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Review
. 2023 Aug 3;15(8):e42913.
doi: 10.7759/cureus.42913. eCollection 2023 Aug.

Topical Anesthetics and Premature Ejaculation: A Systematic Review and Meta-Analysis

M Danial Ali Shah  1 , Safdar Shah  2 , Nadeem Bin Nusrat  1 , Nauman Zafar  1 , Assad Ur Rehman  1
Affiliations
Review

Topical Anesthetics and Premature Ejaculation: A Systematic Review and Meta-Analysis

M Danial Ali Shah et al. Cureus. .

Abstract

This meta-analysis was conducted to assess the effectiveness of topical anesthetics in preventing premature ejaculation. We conducted an online database search for original studies comparing topical anesthetic agents with placebo in patients with premature ejaculation. After selecting relevant articles, we extracted data on baseline characteristics and predetermined endpoints. Intravaginal ejaculatory latency time (IELT) was the primary outcome for efficacy. Mean differences and corresponding 95% confidence intervals were used to present continuous data. A random-effects model was used to pool the data, and subgroup analysis was performed based on the type of anesthetic agent used. Eleven randomized controlled trials were examined, involving a total of 2008 participants. After analyzing the combined results, it was found that Severance Secret (SS) cream (CJ CheilJedang Corporation, Seoul, South Korea) demonstrated significantly higher effectiveness than a placebo in increasing IELT (P = 0.001). Similarly, the topical eutectic mixture for premature ejaculation (TEMPE), lidocaine, and the eutectic mixture of local anesthetics (EMLA) were significantly more efficient than a placebo (P<0.00001; P = 0.0001; P<0.00001). Additionally, it was found that lidocaine gel was more efficient than paroxetine or sildenafil (P = 0.04; P<0.00001). In conclusion, topical anesthetics increase IELT in men with premature ejaculation more effectively than placebo, sildenafil, tadalafil, paroxetine, and dapoxetine.

Keywords: meta-analysis; premature ejaculation; sexual health; systematic review; topical anesthetics.

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Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Figure 1
Figure 1. PRISMA flowchart of selection of studies.
PRISMA, Preferred Reporting Items for Systematic Reviews and Meta-Analyses
Figure 2
Figure 2. Risk of bias assessment summary.
References: [11-21]
Figure 3
Figure 3. Forest plot comparing the effect of topical agents and placebo on IELT.
SS: Severance Secret*; EMLA: eutectic mixture of local anesthetics; TEMPE: topical eutectic-like mixture for premature ejaculation; IELT: intravaginal ejaculation latency time References: [11-18, 20] *CJ CheilJedang Corporation, Seoul, South Korea
Figure 4
Figure 4. Forest plot comparing the effect of topical agents and oral agents on IELT.
PDE5i: phosphodiesterase type 5 inhibitor; SSRI: selective serotonin reuptake inhibitor; IELT: intravaginal ejaculation latency time References: [18-19, 21]
See this image and copyright information in PMC

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