Recent concepts of premature ejaculation

Won Sik Ham, Won Tae Kim, Hyung Ki Choi, Young Deuk Choi

Research output: Contribution to journalReview article

Abstract

Premature ejaculation (PE) is the most prevalent male sexual complaint, yet it remains underdiagnosed and undertreated. The sympathetic, parasympathetic, and somatic spinal centers, under the influence of sensory genital and cerebral stimuli integrated and processed at the spinal cord level, act in synergy to command physiologic events occurring during ejaculation. Experimental evidence indicates that serotonin (5-HT), throughout brain descending pathways, exerts an inhibitory role on ejaculation and pharmacologic manipulation of the serotonergic system has been performed in rats, with the antidepressant selective serotonin reuptake inhibitors (SSRIs) exhibiting the greatest efficacy in delaying ejaculation. Over the last decade, an increasing number of studies of drug treatment of PE have been published. A meta-analysis of those studies demonstrated similar efficacies for daily treatment with the serotonergic antidepressants paroxetine hemihydrate, clomipramine, sertraline and fluoxetine, with paroxetine (hydrochloride) hemihydrate exerting the strongest effect on ejaculation. On the basis of fundamental insights into serotonergic neuro-transmission, it has been suggested that on-demand selective serotonin reuptake inhibitor (SSRI) treatment will not lead to similarly impressive delays in ejaculation as has been observed with daily SSRI treatment. Apart from daily treatment with SSRIs, PE can be delayed by on-demand use of topical anaesthetics. Treatment with phosphodiesterase type 5 inhibitors may be used if PE is accompanied by erectile difficulties.

Original languageEnglish
Pages (from-to)765-774
Number of pages10
JournalKorean Journal of Urology
Volume49
Issue number9
DOIs
Publication statusPublished - 2008 Sep 1

Fingerprint

Premature Ejaculation
Ejaculation
Serotonin Uptake Inhibitors
Paroxetine
Antidepressive Agents
Serotonin
Phosphodiesterase 5 Inhibitors
Sertraline
Clomipramine
Fluoxetine
Local Anesthetics
Meta-Analysis
Spinal Cord
Brain
Pharmaceutical Preparations

All Science Journal Classification (ASJC) codes

  • Urology

Cite this

Ham, Won Sik ; Kim, Won Tae ; Choi, Hyung Ki ; Choi, Young Deuk. / Recent concepts of premature ejaculation. In: Korean Journal of Urology. 2008 ; Vol. 49, No. 9. pp. 765-774.
@article{9c0228805e7b40e0a6df3a97abdd5034,
title = "Recent concepts of premature ejaculation",
abstract = "Premature ejaculation (PE) is the most prevalent male sexual complaint, yet it remains underdiagnosed and undertreated. The sympathetic, parasympathetic, and somatic spinal centers, under the influence of sensory genital and cerebral stimuli integrated and processed at the spinal cord level, act in synergy to command physiologic events occurring during ejaculation. Experimental evidence indicates that serotonin (5-HT), throughout brain descending pathways, exerts an inhibitory role on ejaculation and pharmacologic manipulation of the serotonergic system has been performed in rats, with the antidepressant selective serotonin reuptake inhibitors (SSRIs) exhibiting the greatest efficacy in delaying ejaculation. Over the last decade, an increasing number of studies of drug treatment of PE have been published. A meta-analysis of those studies demonstrated similar efficacies for daily treatment with the serotonergic antidepressants paroxetine hemihydrate, clomipramine, sertraline and fluoxetine, with paroxetine (hydrochloride) hemihydrate exerting the strongest effect on ejaculation. On the basis of fundamental insights into serotonergic neuro-transmission, it has been suggested that on-demand selective serotonin reuptake inhibitor (SSRI) treatment will not lead to similarly impressive delays in ejaculation as has been observed with daily SSRI treatment. Apart from daily treatment with SSRIs, PE can be delayed by on-demand use of topical anaesthetics. Treatment with phosphodiesterase type 5 inhibitors may be used if PE is accompanied by erectile difficulties.",
author = "Ham, {Won Sik} and Kim, {Won Tae} and Choi, {Hyung Ki} and Choi, {Young Deuk}",
year = "2008",
month = "9",
day = "1",
doi = "10.4111/kju.2008.49.9.765",
language = "English",
volume = "49",
pages = "765--774",
journal = "Korean Journal of Urology",
issn = "2005-6737",
publisher = "Korean Urological Association",
number = "9",

}

Recent concepts of premature ejaculation. / Ham, Won Sik; Kim, Won Tae; Choi, Hyung Ki; Choi, Young Deuk.

