ABSTRACT
Objectives
To evaluate the efficacy and tolerability of Silodosin 4 mg and Dapoxetine 60 mg in the treatment of primary premature ejaculation.
Methods
This is a prospective study that was carried out on 95 adult sexually active patients with PE (IELT < 1 min) attending outpatient clinic, Urology Department, Benha University Hospitals. Patients with primary PE were randomly assigned to two groups; group A: 48 patients who took silodosin 4 mg 2 h before intercourse (on demand) at least 6 times intercourse/month for 2 months and group B: 47 patients who took dapoxetine 60 mg the same like silodosin. Throughout the research, eight patients in silodosin group and seven patients in dapoxetine group were lost to follow-up and subsequently excluded from the study.
Results
The average age of primary PE patients included in the study was 33.4 ± 2.9. IELT significantly increased from 21.4 ± 13.8 to 275 ± 63.4 s in group A and significantly increased from 24.9 ± 14.3 to 293.5 ± 54.3 s in group B. Also both studied groups showed significant improvements in premature ejaculatory profile (PEP), the premature ejaculation diagnostic tool (PEDT), and the Arabic index of premature ejaculation (AIPE) with fewer side effects in group A.
Conclusion
Both Silodosin 4 mg and Dapoxetine 60 mg significantly improved IELT and sexual function scores in primary PE patients. However, Silodosin exhibited a more favorable tolerability profile with fewer side effects, making it a safer, clinically effective alternative.
KEYWORDS: Premature ejaculation, sexual function, ejaculatory profile, latency time
Introduction
A common male sexual dysfunction known as primary premature ejaculation (PE) is Ejaculation that always or nearly always occurs prior to or within about 1 min of vaginal penetration. Negative psychological consequences and a lack of control over ejaculation are frequently reported in conjunction with this condition [1]. Primary PE is a lifelong condition that typically commences with a man’s first sexual experiences, in contrast to secondary PE, which develops after a period of normal ejaculatory function. According to the International Society for Sexual Medicine (ISSM) and EAU Guidelines, the estimated prevalence of PE ranges from 20% to 30% of men globally at some point in their lives and can lead to significant distress, reduced sexual satisfaction, and strained relationships [1].
The exact cause of primary PE remains unclear, but it is believed to involve a combination of biological, psychological, and neurobiological factors. Neurotransmitters such as serotonin play a critical role in regulating ejaculation, with low levels of serotonin activity associated with shorter ejaculatory latency. Genetic predisposition may also contribute, as studies have shown a higher prevalence of primary PE among first-degree relatives. Additionally, hypersensitivity of the glans penis or hyperexcitability of the ejaculatory reflex may play a role in the condition [2,3].
The diagnosis of primary PE is primarily based on a detailed patient history and self-reported symptoms, as there are no specific laboratory tests or imaging studies to confirm the condition. Intravaginal ejaculatory latency time (IELT) measurements, either self-reported or recorded by a partner, can provide objective data to support the diagnosis. IELT normal duration is from 2.5 to 5 min [4,5].
Clinicians often use several tools and profiles to assess and diagnose PE, including the premature ejaculatory profile (PEP) [6], the premature ejaculation diagnostic tool (PEDT) [4], and the Arabic index of premature ejaculation (AIPE) [5]. The PEP is a multidimensional tool designed to evaluate the key domains of PE. It consists of a series of questions that provide a comprehensive assessment of the patient’s experience with PE. The PEP is particularly useful in clinical settings as it helps clinicians quantify the severity of PE and monitor treatment outcomes over time [6]. According to the International Society for Sexual Medicine (ISSM) criteria, PEDT is a structured and validated questionnaire that is designed to diagnose PE. Due to its high reliability and simplicity in distinguishing between primary and acquired PE, it is extensively used and comprises five queries [4]. The AIPE is a culturally adapted diagnostic tool developed for Arabic-speaking populations. It includes questions similar to the PEDT but adapted to ensure better comprehension and relevance in Middle Eastern populations. The AIPE has been validated in clinical studies and is considered an effective tool for diagnosing PE in Arabic-speaking patients [5].
