الفهرس 
Arabic Summary
DEFINITIONS OF PEOnly 14 pages are availabe for public view
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Abstract
Premature ejaculation is the most frequently encountered sexual complaint of men. Premature ejaculation can be defined as persistent or recurrent occurrence of ejaculation with minimal sexual stimulation before, upon, or shortly after vaginal penetration and before the person wishes it. Such sexual dysfunction is an important source of distress to man and his partner. Premature ejaculation can impact many aspects of a man’s life, including reducing self-esteem, deteriorating relationships, causing anxiety, embarrassment and depressed feelings. The exact aetiology of PE is unclear, but probably includes psychological (anxiety- related, behavioral) and biological factors (hypersensitivity of the glans penis).
Currently, no therapy is approved by the FDA for treatment of PE. Treatment modalities which are commonly used include:
Behavioral therapy:
A. stop-start technique
B. squeeze technique
Pharmacological treatment of PE:
A. Oral medications:
1. Tricyclic Antidepressants (Clomipramine).
2. Selective serotonin reuptake inhibitors (SSRIs):
a. Paroxetine
b. Sertraline:
c. Fluoxetine
d. Fluvoxamine
e. Citalopram
f. Escitalopram
g. Dapoxetine
h. Duloxetine
3. Phosphodiesterase type 5 inhibitors (PDE-5 inhibitors).
4. Pain killers (Tramadol).
5. α1-adrenoceptor antagonist (e.g. Alfuzosin, Terazosin)
B. Topical desensitizing drugs:
1. Lidocaine-prilocaine cream
2. Lidocaine-prilocaine spray
3. SS cream
4. Dyclonine-alprostadil cream
5. Lidocaine spray
C. Other treatment options:
1. Penile dorsal neurectomy.
2. Glans penis augmentation using hyaluronic acid gel.
Since the mid 1990s, daily treatment with clomipramine and selective serotonin reuptake inhibitors (SSRIs) has become the cornerstone medical therapy of lifelong premature ejaculation (PE). Of all SSRIs and clomipramine, daily treatment with 20-mg paroxetine may exert the strongest ejaculation delay of a ninefold geometric mean intravaginal ejaculation latency time (IELT).
In this study, we examined efficacy of paroxetine in treatment of PE in a single-blind placebo controlled manner, and reported potential side effects of the drug. Participants in the study were randomly divided in two treatment groups: a group receiving paroxetine 20 mg daily for 1 month; and a group receiving placebo daily for 1 month. Patients were blinded regarding the received medication. We evaluated each participant at initial visit, at 10 days intervals after start of treatment for one month by modified version of Chinese index of Premature Ejaculation and by measurement of IELT.
The main finding from our study:
• Daily administration of 20 mg paroxetine and placebo in patients with PE resulted in an increase of IELT after 10 days.
• No significant difference between paroxetine and placebo regarding increase of IELT after 10 days.
• The increase in IELT was significantly higher in paroxetine group as compared to placebo group after 20 and 30 days.
• There is improvement in control of ejaculation, sexual satisfaction of the patients and anxiety and stress during sexual activity in patients treated with paroxetine.
• Other domains of sexual function including desire and erection were not affected in patients treated with paroxetine.
• Minor side effects include sleepiness and nausea reported by some patients treated with paroxetine.