scholarly journals Topical Treatment of Premature Ejaculation: The Rise of Anesthetic Spray Formulations?

Uro ◽  
2021 ◽  
Vol 1 (1) ◽  
pp. 30-38
Author(s):  
Edoardo Pozzi ◽  
Federico Belladelli ◽  
Carolina Bebi ◽  
Andrea Salonia ◽  
Luca Boeri
Keyword(s):  
Selective Serotonin Reuptake Inhibitors ◽  
Premature Ejaculation ◽  
Treatment Options ◽  
Real Life ◽  
High Rate ◽  
Topical Anesthetic ◽  
Topical Anesthetics ◽  
Anesthetic Agents ◽  
Long Term Follow Up ◽  
Lidocaine Prilocaine

Topical anesthetics are one of the first line therapeutical options for men with premature ejaculation (PE). Real-life PE management often involves a range of interventions including systemic drug treatments (such as off-label and on-label selective serotonin reuptake inhibitors (SSRIs), tricyclic antidepressants, phosphodiesterase-5 inhibitors (PDE5Is)), topical anesthetic creams and sprays, and behavioral approaches. Among them, on-demand dapoxetine and lidocaine/prilocaine spray formulations are the only approved treatment options for lifelong PE. The earliest strategy to treat PE was based on the use of topical anesthetic agents. The rationale behind the use of anesthetics is that by reducing the glans penis sensitivity, the spinal and cerebral input of sexual arousal impulses may also be reduced. Oral SSRI proved to be effective to treat PE, but their high rate of side effects limit treatment adherence and both short and long term follow up data are lacking. Conversely, topical anesthetics have proved to increase ejaculatory latency, control, and sexual satisfaction in couple affected by PE with limited rates of adverse events. In this context, we aimed to perform a narrative review to summarize the most recent findings regarding the use of topical treatments for PE.

EARLY EJACULATION

2021 ◽  
Vol 3 (1) ◽  
Author(s):  
Emilia Claudia Todoruti
Keyword(s):  
Serotonin Reuptake ◽  
American Psychiatric Association ◽  
Selective Serotonin Reuptake Inhibitors ◽  
Premature Ejaculation ◽  
Current Evidence ◽  
Evidence Based ◽  
Treatment Interventions ◽  
Pharmacological Agents ◽  
Evidence Based Treatment ◽  
Topical Anesthetics

Information on the epidemiology, etiology and treatment of premature ejaculation is reviewed. Evidence of the prevalence of premature ejaculation indicates that subjective concern about rapid ejaculation is a common concern worldwide. The hypotheses regarding the pathogenesis of premature ejaculation include: 1.) that it is a learned model of ejaculation maintained by interpersonal anxiety and 2.) that it is a dysfunctional result of the central or peripheral mechanisms that regulate ejaculatory thresholds and 3.) that it is a normal variant in latency ejaculation. Current evidence-based treatment interventions include behavioral psychotherapy and the use of pharmacological agents, including topical anesthetics and selective serotonin reuptake inhibitors. The purpose of this paper is to review the existing knowledge base on the definition, prevalence, etiology and treatment of premature ejaculation. American Psychiatric Association (2013).

scholarly journals Comparison of Topical Anesthetics for Radiofrequency Ablation of Achrocordons: Eutectic Mixture of Lignocaine/Prilocaine versus Lidocaine/Tetracaine

2014 ◽  
Vol 2014 ◽  
pp. 1-5
Author(s):  
Pratik Gahalaut ◽  
Nitin Mishra ◽  
Sandhya Chauhan ◽  
Madhur Kant Rastogi
Keyword(s):  
Radiofrequency Ablation ◽  
Analogue Scale ◽  
Eutectic Mixture ◽  
Time Interval ◽  
Short Time Interval ◽  
Topical Anesthetic ◽  
Efficient Manner ◽  
Topical Anesthetics ◽  
Lidocaine Prilocaine ◽  
Short Time

Introduction. Topical application of local anesthetics is currently considered to be the easiest, most effective, and convenient way for treatment of patients who may be undergoing superficial dermatosurgical procedures. Materials and Methods. This study compares the anesthetic potential of 2.5% lidocaine and 2.5% prilocaine topical cream with 7% lignocaine and 7% tetracaine combination cream for radio ablative dermatosurgery when applied, under occlusion, for 30 minutes. 40 subjects of achrocordons were enrolled in this split-side randomized trial. Result. The pain severity experienced by subjects in terms of visual analogue scale score was significantly lesser for lignocaine/tetracaine combination cream as compared to lidocaine/prilocaine combination. Conclusion. This small study proves the efficacy of lidocaine/tetracaine combination as a topical anesthetic cream when applied for a short time interval of 30 minutes. This will help a dermatosurgeon to perform various dermatological procedures in a better and efficient manner with a shorter waiting period for analgesia to set in.

