{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,1]],"date-time":"2026-06-01T17:11:35Z","timestamp":1780333895523,"version":"3.54.1"},"reference-count":27,"publisher":"Public Library of Science (PLoS)","issue":"5","license":[{"start":{"date-parts":[[2025,5,30]],"date-time":"2025-05-30T00:00:00Z","timestamp":1748563200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["Nos. 82370690, 82303813"],"award-info":[{"award-number":["Nos. 82370690, 82303813"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Shandong Science and Technology Program","award":["Nos. ZR2023MH241, ZR2023QH271"],"award-info":[{"award-number":["Nos. ZR2023MH241, ZR2023QH271"]}]},{"name":"Taishan Scholars Program of Shandong Province","award":["Nos.tsqn201909199, tsqn202306403"],"award-info":[{"award-number":["Nos.tsqn201909199, tsqn202306403"]}]},{"name":"basic research project of Yantai Science and Technology Innovation development plan","award":["No.2023JCYJ069"],"award-info":[{"award-number":["No.2023JCYJ069"]}]}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS One"],"abstract":"<jats:sec id=\"sec022\">\n<jats:title>Introduction<\/jats:title>\n<jats:p>Premature ejaculation (PE) is a common male sexual dysfunction, impacting sexual satisfaction and quality of life. Botulinum toxin-A (BoNT-A), known for its muscle-relaxing properties, has been proposed as a treatment for PE, but its efficacy and safety remain uncertain.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec023\">\n<jats:title>Objectives<\/jats:title>\n<jats:p>To systematically evaluate the efficacy and safety of BoNT-A injection compared to placebo for treating PE.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec024\">\n<jats:title>Methods<\/jats:title>\n<jats:p>A comprehensive search of PubMed, EMBASE, and Cochrane databases was conducted to identify randomized controlled trials comparing BoNT-A and placebo in treating PE. Primary outcomes included intravaginal ejaculatory latency time (IELT) and premature ejaculation profile (PEP), while sexual satisfaction score was a secondary outcome. Mean differences (MD) with 95% confidence intervals (CI) and odds ratios (OR) for adverse events were calculated using a random-effects model.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec025\">\n<jats:title>Results<\/jats:title>\n<jats:p>Three studies were included in the analysis. BoNT-A significantly increased IELT and PEP at the 1-month follow-up (MD\u2009=\u200922.32; 95% CI\u2009=\u200910.83\u201333.82; P\u2009=\u20090.001 for IELT; MD\u2009=\u20090.91; 95% CI\u2009=\u20090.41\u20131.42; P\u2009&lt;\u20090.001 for PEP), but no significant differences were observed at 3-month and 6-month follow-ups (P\u2009&gt;\u20090.05). No significant improvements in sexual satisfaction were found (P\u2009=\u20090.32). BoNT-A was associated with a higher incidence of adverse events compared to placebo (OR\u2009=\u20095.90; 95% CI\u2009=\u20091.29\u201326.89; P\u2009=\u20090.02), but no significant differences were observed for drippling or erectile dysfunction (P\u2009&gt;\u20090.05).<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec026\">\n<jats:title>Conclusion<\/jats:title>\n<jats:p>BoNT-A injections may be an effective short-term treatment for PE, significantly improving IELT and PEP at 1-month follow-up. However, the effects appear to diminish over time, and no significant improvement in sexual satisfaction was observed. BoNT-A is associated with a higher rate of adverse events, but does not increase the risk of drippling or erectile dysfunction. Further studies with longer follow-up periods are needed to assess long-term efficacy and safety.<\/jats:p>\n<\/jats:sec>","DOI":"10.1371\/journal.pone.0315470","type":"journal-article","created":{"date-parts":[[2025,5,30]],"date-time":"2025-05-30T17:37:01Z","timestamp":1748626621000},"page":"e0315470","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":3,"title":["Efficacy and safety of botulinum toxin-A injection in the treatment of premature ejaculation: A systematic review and 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