AB176. Assessing efficacy of drug treatment of premature ejaculation

Introduction: Premature (PE) or rapid ejaculation is common form of sexual dysfunction in men. According to the latest statistics about 30% of all representatives of a strong half of humanity suffer from this problem. Today in the world there are several types of questionnaires to identify PE, such as CIPE, AIPE, PEP, PEDT, CPE including CIPE-5.

Objective: Purpose of our study was to compare the effectiveness of different methods of treating PE.

Materials and methods: In the period from 07/06/2012 to 31/05/2014, we examined 520 male patients attending a Republican Specialized Urology Center for examination and treatment regardless of nosology. Further, patients were asked to answer the standard questions shortened version of the Chinese index of premature ejaculation (CIPE-5), to determine the severity of premature ejaculation. To determine the scale of severity of erectile dysfunction (ED), used standard questions shortened version of the International Index of Erectile Dysfunction (IIEF-5). Exclusion criteria were: patients with ED and/or the presence of a urinary tract infection, low levels of testosterone, polygamous, scoring over 18 points on domains CIPE-5 and scored less than 21 points on the IIEF-5 domains. Based on the inclusion and exclusion criteria, 244 patients depending on the type of treatment were divided into three groups: the first group (n=106) received monotherapy with selective serotonin reuptake inhibitors (SSRIs). Age ranged from 20 to 56 years, mean 32.43±0.79 years (M ± m). Average amount of points CIPE-5 was 7.21±0.22 (M ± m), and the average amount of points IIEF-5 score was 22.39±0.15 (M ± m) intravaginal ejaculatory latency duration time (IELT), was from 10 to 300 seconds, the average was 1.57±0.10 min (M ± m). The second group (n=105) received combined therapy with inhibitors of phosphodiesterasetype-5 (PDE-5) and SSRIs. The age of patients ranged from 19 to 59, the mean age was 30.88±0.76 years (M ± m). Average amount of points CIPE-5 was 6.99±0.19 (M ± m), and the average amount of points IIEF-5 score was 22.10±0.13 (M ± m), IELT ranged from 7 to 180 seconds, average was 1.32±0.08 min (M ± m). The third group (n=33) received a monotherapy with inhibitors of phosphodiesterasetype-5 (PDE-5). The age of patients ranged from 22 to 59, the mean age was 31.58±1.45 years (M ± m). Average amount of points CIPE-5 was 6.61±0.47 (M ± m), and IIEF-5 score was 22.21±0.20 (M ± m), as well IELT ranged from 2 to 600 seconds, which is in average 1.52±0.34 min (M ± m).

Results: In the first group of patients, after 2 months of treatment IELT increased and amounted on average, was 5.41±0.14 m (P<0.001). Summary on the same score in the CIPE-5 increased, reaching an average of 19.86±0.24 (P<0.001), but scores on the IIEF-5 decreased reaching an average of 19.86±0.16 (P>0.05). The second group had the following results: IELT increased, reaching an average, 7.61±0.32 (P<0.001). Summary on the same score in the CIPE-5 increased, on average 22.70±0.37 (P<0.001), and scores on the IIEF-5 increased reaching an average of 23.28±0.10 (P>0.05). In the third group IELT was on average, 2.94±0.33 min (P<0.05). Summary on the same score in the CIPE-5 was on average 12.15±0.67 (P<0.05), but scores on the IIEF-5 increased reaching an average of 23.67±0.14 (P>0.05).

Conclusions: Therapy of patients who is suffering from premature ejaculation by applying serotonin reuptake inhibitors in combination with inhibitors of phosphodiesterase type-5 is safe and more effective against other groups.

Keywords: Premature ejaculation (PE); drug treatment; efficacy