Research and Clinical Value of New Classification for Premature Ejaculation: Multi-Center Research
Condition: Premature Ejaculation
MeSH terms: Premature Birth; Premature Ejaculation
Study type: Observational

Summary: 
      An observational study on the effect of new classification for premature ejaculation.
    

Detailed description: 
      Premature ejaculation (PE) is one of the the most common male sexual dysfunctions and it has
      negative impacts on people's quality of life. According to the time that PE syndromes come
      out, PE is clinically divided to primary PE , which appear from the first sex ,and secondary
      PE ,which occurred after a period of normal ejaculation. This method of classification make
      little sense for treatment. In 2008, PE was divided into four types: primary PE, secondary
      PE, natural variable PE and premature-like ejaculatory dysfunction , and different types of
      premature ejaculation have their corresponding treatment. Both method of classification are
      based on the subjective feelings of patients, then whether certain objective test can be used
      to help diagnosing premature ejaculation? The drug treatment of PE mainly includes local
      anesthetics and selective 5- serotonin reuptake inhibitor (SSRI), and the selective penile
      dorsal nerve block is the most used surgery. But the efficacy of dapoxetine(a new SSRI for
      PE) and local anesthetics is only about 60-70% and 60%, respectively, while the efficacy of
      surgery is not exact without a standard surgical indication. We suppose that there may be
      different subtypes of the nerve of patients with premature ejaculation may exist in, which
      corresponds to a specific treatment.

      In previous study, the investigators studied the somatic sensory pathway and autonomic nerve
      function of patients with premature ejaculation, and found that they were characterized by
      different neural electrophysiological characteristics. About 60% patients with primary PE
      show hypersensitivity of penis, and the efficacy of local anesthetics or selective penile
      dorsal nerve block for them reached 90%. While SSRI can reduce the excitability of the
      sympathetic nervous system in patients with PE, and the effect of this drug on patients with
      Sympathetic hyperexcitability is better than those without Sympathetic hyperexcitability.
      Thus doctors here have already been dividing patients who only suffer from PE(no other
      diseases mentioned in exclusion criteria)into 4 groups according to the results of nerve
      electrophysiological examination and give corresponding treatment: 1. Penile sensory
      hyperexcitability Group, using local anaesthetics(compound lidocaine cream)to treat; 2.
      Sympathetic hyperexcitability Group: using selective serotonin reuptake
      inhibitor(SSRI)(Dapoxetine) to treat. 3. Mixed type Group: both Penile sensory
      hyperexcitability and Sympathetic hyperexcitability: Combined use of two treatments above. 4.
      Other Group: result of nerve electrophysiological examination is normal: this group of
      patients will receive further examination to figure out the reason. This pattern of treatment
      has been used in clinical practice for years.

      In this research, the investigators will systemically observe the result of this
      classification and treatment for 12 weeks. Patients will be asked for participating in this
      research. The questionnaires(IELT,PEDT,PEP) can be filled in when visited or online about
      every 4 weeks. If he refused , he would still receive the classified treatment but not
      enrolled in this research. After treatment of 12 weeks, the investigators will measure the
      change of IELT, PEDT, PEP, nerve electrophysiological examination and CGIC, then compare the
      efficacy of the treatment to that has been reported before. If anyone do not want to continue
      the treatment, he could quit from this research. Software SPSS17.0 will be used for data
      analysis. The age, height, weight, quantity table, the latency and amplitude of each group
      will be expressed by the mean add or subtract standard deviation. Quantitative data
      comparison among groups was analyzed by single factor variance analysis (one-way ANOVA and
      LSD), comparison of rate using x2 test, comparison of before and after treatment compared
      with paired t test. P<0.05 showed statistically significant difference.
    

Observational model: Cohort
Time perspective: Prospective
Sampling method: Probability Sample
Study population: 
        Adult males with sympton of premature ejaculation, excepting for other diseases.
      
Keywords: Premature ejaculation; Dapoxetine; local anaesthetics; nerve electrophysiology