While behavioral therapies and psychological interventions have been used historically, pharmacological treatments have become the cornerstone of PE management. This includes Dapoxetine 60 mg, the initial FDA-approved on-demand treatment for PE, which is a selective serotonin reuptake inhibitor (SSRI) [7]. However, Silodosin 4 mg, an α1-adrenoceptor antagonist, has emerged as a promising alternative, particularly for patients dissatisfied with Dapoxetine [8]. To our knowledge, no previous studies reported efficacy and tolerability of sildosin 4 mg as a treatment of PE. So this study was designed to evaluate the efficacy and tolerability of Silodosin 4 mg versus the established treatment, Dapoxetine 60 mg in the treatment of primary premature ejaculation.
Patients and methods
This is a prospective randomized study that was carried out on 95 patients with premature ejaculation who attending outpatient clinic, Urology Department, Benha University Hospitals over a period of 12 months starting from March 2024 to March 2025. A total of 115 patients were screened for eligibility, of which 20 patients declined to participate.
An informed written consent was obtained from the patients in accordance with the Declaration of Helsinki. In addition, the study received approval from the local ethics committee at the Faculty of Medicine, Benha University, marked as ethically approved under (MS 13–3-2024). This study was registered as a clinical trial at ClinicalTrials.gov under ID identifier NCT07081659. Research results were only used for scientific purposes. Any unexpected risks appearing during research were clarified to the participants and to the ethical committee on time.
The inclusion criteria of the patients Heterosexual, sexually active, and aged 25 to 65, the participants in the study were. Their primary premature ejaculation (IELT < 1 min) was diagnosed, and they had experienced primary PE from their first sexual experience, IELT was measured by the partner stopwatch in her hand during the relationship. Patients with a history of diabetes or uncontrolled hypertension (systolic ≥140 mmHg or diastolic ≥90 mmHg), anatomic abnormalities of the penis or genital region, erectile dysfunction, chronic prostatitis, psychological disorder, and patients on anti-psychiatric drugs were precluded from the study.
Patients with primary PE were randomly assigned prior to the study, random allocation took place using computerized randomization to two groups; group A: 48 patients who prescribed silodosin 4 mg 2 h before intercourse (on demand) at least 6 times intercourse/month for 2 months and group B: 47 patients who prescribed dapoxetine 60 mg the same like silodosin. Patients were blind to randomization.
All patients meeting the selection criteria were subjected to personal, present, past, family, and surgical histories taking. A thorough clinical examination of the patients to evaluate their general health and assess any physical signs and symptoms related to premature ejaculation or other conditions.
The change in IELT 2 months after the treatment was recorded in the studied groups. Follow-up patients were evaluated by PEP, PEDT, and AIPE at baseline and 2 months after start of treatment.
The PEP consists of four items. The total score ranges from 0 to 16, with higher scores reflecting more favorable sexual experience concerning ejaculation control [6]. The PEDT comprises five items that evaluate a variety of aspects of PE, such as the capacity to regulate ejaculation, frequency of premature ejaculation, the effects on sexual intercourse, distress, and interpersonal challenges. Each item is assigned a score on a Likert scale that spans from 0 to 4. Scores of 9–10 are regarded ambiguous, while scores of 8 or lower indicate the absence of PE. Conversely, a score of 11 or higher indicates the presence of PE. PE is indicated by a score of 11 or higher, while a score of 9–10 is considered borderline [4]. The AIPE comprises seven items ranging from 7 to 35. A cutoff score of 30 has been established to differentiate between individuals with and without PE, with higher scores indicating less severe symptoms [5]. Any side effects of drugs were also recognized and recorded. Throughout the research, eight patients in silodosin group A and seven patients in dapoxetine group B were lost to follow-up and subsequently excluded from the study (Figure 1).
Figure 1.
Flow diagram.
