Mantovani Franco
Clinica San Giovanni, Milan.
Arch Ital Urol Androl. 2017 Jun 30;89(2):148-150. doi: 10.4081/aiua.2017.2.148.
Premature ejaculation (PE) is a sexual disorder characterised by excessive rapidity of orgasm. It is defined as either primary (60%), present since the onset of sexual activity, or secondary (40%), manifesting later in life. To date, dapoxetine is the only preparation approved for the on-demand treatment of PE. However, side effects, costs associated with the treatment of chronic PE, drug dependence and its variable effectiveness leads to a not insignificant drop-out rate. Dynamic rehabilitative/behavioural therapy may be a viable therapeutic option, working alongside pharmacological treatment, as long as the participation and involvement of both the individual and the couple is optimal.
18 patients were enrolled, aged between 25 and 55 (mean: 40), all with primary PE, free of comorbidities and with their partners involved. Six patients were prescribed 30 mg dapoxetine two hours before sexual relations for 3 months (group A); 6 patients began the dynamic rehabilitative treatment (group B); 6 other couples were assigned to pharmacological treatment in association with dynamic rehabilitative behavioural treatment for 3 months (group C). Division of subjects was carried out by simple randomisation, excluding patients with a short frenulum, phimosis, ED, chronic prostatitis or experiencing results from previous treatment.
Outcomes of treatment were evaluated at the end of the 3 months of treatment and 3 months after discontinuing treatment. In Group A 75% of patients were cured at 3 months and 25% at 6 months. In Group B 25% patients were cured at 3 months and 25% at 6 months. In Group C 75% of patients were cured 3 months and 50% at 6 months. "Cured" means a Premature Ejaculation Diagnostic Tool (PEDT) score reduced from an average of 12 to an average of 6 and Intravaginal Ejaculation Latency Time (IELT) values from < 1 to > 6 minutes.
the integration of pharmacological treatment with dynamic behavioural rehabilitation has the specific aim of optimising and stabilising the results, supporting a more efficient recovery of ejaculatory control. The close involvement of the partner is extremely useful for all results.
早泄（PE）是一种以性高潮过度快速为特征的性功能障碍。它被定义为原发性（60%），自性活动开始就存在，或继发性（40%），在生命后期出现。迄今为止，达泊西汀是唯一被批准用于按需治疗早泄的制剂。然而，副作用、慢性早泄治疗的费用、药物依赖性及其疗效的变异性导致了相当高的退出率。动态康复/行为疗法可能是一种可行的治疗选择，只要个体和配偶的参与度和投入度达到最佳，就可以与药物治疗协同作用。
招募了18名年龄在25至55岁之间（平均40岁）的患者，均为原发性早泄，无合并症且配偶参与。6名患者在性交前两小时服用30毫克达泊西汀，持续3个月（A组）；6名患者开始动态康复治疗（B组）；另外6对配偶被分配接受药物治疗并结合动态康复行为治疗3个月（C组）。通过简单随机化进行受试者分组，排除包皮系带过短、包茎、勃起功能障碍、慢性前列腺炎或有既往治疗史的患者。
在治疗3个月结束时和停药3个月后评估治疗结果。A组75%的患者在3个月时治愈，25%在6个月时治愈。B组25%的患者在3个月时治愈，25%在6个月时治愈。C组75%的患者在3个月时治愈，50%在6个月时治愈。“治愈”是指早泄诊断工具（PEDT）评分从平均12分降至平均6分，阴道内射精潜伏期（IELT）值从<1分钟增至>6分钟。
药物治疗与动态行为康复相结合的具体目的是优化和稳定治疗效果，支持射精控制更有效的恢复。配偶的密切参与对所有治疗结果都极为有用。