scholarly journals Efficacy of Topical Anesthetics in Pain Perception During Mini-implant Insertion: Systematic Review of Controlled Clinical Trials

2019 ◽  
Vol 66 (3) ◽  
pp. 119-132 ◽  
Author(s):  
Rogério Lacerda-Santos ◽  
Thaísa Caliman Bravin ◽  
Fabíola Galbiatti Carvalho ◽  
Matheus Melo Pithon ◽  
Antonia Bárbara Leite Lima ◽  
...  
Keyword(s):  
Systematic Review ◽  
Clinical Trials ◽  
Pain Perception ◽  
The Body ◽  
Anesthetic Techniques ◽  
Controlled Clinical Trials ◽  
Topical Anesthetic ◽  
Topical Anesthetics ◽  
Anesthetic Agents ◽  
Lidocaine Concentration

The focus of this systematic review is to assess the efficacy of several commonly utilized anesthetic techniques for reducing pain during the placement of mini-implants. An electronic search was conducted in the databases PubMed, Scopus, Web of Science, Medline Complete, Cochrane, Trials Central, and Clinical Trials, without limitations on year of publication or language. Randomized controlled trials (RCTs) and controlled clinical trials (CCTs) were considered. Two reviewers of articles independently evaluated the results of the study, and the risk of bias of included articles was evaluated according to the Cochrane Scale. Five eligible articles (3 RCTs and 2 CCTs) were included. The quality of the body of evidence was considered low because of the presence of multiple methodological problems, high risks of bias, and heterogeneity in the articles included. There was evidence that the efficacy of the analgesia of infiltrative anesthesia was most effective in promoting a lower perception of pain compared to the other anesthetic agents, although an injection was required. Among topical anesthetics, compound topical anesthetics with 20% lidocaine were more effective than compound topical anesthetics with low lidocaine concentration and conventional topical anesthetic with 20% benzocaine.

Topical Anesthetic Agents for Premature Ejaculation: A Systematic Review and Meta-analysis

Urology ◽  
2013 ◽  
Vol 81 (4) ◽  
pp. 799-804 ◽  
Author(s):  
Chunxiao Pu ◽  
Lu Yang ◽  
Liangren Liu ◽  
Haichao Yuan ◽  
Qiang Wei ◽  
...  
Keyword(s):  
Systematic Review ◽  
Premature Ejaculation ◽  
Meta Analysis ◽  
Topical Anesthetic ◽  
Anesthetic Agents

EARLY EJACULATION

2021 ◽  
Vol 3 (2) ◽  
Author(s):  
Keyword(s):  
Knowledge Base ◽  
Serotonin Reuptake ◽  
Selective Serotonin Reuptake Inhibitors ◽  
Premature Ejaculation ◽  
Current Evidence ◽  
Evidence Based ◽  
Treatment Interventions ◽  
Pharmacological Agents ◽  
Evidence Based Treatment ◽  
Topical Anesthetics

Information on the epidemiology, etiology and treatment of premature ejaculation is reviewed. Evidence of the prevalence of premature ejaculation indicates that subjective concern about rapid ejaculation is a common concern worldwide. The hypotheses regarding the pathogenesis of premature ejaculation include: 1.) that it is a learned model of ejaculation maintained by interpersonal anxiety and 2.) that it is a dysfunctional result of the central or peripheral mechanisms that regulate ejaculatory thresholds and 3.) that it is a normal variant in latency ejaculation. Current evidence-based treatment interventions include behavioral psychotherapy and the use of pharmacological agents, including topical anesthetics and selective serotonin reuptake inhibitors. The purpose of this paper is to review the existing knowledge base on the definition, prevalence, etiology and treatment of premature ejaculation.

scholarly journals Endovascular Treatment of Anterior Circulation Aneurysms With the p64 Flow Modulation Device: Mid- and Long-Term Results in 617 Aneurysms From a Single Center

2021 ◽  
Author(s):  
Marta Aguilar Pérez ◽  
Elina Henkes ◽  
Victoria Hellstern ◽  
Carmen Serna Candel ◽  
Christina Wendl ◽  
...  
Keyword(s):  
Intracranial Aneurysms ◽  
High Rate ◽  
Long Term Results ◽  
Effective Treatment Option ◽  
Anterior Circulation ◽  
Acute Hemorrhage ◽  
Unruptured Aneurysms ◽  
Long Term Follow Up

