Dinsmore WW et al. (2007) Topical eutectic mixture for premature ejaculation (TEMPE): a novel aerosol-delivery form of lidocaine–prilocaine for treating premature ejaculation. BJU Int 99: 369–375

Current treatments for premature ejaculation lose efficacy over time (because of behavior modification), have adverse effects (penile anesthesia) or must be used with a condom (topical creams). Dinsmore and colleagues investigated the efficacy and safety of topical eutectic lidocaine–prilocaine mixture for premature ejaculation (TEMPE), applied to the glans penis via a metered-dose, desensitizing aerosol spray.

In this double-blind, randomized, multicenter, phase II study, the authors evaluated data from 54 men (aged 18–75 years) in stable heterosexual relationships, who had clinically diagnosed premature ejaculation for ≥6 months and a baseline intravaginal ejaculatory latency time (IELT) of ∼1 min (mean of values on three consecutive attempts during 1 month). The men were randomly allocated to use TEMPE or placebo spray for 1 month; 43 men used the spray at least once, and their IELTs were determined as the mean of values from all intercourse attempts.

Active treatment resulted in a clinically meaningful increase in mean IELTs (from ∼1 min at baseline to 4.9 min at follow-up), and statistical analysis showed that TEMPE was 2.4 times more effective than placebo. Ejaculatory control increased, as did sexual quality of life for men and their partners. TEMPE was well tolerated by men and their partners; mild or moderate local numbness was experienced by 3 of 26 TEMPE-treated patients.

The authors suggest that TEMPE is fast-acting, easy-to-use, effective and safe. Further large-scale studies are warranted to establish the usefulness of TEMPE as a first-line treatment for premature ejaculation.