Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

Transcutaneous electric nerve stimulation to treat patients with premature ejaculation: phase II clinical trial

Abstract

A phase II single-arm trial was conducted from June 2017 to October 2018 to evaluate the efficacy and safety of transcutaneous posterior tibial nerve stimulation (TPTNS) for premature ejaculation (PE) treatment. Twelve men with PE and no prior treatment were enrolled, one was withdrawn and 11 subjects provided data for the main outcome. TPTNS consisted of 30-min sessions of the application of 20 Hz with a pulse amplitude of 200 µsec. The intensity was adjusted based on individual sensibility. The participants received 3 weekly sessions for 12 consecutive weeks. Follow-up continued for 9 months after therapy completion. The main outcome was a threefold increase in the intravaginal ejaculation latency time (IELT) at week 12. Eleven patients completed therapy, and 54.5% (p = 0.037) showed tripled baseline IELT scores at week 12. The IELT increased 4.8-fold, 6.8-fold, and 5.4-fold at weeks 12, 24, and 48, respectively. One episode of constipation was reported, and one patient reported a sensation of heat in the leg during one therapy session. The findings suggest that TPTNS therapy delays ejaculation in patients with lifelong premature ejaculation, with no serious secondary effects. Controlled trials with larger sample sizes are needed to verify these results.

Access options

Rent or Buy article

Get time limited or full article access on ReadCube.

from$8.99

All prices are NET prices.

Fig. 1
Fig. 2
Fig. 3
Fig. 4

References

  1. 1.

    Porst H, Montorsi F, Rosen RC, Gaynor L, Grupe S, Alexander J. The premature ejaculation prevalence and attitudes (PEPA) survey: prevalence, comorbidities, and professional help-seeking. Eur Urol. 2007;51:816–24.

    Article  Google Scholar 

  2. 2.

    Sridharan K, Sivaramakrishnan G, Sequeira RP, Al-Khaja KA. Pharmacological interventions for premature ejaculation: a mixed-treatment comparison network meta-analysis of randomized clinical trials. Int J Impot Res. 2018;30:215–23.

    CAS  Article  Google Scholar 

  3. 3.

    Jin K, Deng L, Qiu S, Tu X, Li J, Bao Y, et al. Comparative efficacy and safety of phosphodiesterase-5 inhibitors with selective serotonin reuptake inhibitors in men with premature ejaculation: A systematic review and Bayesian network meta-analysis. Medicine. 2018;97:e13342.

    CAS  Article  Google Scholar 

  4. 4.

    Althof SE. Psychosexual therapy for premature ejaculation. Transl Androl Urol. 2016;5:475–81.

    Article  Google Scholar 

  5. 5.

    Russo A, Capogrosso P, Ventimiglia E, La Croce G, Boeri L, Montorsi F, et al. Efficacy and safety of dapoxetine in treatment of premature ejaculation: an evidence-based review. Int J Clin Pr. 2016;70:723–33.

    CAS  Article  Google Scholar 

  6. 6.

    Castro R, Cruz N, Cabello F, García F, Fernández A, Larrazábal M, et al. Diagnóstico, tratamiento y seguimiento de la eyaculación precoz: recomendaciones de experto. Rev Internacional de Andrología. 2017;15:70–77.

    Article  Google Scholar 

  7. 7.

    Althof SE, McMahon CG, Waldinger MD, Serefoglu EC, Shindel AW, Adaikan PG, et al. An update of the International Society of Sexual Medicine’s guidelines for the diagnosis and treatment of premature ejaculation (PE). J Sex Med. 2014;11:1392–422.

    Article  Google Scholar 

  8. 8.

    Giuliano F. Neurophysiology of erection and ejaculation. J Sex Med. 2011;8:310–5.

    Article  Google Scholar 

  9. 9.

    Alwaal A, Breyer BN, Lue TF. Normal male sexual function: emphasis on orgasm and ejaculation. Fertil Steril. 2015;104:1051–60.

    Article  Google Scholar 

  10. 10.

    El-Hamd MA, Saleh R, Majzoub A. Premature ejaculation: an update on definition and pathophysiology. Asian J Androl. 2019;21:425–32.

  11. 11.

    Ferran J, Puigvert A, Castro P. Eyaculación prematura. Rev Int Androl. 2010;8:28–50. 2010;8(1):28–50

    Google Scholar 

  12. 12.

