Effect of Topical Clove (Syzygium aromaticum (L.) Merr. & L.M.Perry) Gel on Premature Ejaculation: A Pilot Randomized Double-Blind Placebo-Controlled Clinical Trial

Premature ejaculation is one of the most common sexual disorders worldwide without a satisfying treatment. In this study, we investigated the efficacy of a topical formulation of clove oil in premature ejaculation patients. Eligible patients were randomly divided into two groups to use either Syzygium aromaticum (SA) 1% gel or placebo gel 10 minutes before the intercourse for a period of 8 weeks. Outcome measurement were Premature Ejaculation Diagnostic Tool (PEDT) and International Index of Erectile Function (IIEF) questionnaires in addition to Intravaginal Ejaculation Latency Time (IELT). A total number of 22 (11 patients in each group) participants completed the study. At the end of the intervention, the IELT scores changed from 29.84 ± 18.59 to 97.09 ± 91.86 and 42.51 ± 13.98 to 52.45 ± 32.7 seconds in SA gel and placebo groups, respectively (p-value = 0.003). Also, the changes of PEDT scores in the SA gel group (from 14 ± 3.55 to 9.2 ± 4.56) comparing to that of placebo gel group (from 14.63 ± 3.61 to 13.5 ± 3.78) was significantly different (p-value =0.001). Moreover, results of IIEF questionnaire revealed significant improvement of “Intercourse Satisfaction” in SA gel group (p-value = 0.016). No adverse event was observed. It seems that SA gel could be beneficial in the treatment of premature ejaculation; however, it should be further evaluated in larger studies.

Comparative study between usage of medicine containing a mixture of Dapoxetine and Tadalafil with the usage of these drugs separately in treatment of rapid ejaculation

A study was conducted on 58 patients aged from 18-63 years old, they suffering from rapid ejaculation and all their Intravaginal ejaculation latency time (IELT) were less than 2 minutes. This study done at Erectile dysfunction unit in Al-Muthana teaching hospital for a period of 1 month (March/2019). The patients were divided into 2 groups: Group 1: Patient received 30 mg of Dapoxetine 1hr before coitus and 10 mg of Tadalafil 30 min before coitus. Group 2: Patient received Dapoxetine 20 mg + Tadalafil 10 mg mixed in one tablet 1 hr before coitus. The result of our study revealed that the IELT before treatment was less than 2 minutes in both groups, after treatment the IELT increased significantly (P≤0.05) in group 1 and group 2 (337.9±3.72 and 222.4±2.88 seconds) respectively. The IELT in group 1 was increased significantly (P≤0.05) compared to IELT in group 2 after treatment. In conclusion, the administration of Dapoxetine before 1 hr. of coitus and Tadalafil 30 min. before coitus (G1) gave a good results in increasing of IELT as compared to mixture of these drugs in one tablet.

Risk factors of premature ejaculation and its influence on sexual function of spouse

Background Premature ejaculation (PE) is a multifactorial problem with a complicated aetiology that has detrimental effects on female partners’ sexual function. However, there is a lack of studies on the relationship between the factors related to PE and female sexual dysfunction (FSD) in China. We aimed to identify and explore the relationship between the factors associated with PE and FSD. Results Ultimately, information was collected from 761 couples: 445 couples with PE complaints and 316 couples without PE complaints. The mean ages of the men with and without PE complaints were 36.29 ± 9.87 years and 31.48 ± 10.77 years, respectively. Female partners in the group with PE complaints reported lower total and subdomain female sexual function index (FSFI) scores, and approximately 65% of them were diagnosed with FSD (vs. control group: 31.96%). A PE duration of more than 14 months, a self-estimated intravaginal ejaculation latency time (self-estimated IELT) less than 2 min, a negative attitude towards PE problems, men’s introversion, and men’s depression were risk factors for FSD in the PE group. Conclusions PE affects not only the patient himself but also the spouse. Comprehensive analysis reveals a clear relationship and interaction between female sexual function and PE. Moreover, in PE treatment, we should not ignore the occurrence of FSD and its impact and should emphasize the treatment of couples together.