In: Korean Journal of Urology, Vol. 49, No. 9, 01.09.2008, p. 765-774.

Research output: Contribution to journalReview article

TY - JOUR

T1 - Recent concepts of premature ejaculation

AU - Ham, Won Sik

AU - Kim, Won Tae

AU - Choi, Hyung Ki

AU - Choi, Young Deuk

PY - 2008/9/1

Y1 - 2008/9/1

N2 - Premature ejaculation (PE) is the most prevalent male sexual complaint, yet it remains underdiagnosed and undertreated. The sympathetic, parasympathetic, and somatic spinal centers, under the influence of sensory genital and cerebral stimuli integrated and processed at the spinal cord level, act in synergy to command physiologic events occurring during ejaculation. Experimental evidence indicates that serotonin (5-HT), throughout brain descending pathways, exerts an inhibitory role on ejaculation and pharmacologic manipulation of the serotonergic system has been performed in rats, with the antidepressant selective serotonin reuptake inhibitors (SSRIs) exhibiting the greatest efficacy in delaying ejaculation. Over the last decade, an increasing number of studies of drug treatment of PE have been published. A meta-analysis of those studies demonstrated similar efficacies for daily treatment with the serotonergic antidepressants paroxetine hemihydrate, clomipramine, sertraline and fluoxetine, with paroxetine (hydrochloride) hemihydrate exerting the strongest effect on ejaculation. On the basis of fundamental insights into serotonergic neuro-transmission, it has been suggested that on-demand selective serotonin reuptake inhibitor (SSRI) treatment will not lead to similarly impressive delays in ejaculation as has been observed with daily SSRI treatment. Apart from daily treatment with SSRIs, PE can be delayed by on-demand use of topical anaesthetics. Treatment with phosphodiesterase type 5 inhibitors may be used if PE is accompanied by erectile difficulties.

AB - Premature ejaculation (PE) is the most prevalent male sexual complaint, yet it remains underdiagnosed and undertreated. The sympathetic, parasympathetic, and somatic spinal centers, under the influence of sensory genital and cerebral stimuli integrated and processed at the spinal cord level, act in synergy to command physiologic events occurring during ejaculation. Experimental evidence indicates that serotonin (5-HT), throughout brain descending pathways, exerts an inhibitory role on ejaculation and pharmacologic manipulation of the serotonergic system has been performed in rats, with the antidepressant selective serotonin reuptake inhibitors (SSRIs) exhibiting the greatest efficacy in delaying ejaculation. Over the last decade, an increasing number of studies of drug treatment of PE have been published. A meta-analysis of those studies demonstrated similar efficacies for daily treatment with the serotonergic antidepressants paroxetine hemihydrate, clomipramine, sertraline and fluoxetine, with paroxetine (hydrochloride) hemihydrate exerting the strongest effect on ejaculation. On the basis of fundamental insights into serotonergic neuro-transmission, it has been suggested that on-demand selective serotonin reuptake inhibitor (SSRI) treatment will not lead to similarly impressive delays in ejaculation as has been observed with daily SSRI treatment. Apart from daily treatment with SSRIs, PE can be delayed by on-demand use of topical anaesthetics. Treatment with phosphodiesterase type 5 inhibitors may be used if PE is accompanied by erectile difficulties.

UR - http://www.scopus.com/inward/record.url?scp=53849143984&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=53849143984&partnerID=8YFLogxK

U2 - 10.4111/kju.2008.49.9.765

DO - 10.4111/kju.2008.49.9.765

M3 - Review article

AN - SCOPUS:53849143984

VL - 49

SP - 765

EP - 774

JO - Korean Journal of Urology

JF - Korean Journal of Urology

SN - 2005-6737

IS - 9

ER -