HIV Insight: Premature Ejaculation

Friday, December 25, 2015

Topical Anaesthetics for Premature Ejaculation: A Systematic Review & Meta-Analysis

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 meta-analysis. 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.

Purchase full article at: http://goo.gl/lJ9BZr

By: Marrissa Martyn-St James A E, Katy Cooper A, Kate Ren A, Eva Kaltenthaler A, Kath Dickinson A, Anna Cantrell A, Kevan Wylie B, Leila Frodsham C and Catherine Hood D

A School for Health and Related Research (ScHARR), University of Sheffield, Regent Court, 30 Regent Street, Sheffield, S1 4DA, UK. B Porterbrook Clinic, Sexual Medicine, 9 Sunderland Street, Sheffield, S11 8HN, UK. C Institute of Psychosexual Medicine, Building 3 Chiswick Park, 566 Chiswick High Road, London, W4 5YA, UK. D St George’s Hospital, Blackshaw Road, Tooting, London, SW17 0QT, UK. E Corresponding author. Email: m.martyn-stjames@sheffield.ac.uk

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Tuesday, November 3, 2015

Anxiety & Depression among Greek Men with Primary Erectile Dysfunction & Premature Ejaculation

Erectile dysfunction (ED) and premature ejaculation (PE) are the two most prevalent sexual disorders among males associated with significant distress and impairment in quality of life. The aim of this study was to investigate the prevalence of anxiety and depression symptoms among patients with primary ED and PE.

A sample of 57 men (ED = 31; PE = 26) were compared to 25 male outpatients with anxiety disorder (AD) and 25 healthy controls. Principal assessment measures included the State-Trait Anxiety Inventory (STAI) and the Beck Depression Inventory (BDI).

Greater levels of STAI state anxiety were reported among the ED, PE, and AD groups as compared to healthy controls. In contrast ED and AD groups scored higher than controls on the STAI trait anxiety and BDI, but PE scores were not different from healthy controls in both measures.

The study findings suggest that both primary ED and PE are conditions associated with significant state anxiety; however, PE appears to be less associated with trait anxiety and depression compared to ED, a finding that corroborates the recent acknowledgement of PE as a more biologically based condition. Limitations and potential clinical implications are also discussed.

Full article at: http://goo.gl/rDZq8I