Premature Ejaculation (PE) is a very common and disturbing sexual dysfunction in men. Currently available treatment modalities are associated with limited efficacy and low treatment adherence. In this prospective, single-blinded, self-controlled study, we evaluated the efficacy and safety of transcutaneous electrical stimulation (TES) for the treatment of (PE). We included 23 patients aged 20–60 (mean: 38.7) with lifelong PE. On the first visit, we delivered either TES or sham treatment to the perineum, based on the enrollment order. For stimulation, we used a commercial neuromuscular electrical stimulation device. The patients were invited for the second visit after at least 7 days for receiving the alternating treatment. During the treatment sessions, the patients were left alone in a privet silent room to masturbate and a stopwatch was used to measure their masturbation ejaculatory latency time (MELT). The patients also filled-out safety questionnaires after each visit and on each of the 3 following days. Of the 20 patients who completed the study, 17 (85%) experienced prolonged MELT under TES compared with the sham treatment. Mean MELT values increased 3.5-folds under TES (p = 0.0009). We demonstrated a significant increase in MELT in lifelong PE patients using TES. This therapeutic option may have the potential to become an on-demand treatment option for PE. Future studies with wireless devices are needed to confirm the efficacy and safety of this treatment concept during intercourse.
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Giuliano, F, Patrick DL, Porst H, La Pare G, Kokoszka A, Merchant S et al. Premature ejaculation: results from a five-country european observational study. Eur Urol. 2008. https://doi.org/10.1016/j.eururo.2007.10.015.
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. https://doi.org/10.1016/j.eururo.2006.07.004.
Serefoglu EC, Yaman O, Cayan S, Asci R, Orhan I, Usta MF, et al. Prevalence of the complaint of ejaculating prematurely and the four premature ejaculation syndromes: results from the Turkish Society of Andrology Sexual Health Survey. J Sex Med 2011. https://doi.org/10.1111/j.1743-6109.2010.02095.x.
Waldinger MD, Schweitzer DH. Changing paradigms from a historical DSM-III and DSM-IV view toward an evidence-based definition of premature ejaculation. Part II-Proposals for DSM-V and ICD-11. J Sex Med 2006. https://doi.org/10.1111/j.1743-6109.2006.00276.x.
Saitz TR, Serefoglu EC. The epidemiology of premature ejaculation. Transl Androl Urol 2016. https://doi.org/10.21037/tau.2016.05.11.
Althof SE. Prevalence, characteristics and implications of premature ejaculation/rapid ejaculation. J Urol. 2006. https://doi.org/10.1016/S0022-5347(05)00341-1.
Corona G, Rastrelli G, Limoncin E, Sforza A, Jannini EA, Maggi M. Interplay between premature ejaculation and erectile dysfunction: a systematic review and meta-analysis. J Sex Med. 2015. https://doi.org/10.1111/jsm.13041.
Saitz TR, Serefoglu EC. Advances in understanding and treating premature ejaculation. Nat Rev Urol. 2015. https://doi.org/10.1038/nrurol.2015.252.
Sangkum P, Badr R, Serefoglu EC, Hellstrom WJG. Dapoxetine and the treatment of premature ejaculation. Transl Androl Urol 2013. https://doi.org/10.3978/j.issn.2223-4683.2013.12.01.
Pryor JL, Althof SE, Steidle C, Rosen RC, Hellstrom WG, Shabsigh R, et al. Efficacy and tolerability of dapoxetine in treatment of premature ejaculation: an integrated analysis of two double-blind, randomised controlled trials. Lancet. 2006. https://doi.org/10.1016/S0140-6736(06)69373-2.
Mondaini N, Fusco F, Cai T, Benemei S, Mirone V, Bartolleti R. Dapoxetine treatment in patients with lifelong premature ejaculation: the reasons of a ‘waterloo’. Urology. 2013. https://doi.org/10.1016/j.urology.2013.05.018.
Park HJ, Park NC, Kim TN, Baek SR, Lee KM, Choe S. Discontinuation of dapoxetine treatment in patients with premature ejaculation: a 2-year prospective observational study. Sex Med 2017. https://doi.org/10.1016/j.esxm.2017.02.003.
Koyuncu H, Serefoglu EC, Ozdemir AT, Hellstrom WJ. Deleterious effects of selective serotonin reuptake inhibitor treatment on semen parameters in patients with lifelong premature ejaculation. Int J Impot Res. 2012. https://doi.org/10.1038/ijir.2012.12
Giuliano F, Clément P. Physiology of ejaculation: emphasis on serotonergic control. Eur Urol. 2005. https://doi.org/10.1016/j.eururo.2005.05.017.