Sample size calculation
The sample size was determined a priori using G*Power software (version 3.1.9.2, Heinrich-Heine-Universität Düsseldorf, Germany). Based on a two-tailed independent t-test analysis with α = 0.05 and 90% statistical power, a minimum of 34 participants per group was required to detect a large effect size (Cohen’s d = 0.8) [9]. This calculation anticipated a 2.5-fold mean difference in IELT improvement from baseline between treatment arms, established as the primary efficacy endpoint. To account for potential attrition during follow-up, the sample size was inflated by 17.6% (6 participants/group). Consequently, the final enrollment target was set at 40 participants per treatment arm (total N = 80) to maintain adequate power throughout the study duration.
Statistical analysis
We used IBM’s Statistical Package for the Social Sciences (2017, Released) to edit, code, and tabulate the data we gathered. IBM Corp., Armonk, New York, USA: IBM SPSS Statistics for Windows, Version 25.0. To ensure that the data was distributed normally, the Shapiro–Wilk test was employed. Each parameter’s data type informed the presentation and analysis of the corresponding data. Nominal data were expressed as mean ± SD. For categorical data, percentages and frequencies were employed. The statistical significance of a difference between the two study groups for parametric variables was assessed using an independent samples t-test, and for non-parametric variables, the Mann Whitney Test (U test) was employed. We looked examined the correlation between the two qualitative variables using the Chi-Square test. At a 95% confidence interval, a p-value is deemed significant if it is less than 0.05.
Results
Table 1 shows that the average age of primary PE patients included in the study was 33.4 ± 2.9. The age of patients in group A ranged from 27 to 39 years old with an average age of 32.8 ± 2.9 and the average age of group B ranged from 29 to 43 years old with an average age of 33.9 ± 2.8. There was no significant difference in the distribution of age among the studied groups. There was insignificant difference in baseline IELT between the studied groups. There was also insignificant difference in baseline PEP subsets scores, PEDT and AIPE questionaires scores between the studied groups. After 2 months of follow-up, there was still no significant differences in IELT and PEP subsets scores, PEDT and AIPE questions scores between the studied groups as shown in Table 2.
Table 1.
Baseline age, intravaginal ejaculatory latency time, and premature ejaculation scores of patients with primary premature ejaculation in groups A and B.
| Group A (n = 40) |
Group B (n = 40) |
P value | |
|---|---|---|---|
| Age (years) IELT (seconds) PEP subsets Satisfaction with intercourse Control over ejaculation Ejaculation-related distress Ejaculation-related difficulty in interpersonal relationship PEDT Control over ejaculation Frequency of premature ejaculation Impact on sexual intercourse Distress Interpersonal difficulty AIPE Erectile function Sexual desire Ejaculation latency Ejaculation control Patient satisfaction Partner satisfaction Psychological distress |
32.8 ± 2.9 21.4 ± 13.8 1.63 ± 0.7 0.38 ± 0.54 0.68 ± 0.47 1.03 ± 0.7 3.33 ± 0.76 3.35 ± 0.62 3.48 ± 0.51 3.38 ± 0.49 2.3 ± 0.46 1.4 ± 0.5 3.28 ± 0.78 1.58 ± 0.5 1.43 ± 0.5 1.55 ± 0.5 1.2 ± 0.41 1.68 ± 0.73 |
33.9 ± 2.8 24.9 ± 14.3 1.53 ± 0.55 0.45 ± 0.6 0.55 ± 0.71 0.9 ± 0.74 3.08 ± 0.69 3.45 ± 0.68 3.3 ± 0.46 3.23 ± 0.66 2.43 ± 0.5 1.58 ± 0.5 2.93 ± 0.86 1.7 ± 0.46 1.35 ± 0.48 1.7 ± 0.46 1.38 ± 0.49 1.8 ± 0.79 |
0.075 0.268 0.699 0.655 0.199 0.466 0.125 0.432 0.171 0.423 0.329 0.172 0.081 0.327 0.559 0.240 0.169 0.527 |
Values are presented as mean ± standard deviation (SD). AIPE: Arabic Index of Premature Ejaculation; IELT: intravaginal ejaculatory latency time; PEDT: Premature Ejaculation Diagnostic Tool; PEP: Premature Ejaculatory Profile. Group A: 40 patients who took silodosin 4 mg 2 h before intercourse (on demand) at least 6 times a month for 2 months, and Group B: 40 patients who took dapoxetine 60 mg the same way as silodosin. Comparisons between groups were performed using the independent samples t-test or Mann–Whitney test where appropriate. No statistically significant differences were observed between groups for any variable (p > 0.05).
