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premature ejaculation
Persistent or recurrent ejaculation with minimal sexual stimulation before, upon, or shortly after penetration & before the person wishes it.
Etiology: organic factors are rarely the cause
Epidemiology:
1) most prevalent form of male sexual dysfunction
2) affects 30% of men
Clinical manifestations:
- generally present with onset of sexual activity
Management:
1) behavioral strategies focusing on awareness
- limited benefit
2) selective serotonin-reuptake inhibitors 1st line [1]
- paroxetine may be most effective SSRI [1]
4) topical lidocaine
3) clomipramine of modest benefit
General
ejaculatory dysfunction
References
- Medical Knowledge Self Assessment Program (MKSAP) 11, 18, 19.
American College of Physicians, Philadelphia 1998, 2018, 2022.
- Liu H, Zhang M, Huang M, et al.
Comparative efficacy and safety of drug treatment for premature ejaculation:
a systemic review and Bayesian network meta-analysis.
Andrologia. 2020;52:e13806.
PMID: 32892379