Sato Yoshikazu, Otani Toshikazu, Amano Toshiyasu, Araki Tohru, Kondou Nobuyuki, Matsukawa Masanori, Tobe Musashi, Haga Kazunori, Uchida Kousuke, Honma Ichiya
Department of Urology, Sanjukai Hospital, Sapporo, Hokkaido, Japan.
Department of Urology, Chubu Rosai Hospital, Nagoya, Aichi, Japan.
Int J Urol. 2017 Aug;24(8):626-631. doi: 10.1111/iju.13392. Epub 2017 Jun 18.
To determine the efficacy of two α1-adrenoceptor antagonists with different affinities for α1-adrenoceptor subtypes, silodosin and naftopidil, in the treatment of premature ejaculation.
This was a prospective, open-label, multicenter trial. A total of 26 patients with untreated acquired premature ejaculation were enrolled. Premature ejaculation was defined based on the International Society for Sexual Medicine recommendation. Patients self-administered on demand silodosin 4 mg or naftopidil 25 mg 1 h before intercourse, alternating drugs at least three times each. Clinical global impression change for premature ejaculation, premature ejaculation profile, and intravaginal ejaculation latency time were evaluated at baseline and during treatment.
Due to clinical global impression change, 24 patients (92%) and 12 patients (46%) reported improvement in their own premature ejaculation problems under silodosin and nafitopidil administration, respectively. Silodosin treatment produced a significantly higher improvement rate compared with naftopidil (P = 0.0002). Objectively, silodosin significantly prolonged intravaginal ejaculation latency time compared with baseline and naftopidil (P < 0.01). Mean intravaginal ejaculation latency times were 1.9, 4.1, and 7.6 min at baseline, control and with silodosin, respectively. The rate of reduced semen volume during silodosin treatment was higher than during naftopidil treatment. There were no adverse systemic effects in either group.
Silodosin, a highly selective α1A-adrenoceptor antagonist, produces greater improvements in premature ejaculation profiles and related symptoms along with intravaginal ejaculation latency time in acquired premature ejaculation patients with or without erectile dysfunction. This result supports the clinical use of silodosin as an alternative treatment for premature ejaculation.
确定两种对α1 - 肾上腺素能受体亚型亲和力不同的α1 - 肾上腺素能受体拮抗剂西洛多辛和萘哌地尔治疗早泄的疗效。
这是一项前瞻性、开放标签、多中心试验。共纳入26例未经治疗的获得性早泄患者。早泄根据国际性医学学会的建议进行定义。患者在性交前1小时按需自行服用4毫克西洛多辛或25毫克萘哌地尔，每种药物至少交替使用三次。在基线和治疗期间评估早泄的临床总体印象变化、早泄概况和阴道内射精潜伏期。
根据临床总体印象变化，分别有24例患者（92%）和12例患者（46%）报告在服用西洛多辛和萘哌地尔治疗后自身早泄问题有所改善。与萘哌地尔相比，西洛多辛治疗的改善率显著更高（P = 0.0002）。客观上，与基线和萘哌地尔相比，西洛多辛显著延长了阴道内射精潜伏期（P < 0.01）。基线、对照和服用西洛多辛时的平均阴道内射精潜伏期分别为1.9分钟、4.1分钟和7.6分钟。西洛多辛治疗期间精液量减少的发生率高于萘哌地尔治疗期间。两组均未出现不良全身效应。
西洛多辛是一种高度选择性的α1A - 肾上腺素能受体拮抗剂，在有或无勃起功能障碍的获得性早泄患者中，对早泄概况及相关症状以及阴道内射精潜伏期有更大改善。这一结果支持西洛多辛作为早泄替代治疗的临床应用。