Shafik A, El-Sibai O. Mechanism of ejection during ejaculation: identification of a urethrocavernosus reflex. Arch Androl 2000. https://doi.org/10.1080/014850100262443.
Bhat GS, Shastry A. New tools to measure ejaculatory latency—arousal to ejaculation time interval and erection to ejaculation time interval: a pilot study. Urology. 2018. https://doi.org/10.1016/j.urology.2018.01.034.
GERSTENBERG TC, LEVIN RJ, WAGNER G. Erection and ejaculation in man. assessment of the electromyographic activity of the bulbocavernosus and ischiocavernosus muscles. Br J Urol 1990. https://doi.org/10.1111/j.1464-410X.1990.tb14764.x.
Shafik A. Response of the urethral and intracorporeal pressures to cavernosus muscle stimulation: role of the muscles in erection and ejaculation. Urology. 1995. https://doi.org/10.1016/S0090-4295(99)80165-4.
Gruenwald I, Serefoglu EC, Gollan T, Springer S, Meiry G, Appel B, et al. Transcutaneous neuromuscular electrical stimulation may be beneficial in he treatment of premature ejaculation. Med Hypotheses. 2017;109:181–3.
Serefoglu EC, McMahon CG, Waldinger MD, Althof SE, Shindel A, Adaikan G, et al. An evidence-based unified definition of lifelong and acquired premature ejaculation: report of the second international society for sexual medicine ad hoc committee for the definition of premature ejaculation. Sex Med 2014. https://doi.org/10.1002/sm2.27.
McMahon CG, Althof SE, Kaufman JM, Buvat J, Levine SB, Aquilina JW, et al. Efficacy and safety of dapoxetine for the treatment of premature ejaculation: integrated analysis of results from five phase 3 trials. J Sex Med 2011. https://doi.org/10.1111/j.1743-6109.2010.02097.x.
Jian Z, Wei X, Ye D, Li H, Wang K. Pharmacotherapy of premature ejaculation: a systematic review and network meta-analysis. Int Urol Nephrol. 2018. https://doi.org/10.1007/s11255-018-1984-9.
Limoncin E, Tomassetti M, Gravina GL, Ciocca G, Carosa E, Di Sante S, et al. Premature ejaculation results in female sexual distress: standardization and validation of a new diagnostic tool for sexual distress. J Urol 2013. https://doi.org/10.1016/j.juro.2012.11.007.
Porst H, Burri A. Novel treatment for premature ejaculation in the light of currently used therapies: a review. Sex Med Rev. 2018. https://doi.org/10.1016/j.sxmr.2018.05.001.
Rosen RC, McMahon CG, Niederberger C, Broderick GA, Jamieson C, Gagnon DD. Correlates to the clinical diagnosis of premature ejaculation: results from a large observational study of men and their partners. J Urol. 2007. https://doi.org/10.1016/j.juro.2006.10.044.
Corty EW. Perceived ejaculatory latency and pleasure in different outlets. J Sex Med. 2008. https://doi.org/10.1111/j.1743-6109.2008.00939.x.
Gomez-Tames JD, Gonzalez J, Yu W. A simulation study: effect of the inter-electrode distance, electrode size and shape in transcutaneous electrical stimulation. Proc Annu Int Conf IEEE Eng Med Biol Soc. 2012. https://doi.org/10.1109/EMBC.2012.6346739.
Pastore AL, Palleschi G, Fuschi A, Maggioni C, Rago R, Zucchi A, et al. Pelvic floor muscle rehabilitation for patients with lifelong premature ejaculation: a novel therapeutic approach. Ther Adv Urol 2014. https://doi.org/10.1177/1756287214523329
Springer S, Shapiro M. Effects of amplitude and phase-duration modification on electrically induced contraction force and discomfort. Technol Heal Care. 2017. https://doi.org/10.3233/THC-160733.
Conflict of interest
AS is a consultant for Virility Medical Ltd, and received compensation. AS was also granted the option to purchase equity of Virility Medical Ltd. For conducting the study. SEC is a consultant for Virility Medical Ltd, and was granted the option to purchase equity of Virility Medical Ltd. TG is an employee of Virility Medical Ltd, and a shareholder. SS is a consultant and shareholder of Virility Medical Ltd. GM was an employee of Virility Medical Ltd during the time of the study, and was granted the option to purchase equity of Virility Medical Ltd. IG is a consultant for Virility Medical Ltd, and received compensation. IG was also granted the option to purchase equity of Virility Medical Ltd for conducting the study. BA has no conflict of interest.
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Shechter, A., Serefoglu, E.C., Gollan, T. et al. Transcutaneous functional electrical stimulation—a novel therapy for premature ejaculation: results of a proof of concept study. Int J Impot Res 32, 440–445 (2020). https://doi.org/10.1038/s41443-019-0207-y