Treatments of premature ejaculation and psychogenic impotence: A critical review of the literature

Kilmann, Peter R.; Auerbach, Roy

doi:10.1007/bf01541215

Cited by 77 publications

(15 citation statements)

References 51 publications

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“…Nomination of an exact threshold stopwatch IELT cutoff point for diagnosis of PE is an integral part of the inclusion criteria for a clinical trial. There is considerable variance of the latencies used to identify subjects with PE with IELTs that range from 1 to 7 minutes [35][36][37][38][39][40][41][42][43][44][45][46]. These IELT cutoff points include ejaculation 1 minute after vaginal intromission [40], 2 [41,44], 3 [43], 4 [37], 5 [36,38,42], and 7 minutes [39].…”

Section: Baseline Ejaculatory Latency Time (Elt)mentioning

confidence: 99%

Clinical Trial Methodology in Premature Ejaculation Observational, Interventional, and Treatment Preference Studies—Part I—Defining and Selecting the Study Population

McMahon

2008

The Journal of Sexual Medicine

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Introduction Large, well-designed observational or clinical efficacy and safety randomized clinical trials are required to identify the prevalence of premature ejaculation (PE) and its associated risk factors, to characterize the dimensions of PE and the basis for treatment-seeking behaviour, and to achieve regulatory approval of new drug treatments. Aims The objective of this article was to make recommendations for the criteria for defining and selecting the study population. Main Outcome Measures Contemporary published data on clinical trial design and the epidemiology, definitions, dimensions, and psychological impact of PE. Methods Contemporary data on the epidemiology, definitions, dimensions, and psychological impact of PE were reviewed, critiqued using the principles of evidence-based medicine, and incorporated into a series of evidence-based recommendations for standardization of patient selection for clinical trials in PE. Results Data from PE observational, interventional, and treatment preference studies are only reliable, interpretable, and capable of being generalized to patients with PE when study populations are defined by the constructs of an ejaculatory latency time of less than about 1 minute on all or nearly all occasions, the inability to delay ejaculation, and the presence of negative personal consequences, such as distress, bother, frustration, and/or the avoidance of sexual intimacy. Conclusion These constructs can be incorporated into a multidimensional evidence-based definition of PE and/or single-item questions or multi-item diagnostic questionnaires. The International Society of Sexual Medicine definition of PE reflects the contemporary understanding of PE, represents the state-of-the-art multidimensional definition of PE, and is recommended as the basis of diagnosis of PE for all PE clinical trials.

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Section: Baseline Ejaculatory Latency Time (Elt)mentioning

confidence: 99%

Clinical Trial Methodology in Premature Ejaculation Observational, Interventional, and Treatment Preference Studies—Part I—Defining and Selecting the Study Population

McMahon

2008

The Journal of Sexual Medicine

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“…IELT is defined as the time between vaginal intromission and intravaginal ejaculation [11]. Although it has been suggested that an IELT of 2 minutes or less may serve as an adequately sensitive criterion for defining PE [7], a standard cut‐off for ejaculatory latency does not exist, and studies have used latency values ranging from 1 to 7 minutes for defining PE [2,7,9,12–18].…”