Table 2.
Changes in intravaginal ejaculatory latency time (IELT) and premature ejaculation-related scores in patients with primary premature ejaculation after 2 months of treatment in groups A and B.
| Group A (n = 40) |
Group B (n = 40) |
P value | |
|---|---|---|---|
| IELT (seconds) PEP subsets Satisfaction with intercourse Control over ejaculation Ejaculation-related distress Ejaculation-related difficulty in interpersonal relationship PEDT Control over ejaculation Frequency of premature ejaculation Impact on sexual intercourse Distress Interpersonal difficulty AIPE Erectile function Sexual desire Ejaculation latency Ejaculation control Patient satisfaction Partner satisfaction Psychological distress |
275 ± 63.4 3.03 ± 0.6 3.2 ± 0.7 3.3 ± 0.82 3.65 ± 0.48 1.35 ± 0.53 1.43 ± 0.55 0.88 ± 0.33 1.23 ± 0.48 0.93 ± 0.42 3.4 ± 0.5 3.8 ± 1.18 3.3 ± 0.65 3.65 ± 0.62 4.1 ± 0.74 4.2 ± 0.69 3.65 ± 0.66 |
293.5 ± 54.3 3.2 ± 0.7 3.4 ± 0.6 3.35 ± 0.83 3.58 ± 0.5 1.28 ± 0.55 1.3 ± 0.52 0.73 ± 0.45 0.98 ± 0.58 0.78 ± 0.58 3.53 ± 0.78 3.48 ± 1.04 3.5 ± 0.82 3.88 ± 0.46 3.73 ± 0.68 4.43 ± 0.75 3.78 ± 0.92 |
0.165 0.264 0.277 0.766 0.559 0.482 0.339 0.235 0.099 0.257 0.129 0.190 0.102 0.089 0.063 0.123 0.380 |
Values are presented as mean ± standard deviation (SD). AIPE: Arabic Index of Premature Ejaculation; IELT: intravaginal ejaculatory latency time; PEDT: Premature Ejaculation Diagnostic Tool; PEP: Premature Ejaculatory Profile. Group A: 40 patients who took silodosin 4 mg 2 h before intercourse (on demand) at least 6 times a month for 2 months, and Group B: 40 patients who took dapoxetine 60 mg the same way as silodosin. Comparisons between groups were performed using the independent samples t-test or Mann–Whitney test where appropriate. No statistically significant differences were observed between groups after 2 months of follow-up (p > 0.05).
Table 3 shows that IELT significantly increased from 21.4 ± 13.8 to 275 ± 63.4 s in group A and significantly increased from 24.9 ± 14.3 to 293.5 ± 54.3 s in group B. The table shows also that PEP, PEDT, and AIPE total scores were significantly increased after 2 months compared to baseline level in both studied groups.
Table 3.
Changes in intravaginal ejaculatory latency time (IELT) and total scores of premature ejaculation assessment tools from baseline to 2 months in groups A and B.
