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Multicenter Study
. 2022 Jan;207(1):172-182.
doi: 10.1097/JU.0000000000002198. Epub 2021 Aug 30.

The Diagnostic Role of Neurophysiological Tests for Premature Ejaculation: A Prospective Multicenter Study

Baibing Yang  1   2 , Zhiwei Hong  3   4 , Dustin C Luse  2 , Youfeng Han  1 , Guohai Sun  1 , Yuming Feng  4 , Chenwang Zhang  5 , Chao Sun  6 , Zhipeng Xu  1 , Hai Chen  1 , Bing Yao  4 , Kaifeng Liu  5 , Weidong Zhu  6 , Yun Chen  1   7 , Run Wang  2 , Yutian Dai  1 , Jiadong Xia  8
Affiliations
Multicenter Study

The Diagnostic Role of Neurophysiological Tests for Premature Ejaculation: A Prospective Multicenter Study

Baibing Yang et al. J Urol. 2022 Jan.

Abstract

Purpose: Premature ejaculation (PE) is one of the most common male sexual dysfunctions. Local anesthetics (LAs) and dapoxetine are frequently used to treat PE; however, previous studies show variable efficacy. This study aims to determine the efficacy of LAs and dapoxetine using a novel classification based on neurophysiological tests.

Materials and methods: This multicenter cohort study enrolled adult men (568) with an intravaginal ejaculatory latency time (IELT) ≤2 minutes. Patients were divided into 4 groups according to the results of neurophysiological tests and assigned different treatments for 12 weeks: 1) penile sensory hyperexcitability type (Sens)-LAs; 2) penile sympathetic hyperexcitability type (Symp)-dapoxetine; 3) mixed type (Mixed)-both LAs and dapoxetine; 4) normal type (Norm)-both LAs and dapoxetine. Self-estimated IELT and patient-reported outcomes were recorded.

Results: The total percentage of men achieving IELT >2 minutes and ≥5 minutes after treatment were 82.7% and 76.7%, respectively. For men with abnormal results of neurophysiological tests, 401 (86.6%) had improved IELT >2 minutes after the 12-week treatment course, in which 375 (81.0%) achieved IELT ≥5 minutes. All patient-reported outcome measures improved in each group after 12 weeks of treatment, with greater improvements among those with abnormal neurophysiological tests.

Conclusions: The efficacy of LAs and dapoxetine increased in PE patients with abnormal results of neurophysiological tests. This novel classification of PE using neurophysiological tests could help guide and improve efficacy of PE therapies.

Keywords: anesthetics, local; neurophysiological monitoring; premature ejaculation; serotonin uptake inhibitors.

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Figures

Figure 1.
Figure 1.
Subject disposition. Data from all patients who took medication and reported at least once were used for analysis as intention to treat analysis.
Figure 2.
Figure 2.
Improvement of IELT and percentage of men with improved IELT over time. A, percentage of men achieving IELT >2 minutes and IELT ≥5 minutes after treatment. B, mean average IELT over time. a, p <0.05 compared with Norm group.
Figure 3.
Figure 3.
PEP change over time. A, control over ejaculation. B, satisfaction with sexual intercourse. C, personal distress. D, interpersonal difficulty. a, p <0.05 compared with Norm group.
Figure 4.
Figure 4.
Proportion of patients with improved score of PEDT, CIPE and CGI-C. a, p <0.05 compared with Norm group.
Figure 5.
Figure 5.
Neurophysiological test results. A, SEPs. B, PSSR. a, p <0.05 compared with Norm group.
See this image and copyright information in PMC

Comment in

  • Editorial Comment.
    O'Neil B. O'Neil B. J Urol. 2022 Jan;207(1):189. doi: 10.1097/JU.0000000000002180.01. Epub 2021 Sep 30. J Urol. 2022. PMID: 34587772 No abstract available.
  • Editorial Comment.
    Soubra A, Hellstrom W. Soubra A, et al. J Urol. 2022 Jan;207(1):181-182. doi: 10.1097/JU.0000000000002198.01. Epub 2021 Oct 5. J Urol. 2022. PMID: 34607448 No abstract available.

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