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PE can be either lifelong and present since first sexual experiences (primary), or acquired (secondary), beginning later (Godpodinoff ML. Premature ejaculation: clinical subgroups and etiology.J Sex Marital Ther<\/jats:italic>1989;15<\/jats:bold>:130\u20134). Treatments include behavioural and pharmacological interventions.<\/jats:p><\/jats:sec>Objective<\/jats:title>To systematically review evidence for clinical effectiveness of behavioural, topical and systemic treatments for PE.<\/jats:p><\/jats:sec>Data sources<\/jats:title>The following databases were searched from inception to 6 August 2013 for published and unpublished research evidence: MEDLINE; EMBASE; Cumulative Index to Nursing and Allied Health Literature; The Cochrane Library including the Cochrane Systematic Reviews Database, Cochrane Controlled Trials Register, Database of Abstracts of Reviews of Effects and theHealth Technology Assessment<\/jats:italic>database; ISI Web of Science, including Science Citation Index, and the Conference Proceedings Citation Index-Science. The US Food and Drug Administration website and the European Medicines Agency (EMA) website were also searched.<\/jats:p><\/jats:sec>Methods<\/jats:title>Randomised controlled trials (RCTs) in adult men with PE were eligible (or non-RCTs in the absence of RCTs). RCT data were extrapolated from review articles when available. The primary outcome was intravaginal ejaculatory latency time (IELT). Data were meta-analysed when possible. Other outcomes included sexual satisfaction, control over ejaculation, relationship satisfaction, self-esteem, quality of life, treatment acceptability and adverse events (AEs).<\/jats:p><\/jats:sec>Results<\/jats:title>A total of 103 studies (102 RCTs, 65 from reviews) were included. RCTs were available for all interventions except yoga. The following interventions demonstrated significant improvements (p<\/jats:italic>\u2009<\u20090.05) in arithmetic mean difference in IELT compared with placebo:topical anaesthetics<\/jats:italic>\u2013 eutectic mixture of local anaesthetics (EMLA\u00ae<\/jats:sup>, AstraZeneca), topical eutectic mixture for PE (Plethora Solutions Ltd) spray;selective serotonin reuptake inhibitors<\/jats:italic>(SSRIs<\/jats:italic>) \u2013 citalopram (Cipramil\u00ae<\/jats:sup>, Lundbeck), escitalopram (Cipralex\u00ae<\/jats:sup>, Lundbeck), fluoxetine, paroxetine, sertraline, dapoxetine (Priligy\u00ae<\/jats:sup>, Menarini), 30\u2009mg or 60\u2009mg;serotonin\u2013noradrenaline reuptake inhibitors<\/jats:italic>\u2013 duloxetine (Cymbalta\u00ae<\/jats:sup>, Eli Lilly & Co Ltd);tricyclic antidepressants<\/jats:italic>\u2013 inhaled clomipramine 4\u2009mg;phosphodiesterase-5<\/jats:italic>(PDE5<\/jats:italic>)inhibitors<\/jats:italic>\u2013 vardenafil (Levitra\u00ae<\/jats:sup>, Bayer), tadalafil (Cialis\u00ae<\/jats:sup>, Eli Lilly & Co Ltd);opioid analgesics<\/jats:italic>\u2013 tramadol (Zydol SR\u00ae<\/jats:sup>, Gr\u00fcnenthal). Improvements in sexual satisfaction and other outcomes compared with placebo were evident for SSRIs, PDE5 inhibitors and tramadol. Outcomes for interventions not compared with placebo were as follows:behavioural therapies<\/jats:italic>\u2013 improvements over wait list control in IELT and other outcomes, behavioural therapy plus pharmacotherapy better than either therapy alone;alpha blockers<\/jats:italic>\u2013 terazosin (Hytrin\u00ae<\/jats:sup>, AMCO) not significantly different to antidepressants in ejaculation control;acupuncture<\/jats:italic>\u2013 improvements over sham acupuncture in IELT, conflicting results for comparisons with SSRIs;Chinese medicine<\/jats:italic>\u2013 improvements over treatment as usual;delay device<\/jats:italic>\u2013 improvements in IELT when added to stop\u2013start technique;yoga<\/jats:italic>\u2013 improved IELT over baseline, fluoxetine better than yoga. Treatment-related AEs were evident with most pharmacological interventions.<\/jats:p><\/jats:sec>Limitations<\/jats:title>Although data extraction from reviews was optimised when more than one review reported data for the same RCT, the reliability of the data extraction within these reviews cannot be guaranteed by this assessment report.<\/jats:p><\/jats:sec>Conclusions<\/jats:title>Several interventions significantly improved IELT. Many interventions also improved sexual satisfaction and other outcomes. However, assessment of longer-term safety and effectiveness is required to evaluate whether or not initial treatment effects are maintained long term, whether or not dose escalation is required, how soon treatment effects end following treatment cessation and whether or not treatments can be stopped and resumed at a later time. In addition, assessment of the AEs associated with long-term treatment and whether or not different doses have differing AE profiles is required.<\/jats:p><\/jats:sec>Study registration<\/jats:title>This study is registered as PROSPERO CRD42013005289.<\/jats:p><\/jats:sec>Funding<\/jats:title>The National Institute for Health Research Health Technology Assessment programme.<\/jats:p><\/jats:sec>","DOI":"10.3310\/hta19210","type":"journal-article","created":{"date-parts":[[2015,3,17]],"date-time":"2015-03-17T13:13:15Z","timestamp":1426597995000},"page":"1-180","update-policy":"https:\/\/doi.org\/10.3310\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":28,"title":["Interventions to treat premature ejaculation: a systematic review short report"],"prefix":"10.3310","volume":"19","author":[{"given":"Katy","family":"Cooper","sequence":"first","affiliation":[{"name":"School of Health and Related Research (ScHARR) Technology Assessment Group, The University of Sheffield, 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