| Group A (n = 40) |
Group B (n = 40) |
|
|---|---|---|
| IELT (seconds) At baseline After 2 months p value of change PEP total score At baseline After 2 months p value of change PEDT total score At baseline After 2 months p value of change AIPE total score At baseline After 2 months p value of change |
21.4 ± 13.8 275 ± 63.4 < 0.001a 3.7 ± 1.24 13.2 ± 1.4 < 0.001a 15.8 ± 1.4 5.8 ± 1.2 < 0.001a 12.1 ± 1.43 25.78 ± 1.78 < 0.001a |
24.9 ± 14.3 293.5 ± 54.3 < 0.001a 3.4 ± 1.6 13.5 ± 1.2 < 0.001a 15.5 ± 1.6 5.1 ± 1.2 < 0.001a 12.43 ± 1.39 26.3 ± 2.03 < 0.001a |
Values are presented as mean ± standard deviation (SD). AIPE: Arabic Index of Premature Ejaculation; IELT: intravaginal ejaculatory latency time; PEDT: Premature Ejaculation Diagnostic Tool; PEP: Premature Ejaculatory Profile. Group A: 40 patients who took silodosin 4 mg 2 h before intercourse (on demand) at least 6 times a month for 2 months, and Group B: 40 patients who took dapoxetine 60 mg the same way as silodosin. Comparisons between baseline and 2-month follow-up within each group were performed using the paired samples t-test or Wilcoxon signed-rank test where appropriate. (a) denotes statistical significance at p < 0.05.
Regarding the side-effects occurred in the studied groups, the number of patients who suffered from side-effects was significantly higher in group B compared to group A. In group A, nausea, hypotension, decreased semen volume, and anejaculation occurred in 2 (5%), 4 (10%), 8 (20%), and 2 (5%) patients respectively. In group B, nausea, dizziness, somnolence, and yawing occurred in 12 (30%), 5 (12.5%), 6 (15.0) and 7 (17.5%) patients, respectively. The number of patients who suffered from nausea, somnolence, and yawing were significantly higher in group B compared to group A, but the number of patients who suffered from decreased semen volume was significantly higher in group A compared to group B. There was no significant difference in the number of patients who suffered from dizziness, hypotension, and anejaculation between both groups A and B as showed in Figure 2.
Figure 2.
Prevalence of side-effects among the studied groups.
Discussion
Consistent ejaculation that occurs with minimal sexual stimulation, frequently prior to or shortly following penetration, is a defining feature of primary PE, a sexual disorder that is commonly observed. This condition can result in interpersonal difficulties or distress [10]. Pharmacological interventions, particularly the use of silodosin and dapoxetine, have demonstrated efficacy in managing primary PE. Silodosin, an alpha-1 adrenoceptor antagonist, works by relaxing smooth muscle in the prostate and urethra, which delays ejaculation. On the other hand, dapoxetine, a short-acting SSRI, increases serotonin activity in the central nervous system, modulating the ejaculatory reflex and prolonging IELT. Both agents, either as monotherapy or in combination, provide significant symptom relief and improve quality of life in affected individuals, although tailored treatment approaches remain essential for optimal outcomes [1,11].
The present study showed that IELT significantly increased from 21.4 ± 13.8 to 275 ± 63.4 s in group A at the end of 2-month follow-up.
This in accordance with Sato et al. [12] who showed that the average IELT in patients treated with Silodosin for PE was significantly increased from 1.9 min at baseline to 7.6 min with Silodosin treatment, indicating a significant improvement in ejaculatory control with fourfold increase in IELT. Moreover, in a study by Akin et al. [13] They conducted a comparison between silodosin and a variety of alpha blockers and demonstrated a statistically significant increase in IELT in patients using silodosin in comparison to other alpha blockers. This suggests that silodosin has unique properties contribute to its superior performance in treating premature ejaculation.
Adding to that in a systematic review and meta-analysis by Fauzan et al. [14] to assess the efficacy of silodosin in treating PE. They reported that silodosin significantly increases IELT compared to control, with a mean difference of 132.54.
The current study showed that IELT significantly increased from 24.9 ± 14.3 to 293.5 ± 54.3 s in group B at the end of 2-month follow-up.
This is in line with a study by Serefoglu et al. [15] who showed that the administration of Dapoxetine in clinical trials generated a 2.5- to 3-fold increase in IELT from 0.9 min to 3.1 min with 30 mg and 3.6 min with 60 mg compared to the baseline. This is also in accordance with a study by Manek et al. [16] who showed that Dapoxetine 60 mg increased IELT from a mean of 35 s to 184 s after 12 weeks of treatment, demonstrating its efficacy for premature ejaculation. The results of these studies suggests that both medications are effective in prolonging IELT.
