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Cooper, K. orcid.org/0000-0002-7702-8103, Martyn-St James, M. orcid.org/0000-0002-4679-7831, Kaltenthaler, E. et al. (5 more authors) (2015) Behavioral Therapies for Management of Premature Ejaculation: A Systematic Review. Sexual Medicine, 3 (3). pp. 174-188. ISSN 0895-7479
Abstract
Introduction Premature ejaculation (PE) is defined by short ejaculatory latency and inability to delay ejaculation causing distress. Management may involve behavioral and/or pharmacological approaches. Aim To systematically review the randomized controlled trial (RCT) evidence for behavioral therapies in the management of PE. Methods Nine databases including MEDLINE were searched to August 2013. Included RCTs compared behavioral therapy against waitlist control or another therapy, or behavioral plus drug therapy against drug treatment alone. Main Outcome Measure Intravaginal ejaculatory latency time (IELT), sexual satisfaction, ejaculatory control, and anxiety and adverse effects. Results Ten RCTs (521 participants) were included. Overall risk of bias was unclear. All studies assessed physical techniques, including squeeze and stop-start, sensate focus, stimulation device, and pelvic floor rehabilitation. Only one RCT included a psychotherapeutic approach (combined with stop-start and drug treatment). Four trials compared behavioral therapies against waitlist control, of which two (involving squeeze, stop-start, and sensate focus) reported IELT differences of 7–9 minutes, whereas two (web-based sensate focus, stimulation device) reported no difference in ejaculatory latency posttreatment. For other outcomes (sexual satisfaction, desire, and self-confidence), some waitlist comparisons significantly favored behavioral therapy, whereas others were not significant. Three trials favored combined behavioral and drug treatment over drug treatment alone, with small but significant differences in IELT (0.5–1 minute) and significantly better results on other outcomes (sexual satisfaction, ejaculatory control, and anxiety). Direct comparisons of behavioral therapy vs. drug treatment gave mixed results, mostly either favoring drug treatment or showing no significant difference. No adverse effects were reported, though safety data were limited. Conclusions There is limited evidence that physical behavioral techniques for PE improve IELT and other outcomes over waitlist and that behavioral therapies combined with drug treatments give better outcomes than drug treatments alone. Further RCTs are required to assess psychotherapeutic approaches to PE
Metadata
Item Type: | Article |
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Authors/Creators: |
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Copyright, Publisher and Additional Information: | © 2015 The Authors. Sexual Medicine published by Wiley Periodicals, Inc. on behalf of International Society for Sexual Medicine. This is an open access article under the terms of the Creative Commons Attribution-NonCommercial License (http://creativecommons.org/licenses/by-nc/4.0/), which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes. |
Keywords: | Review; Systematic; Premature Ejaculation; Behavior Therapy; Psychological Therapy |
Dates: |
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Institution: | The University of Sheffield |
Academic Units: | The University of Sheffield > Faculty of Medicine, Dentistry and Health (Sheffield) > School of Health and Related Research (Sheffield) > ScHARR - Sheffield Centre for Health and Related Research |
Funding Information: | Funder Grant number DEPARTMENT OF HEALTH RNC/023/001 DEPARTMENT OF HEALTH none |
Depositing User: | Symplectic Sheffield |
Date Deposited: | 29 Mar 2016 13:21 |
Last Modified: | 23 Jun 2023 22:01 |
Published Version: | http://dx.doi.org/10.1002/sm2.65 |
Status: | Published |
Publisher: | Elsevier |
Refereed: | Yes |
Identification Number: | 10.1002/sm2.65 |
Open Archives Initiative ID (OAI ID): | oai:eprints.whiterose.ac.uk:96934 |
Available Versions of this Item
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Behavioral Therapies for Management of Premature Ejaculation: A Systematic Review. (deposited 07 Dec 2015 15:34)
- Behavioral Therapies for Management of Premature Ejaculation: A Systematic Review. (deposited 29 Mar 2016 13:21) [Currently Displayed]
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