The primary premature ejaculation (PPE) is a common male sexual disorder. We proposed a novel behavioral therapy for PPE through regular penis-root masturbation (PRM). Nine heterosexual men with PPE completed the self-controlled study. After a 3-month PRM training, the median intravaginal ejaculatory latency time (IELT) increased from 60 s to 180 s (P = 0.018), and the mean Premature Ejaculation Diagnostic Tool (PEDT) score decreased from 14.8 ± 3.7 to 12.8 ± 4.1 (P = 0.074). Five out of eight patients had the prolonged dorsal nerve somatosensory evoked potential (DNSEP). The results suggest that PRM has a short-term therapeutic effect. Randomized controlled trials are needed to validate the efficacy.
Adult ; Behavior Therapy/methods* ; Humans ; Male ; Masturbation ; Penis ; Premature Ejaculation/therapy*

Premature ejaculation (PE) is a most common type of ejaculatory dysfunction, which has significant adverse effects on the life quality of the patients and their partners. Medication is currently the first choice for PE and psycho-behavior therapy is sometimes used as an adjuvant means. It is reported in a number of studies that medication alone or combined with psycho-behavior therapy has a great short-term efficacy and a very low risk of side effects. Conservative therapies for PE, however, have some obvious disadvantages such as easy recurrence after drug withdrawal, ineffectiveness in some cases, and so on. Thus, clinicians in China and abroad have developed and tried various surgical methods for the treatment of PE, most of which are reportedly safe and effective. However, International Society for Sexual Medicine guidelines for the diagnosis and treatment of PE recommended against surgical methods because of possible permanent loss of sexual function and insufficient reliable data, though without support from evidence or relevant literature. Although controversial, surgical treatment remains an effective and feasible strategy for refractory PE that does not respond to any conservative therapies. This review summarizes a variety of surgical techniques for PE, along with their basic principles, indications, effects and safety.
Behavior Therapy ; China ; Conservative Treatment ; Ejaculation ; Humans ; Male ; Premature Ejaculation ; drug therapy ; surgery ; Quality of Life ; Recurrence ; Sexual Partners

Objective To evaluate the effect of interventions for premature ejaculation (PE) in the management of patients with chronic prostatitis and secondary premature ejaculation. Methods Totally 90 patients diagnosed as chronic prostatitis with PE were randomly divided into control group (n=45) and interventional group (n=45). Control group received a conventional therapy consisted of oral administration of antibiotics,α-receptor blocker,and proprietary Chinese medicine for clearing away heat and promoting diuresis. Interventional group received a conventional therapy combined with treatment for ameliorating the PE symptom (oral dapoxetine on-demand and ejaculation control exercise).National Institutes of Health Chronic Prostatitis Symptom Index (NIH-CPSI),Chinese Index of Sexual Function for Premature Ejaculation (CIPE)-5 questionnaires,intravaginal ejaculatory latency time,and the number of coituses per week were applied for evaluating the treatment outcomes. Results Follow-up was accomplished in 35 and 38 patients in the control and interventional group.The CIPE-5 score,intravaginal ejaculatory latency time,and the number of coituses per week were significantly improved in both two groups but more significantly in interventional group (all P<0.05). The NIH-CPSI pain,urination,and quality of life subscores and total score were improved significantly in both two groups after treatment,but the NIH-CPSI pain and quality of life subscores had been improved more significantly in the interventional group (all P<0.05). The variation of NIH-CPSI was negatively correlated with that of CIPE-5 in both two groups (r=-0.362,P=0.016;r=-0.330,P=0.021). Conclusions For CP with secondary PE patients,the interventions for PE can not only improve the quality of sexual life but also help improve the NIH-CPSI pain and quality of life subscores. PE should be routinely screened and treated during the management of CP.p.
Anti-Bacterial Agents ; therapeutic use ; Chronic Disease ; Chronic Pain ; Coitus ; Drugs, Chinese Herbal ; therapeutic use ; Ejaculation ; Humans ; Male ; Premature Ejaculation ; drug therapy ; etiology ; Prostatitis ; complications ; drug therapy ; Quality of Life ; Surveys and Questionnaires ; Treatment Outcome

OBJECTIVETo observe the effificacy and safety of Qiaoshao Formula (, QSF) on patients with lifelong premature ejaculation (LPE) of Gan (Liver) depression and Shen (Kidney) defificiency syndrome.

