Siroosbakht Soheila, Rezakhaniha Sadra, Rezakhaniha Bijan
Faculty of Medicine, Imam Reza Hospital, Aja University of Medical Sciences, Tehran, Iran.
Department of Nutrition, Science and Research Islamic Azad University, Tehran, Iran.
Asian J Urol. 2021 Apr;8(2):209-214. doi: 10.1016/j.ajur.2019.10.002. Epub 2019 Oct 18.
The intravaginal ejaculatory latency time (IELT) may increase less in on-demand compared to daily intake, but may fulfill a suitable treatment for specific patients. We decided to compare the efficacy and safety of on-demand and daily use of sertraline in order to find the most effective and least complicated method in treatment of premature ejaculation (PE).
This study was parallel or concurrent control randomized clinical trial. Two hundred and forty patients with PE diagnosed by urologist in the two groups of 120 from July 2017 to February 2019 enrolled in the study. In the first group, it is prescribed 50 mg sertraline each 12 h daily and the second group received 50 mg 4 h before coitus for 4 and 8 weeks. The IELT before treatment and during all coitus after treatment were recorded by the patient's wife with a stopwatch.
Mean IELT before, 4 and 8 weeks after treatment in two groups were: On-demand group 101.62±65.44 s, 208.75±128.02 s and 265.87±145.70 s; daily use group 102.50±81.22 s, 276.87±181.08 s and 353.75±176.45 s, respectively. The ejaculation time increased significantly in both groups (<0.05). However, increase in ejaculation time in daily use group was significantly higher than the on-demand group in 4 weeks (=0.036), especially in 8 weeks (=0.009). The percent of side effects in daily use group (26.7%) was higher than on-demand group (20%) (<0.05). Drowsiness, diarrhea and vertigo were significantly higher in the daily use than on-demand (<0.05).
On-demand and daily use of sertraline are effective and usually have no serious complications, but the on-demand method is considerably more tolerable. In patients who did not tolerate to daily use of this drug, on-demand could be used as a salvage therapy.
与每日服用相比，按需服用舍曲林时阴道内射精潜伏期（IELT）的增加可能较少，但对特定患者可能是一种合适的治疗方法。我们决定比较按需服用和每日服用舍曲林的疗效和安全性，以找出治疗早泄（PE）最有效且最简便的方法。
本研究为平行或同期对照随机临床试验。2017年7月至2019年2月，两组各120例经泌尿科医生诊断为PE的患者纳入研究。第一组患者每日每12小时服用50毫克舍曲林，第二组患者在性交前4小时服用50毫克，持续4周和8周。治疗前及治疗后所有性交过程中的IELT由患者妻子用秒表记录。
两组治疗前、治疗后4周和8周的平均IELT分别为：按需服用组101.62±65.44秒、208.75±128.02秒和265.87±145.70秒；每日服用组102.50±81.22秒、276.87±181.08秒和353.75±176.45秒。两组射精时间均显著增加（P<0.05）。然而，每日服用组射精时间的增加在4周时显著高于按需服用组（P=0.036），在8周时尤其明显（P=0.009）。每日服用组的副作用发生率（26.7%）高于按需服用组（20%）（P<0.05）。每日服用组的嗜睡、腹泻和眩晕发生率显著高于按需服用组（P<0.05）。
按需服用和每日服用舍曲林均有效且通常无严重并发症，但按需服用方法的耐受性更好。对于不耐受每日服用该药的患者，按需服用可作为挽救疗法。
