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Treatment of premature ejaculation: a new combined approach

Abstract

Background

Selective serotonin reuptake inhibitors (SSRIs) are utilized to treat premature ejaculation (PE). However, their effect is moderate, with no universally adopted schedule. A possible role for pelvic floor dysfunction in the pathogenesis of PE was reported previously.

Objective

The aim of this study was to compare the efficacy of combined sertraline and pelvic floor rehabilitation with either line in patients with an unsatisfactory response to SSRIs.

Design, setting, and participants

From June 2009 to December 2012, 74 PE patients with an unsatisfactory response to sertraline 50 mg were enrolled and subjected to pelvic floor rehabilitation as an alternative therapy, and then a combination of both was tested on the same group.

Outcome measurements and statistical analysis

Relationships with outcome were analyzed using the Student t-test, Pearson’s correlation, and linear regression.

Results and limitations

The baseline intravaginal ejaculatory latency time (IELT) was 20–110 s (mean ± SD = 56.35 ± 21.67). With sertraline 50 mg therapy alone, IELT reached 90–180 s (mean ± SD = 121.69 ± 21.76, P = 0.0001). Of them, 44 (59.46%) patients failed to exceed an IELT of 120 s. With pelvic floor rehabilitation alone, IELT reached 90–270 s (mean ± SD = 174.73 ± 45.79, P = 0.0001). Of them, 13 (17.56%) patients failed to exceed an IELT of 120 s. Using a combination therapy of both, IELT reached 180–420 s (mean ± SD = 297.57 ± 59.19, P = 0.0001). This response was significantly higher than the baseline IELT and that of either lines alone (P = 0.0001, for all tests).

Conclusion

Pelvic floor rehabilitation is an important addition when treating PE, particularly in patients with pelvic floor dysfunction. We recommend this combination in patients with an unsatisfactory response to SSRIs.

Patient summary

Causes of PE differ considerably. In this paper, we compared the outcomes of two single treatment lines together with a combination of both. The combination therapy was more effective than either line alone.

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Correspondence to Sherif M. Abulsorour MD.

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Kurkar, A., Abulsorour, S.M., Gamal, R.M. et al. Treatment of premature ejaculation: a new combined approach. Egypt Rheumatol Rehabil 42, 39–44 (2015). https://doi.org/10.4103/1110-161X.155649

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  • DOI: https://doi.org/10.4103/1110-161X.155649

Keywords

  • male sexual dysfunction
  • pelvic floor rehabilitation
  • premature ejaculation
  • selective serotonin reuptake inhibitors