METHODSA total of 60 LPE patients were randomly divided into treatment (QSF) and control (dapoxetine) groups. The treatment group received QSF twice a day and the control group received dapoxetine 1 to 2 h prior to planned sexual intercourse for 4 weeks. The outcomes included intra-vaginal ejaculation latency time (IELT), premature ejaculation diagnostic tool (PEDT), clinical global impression of change (CGIC), scores of Chinese medicine symptoms (CMSS), sex life satisfaction (SLS) and adverse events (AEs).

RESULTSIn the treated group, the median IELT was 3 min vs. 1.5 min before and after treatment (P<0.05). PEDT in the treated group was reduced to 11.76±1.68 from 15.83±2.30 after treatment (P<0.05). Besides, patient's SLS was improved from 1.30±0.05 to 6.30±0.04 (P<0.05), and spouse's SLS was increased from 1.30±0.to 6.10±0.06 (P<0.05); CMSS was decrease from 14.86±3.02 to 9.62±2.87 (P<0.05). In addition, no significant AE was observed in both groups.

CONCLUSIONQSF may be effective and safe on LPE patients with Gan depression and Shen defificiency syndrome.

Adult ; Drugs, Chinese Herbal ; adverse effects ; therapeutic use ; Humans ; Kidney ; pathology ; Liver ; pathology ; Male ; Middle Aged ; Personal Satisfaction ; Premature Ejaculation ; diagnosis ; drug therapy ; Syndrome ; Time Factors ; Treatment Outcome ; Young Adult

Premature ejaculation (PE) is a common male sexual dysfunction that can have significant effects on a couple's relationship. Behavioral therapy and psychotherapy are both safe and effective methods of treating PE. Ancient Chinese fangzhongshu (sexual skills and methods), which reflects a summary of expert experiences in sexology, contains many therapies for sexual dysfunction that are similar to those used in behavioral therapy or psychotherapy. A brief introduction dealing with the latest definitions of PE and treatment strategies drawn from behavioral therapy and psychotherapy is provided. Typical therapies for PE from ancient Chinese fangzhongshu are listed and briefly analyzed in order to define their domain of applicability and instructions for use. Ancient Chinese fangzhongshu contains many effective and safe therapies for PE. It should be incorporated into modern medical practice after critical analysis, and its scientific aspects should be promoted as a way of improving reproductive health, both to benefit individuals affected by PE and to promote traditional Chinese culture. Based on an analysis of the condition of the individual patient, one or multiple therapies guided by fangzhongshu can be expected to have an effect on the patient. Ancient Chinese fangzhongshu is of great value and should to be popularized and applied as a remedy for PE.
Asian Continental Ancestry Group* ; Cognitive Therapy ; Humans ; Male ; Medicine, Chinese Traditional ; Premature Ejaculation* ; Psychotherapy ; Reproductive Health ; Sexology

ObjectiveTo evaluate the effect and safety of Yimusake Tablets combined with dapoxetine hydrochloride and either of them used alone in the treatment of premature ejaculation (PE).

METHODSWe randomly assigned 180 PE patients to oral medication of Yimusake Tablets at 1.5 g per night (group A), dapoxetine hydrochloride at 30 mg at 1－3 hours before anticipated sexual activity (group B), the Yimusake Tablets plus dapoxetine hydrochloride simultaneously (group C), all for 8 weeks. After 4 and 8 weeks of medication, we recorded and compared the changes in the intravaginal ejaculation latency time (IELT), measures of the PE profile (PEP), and adverse events among the three groups of patients.

RESULTSThe treatment was accomplished and complete data obtained from 154 of the patients, 56 in group A, 52 in group B, and 46 in group C. After 4 and 8 weeks of medication, the mean IELT was dramatically prolonged in all the three groups as compared with the baseline (P<0.01), most significantly at 8 weeks in group C (［2.08±0.68］ min), followed by B (［1.76±0.52］ min) and A (［1.47±0.44］ min), with statistically significant differences among the three groups (P<0.01). The PEP measures were remarkably improved in group A at 8 weeks (P<0.05), and both in B and C at 4 and 8 weeks (P<0.05), most significantly at 8 weeks in group C (P<0.05), in which the patients scored 1.96±0.77 in perception of control over ejaculation, 2.62±0.98 in satisfaction with sexual intercourse, 3.04±0.62 in PE-related distress, and 3.57±0.80 in PE-induced difficult relationship with their partners, all markedly improved as compared with groups A and B (P<0.05). Adverse reactions were observed in 2 cases (3.6%) in group A, 6 cases (9.6%) in B, and 5 cases (10.9%) in C. No severe adverse events occurred in any of the patients during the study.

