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Premature Ejaculation: 2020 Update

  • Giorgio Ivan Russo
  • Ege Can SerefogluEmail author
Urology, Gynecology, and Endocrinology (J Simon and M Luria, Section Editors)
Part of the following topical collections:
  1. Topical Collection on Urology, Gynecology, and Endocrinology

Abstract

Purpose of Review

Premature ejaculation (PE) is one of the most common forms of male sexual disorder. There are still different opinions and point of view regarding its definition, classification, prevalence, pathophysiology and treatment alternatives. For these reasons, we aim to recap the recently accumulated data on definition, classification, pathophysiology and treatment alternatives of PE. The literature pertaining to PE has been reviewed by the authors. All the related articles were critically analyzed and examined. Levels of evidence (Les) and grades of recommendation (Grs) are provided based on a thorough analysis of the literature and consensus.

Recent Findings

After the initial evidence-based definition developed for lifelong PE, the International Society for Sexual Medicine (ISSM) advertised another unified definition for lifelong and acquired PE and confirmed the time criterion for the diagnosis of PE. The ISSM has also acknowledged the presence of the two more PE subtypes (variable and subjective PE) underlining the fact that more research is required to develop an evidence-based definition of these sexual problems. Although the pathophysiology of these four PE syndromes has not been completely elucidated yet, pharmacotherapy must be considered the treatment of choice for lifelong PE patients whereas treating the underlying pathology must be the initial goal for patients with acquired PE. To treat PE, we can use daily or on-demand use of SSRIs, on-demand use of topical anaesthetics, on-demand tramadol or phosphodiesterase type-5 inhibitors. Psychotherapy can be offered to patients who describe variable and subjective PE.

Summary

Despite the recent progress reached in the field of PE, there are on-going debates regarding the definition, classification, pathophysiology and treatment of this common problem. Future clinical trials must be performed to understand the actual aetiology of the four PE syndromes and develop more effective and safe treatment alternatives.

Keywords

Premature ejaculation Definition Classification Genetics Drug treatment Epidemiology 

Abbreviations

PE

premature ejaculation

Les

levels of evidence

Grs

grades of recommendation

ISSM

International Society for Sexual Medicine

IELT

intravaginal ejaculatory latency time

APA

American Psychiatric Association

DSM-5

Diagnostic and Statistical Manual for Mental Disorders, 5th edition

ICD-10

International Classification of Diseases and Related Health Problems 10th edition

MELT

masturbation ejaculation latency time

LSt

lumbar spinothalamic

Notes

Compliance with Ethical Standards

Conflict of Interest

Dr. Serefoglu reports role as consultant for Virility Lts., Israel, outside of the submitted work. Dr. Russo declares no conflict of interest.

Research Involving Human Participants and/or Animals

This article does not contain any studies with human or animal subjects performed by the author.

References

Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Urology Section, Department of SurgeryUniversity of CataniaCataniaItaly
  2. 2.Department of UrologyBiruni University, School of MedicineIstanbulTurkey

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