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Pharmacotherapy of premature ejaculation: a systematic review and network meta-analysis
- Source :
- International urology and nephrology. 50(11)
- Publication Year :
- 2018
-
Abstract
- The purpose of the study was to conduct a systematic evaluation of the different general prescribed drugs for premature ejaculation (PE). A systematic literature search of MEDLINE, Cochrane Central Register of Controlled Trials, and Web of Science for Systematic Reviews was performed on 1 March 2018. Intravaginal ejaculation latency time (IELT) was the main outcome. Analysis was performed under multivariate random-effects network model and efficacies of drugs were ranked with surface under the cumulative ranking (SUCRA) probabilities. A total of 48 studies were reviewed and 40 of them were further enrolled into network meta-analysis. The majority of RCTs were of unclear methodological quality. Pooled evidence suggested that topical anaesthetic creams (TAs), tramadol, selective serotonin reuptake inhibitors (SSRIs), and phosphodiesterase type 5 inhibitors (PDE5is) are more effective at prolonging IELT comparing with placebo. TAs (90%) on demand (OD) and PDE5is plus SSRI (89.8%) had the highest SUCRA, which meant the most probable to be the most effective intervention. We recommend the initial use of dapoxetine 30 mg OD for PE because it has been tested in largest and better designed clinical trials rather than it is more effective than the other drugs studied. TAs and tramadol 50 mg OD can be used as a viable alternative to oral treatment with SSRIs. PDE5is combined with SSRIs are more effective than SSRIs monotherapy but are also associated with more side effects. PDE5is OD can be recommended to PE patients with ED.
- Subjects :
- Male
medicine.medical_specialty
Urology
030232 urology & nephrology
Placebo
03 medical and health sciences
0302 clinical medicine
Internal medicine
Premature ejaculation
medicine
Humans
Anesthetics, Local
Premature Ejaculation
Tramadol
030219 obstetrics & reproductive medicine
business.industry
Phosphodiesterase 5 Inhibitors
Dapoxetine
Clinical trial
Analgesics, Opioid
Systematic review
Nephrology
Meta-analysis
Intravaginal ejaculation latency time
medicine.symptom
business
Selective Serotonin Reuptake Inhibitors
medicine.drug
Subjects
Details
- ISSN :
- 15732584
- Volume :
- 50
- Issue :
- 11
- Database :
- OpenAIRE
- Journal :
- International urology and nephrology
- Accession number :
- edsair.doi.dedup.....178ec60b86147d044c814934b5effe26