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Comparison of efficacy of sildenafil-only, sildenafil plus topical EMLA cream, and topical EMLA- cream-only in treatment of premature ejaculation.

Third Department of Urology, Ministvy of Health, Ankara Numune Research and Training Hospital, Ankara, Turkey.

Urology, 2006,67: 388-391.

Objectives Cette étude ne retrouve pas de différence significative entre le placebo et le SildenaJilB, démontrant indirectement l'influence To compare the efficacy of sildenafil (Viagra) only, sildenafil

du 'Ipsychologique"sur I'éjaculation. On peut regretter Iabsen- plus topical anesthetic cream (EMLA), and topical EMLA-

ce d'analyse objective sur la durée d'apparition de l'éjaculation cream-only to that of placebo in treating premature ejaculation.

dans les différents groupes avant et après traitement, qui aurait Methods permis une analyse plus concrète des résultats. Aucun effet . . A total of 84 patients were enrolled in this study. The duration of secondaire du traitement topique n'a été recensé chez l'homme, premature ejaculation in the patients ranged from 9 to 60 months en particulier les irritations et les anorgasmies qui ont été rap- (mean 32.5

*

14.6). Patients were randomized into four groups. portées chez la femme dont l'avis n 'a pas été recueilli dans cette Group 1 consisted of 20 patients who took placebo for 2 months. étude. Celle-ci met néanmoins à nouveau en évidence I'efficaci- Groups 2 and 3 consisted of 20 and 22 patients, respectively, and té des traitements anesthésiques locaux dans la prise en charge they received 50 mg sildenafil45 minutes before coitus for 2 de ces patients.

mokths. In additionTpatients in group 3 applied topical EMLA cream to the glans penis 15 minutes before coitus. The 22 patients in group 4 used topical EMLA-cream-only. After at least eight sexual attempts, the patients' clinical responses were assessed using the patient self-description method. Effectiveness was described as improvement plus cure.

Results

The effectiveness was 40% in group 1,55% in group 2,86.4% in group 3, and 77.3% in group 4. Of the groups, a significant diffe- rence was found in the effectiveness of the treatments (Pearson chi-square = 0.00). No significant difference was found between groups 1 and 2 (P = 0.26). Efficacy was more successful in groups 3 and 4 than in the others (P = 0.00). The difference bet- ween groups 3 and 4 was not significant (Pearson chi-square =

0.42).

Conclusions

Sildenafil-only was not supenor to placebo or combination treat- ment. Topical EMLA-cream-only had equal effectiveness to that of sildenafil plus topical EMLA treatment. The use of topical EMLA-cream-only seems to be an effective treatment of prema- ture ejaculation.

Commentaires

L'éjaculation prématurée est un problème très fréquent, tou- chantplus de 20% des hommes dans certaines études. De nou- veaux traitements sont en voie de recherche et la prise en charge est basée essentiellement sur l'association de thérapies compor- tementales, des traitements locaux à base d'anesthésiques et des inhibiteurs de la recapture de la sérotonine. Les IPDES agi- raient en diminuant lapériode réfractairepost-olgasmique mais aussi peut être sur l'éjaculation elle-même en relâchant lesfib- res musculaires lisses des vésicules séminales et de la prostate.

M. DEMAILLY, Urologie, Hôpital Sud, CHU d'Amiens, Amiens

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