This study aimed to appraise the effectiveness and tolerability of lidocaine 5% spray in the treatment of patients with premature ejaculation (PE). The current study has been designed as a randomized single-blind placebo-controlled clinical trial. It was done on 150 lifelong PE patients with normal erection. They were randomized evenly categorized into two treatment groups. Group 1 (n = 75); was given on demand lidocaine 5% spray for 8 weeks. Group 2 (n = 75); was given placebo in the form on demand alcohol spray for 8 weeks. All medications were applied on the glans penis for 10–20 min, and then cleaned before planned sexual intercourse. Patients were evaluated with the Arabic Index of Premature Ejaculation (AIPE) scores, intravaginal ejaculatory latency times (IELTs), and frequency of sexual intercourse before and after treatments. The mean values of the AIPE scores, IELTs, and sexual intercourse frequency in the lidocaine 5% spray group were statistically significant increased than the group of placebo after treatment (P value 0.0001). The present study deduced that local use of lidocaine 5% spray on glans penis 10–20 min prior to sexual intercourse could significantly improve PE patients, with tolerated local adverse effects.
This is a preview of subscription content, access via your institution
Subscribe to this journal
Receive 8 print issues and online access
$259.00 per year
only $32.38 per issue
Rent or buy this article
Prices vary by article type
Prices may be subject to local taxes which are calculated during checkout
Porst H, Montorsi F, Rosen RC, Gaynor L, Grupe S, Alexander J. The premature ejaculation prevalence and attitudes (PEPA) survey: prevalence, comorbidities and proessional help-seeking. Eur Urol. 2007;51:816–24.
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;2:41–59.
El-Hamd MA, Saleh R, Majzoub A. Premature ejaculation: an update on definition and pathophysiology. Asian J Androl. 2019;21:425–32.
Waldinger MD. Recent advances in the classification, neurobiology and treatment of premature ejaculation. Adv Psychosom Med. 2008;29:50–69.
Schapiro B. Premature ejaculation, a review of 1130 cases. J Urol. 1943;50:374–9.
Guo L, Liu Y, Wang X, Yuan M, Yu Y, Zhang X, et al. Significance of penile hypersensitivity in premature ejaculation. Sci Rep. 2017;7:10441.
Jern P, Santtila P, Johansson A, Varjonen M, Witting K, von derPahlen B, et al. Evidence for a genetic etiology to ejaculatory dysfunction. Int J Impot Res. 2009;21:62–7.
Waldinger M, Berendsen HH, Blok BF, Olivier B, Holstege G. Premature ejaculation and serotonergic antidepressants induced delayed ejaculation: the involvement of the serotonergic system. Behav Brain Res. 1998;92:111–8.
Carani C, Isidori AM, Granata A, Carosa E, Maggi M, Lenzi A, et al. Multicenter study on the prevalence of sexual symptoms in male hypo- and hyperthyroid patients. JCEM. 2005;90:6472–9.
Shamloul R, el-Nashaar A. Chronic prostatitis in premature ejaculation: a cohort study in 153 men. J Sex Med. 2006;3:150–4.
Jannini EA, Lombardo F, Lenzi A. Correlation between ejaculatory and erectile dysfunction. Int J Androl. 2005;28:40–5.
Clèment GiulianoF. Pharmacology for the treatment of premature ejaculation. Pharm Rev. 2012;64:621–44.
Wyllie MG, Hellstrom WJ. The link between penile hypersensitivity and premature ejaculation. BJU Int. 2011;107:452–7.
Atikeler MK, Gecit I, Senol FA. Optimum usage of prilocaine lidocaine cream in premature ejaculation. Andrologia. 2002;34:356–9.
Busato W, Galindo CC. Topical anaesthetic use for treating premature ejaculation: a double-blind, randomized, placebo controlled study. BJU Int. 2004;93:1018–21.
Henry R, Morales A, Wyllie MG. TEMPE: topical eutectic-like mixture for premature ejaculation. Expert Opin Drug Deliv. 2008;5:251–61.
Dinsmore WW, Wyllie MG. PSD502 improves ejaculatory latency, control and sexual satisfaction when applied topically 5 min before intercourse in men with premature ejaculation: results of a phase III, multicentre, double-blind, placebo controlled study. BJU Int. 2009;103:940–9.
Shamloul R, Ghanem H, Abou-zeid A. Validity of the Arabic version of the sexual health inventory for men among Egyptians. Int J Impot Res. 2004;16:452–5.
Arafa M, Shamloul R. Development and evaluation of the Arabic Index of Premature Ejaculation (AIPE). J Sex Med. 2007;4:1750–56.
Waldinger MD, Olivier B. Utility of selective serotonin reuptake inhibitors in premature ejaculation. Curr Opin Investig Drugs. 2004;5:743–7.
Pryor JL, Althof SE, Steidle C, Rosen RC, Hellstrom WJG, Shabsigh R, et al. Efficacy and tolerability of dapoxetine in treatment of premature ejaculation: an integrated analysis of two doubleblind, randomised controlled trials. Lancet. 2006;368:929–37.
Butcher MJ, Zubert T, Christiansen K, Carranza A, Pawlicki P, Seibel S. Topical agents for premature ejaculation: a review. Sex Med Rev. 2019. https://doi.org/10.1016/j.sxmr.
Dinsmore WW, Hackett G, Goldmeier D. Topical eutectic mixture for premature ejaculation (TEMPE): a novel aerosol-delivery form of lidocaine-prilocaine for treating premature ejaculation. BJU Int. 2006;99:369–75.
Berkovitch M, Keresteci A, Koren G. Efficacy of prilocaine lidocaine cream in the treatment of premature ejaculation. J Urol. 1995;154:1360–1.
Conflict of interest
The author declares that he has no conflict of interest.
The current study was reviewed and asserted by the ethical and scientific committee, Faculty of Medicine, Sohag University.
Informed consents were taken from patients after compete explanations for the possible benefits and side effects from the current clinical trial.
This clinical trial was registered on the Clinical Trials.gov website (https://clinicaltrials.gov. NCT04062357).
Publisher’s note Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
About this article
Cite this article
Abu El-Hamd, M. Effectiveness and tolerability of lidocaine 5% spray in the treatment of lifelong premature ejaculation patients: a randomized single-blind placebo-controlled clinical trial. Int J Impot Res 33, 96–101 (2021). https://doi.org/10.1038/s41443-019-0225-9
This article is cited by
Nature Reviews Urology (2022)