The current study showed that PEP, PEDT, and AIPE total scores were significantly higher after 2 months of treatment compared to baseline in group A.
This is in line with a study by Hodeeb et al. [17] Individuals who demonstrated that silodosin enhanced interpersonal difficulties, satisfaction with sexual intercourse, personal distress associated with ejaculation, and control over ejaculation. Silodosin 4 mg’s affordability, safety, and efficacy were emphasized as potential treatments for premature ejaculation.
The current study showed that PEP, PEDT, and AIPE total scores were significantly higher after 2 months of treatment compared to baseline in group B.
This is in accordance with a study by Gamidov et al. [18] who showed that the use of dapoxetine was associated with improvement in ejaculation latency and patient satisfaction with a decrease in PEDT score, which decreased from a median of 16 at baseline to 7 after 30 days of therapy. Moreover, it is in line with Tuken et al. [19] who reported that dapoxetine treatment significantly improved the mean PEDT score from 16.85 ± 2.42 to 2.36 ± 1.13. Additionally, in a study by [20] they reported that use of dapoxetine significantly increased AIPE score by the sixth week of treatment. Similarly, in a study by Kati et al. [21], they reported that use of dapoxetine was associated with significant increase in AIPE score.
IELT, PEP, PEDT, and AIPE scores showed no significant difference between the studied groups at baseline and after 2 months of follow-up in the present study. On the other hand, in a study by Bhat et al. [22] they reported that silodosin significantly improved IELT in patients with PE compared to dapoxetine. They showed that patients receiving silodosin reported better outcomes in various PEP subsets, suggesting that silodosin is more effective in addressing the specific concerns related to premature ejaculation compared to dapoxetine.
The difference in their study compared to the present study that the dapoxetine used was 30 mg, which may have limited efficacy compared to the used 60 mg dose in the present study. To our knowledge, no previous studies have compared the effectiveness of silodosin 4 mg compared to dapoxetine 60 mg.
The current study showed that adverse events were significantly more frequent in Group B than in Group A. Nausea, somnolence, and yawning were significantly higher in Group B, while reduced semen volume was significantly higher in Group A. No significant differences were observed in dizziness, hypotension, or an ejaculation between the groups.
This is in accordance with a study by [23] who indicated that nausea was reported by a fifth of patients on 60 mg dapoxetine. The adverse effects of dapoxetine were dose-dependent, with side effects including nausea and headache. Similarly, this is in line with McMahon et al. [24] Demonstrated that the most prevalent treatment-related adverse effects of dapoxetine 60 mg were headache, dizziness, and nausea, as demonstrated by the authors. Examination of validated measures demonstrated that the use of dapoxetine in patients with primary PE did not result in any SSRI class-related effects. Dapoxetine 60 mg is generally well tolerated, but its side effect profile which are common among SSRIs, coupled with the potential for drug interactions, limit its long-term use in some patients. Additionally, dapoxetine’s on-demand use can lead to inconsistent efficacy and patient dissatisfaction [25].
Additionally, this is comparable to Sato et al. [26] who showed that silodosin had a favourable safety profile with minimal systemic side effects. The most notable adverse effect is reduced semen volume, reported in 14% of patients, which is attributed to its high selectivity for α1A-adrenoceptors. The suggested that unlike dapoxetine, Silodosin does not cause significant nausea or dizziness, making it a more tolerable option for many patients.
Nevertheless, limitations of this study, such as the small sample size, single-center approach, and short follow-up duration, should be considered in next studies.
Conclusion
Silodosin 4 mg and Dapoxetine 60 mg significantly enhanced the intravaginal ejaculatory latency time and sexual function scores of primary premature ejaculation patients. However, Silodosin exhibited a more favorable tolerability profile with fewer side effects, making it a safer, clinically effective alternative.
Disclosure statement
No potential conflict of interest was reported by the author(s).
