[Recommendations for the treatment of premature ejaculation]

Abstract

Objectives: The Post-University Interdisciplinary Association of Sexology (AIUS) has brought together a panel of experts to develop French recommendations for the management of premature ejaculation.

Methods: Systematic review of the literature between 01/1995 and 02/2022. Use of the clinical practice guidelines (CPR) method.

Results: We recommend giving all patients with PE psychosexological counseling, and whenever possible combining pharmacotherapies and sexually-focused cognitive-behavioral therapies, involving the partner in the treatment process. Other sexological approaches could be useful. We recommend the use of dapoxetine as first-line, on-demand oral therapy for primary and acquired PE. We recommend the use of lidocaine 150mg/mL/prilocaine 50mg/mL spray as local treatment for primary PE. We suggest the combination of dapoxetine and lidocaine/prilocaine in patients insufficiently improved by monotherapy. In patients who have not responded to treatments with marketing authorisation, we suggest using an off-label SSRI, preferably paroxetine, in the absence of a contraindication. We recommend treating ED before PE in patients with both symptoms. We do not recommend using α-1 blockers or tramadol in patients with PE. We do not recommend routine posthectomy or penile frenulum surgery for PE.

Conclusion: These recommendations should contribute to improving the management of PE.

Keywords: Dapoxetine; Dapoxétine; Médecine sexuelle; Premature ejaculation; Sexologie; Sexology; Sexual medicine; Éjaculation précoce.