Department of Urology, Sanjukai Hospital, Sapporo, Hokkaido, Japan.
Int J Urol. 2012 Mar;19(3):268-72. doi: 10.1111/j.1442-2042.2011.02941.x. Epub 2011 Dec 20.
Premature ejaculation is a common sexual problem, as is erectile dysfunction. We evaluated silodosin, a highly selective α1A-adrenoceptor antagonist, as a new treatment option for premature ejaculation. α1-Adrenoceptor antagonists are widely used for lower urinary tract symptoms, and clinical studies on silodosin have shown excellent clinical efficacy for lower urinary tract symptoms. However, compared with other α1-adrenoceptor antagonists, silodosin appeared to suppress ejaculation in a relatively higher percent of trial participants. This suppression of ejaculation by silodosin suggested its potential for treating premature ejaculation. Consequently, we evaluated the feasibility of off-label silodosin as a new treatment option for premature ejaculation. Eight patients suffering premature ejaculation were treated with silodosin. Silodosin (4 mg) was given 2 h before sexual intercourse. Intravaginal ejaculatory latency time, premature ejaculation profile item, clinical global impression change in premature ejaculation and systemic adverse events were recorded. Intravaginal ejaculatory latency time was significantly prolonged (from 3.4 min to 10.1 min, P = 0.003). All patients answered better (much better) or slightly better for their own premature ejaculation problem compared with pretreatment condition in the clinical global impression change. Premature ejaculation profile also significantly improved. Two (25%), three (37.5%) and seven patients (87.5%) experienced anejaculation, reduced semen volume and discomfort during orgasm, respectively. However, these problems were not of major concern for the participants. No systemic adverse effects were reported. The current results support the possible use of silodosin as a new treatment option for premature ejaculation, and suggest that a placebo controlled study assessing its clinical usefulness would be worthwhile.
早泄是一种常见的性问题，勃起功能障碍也是如此。我们评估了作为一种新的治疗选择的高选择性 α1A-肾上腺素能受体拮抗剂——西洛多辛治疗早泄。α1-肾上腺素能受体拮抗剂广泛用于治疗下尿路症状，西洛多辛的临床研究表明其对下尿路症状具有出色的临床疗效。然而，与其他 α1-肾上腺素能受体拮抗剂相比，西洛多辛似乎在更高比例的试验参与者中抑制射精。西洛多辛对射精的这种抑制作用表明其在治疗早泄方面具有潜力。因此，我们评估了将西洛多辛作为治疗早泄的新治疗选择的可行性。8 名早泄患者接受了西洛多辛治疗。在性行为前 2 小时给予西洛多辛（4mg）。记录阴道内射精潜伏期、早泄症状量表、早泄临床整体印象变化和全身不良事件。阴道内射精潜伏期显著延长（从 3.4 分钟延长至 10.1 分钟，P = 0.003）。与治疗前相比，所有患者在早泄临床整体印象变化中均回答自己的早泄问题改善（明显改善）或稍有改善。早泄症状量表也显著改善。2 名（25%）、3 名（37.5%）和 7 名（87.5%）患者分别出现不射精、精液量减少和射精时不适，但这些问题对参与者来说不是主要问题。没有报告全身不良反应。目前的结果支持将西洛多辛作为治疗早泄的新治疗选择的可能性，并表明评估其临床疗效的安慰剂对照研究是值得的。
