2nd Department of Urology, School of Medicine, Sismanoglio Hospital, National and Kapodistrian University of Athens, Athens, Greece.
Department of Surgery, School of Medicine, Aretaieion Hospital, National and Kapodistrian University of Athens, Athens, Greece.
Expert Opin Pharmacother. 2022 Jun;23(9):1043-1050. doi: 10.1080/14656566.2022.2035361. Epub 2022 Feb 2.
Premature ejaculation (PE) is a sexual dysfunction of unknown etiology affecting a substantial number of males and deteriorating sexual health and quality of life of the patient and his partner. Treatment still remains challenging; however, pharmacotherapy is considered the mainstay of therapy with behavioral and psychosexual interventions being particularly important as adjudicate procedures, within the context of a holistic approach.
The authors review the literature on the available medications for PE, both officially registered and non-registered. Currently, only dapoxetine and an anesthetic spray containing lidocaine and prilocaine (Fortacin™) are officially approved, with the rest being used off-label. Herein, updated data regarding the efficacy and safety of the pharmaceutical agents are presented.
On-demand dapoxetine is reportedly efficacious and safe in treating lifelong PE and is the first medication to be approved for this purpose. Fortacin has also shown considerable efficacy and may be reliably used on-demand. Phosphodiesterase type 5 inhibitors (PDE5Is) have been found to be effective in the treatment of PE and are therefore recommended either as monotherapy or combined with other therapies (i.e. dapoxetine). Adverse events of any therapy should be taken under consideration. Physicians should encourage patients to discuss their needs and expectations and grade any improvement of their condition with treatment.
早泄（PE）是一种病因不明的性功能障碍，影响了大量男性，降低了患者及其伴侣的性健康和生活质量。尽管治疗仍然具有挑战性，但药物治疗被认为是主要的治疗方法，行为和性心理干预尤为重要，是整体治疗方法中的判断程序。
作者回顾了有关 PE 可用药物的文献，包括已注册和未注册的药物。目前，只有达泊西汀和含有利多卡因和丙胺卡因的麻醉喷雾剂（Fortacin™）正式获得批准，其余药物均为非适应证用药。本文提供了关于这些药物制剂的疗效和安全性的最新数据。
按需使用达泊西汀治疗终身性 PE 被报道是有效且安全的，是第一种为此目的获得批准的药物。Fortacin 也显示出相当的疗效，可以可靠地按需使用。磷酸二酯酶 5 抑制剂（PDE5Is）已被证明对 PE 治疗有效，因此被推荐单独使用或与其他治疗方法（如达泊西汀）联合使用。任何治疗的不良反应都应加以考虑。医生应鼓励患者讨论他们的需求和期望，并对治疗效果进行评分。
