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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.
UROLOGY, GYNECOLOGY, AND ENDOCRINOLOGY (J SIMON AND M LURIA, SECTION
EDITORS)
Premature Ejaculation: 2020 Update
Giorgio Ivan Russo
1
&Ege Can Serefoglu
2
#Springer Science+Business Media, LLC, part of Springer Nature 2019
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 ona 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, classifica-
tion, 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
Introduction
Premature ejaculation (PE) is one of the most common male
sexual complaints [1,2] (two level 3 studies). As the first
report on this sexual problem was published over 100 years
ago [3], there are still different points of view and opinions
regarding its definition, classification, prevalence,
pathophysiology and treatment alternatives [4]. These differ-
ent views are mainly arising from the historical psychological
theories, which are formulated before the area of evidence-
based medical research. Moreover, different perspectives on
the interpretation of the validity and reliability of the methods,
designs and data of the new studies resulted in disagreements
between researchers. A Dutch group has introduced
intravaginal ejaculatory latency time (IELT) as the objective
measurement for PE studies [48], whereas endocrinological
(testosterone and prolactin) data have mainly been derived
from an Italian group [9,10,11,12], and twin studies have
been performed only by a Finnish group [1316]. Although
these recent data have resulted in the development of
evidence-based PE definitions and guidelines [1720], there
is a continuous discussion on what ought to be considered PE
and what biological, endocrinological, somatic and genetic
factors play role in its aetiology.
This article is part of the Topical Collection on Urology, Gynecology, and
Endocrinology
*Ege Can Serefoglu
egecanserefoglu@hotmail.com
1
Urology Section, Department of Surgery, University of Catania,
Catania, Italy
2
Department of Urology, Biruni University, School of Medicine,
Istanbul, Turkey
https://doi.org/10.1007/s11930-019-00232-9
Current Sexual Health Reports (2019) 11:411420
Published online: 7 November 2019
Content courtesy of Springer Nature, terms of use apply. Rights reserved.
ResearchGate has not been able to resolve any citations for this publication.
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