Abstract BACKGROUND Flow diverters have become an important tool in the treatment of intracranial aneurysms, especially when dealing with difficult-to-treat or complex aneurysms. The p64 is the only fully resheathable and mechanically detachable flow diverter available for clinical use. OBJECTIVE To evaluate the safety and effectiveness of p64 for the treatment of intracranial saccular unruptured aneurysms arising from the anterior circulation over a long-term follow-up period. METHODS We retrospectively reviewed our prospectively maintained database to identify all patients who underwent treatment for an intracranial saccular (unruptured or beyond the acute hemorrhage phase) aneurysm arising from the anterior circulation with ≥1 p64 between December 2011 and December 2019. Fusiform aneurysms and dissections were excluded. Aneurysms with prior or concomitant saccular treatment (eg, coiling and clipping) were included. Aneurysms with parent vessel implants other than p64 were excluded. Anatomic features, intraprocedural complications, clinical outcome, as well as clinical and angiographic follow-ups were all recorded. RESULTS In total, 530 patients (388 females; median age 55.9 yr) with 617 intracranial aneurysms met the inclusion criteria. The average number of devices used per aneurysm was 1.1 (range 1-3). Mean aneurysm dome size was 4.8 mm (range 1-27 mm). Treatment-related morbimortality was 2.4%. Early, mid-term, and long-term angiographic follow-up showed complete or near-complete aneurysm occlusion in 76.8%, 89.7%, and 94.5%, respectively. CONCLUSION Treatment of intracranial saccular unruptured aneurysms of the anterior circulation using p64 is a safe and effective treatment option with high rate of occlusion at long-term follow-up and low morbimortality.

scholarly journals Moxetumomab pasudotox in heavily pre-treated patients with relapsed/refractory hairy cell leukemia (HCL): long-term follow-up from the pivotal trial

2021 ◽  
Vol 14 (1) ◽  
Author(s):  
Robert J. Kreitman ◽  
◽  
Claire Dearden ◽  
Pier Luigi Zinzani ◽  
Julio Delgado ◽  
...  
Keyword(s):  
Hairy Cell Leukemia ◽  
Residual Disease ◽  
Braf Inhibitor ◽  
Nucleoside Analogs ◽  
High Rate ◽  
Hairy Cell ◽  
Cell Leukemia ◽  
Long Term Follow Up

Abstract Background Moxetumomab pasudotox is a recombinant CD22-targeting immunotoxin. Here, we present the long-term follow-up analysis of the pivotal, multicenter, open-label trial (NCT01829711) of moxetumomab pasudotox in patients with relapsed/refractory (R/R) hairy cell leukemia (HCL). Methods Eligible patients had received ≥ 2 prior systemic therapies, including ≥ 2 purine nucleoside analogs (PNAs), or ≥ 1 PNA followed by rituximab or a BRAF inhibitor. Patients received 40 µg/kg moxetumomab pasudotox intravenously on Days 1, 3, and 5 of each 28-day cycle for up to six cycles. Disease response and minimal residual disease (MRD) status were determined by blinded independent central review. The primary endpoint was durable complete response (CR), defined as achieving CR with hematologic remission (HR, blood counts for CR) lasting > 180 days. Results Eighty adult patients were treated with moxetumomab pasudotox and 63% completed six cycles. Patients had received a median of three lines of prior systemic therapy; 49% were PNA-refractory, and 38% were unfit for PNA retreatment. At a median follow-up of 24.6 months, the durable CR rate (CR with HR > 180 days) was 36% (29 patients; 95% confidence interval: 26–48%); CR with HR ≥ 360 days was 33%, and overall CR was 41%. Twenty-seven complete responders (82%) were MRD-negative (34% of all patients). CR lasting ≥ 60 months was 61%, and the median progression-free survival without the loss of HR was 71.7 months. Hemolytic uremic and capillary leak syndromes were each reported in ≤ 10% of patients, and ≤ 5% had grade 3–4 events; these events were generally reversible. No treatment-related deaths were reported. Conclusions Moxetumomab pasudotox resulted in a high rate of durable responses and MRD negativity in heavily pre-treated patients with HCL, with a manageable safety profile. Thus, it represents a new and viable treatment option for patients with R/R HCL, who currently lack adequate therapy. Trial registration ClinicalTrials.gov identifier: NCT01829711; first submitted: April 9, 2013. https://clinicaltrials.gov/ct2/show/NCT01829711

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