CONCLUSIONSCombined medication of Yimusake Tablets and dapoxetine hydrochloride, with its advantages of effectiveness and safety, deserves to be recommended for the treatment of PE.

Administration, Oral ; Adult ; Benzylamines ; therapeutic use ; Coitus ; psychology ; Drug Therapy, Combination ; Drugs, Chinese Herbal ; therapeutic use ; Ejaculation ; Humans ; Male ; Naphthalenes ; therapeutic use ; Personal Satisfaction ; Premature Ejaculation ; drug therapy ; Sexual Behavior ; Tablets ; Time Factors ; Treatment Outcome

OBJECTIVETo evaluate the clinical effect and safety of dapoxetine in the treatment of premature ejaculation (PE).

METHODSWe randomly assigned 116 PE patients to receive dapoxetine on demand at 30 mg qd (dapoxetine group, n = 60, aged 23-49 years) or oral tamsulosin at 20 mg qd (control group, n = 56, aged 24-46 years). After 4 weeks of medication, we compared the clinical global impression of change (CGIC) , PE profile (PEP) scores, intravaginal ejaculation latency time (IELT) , and adverse reactions between the two groups of patients.

RESULTSCompared with the baseline, the IELT was remarkably prolonged after treatment both in the dapoxetine group ([0.86 ± 0.17] vs [4.32 ± 2.23] min, P < 0.05) and the control ([0.88 ± 0.15] vs [4.17 ± 2.26] min, P < 0.05), with no statistically significant difference between the two groups (P > 0. 05). The post-treatment rate of CGIC in the dapoxetine group had no statistically significant difference from that in the control (85.00% vs 82.14%, P > 0.05). In comparison with pre-treatment, the patients of both the dapoxetine and control groups showed dramatically improved scores after medication in perceived control over ejaculation (0.85 ± 0.23 vs 2.13 ± 0.97 and 0.88 ± 0.21 vs 2.06 ± 0.34, both P < 0.05), ejaculation-related personal distress (1.15 ± 0.64 vs 2.89 ± 0.26 and 1.19 ± 0.53 vs 2.82 ± 0.69, both P < 0.05), satisfaction with sexual intercourse (0.81 ± 0.33 vs 2.58 ± 0.37 and 0.79 ± 0.28 vs 2.45 ± 0.32, both P < 0.05), and ejaculation-related interpersonal difficulty (2.05 ± 0.61 vs 3.24 ± 0.35 and 2.03 ± 0.65 vs 3.18 ± 0.76, both P < 0.05), with no significant differences between the two groups (P > 0.05). The incidence of adverse reactions was significantly lower in the dapoxetine than in the control group (3.33% vs 30.36%, P < 0.05).

CONCLUSIONDapoxetine is effective for the treatment of PE, with its advantages of prolonging the intravaginal ejaculation latency time, improving the quality of sexual life, and low incidence of adverse reactions.

Adult ; Benzylamines ; administration & dosage ; therapeutic use ; Coitus ; Double-Blind Method ; Ejaculation ; Humans ; Male ; Middle Aged ; Naphthalenes ; administration & dosage ; therapeutic use ; Patient Satisfaction ; Premature Ejaculation ; drug therapy ; Serotonin Uptake Inhibitors ; administration & dosage ; therapeutic use ; Sexual Behavior ; Sulfonamides ; administration & dosage ; therapeutic use ; Treatment Outcome ; Young Adult

Premature ejaculation (PE) is a most common sexual dysfunction, for which dapoxetine, a novel selective serotonin (5-HT) re-uptake inhibitor (SSRI), is the only licensed oral medicine at present. With the advantages of fast absorption, rapid action, on-demand medication, and short half-life time, dapoxetine has been proved by clinical trials to be effective in prolonging the intravaginal ejaculation latency time (IELT) and improving the overall condition of PE patients in various areas and populations. Compared with the traditional SSRIs, dapoxetine has a better safety and tolerability. The most frequently reported dapoxetine-related adverse events include nausea, diarrhea, headache and dizziness, but with very few severe or serious cases.
Benzylamines ; therapeutic use ; Biomedical Research ; Ejaculation ; drug effects ; Humans ; Male ; Naphthalenes ; therapeutic use ; Premature Ejaculation ; drug therapy ; Reaction Time ; drug effects ; Serotonin Uptake Inhibitors ; therapeutic use ; Treatment Outcome

OBJECTIVETo investigate the clinical value of Paroxetine combined with mid-frequency electrical pulse acupoint stimulation (EPAS) in the treatment of premature ejaculation (PE).