Section: Introductionmentioning

confidence: 99%

Premature Ejaculation: An Observational Study of Men and Their Partners

Patrick

Althof

Pryor

et al. 2005

The Journal of Sexual Medicine

418

495

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Introduction Premature ejaculation (PE) is the most common male sexual dysfunction affecting men and their partners. Lack of community-based data describing this condition limits understanding of PE and its outcomes. Aim To characterize PE in a large population of men with and without PE using patient-reported outcome (PRO) measures elicited from men and their partners. Methods 4-week, multicenter, observational study of males (≥18 years) and their female partners in monogamous relationships (≥6 months). Screening, baseline, and follow-up visits scheduled at 2-week intervals. Clinicians diagnosed PE utilizing DSM-IV-TR criteria. Intravaginal ejaculatory latency time (IELT), measured by a stopwatch held by the partner, was recorded for each sexual intercourse experience. Subject and partner independently assessed PROs: control over ejaculationand satisfaction with sexual intercourse(0 = very poor to 4 = very good), personal distressand interpersonal difficulty(0 = not at all to 4 = extremely), and severity of PE(0 = none to 3 = severe). Results Of the total study population (N = 1,587), 207 subjects were diagnosed with PE and 1,380 were assigned to the non-PE group. Median IELT (min) was 1.8 (range, 0–41) for PE and 7.3 (range, 0–53) for non-PE subjects (P < 0.0001). More PE vs. non-PE subjects gave ratings of “very poor” or “poor” for control over ejaculation(72% vs. 5%; P < 0.0001) and satisfaction with sexual intercourse(31% vs. 1%; P < 0.0001). More subjects in the PE vs. non-PE group gave ratings of “quite a bit” or “extremely” for personal distress(64% vs. 4%; P < 0.0001) and interpersonal difficulty(31% vs. 1%; P < 0.0001). Subject and partner assessments showed similar patterns and correlated moderately (0.36–0.57). Conclusions PE subjects reported significantly shorter IELT. Overlap in IELT distributions was observed between the PE and non-PE groups, indicating the need for additional PRO measures to characterize PE. Shorter IELT was significantly associated with reduced ejaculatory control and sexual satisfaction and increased distress and interpersonal difficulty.

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“…The therapist carefully chooses the environment and atmosphere, with patients and therapists on large cushions, using a friendly relationship on first-name terms, and involving non-erotic massages and role-playing. Hypnosis [32] , mechanotherapy [33] , re-educative and supportive therapies, and the extensive training programmes described elsewhere as alternatives to behavioural therapies, all suffer from considerable methodological weaknesses, a failure to specify subject and treatment variables, inadequate or non-existent control groups, a limited follow-up, and failure to obtain the partner’s validation of the patient’s progress [34] .…”

Section: Psychological Therapies For Pementioning

confidence: 99%

Integrating psychotherapy and pharmacotherapy in the treatment of premature ejaculation

Ciocca

Limoncin

Mollaioli

et al. 2013

Arab Journal of Urology

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ObjectivesTo describe the different approaches to the treatment of premature ejaculation (PE), with a final focus on integrated treatment, as conventional theories and therapies for PE are based on an organic or psychogenic dichotomy.MethodsWe list the principal hypotheses of the causes and therapy of PE on the basis of psychological and medical perspectives, after identifying all relevant studies available on Medline up to 2012.ResultsThe cognitive feedback from PE can lead to a ‘performance anxiety’, which can combine with other conditions to further impair ejaculatory control. For these reasons, a psychological approach is always useful in treating PE, the most useful of which are sex therapy and behavioural therapy. For pharmacological treatment, reports suggest that dapoxetine (60 mg) significantly improves the control of the ejaculatory reflex, and it thus represents the first-line officially approved pharmacotherapy for PE.ConclusionsA holistic approach which considers the biological, psychological and relational aspects is the advised treatment for PE. Integrated medical and psycho-sexological therapy requires a mutual understanding of and respect for the different disciplines involved in sexology. In this aspect two very important roles are those of the physician and the psychologist.

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Treatments of premature ejaculation and psychogenic impotence: A critical review of the literature

Cited by 77 publications

References 51 publications

Clinical Trial Methodology in Premature Ejaculation Observational, Interventional, and Treatment Preference Studies—Part I—Defining and Selecting the Study Population

Clinical Trial Methodology in Premature Ejaculation Observational, Interventional, and Treatment Preference Studies—Part I—Defining and Selecting the Study Population

Premature Ejaculation: An Observational Study of Men and Their Partners

Integrating psychotherapy and pharmacotherapy in the treatment of premature ejaculation

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