The latter was related to the age of the subject and not the type of medication employed. Forty percent experienced at least partially improved control over ejaculation and almost 50% experienced some degree of increase in libido. One quarter retained penile rigidity after ejaculation but this was age-dependent. In those satis®ed with intracavernosal treatment, 80% admitted that it had improved the quality of their lives. Sixty percent did not feel that their dependency on intracavernosal treatment had lessened during the treatment period.Approximately 40% of subjects admitted to dropping out of the programme, the majority within the ®rst six months. The age of the subject did not in¯uence the decision and the type of medication or the mode of injection had only a minor impact on drop-out rate. Of those currently using IC therapy, 87% were either fully or partly satis®ed with this form of treatment. The corresponding ®gure for those discontinuing treatment was 58%. Dissatisfaction was higher in the younger age groups and could not be clearly related to the mode of injection. The major reasons for drop out or dissatisfaction were inadequate penile rigidity, the expense of the treatment, penile discomfort and the lack of spontaneity it necessitated. Penile discomfort was more associated with younger age groups, whilst an inadequate response to medication was more often experienced by men over 60 y. Deformation of the penile shaft was observed in 5% of those dissatis®ed with IC therapy and was four times more often reported by those over 70 compared to subjects younger than 40 y. In 6% of cases, a return of spontaneous erections was given as reason for drop-out. This was more often associated with younger subjects. In 16% of the subjects, the partner had expressed dissatisfaction with the technique primarily because of inadequate rigidity, lack of spontaneity or the complicated nature of the treatment.Conclusions:Intracavernosal treatment for erection failure is associated with side-effects such as penile ®brosis and bleeding at the injection site but has advantages including increased libido, an increase in the quality of life and ejaculatory control. Only a small proportion of men reduce thei...

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Section: Discussionmentioning

confidence: 99%

Intracavernosal therapy for erectile failure—Impact of treatment and reasons for drop-out and dissatisfaction

Purvis¹,

Egdetveit²,

Christiansen³

1999

Int J Impot Res

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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%

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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“…11 Some uroandrologists recommend intracavernosal vasoactive drugs, that result in a continued erection after ejaculation and many improve the sexual experience for the partner, 12 so that even if the patient ejaculates too soon he can still maintain an erection. From our data, it might be suggested that sildenafil could be used as a less invasive method of administering such treatment, and that a study to evaluate the place of this drug in premature ejaculation is justified.…”

Section: Discussionmentioning

confidence: 99%

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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Intracavernous medication for treatmentof premature ejaculation

Cited by 43 publications

References 6 publications

Intracavernosal therapy for erectile failure—Impact of treatment and reasons for drop-out and dissatisfaction

Intracavernosal therapy for erectile failure—Impact of treatment and reasons for drop-out and dissatisfaction

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

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

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