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Being a multifactorial dysfunction with strong cultural characteristics, PE requires skillful attitudes in the psychosexological support, necessary to manage the patient's and the couple's expectations, as well as in the medical treatment. Dapoxetine is a short\u2010acting selective serotonin reuptake inhibitor\u00a0approved for use in lifelong and acquired PE in a number of countries. Opinions, not always generated by the evidence\u2010based medicine, impacted the attitudes of Western andrologists, as a nocebo effect which produced a drug's Waterloo, characterized by low prescription rates much more built on the patients\u2019 and doctors\u2019 expectations than on costs, side effects, and efficacy.<\/jats:p><jats:p>In the present study, we retrospectively reviewed real\u2010life data from eight Andrology and Sexual Medicine Public Centers in China to assess the prevalence of PE among attending patients, its association with erectile dysfunction, its subtype, and the proposed treatments. In 2019, among 156,486 patients coming to the centers, 32,667 visits having PE as the chief complaint were performed (20.9%). Almost all patients received treatment prescriptions (32,641 patients, 99.92%); 23,273 patients came back for a follow\u2010up visit in the subsequent 12 months (71.2% of those who initially received treatment). Dapoxetine, either alone or in combination with another therapy, was the most prevalent treatment, prescribed to 22,767 patients (69.7% of treated patients), followed by traditional Chinese medicine (TCM) (39.4%). At follow\u2010up, 8174 patients were unsatisfied with treatment, and a new treatment was proposed (35.12%). Dapoxetine was the best treatment, with an overall 27.1% switching rate when used either alone or in combination: Although the switching rate for Dapoxetine alone was 44.2%, the association of the same drug with psychotherapy resulted in much lower rates (19.5%) and reached a minimum of 12% when also combined with TCM demonstrating how cultural aspects and medical attitudes may dramatically impact on the therapy of a multifaceted, complex, and culture\u2010grounded sexual symptom such as PE.<\/jats:p><jats:p>In conclusion, taking switching rates as surrogate markers of treatment failure, this real\u2010life study\u2014the largest in the field\u2014shows that in a more patient\u2010oriented (as in Chinese medical culture), and less symptom\u2010oriented (as in Western medical attitudes), Dapoxetine is a successful treatment for PE patients, with higher reliability when used alone or as part of combined and integrated therapies.<\/jats:p><\/jats:sec>","DOI":"10.1111\/andr.13403","type":"journal-article","created":{"date-parts":[[2023,2,7]],"date-time":"2023-02-07T12:12:57Z","timestamp":1675771977000},"page":"247-258","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":23,"title":["From Waterloo to the Great Wall: A retrospective, multicenter study on the clinical practice and cultural attitudes in the management of premature ejaculation, in China"],"prefix":"10.1111","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1210-2843","authenticated-orcid":false,"given":"Andrea","family":"Sansone","sequence":"first","affiliation":[{"name":"Endocrinology and Medical Sexology (ENDOSEX) Department of Systems Medicine University of Rome Tor Vergata  Rome 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