METHODSTotally 69 PE patients were equally assigned to receive oral Paroxetine 20 mg/d, mid-frequency EPAS, or oral Paroxetine 10 mg/d combined with mid-frequency EPAS (P + EPAS) , all for 8 weeks. We obtained the intravaginal ejaculation latency time (IELT) and Chinese Index of Premature Ejaculation (CIPE-5) scores of the patients before and after treatment, and compared adverse reactions among the three groups of patients.

RESULTSOne patient of the Paroxetine group gave up treatment because of abdominal pain and nausea. Compared with the baseline, the patients in the Paroxetine, EPAS, and P + EPAS groups all showed markedly increased IELT ([0.92 ± 0.11] vs [4.07 ± 0.11] min, P < 0.01; [0.92 ± 0.12] VS [2.78 ± 0.17] min P < 0.05; [0.91 ± 0.09] vs [5.31 ± 0.13], P < 0.01) and decreased CIPE-5 scores (12.5 ± 3.0 vs 22.0 ± 2.1, P < 0.01; 12.8 ± 2.9 vs 19.5 ± 1.9, P > 0.05; 13.1 ± 2.8 vs 25.2 ± 2.1, P 0.01), with statistically significant differences between the P + EPAS group and the other two (P < 0.05). The total effectiveness rate was 95.7% in the P + EPAS group, remarkably higher than in the Paroxetine (72.7%, P < 0.05) and the EPAS group (47.8, P < 0.01).

CONCLUSIONOral Paroxetine combined with mid-frequency EPAS has a higher safety and efficacy than either Paroxetine or EPAS alone in the treatment of PE.

Acupuncture Points ; Aged ; Combined Modality Therapy ; methods ; Ejaculation ; Electroacupuncture ; methods ; Humans ; Male ; Paroxetine ; therapeutic use ; Premature Ejaculation ; therapy ; Serotonin Uptake Inhibitors ; therapeutic use ; Treatment Outcome

OBJECTIVETo investigate the efficacy and adverse effects of dapoxetine in the treatment of premature ejaculation.

METHODSWe randomly assigned outpatients with premature ejaculation in the proportion of 2:1 to receive 30 mg dapoxetine on demand (n =78) or 50 mg sertraline qd for one month (n = 39). Follow-up was accomplished in 95 cases, 63 in the dapoxetine group and 32 in the sertraline group. We recorded the intravaginal ejaculatory latency time (IELT), clinical global impression of change (CGIC) score, and adverse reactions of the patients and compared them between the two groups.

RESULTSIELT was significantly increased in both the dapoxetine (from [0.87 ± 0.31] to [2.84 ± 0.68] min, P < 0.05) and the sertraline group (from [0.84 ± 0.28] to [2.71 ± 0.92] min, P < 0.05) after medication. Based on the CGIC scores in premature ejaculation, the rate of excellence or effectiveness was 36.5% in the dapoxetine and 37. 5% in the sertraline group, and the rate of improvement was 63.5% in the former and 71.9% in the latter. The incidence rates of dizziness, nausea, headache, and diarrhea were slightly higher (P > 0.05) while those of fatigue, somnolence, and dry mouth significantly higher (P < 0.05) in the sertraline than in the dapoxetine group.

CONCLUSIONOn-demand oral medication of dapoxetine is effective and well-tolerated for the treatment of premature ejaculation.

Benzylamines ; adverse effects ; therapeutic use ; Double-Blind Method ; Ejaculation ; drug effects ; physiology ; Humans ; Male ; Naphthalenes ; adverse effects ; therapeutic use ; Outpatients ; Premature Ejaculation ; drug therapy ; Reaction Time ; drug effects ; physiology ; Serotonin Uptake Inhibitors ; adverse effects ; therapeutic use ; Sertraline ; administration & dosage ; adverse effects ; Time Factors ; Treatment Outcome