Author contributions
H.Sh: Conceptualization,Methodology,Project administration,Writing – review & editing; W.S,A.S,A.B: Conceptualization,Visualization,Writing – original draft; M.F,I.S.N,S.EL,: Formal analysis,Investigation,Methodology; T.D,M.M: Data curation,Methodology,Writing – original draft
Data availability statement
Upon request.
Ethics approval
The study was approved by the Research Ethics Committee, Faculty of Medicine, Benha University, Egypt.
References
- [1].Gul M, Bocu K, Serefoglu EC.. Current and emerging treatment options for premature ejaculation. Nat Rev Urol. 2022;19(11):659–680. doi: 10.1038/s41585-022-00639-5 [DOI] [PubMed] [Google Scholar]
- [2].Soni KK, Jeong HS, Jang S. Neurons for ejaculation and factors affecting ejaculation. Biol (Basel). 2022;11(5):11. doi: 10.3390/biology11050686 [DOI] [PMC free article] [PubMed] [Google Scholar]
- [3].Dondu A, Boyacioglu O, Orenay-Boyacioglu S. Comorbid psychiatric conditions and genetics accompanying premature ejaculation. In: Martin C, Preedy V, Patel VRajendram R, editors. Handbook of the biology and pathology of mental disorders. Cham: Springer International Publishing; 2025. p. 1–29. [Google Scholar]
- [4].Symonds T, Perelman MA, Althof S, et al. Development and validation of a premature ejaculation diagnostic tool. Eur Urol. 2007;52(2):565–573. doi: 10.1016/j.eururo.2007.01.028 [DOI] [PubMed] [Google Scholar]
- [5].Arafa M, Shamloul R. Development and evaluation of the Arabic index of premature ejaculation (AIPE). J Sex Med. 2007;4(6):1750–1756. doi: 10.1111/j.1743-6109.2006.00213.x [DOI] [PubMed] [Google Scholar]
- [6].Patrick DL, Giuliano F, Ho KF, et al. The premature ejaculation profile: validation of self-reported outcome measures for research and practice. BJU Int. 2009;103(3):358–364. doi: 10.1111/j.1464-410X.2008.08041.x [DOI] [PubMed] [Google Scholar]
- [7].Vieiralves RR, Favorito LA. Dapoxetine and premature ejaculation. Int braz j Urol. 2023;49(4):511–514. doi: 10.1590/s1677-5538.ibju.2023.9908 [DOI] [PMC free article] [PubMed] [Google Scholar]
- [8].Britto-Júnior J, Guimarães RAB, Oliveira DL, et al. Alpha1-adrenergic blockers selectively antagonize the contractions induced by 6-nitrodopamine in the human vas deferens. Naunyn-Schmiedeberg’s Arch Pharmacol. 2024;397(5):3227–3238. doi: 10.1007/s00210-023-02805-x [DOI] [PubMed] [Google Scholar]
- [9].Serdar CC, Cihan M, Yücel D, et al. Sample size, power and effect size revisited: simplified and practical approaches in pre-clinical, clinical and laboratory studies. Biochem Med (Online). 2021;31(1):27–53. doi: 10.11613/BM.2021.010502 [DOI] [PMC free article] [PubMed] [Google Scholar]
- [10].Coskuner ER, Ozkan B. Premature ejaculation and endocrine disorders: a literature review. World J Mens Health. 2022;40(1):38–51. doi: 10.5534/wjmh.200184 [DOI] [PMC free article] [PubMed] [Google Scholar]
- [11].Saleh R, Majzoub A, Abu El-Hamd M. An update on the treatment of premature ejaculation: a systematic review. Arab J Urol. 2021;19(3):281–302. doi: 10.1080/2090598X.2021.1943273 [DOI] [PMC free article] [PubMed] [Google Scholar]
- [12].Sato Y, Tanda H, Nakajima H, et al. Silodosin and its potential for treating premature ejaculation: a preliminary report. Int J Urol. 2012;19(3):268–272. doi: 10.1111/j.1442-2042.2011.02941.x [DOI] [PubMed] [Google Scholar]