    Perissinotto MC, DʼAncona CA, Lucio A, Campos RM, Abreu A. Transcutaneous tibial nerve stimulation in the treatment of lower urinary tract symptoms and its impact on health-related quality of life in patients with Parkinson disease: a randomized controlled trial. J Wound Ostomy Cont Nurs. 2015;42(Jan-Feb):94–9.

    Article  Google Scholar 

  13. 13.

    Sucar-Romero S, Escobar-del Barco L, Rodríguez-Colorado S, Gorbea-Chávez V. Estimulación del nervio tibial posterior como tratamiento de la disfunción del piso pélvico. Revisión de la bibliografía. Ginecol Obstet Mex. 2014;82:535–46.

    PubMed  Google Scholar 

  14. 14.

    McMahon CG. The design and methodology of premature ejaculation interventional studies. Transl Androl Urol. 2016;5:508–25. https://doi.org/10.21037/tau.2016.03.28.

    Article  PubMed  PubMed Central  Google Scholar 

  15. 15.

    American Psychiatric Association. Diagnostic and statistical manual of mental disorders (DSM-5). 5th ed. Washington, DC: American Psychiatric Association; 2013.

    Google Scholar 

  16. 16.

    Rosen RC, Cappelleri JC, Smith MD, Lipsky J, Peña BM. Development and evaluation of an abridged, 5-item version of the International Index of Erectile Function (IIEF-5) as a diagnostic tool for erectile dysfunction. Int J Impot Res. 1999;11:319–26.

    CAS  Article  Google Scholar 

  17. 17.

    Symonds T, Roblin D, Hart K, Althof S. How does premature ejaculation impact a man’s life? J Sex Marital Ther. 2003;29:361–70.

    CAS  Article  Google Scholar 

  18. 18.

    Fleming T. One-sample multiple testing procedure for phase II clinical trials. Biometrics. 1982;38:143–51.

    CAS  Article  Google Scholar 

  19. 19.

    Porto R. The impact of premature ejaculation on quality of life of the patient, the partner and the couple. Sexologies. 2013;22:e65–e70.

    Article  Google Scholar 

  20. 20.

    Zulkifli H, Saharuddin A. Premature ejaculation and quality of life among men attending Klinik Kesihatan Jaya Gading, Kuantan. Int J Public Health Res. 2018;8:878–84.

    Google Scholar 

  21. 21.

    Tuken M, Culha MG, Serefoglu EC. Efficacy and safety of dapoxetine/sildenafil combination tablets in the treatment of men with premature ejaculation and concomitant erectile dysfunction-DAP-SPEED Study. Int J Impot Res. 2019;31:92–96.

    CAS  Article  Google Scholar 

  22. 22.

    McMahon CG, Jannini E, Waldinger M, Rowland D. Standard operating procedures in the disorders of orgasm and ejaculation. J Sex Med. 2013;10:204–29.

    Article  Google Scholar 

  23. 23.

    Waldinger MD, Zwinderman AH, Schweitzer DH, Olivier B. Relevance of methodological design for the interpretation of efficacy of drug treatment of premature ejaculation: a systematic review and meta-analysis. Int J Impot Res. 2004;16:369–81.

    CAS  Article  Google Scholar 

  24. 24.

    Castiglione F, Albersen M, Hedlund P, Gratzke C, Salonia A, Giuliano F. Current pharmacological management of premature ejaculation: a systematic review and meta-analysis. Eur Urol. 2016;69:904–16.

    CAS  Article  Google Scholar 

Download references

Acknowledgements

The authors would like to thank Jenny Gutiérrez, Andrés Gallego, and Cristina Amaya for their contributions in the execution of this research study.

Funding

This work was funded by the clinical center where this research was developed, and the devices where purchased without any help from the developer industry.

Author information

Affiliations

Authors

Corresponding author

Correspondence to José P. Saffon.

Ethics declarations

Conflict of interest

The authors are the employees of the clinical center where this research was developed, and there is no relation to the pharmaceutical or technology industry.

Additional information

Publisher’s note Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and Permissions

About this article

Verify currency and authenticity via CrossMark

Cite this article

Uribe, O.L., Sandoval-Salinas, C., Corredor, H.A. et al. Transcutaneous electric nerve stimulation to treat patients with premature ejaculation: phase II clinical trial. Int J Impot Res 32, 434–439 (2020). https://doi.org/10.1038/s41443-019-0196-x

Download citation

Search

Quick links