Department of Psychiatry, University of Miami Miller School of Medicine, West Palm Beach, FL, USA.
J Sex Med. 2010 Sep;7(9):2947-69. doi: 10.1111/j.1743-6109.2010.01975.x.
Over the past 20 years our knowledge of premature ejaculation (PE) has significantly advanced. Specifically, we have witnessed substantial progress in understanding the physiology of ejaculation, clarifying the real prevalence of PE in population-based studies, reconceptualizing the definition and diagnostic criterion of the disorder, assessing the psychosocial impact on patients and partners, designing validated diagnostic and outcome measures, proposing new pharmacologic strategies and examining the efficacy, safety and satisfaction of these new and established therapies. Given the abundance of high level research it seemed like an opportune time for the International Society for Sexual Medicine (ISSM) to promulgate an evidenced-based, comprehensive and practical set of clinical guidelines for the diagnosis and treatment of PE.
Develop clearly worded, practical, evidenced-based recommendations for the diagnosis and treatment of PE for family practice clinicians as well as sexual medicine experts. Method. Review of the literature.
This article contains the report of the ISSM PE Guidelines Committee. It affirms the ISSM definition of PE and suggests that the prevalence is considerably lower than previously thought. Evidence-based data regarding biological and psychological etiology of PE are presented, as is population-based statistics on normal ejaculatory latency. Brief assessment procedures are delineated and validated diagnostic and treatment questionnaires are reviewed. Finally, the best practices treatment recommendations are presented to guide clinicians, both familiar and unfamiliar with PE, in facilitating treatment of their patients.
Development of guidelines is an evolutionary process that continually reviews data and incorporates the best new research. We expect that ongoing research will lead to a more complete understanding of the pathophysiology as well as new efficacious and safe treatments for this sexual dysfunction. Therefore, it is strongly recommended that these guidelines be re-evaluated and updated by the ISSM every 4 years.
在过去的 20 年中,我们对早泄(PE)的认识有了显著的提高。具体来说,我们在理解射精生理学方面取得了重大进展,在基于人群的研究中澄清了 PE 的真实流行率,重新概念化了该障碍的定义和诊断标准,评估了对患者和伴侣的心理社会影响,设计了经过验证的诊断和结局测量方法,提出了新的药理学策略,并研究了这些新疗法和既定疗法的疗效、安全性和满意度。鉴于高水平研究的大量涌现,似乎是国际性医学会(ISSM)颁布一套基于证据、全面且实用的 PE 诊断和治疗临床指南的适当时机。
为家庭实践临床医生和性医学专家制定明确、实用、基于证据的 PE 诊断和治疗建议。
文献回顾。
本文包含了 ISSM PE 指南委员会的报告。它确认了 ISSM 对 PE 的定义,并表明其流行率远低于先前的估计。本文还介绍了与 PE 的生物学和心理学病因相关的基于证据的数据,以及关于正常射精潜伏期的人群统计学数据。描述了简要评估程序,并回顾了验证诊断和治疗问卷。最后,提出了最佳实践治疗建议,以指导对 PE 既熟悉又不熟悉的临床医生,帮助他们为患者提供治疗。
指南的制定是一个不断审查数据并纳入最新最佳研究的演进过程。我们预计,正在进行的研究将导致对这种性功能障碍的病理生理学有更全面的了解,并为其提供新的有效且安全的治疗方法。因此,强烈建议 ISSM 每 4 年对这些指南进行重新评估和更新。