The Use of Delphi Method and Analytical Hierarchy Process in the Establishment of Assessment Tools in Premature Ejaculation: The Scoring System for Premature Ejaculation Treatment Outcomes

There is a lack of objective tools to comprehensively evaluate premature ejaculation (PE) treatment results clinically. We aimed to describe the development of a novel scoring system for PE treatment results as an example of using the Delphi method and an analytical hierarchy process for complex decision-making in the field of sexual medicine. A Delphi question survey was adopted to collect expert opinions from 47 Chinese specialists in andrology/urology on the assessment of PE treatment outcomes based on four primary properties, that is, the improvement in intravaginal ejaculation latency time, a couple’s mental status, the ability to control ejaculation, and sexual intercourse satisfaction. Different weights on those primary properties were assigned to create a mathematical hierarchy matrix and then perform an analysis. The scores were assigned according to the calculated weights. The ratio among the combined weights of the four primary properties was 1:3:2:3. The total numerical score was 36. Scores above 27, between 26 and 18, and below 17 indicated significant improvement, moderate improvement, and no improvement in PE, respectively, with selected treatments. The scoring system with 36 points can be used by physicians, patients, and their sexual partners to comprehensively and objectively assess quantitative PE treatment results.

Age-Related Correlation Between Erectile Dysfunction and Premature Ejaculation

Background and objectiveTo evaluate the relationship between erectile dysfunction (ED) and premature ejaculation (PE) among men aged 40–79 years and to compare age-related differences between men aged 40–59 years and 60–79 years. Materials and methodsFrom January 2014 to January 2019, records of 892 men aged 40–79 years were analyzed. We performed correlation analysis using the self-reported intravaginal ejaculation latency time (IELT), premature ejaculatory diagnostic tool (PEDT), Male Sexual Health Questionnaire-ejaculation (MSHQ-EjD), and International Index of Erectile Function5 (IIEF5) questionnaires. ResultsThe mean age of the 892 males was 52.8 ± 7.3 years (40–76). All subjects were divided into group 1 (40–59 years old) and group 2 (60–79 years old). The IIEF5 score of group 1 was significantly higher than that of group 2 (18.7 ± 5.5 vs. 17.7 ± 5.7, p = 0.049). Of the total subjects, 71 (8%) had IELT value of less than 1 min. A total of 51 (6.9%) and 20 (13.5%) were in groups 1 and 2, respectively (p = 0.02). The PEDT total score was higher and more subjects were identified as suffering from PE (PEDT ≥ 9) from amongst the ED subjects (IIEF-5 ≤ 21). In both groups 1 and 2, more PE subjects were identified in ED subjects (IIEF-5 ≤ 21) than normal subjects (IIEF-5 > 21) (all p < 0.01). In the total subjects, group 1 and 2, the IIEF-5 and PEDT score showed a weak negative correlation (r = −0.302, r = −0.361, r = −0.248, all p < 0.01). In group 2, the IELT and MSHQ-EjD score also showed a weak positive correlation between the IIEF-5 score (r = 0.166, p = 0.044 and r = 0.164, p = 0.047, respectively). ConclusionMore subjects defined PE value as less than 1 min on the self-reported IELT in the elderly group ≥60 years than those among the 40–59 years age group; moreover, the lower the IIEF5 total score among subjects ≥ 60 years, the higher the PEDT score and the lower the IELT and MSHQ-EjD scores.

Can Intraprostatic Injection of OnabotulinumtoxinA be Benefi cial to Treat Premature Ejaculation? Results of a Prospective Study

We prospectively evaluated efficacy and adverse effects of intraprostatic injections of onabotulinumtoxinA to treat premature ejaculation. Twenty-four men ≥19 years-old with premature ejaculation for ≥ 6 months and intravaginal ejaculation latency time ≤ 2 minutes underwent transurethral intraprostatic injections of onabotulinumtoxinA (100 U). Primary endpoint was change of intravaginal ejaculation latency time at 3-months. Secondary endpoints included changes in premature ejaculation profile and patient-reported global impression of change (PGI). Mean baseline ejaculation latency time has significantly increased at 1-, 3- and 6-months, respectively. In premature ejaculation profile “perceived control over ejaculation”, significant improvement was reported at 3-months, while non-significant changes were reported at 1- and 6-months. Patients reported non-significant changes of “personal distress related to ejaculation” and “interpersonal difficulty related to ejaculation”. Only 8.3%, 12.5% and 12.5% of men reported “better” at 1-, 3- and 6-months, respectively, while all other patients reported “no change” or “slightly better” in patient-reported global impression of change. No serious adverse effects were observed. Improvements of intravaginal ejaculation latency time were not clinically meaningful, as most men reported “no change” or “slightly better” in patient-reported global impression of change. These marginal improvements did not support using onabotulinumtoxinA intraprostatic injections to remedy premature ejaculation.