{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,11]],"date-time":"2026-09-11T00:29:22Z","timestamp":1789086562887,"version":"build-2803163510"},"reference-count":29,"publisher":"SAGE Publications","issue":"2","license":[{"start":{"date-parts":[[2025,3,1]],"date-time":"2025-03-01T00:00:00Z","timestamp":1740787200000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2025,3,1]],"date-time":"2025-03-01T00:00:00Z","timestamp":1740787200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"name":"Zhongda Hospital, Southeast University, Jiangsu Province High-Level Hospital Construction Funds","award":["2024GSPKY26"],"award-info":[{"award-number":["2024GSPKY26"]}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Am J Mens Health"],"published-print":{"date-parts":[[2025,3]]},"abstract":"<jats:p>\n                    Botulinum toxin A (BoNT\/A) injections into the bulbospongiosus muscle have emerged as a novel treatment for lifelong premature ejaculation (PE), though efficacy remains controversial. This study evaluates BoNT\/A\u2019s efficacy and safety through a comprehensive search of PubMed, Embase, Cochrane Library, Web of Science, ClinicalTrials.gov, and ISRCTN registry. We included randomized controlled trials, prospective, and retrospective studies, focusing on intravaginal ejaculation latency time (IELT) and adverse events. Four studies (three meta-analyzed) involving 263 patients were analyzed. BoNT\/A increased IELT by 37.87\u2009s at 1\u2009month (MD, 37.87; 95% CI, \u22122.86 to 78.59;\n                    <jats:italic toggle=\"yes\">p<\/jats:italic>\n                    \u2009=\u2009.07;\n                    <jats:italic toggle=\"yes\">I<\/jats:italic>\n                    <jats:sup>2<\/jats:sup>\n                    \u2009=\u200996%), 11.52\u2009s at 3\u2009months (MD, 11.52; 95% CI, \u221216.91 to 39.94;\n                    <jats:italic toggle=\"yes\">p<\/jats:italic>\n                    \u2009=\u2009.43;\n                    <jats:italic toggle=\"yes\">I<\/jats:italic>\n                    <jats:sup>2<\/jats:sup>\n                    \u2009=\u200995%), and 2.41\u2009s at 6\u2009months (MD, 2.41; 95% CI, \u22129.19 to 14.00;\n                    <jats:italic toggle=\"yes\">p<\/jats:italic>\n                    \u2009=\u20090.68;\n                    <jats:italic toggle=\"yes\">I<\/jats:italic>\n                    <jats:sup>2<\/jats:sup>\n                    \u2009=\u200977%). Short-term IELT improvement was observed but lacked statistical significance (\n                    <jats:italic toggle=\"yes\">p<\/jats:italic>\n                    \u2009&gt;\u2009.05), with high heterogeneity (\n                    <jats:italic toggle=\"yes\">I<\/jats:italic>\n                    <jats:sup>2<\/jats:sup>\n                    \u2009=\u200996%). Long-term effects diminished, suggesting declining efficacy. Adverse events occurred in 10.9% of patients, primarily erectile dysfunction (\n                    <jats:italic toggle=\"yes\">n<\/jats:italic>\n                    \u2009=\u20095), and urinary disorders (\n                    <jats:italic toggle=\"yes\">n<\/jats:italic>\n                    \u2009=\u20095). While current evidence does not definitively support BoNT\/A\u2019s efficacy, limited studies and methodological heterogeneity suggest that further research is warranted. Future studies should employ larger, multicenter designs, optimize injection methods, doses, and protocols, and identify suitable patient populations to validate BoNT\/A\u2019s clinical benefits.\n                  <\/jats:p>","DOI":"10.1177\/15579883251328312","type":"journal-article","created":{"date-parts":[[2025,3,29]],"date-time":"2025-03-29T06:56:16Z","timestamp":1743231376000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":4,"title":["Clinical Efficacy and Safety of Botulinum Toxin A Injection into the Bulbospongiosus Muscle for Treating Lifelong Premature Ejaculation: A Systematic Review and Meta-Analysis"],"prefix":"10.1177","volume":"19","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8737-1071","authenticated-orcid":false,"given":"Dawei","family":"Gao","sequence":"first","affiliation":[{"name":"Faculty of Chinese Medicine, Macau University of Science and Technology, Macau, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chuyu","family":"Li","sequence":"additional","affiliation":[{"name":"Faculty of Chinese Medicine, Macau University of Science and Technology, Macau, China"},{"name":"State Key Laboratory of Reproductive Medicine, Clinical Center of Reproductive Medicine, First Affiliated Hospital of Nanjing Medical University, Nanjing Medical University, Nanjing, Jiangsu, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yihan","family":"Jin","sequence":"additional","affiliation":[{"name":"Faculty of Chinese Medicine, Macau University of Science and Technology, Macau, China"},{"name":"Reproductive Medicine Center, Zhongda Hospital, Southeast University, Nanjing, Jiangsu, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dalin","family":"Sun","sequence":"additional","affiliation":[{"name":"Andrology Department of Integrative Medicine, Zhongda Hospital, Southeast University, Nanjing, Jiangsu, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zifeng","family":"Chen","sequence":"additional","affiliation":[{"name":"Faculty of Chinese Medicine, Macau University of Science and Technology, Macau, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bo","family":"Tang","sequence":"additional","affiliation":[{"name":"Department of Urology, Chengdu Pidu District Hospital of Traditional Chinese Medicine, Chengdu, Sichuan, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Weiping","family":"Chen","sequence":"additional","affiliation":[{"name":"Faculty of Chinese Medicine, Macau University of Science and Technology, Macau, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Baofang","family":"Jin","sequence":"additional","affiliation":[{"name":"Andrology Department of Integrative Medicine, Zhongda Hospital, Southeast University, Nanjing, Jiangsu, China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2025,3,28]]},"reference":[{"key":"e_1_3_4_2_1","doi-asserted-by":"crossref","unstructured":"Almekaty K. Ghaith A. Ragab M. Rashed A. Hagras A. Ghoneem A. Raheem A. A. Zahran M. H. (2024). Effect of bulbospongiosus muscle injection with botulinum-A toxin for treatment of lifelong premature ejaculation; a randomized controlled trial. International Journal of Impotence Research 36(8) 864\u2013868. https:\/\/doi.org\/10.1038\/s41443-024-00831-8","DOI":"10.1038\/s41443-024-00831-8"},{"key":"e_1_3_4_3_1","doi-asserted-by":"crossref","unstructured":"Clement P. Giuliano F. (2016). Physiology and pharmacology of ejaculation. Basic & Clinical Pharmacology & Toxicology 119(Suppl. 3) 18\u201325. https:\/\/doi.org\/10.1111\/bcpt.12546","DOI":"10.1111\/bcpt.12546"},{"key":"e_1_3_4_4_1","doi-asserted-by":"crossref","unstructured":"Corona G. Rastrelli G. Bartfai G. Casanueva F. F. Giwercman A. Antonio L. Slowikowska J. Tournoy J. Punab M. Huhtaniemi I. T. Vanderschueren D. O\u2019Neill T. W. Wu F. C. W. Maggi M. (2021). 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