- [13].Akin Y, Gulmez H, Ates M, et al. Comparison of alpha blockers in treatment of premature ejaculation: a pilot clinical trial. Iran Red Crescent Med J. 2013;15(10):e13805. doi: 10.5812/ircmj.13805 [DOI] [PMC free article] [PubMed] [Google Scholar]
- [14].Fauzan MI, Daryanto B, Budaya TN, et al. Promising selective alpha-1 blocker silodosin as a new therapeutic strategy for premature ejaculation and its drug adverse effect: a systematic review and meta-analysis of randomized controlled trials. Arch Ital Urol Androl. 2024;96. doi: 10.4081/aiua.2024.12984 [DOI] [PubMed] [Google Scholar]
- [15].Serefoglu EC, Saitz TR, Trost L, et al. Premature ejaculation: do we have effective therapy? Transl Androl Urol. 2013;2:45. [DOI] [PMC free article] [PubMed] [Google Scholar]
- [16].Manek P, Gupte D. (259) Comparison of dapoxetine vs paroxetine vs clomipramine for premature ejaculation patients. J Sex Med. 2024;21(Supplement_2):21. doi: 10.1093/jsxmed/qdae002.222 [DOI] [Google Scholar]
- [17].Hodeeb YMI, Hasan MSM, Abdelhafez MAB. Effectiveness and safety of silodosin in treatment of premature ejaculation: placebo double blind control study. Egypt J Hosp Med. 2019;77(4):5482–5487. doi: 10.21608/ejhm.2019.60256 [DOI] [Google Scholar]
- [18].Gamidov SI, Popova AY, Shatylko TV, et al. Evaluation of the efficacy of dapoxetine in primary and secondary forms of premature ejaculation. Urologiia. 2022;1_2022:46–49. doi: 10.18565/urology.2022.1.46-49 [DOI] [PubMed] [Google Scholar]
- [19].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(2):92–96. doi: 10.1038/s41443-019-0122-2 [DOI] [PubMed] [Google Scholar]
- [20].Attia AM, Abo-Elmaaty SM. Evaluation of dapoxetine hydrochloride in treatment of primary premature ejaculation. Menoufia Med J. 2016;29(2):393–395. doi: 10.4103/1110-2098.192410 [DOI] [Google Scholar]
- [21].Kati B, Ay H. Evaluation of dapoxetine treatment success in lifelong premature ejaculation patients with penile sympathetic skin response. Andrologia. 2018;50(9):e13076. doi: 10.1111/and.13076 [DOI] [PubMed] [Google Scholar]
- [22].Bhat GS, Shastry A. Effectiveness of ‘on demand’ silodosin in the treatment of premature ejaculation in patients dissatisfied with dapoxetine: a randomized control study. Cent Eur J Urol. 2016;69(3):280–284. doi: 10.5173/ceju.2016.843 [DOI] [PMC free article] [PubMed] [Google Scholar]
- [23].Sikdar TK, Chowdhury M, Ahsan MS, et al. Dapoxetine for the management of premature ejaculation. Bang J Psychiatry. 2020;31(1):15–19. doi: 10.3329/bjpsy.v31i1.45367 [DOI] [Google Scholar]
- [24].McMahon CG. Efficacy of dapoxetine in the treatment of premature ejaculation. Clin Med Insights Reprod Health. 2011;5:25–39. doi: 10.4137/CMRH.S7337 [DOI] [PMC free article] [PubMed] [Google Scholar]
- [25].McMahon CG. Dapoxetine for premature ejaculation. Expert Opin Pharmacother. 2010;11(10):1741–1752. doi: 10.1517/14656566.2010.493174 [DOI] [PubMed] [Google Scholar]
- [26].Sato Y, Otani T, Amano T, et al. Silodosin versus naftopidil in the treatment of premature ejaculation: a prospective multicenter trial. Int J Urol. 2017;24(8):626–631. doi: 10.1111/iju.13392 [DOI] [PubMed] [Google Scholar]
Associated Data
This section collects any data citations, data availability statements, or supplementary materials included in this article.
Data Availability Statement
Upon request.