{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,30]],"date-time":"2026-05-30T08:03:01Z","timestamp":1780128181952,"version":"3.54.0"},"reference-count":34,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T00:00:00Z","timestamp":1777593600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T00:00:00Z","timestamp":1777593600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Clin Med Insights Case Rep"],"published-print":{"date-parts":[[2026,5]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Premature ejaculation (PE) is the most common male sexual dysfunction, which often causes significant psychological problems. Although botulinum toxin A (Botox) has shown promise for delaying ejaculation through chemodenervation, the optimal anatomical target remains uncertain. This study evaluated the efficacy and safety of Botox injection into the penile prepuce and subcoronal region as a novel approach for lifelong PE.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>A prospective case series was conducted in 7 adult men (mean age 54.7\u2009\u00b1\u20096.5\u2009years) diagnosed with lifelong PE (intravaginal ejaculatory latency time\u2009&lt;1 minute, PEDT\u2009\u2a7e11). Participants received a single 100-unit Botox injection, administered subcutaneously into the prepuce and subcoronal region. The Premature Ejaculation Diagnostic Tool (PEDT) and Male Sexual Health Questionnaire (MSHQ) were completed before, 4\u2009weeks, and 6\u2009months after treatment to assess the efficacy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      Seven patients were included in the analysis. No significant changes were observed in PEDT scores at 4\u2009weeks (18.00\u2009\u00b1\u20090.9;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u2009=\u2009.7358) or at 6\u2009months (17.71\u2009\u00b1\u20090.4;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u2009=\u2009.762) compared with baseline. Similarly, MSHQ erection scores (5.00\u2009\u00b1\u20092.0 at 4\u2009weeks; 4.85\u2009\u00b1\u20092.2 at 6\u2009months), ejaculation scores (23.43\u2009\u00b1\u20093.8 at 4\u2009weeks; 23.42\u2009\u00b1\u20093.1 at 6\u2009months), and satisfaction scores (10.71\u2009\u00b1\u20094.07 at 4\u2009weeks; 10.14\u2009\u00b1\u20093.5 at 6\u2009months) did not differ significantly from baseline values (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u2009&gt;\u2009.05 for all comparisons). No adverse events or treatment-related side effects were reported throughout the study period.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>Subcoronal Botox injection was safe and well-tolerated, but it did not show significant improvements in ejaculatory control or sexual function scores. The findings suggest that sensory-targeted Botox administration alone is insufficient to enhance the ejaculatory reflex.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/11795476261452323","type":"journal-article","created":{"date-parts":[[2026,5,26]],"date-time":"2026-05-26T12:11:13Z","timestamp":1779797473000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Evaluating the Role of Subcoronal Botulinum Toxin Injection in the Management of Premature Ejaculation"],"prefix":"10.1177","volume":"19","author":[{"given":"Seyed Reza","family":"Hosseini","sequence":"first","affiliation":[{"name":"Urology Research Center, Tehran University of Medical Sciences, Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mahdi","family":"Najarzadegan","sequence":"additional","affiliation":[{"name":"Urology Research Center, Tehran University of Medical Sciences, Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-0160-104X","authenticated-orcid":false,"given":"Mohammad Mahdi","family":"Mehrabi","sequence":"additional","affiliation":[{"name":"Urology Research Center, Tehran University of Medical Sciences, Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hossein","family":"Chivaee","sequence":"additional","affiliation":[{"name":"Urology Research Center, Tehran University of Medical Sciences, Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abdolreza","family":"Mohammadi","sequence":"additional","affiliation":[{"name":"Urology Research Center, Tehran University of Medical Sciences, Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sara","family":"Ashtari","sequence":"additional","affiliation":[{"name":"Urology