الفهرس 
INTRODUCTIONOnly 14 pages are availabe for public view
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Abstract
Premature ejaculation (PE) is the most common sexual dysfunction in men. PE has been reported to be prevalent between 9 and 83% in various populations by different methods of assessment. There are many methods for its management up to surgical intervention. There are some methods for the treatment of primary premature ejaculation (PE) at present, but its efficacy and safety is not very good and the effectiveness of some treatment method remains to be further confirmed. Psychotherapy and behavior training therapy has a poor adherence for patients. The surgical treatment to PE has not been widely recognized by experts because it’s effect of uncertainty and may cause irreversible damage. The current study aimed to compare the efficacy of tamsulosin versus paroxetine and the effect of combination of them on PE. The study enrolled 120 patients with PE. Those patients were randomly subdivided into three equal groups; one group received tamsulosin 0.4 mg/day, second group received paroxetine 20 mg while the third group received a combination of both drugs. Any patient suffered from diabetes mellitus, hypertension, neurological disorders, psychological disorders and cardiovascular abnormalities was excluded. All patients were subjected to through history taking and thorough physical evaluation. Age, occupation and duration of sexual activity showed no significant differences between the studied groups. Those patients were basically evaluated based on baseline and follow up intravaginal ejaculatory latency time, premature ejaculation diagnostic Tool and premature ejaculation profile. At baseline all of those parameters showed no significant differences between the studied groups. But during follow up, we found that usage of paroxetine and tamsolusin separately or in combination with each other will improve the PE but combined paroxetine with tamsolusin produce more better therapeutic effects than using them separately. It could be a priority for the treatment of lifelong premature ejaculation CONCLUSION AND RECOMMENDATIONS Premature ejaculation (PE) is a common sexual problem encountered by men in day-to-day clinical practice. It affects about 20-30% of men in the sexually active age group leading to psychological stress and loss of self-esteem, resulting in significant adverse effects on the quality of life, of both the patient and the partner. The pathophysiological mechanism is complex. Diagnosis is mainly clinical. Behavioral techniques and psychotherapy have been the main modes of therapy for years. Topical anesthetic creams, TCA and SSRIs tramadol, Alpha-1 adrenoceptor antagonist and PDE-5 inhibitors were the main treatment modalities for years. Development of newer drugs like Dapoxetine have promising role in the management of PE. Based on the current study, we recommended; Combination of paroxetine and tamsolusin showed great therapeutic effects on those patients with PE. So, this commination could have a priority for management of PE. Future studies in more than one center with large sample size are warranted to prove and confirm our findings Perform such study with measuring plasma level of 5-HT at baseline and during follow with comparing between different groups as regard plasma level of 5-HT