Research Center, Tehran University of Medical Sciences, Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fateme","family":"Guitynavard","sequence":"additional","affiliation":[{"name":"Urology Research Center, Tehran University of Medical Sciences, Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Parsa","family":"Nikoufar","sequence":"additional","affiliation":[{"name":"Department of Urology, Thunder Bay Regional Health Sciences Centre, Northern Ontario School of Medicine, Thunder Bay, ON, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1611-0362","authenticated-orcid":false,"given":"Seyed Mohammad Kazem","family":"Aghamir","sequence":"additional","affiliation":[{"name":"Urology Research Center, Tehran University of Medical Sciences, Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,5,26]]},"reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.eururo.2010.02.020"},{"key":"e_1_3_3_3_2","volume-title":"Erectile Dysfunction\u2013Disease-Associated Mechanisms and Novel Insights Into Therapy","author":"Al-Shaiji T.","year":"2012","unstructured":"Al-Shaiji T. Premature ejaculation re-visited: definition and contemporary management approaches. In: Nunes KP, ed. Erectile Dysfunction\u2013Disease-Associated Mechanisms and Novel Insights Into Therapy. IntechOpen; 2012:97-114."},{"key":"e_1_3_3_4_2","doi-asserted-by":"publisher","DOI":"10.4103\/0253-7184.142391"},{"key":"e_1_3_3_5_2","doi-asserted-by":"publisher","DOI":"10.5534\/wjmh.200184"},{"key":"e_1_3_3_6_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1743-6109.2005.20369.x"},{"key":"e_1_3_3_7_2","doi-asserted-by":"publisher","DOI":"10.21037\/tau.2016.05.08"},{"key":"e_1_3_3_8_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1743-6109.2008.00825.x"},{"key":"e_1_3_3_9_2","doi-asserted-by":"publisher","DOI":"10.1038\/s41585-022-00639-5"},{"key":"e_1_3_3_10_2","doi-asserted-by":"publisher","DOI":"10.1002\/smrj.49"},{"key":"e_1_3_3_11_2","doi-asserted-by":"publisher","DOI":"10.1111\/andr.12032"},{"key":"e_1_3_3_12_2","doi-asserted-by":"publisher","DOI":"10.1007\/978-88-470-2646-9"},{"key":"e_1_3_3_13_2","doi-asserted-by":"publisher","DOI":"10.12703\/P6-55"},{"key":"e_1_3_3_14_2","doi-asserted-by":"publisher","DOI":"10.1007\/s11930-014-0014-x"},{"issue":"11","key":"e_1_3_3_15_2","article-title":"The role of local anaesthetics in premature ejaculation","volume":"110","author":"Wyllie MG","year":"2012","unstructured":"Wyllie MG, Powell JA. The role of local anaesthetics in premature ejaculation. 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Psychometric properties of Iranian version of male sexual function index. Jundishapur Scientific Medical Journal. 2014;12(6):655-663.","journal-title":"Jundishapur Scientific Medical Journal"},{"key":"e_1_3_3_25_2","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0315470"},{"key":"e_1_3_3_26_2","first-page":"713","article-title":"[Injection of botulinum-A toxin into bulbospongiosus muscle for primary premature ejaculation: a preliminary clinical study]","volume":"24","author":"Li ZT","year":"2018","unstructured":"Li ZT, Li YF, Zhang Y, et al. [Injection of botulinum-A toxin into bulbospongiosus muscle for primary premature ejaculation: a preliminary clinical study]. Zhonghua nan ke xue = National journal of andrology. 2018;24:713-718.","journal-title":"Zhonghua nan ke xue = National journal of andrology"},{"issue":"4","key":"e_1_3_3_27_2","first-page":"824","article-title":"Evaluation of efficacy and safety of Botulinum toxin-A injection at three deferent sites in treatment of premature ejaculation","volume":"91","author":"Elshahid AR","year":"2024","unstructured":"Elshahid AR, Taher AOA, Nouh AH. Evaluation of efficacy and safety of Botulinum toxin-A injection at three deferent sites in treatment of premature ejaculation. Urol J. 2024; 91(4):824-829.","journal-title":"Urol J"},{"key":"e_1_3_3_28_2","doi-asserted-by":"publisher","DOI":"10.1080\/10532528.2005.10559833"},{"key":"e_1_3_3_29_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.physbeh.2004.08.023"},{"key":"e_1_3_3_30_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.fertnstert.2015.08.033"},{"key":"e_1_3_3_31_2","first-page":"35","volume-title":"Anatomy of the Prepuce. 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