title: Comparison of efficacy of sildenafil-only, sildenafil plus topical EMLA cream, and topical EMLA-cream-only in treatment of premature ejaculation.
abstract: OBJECTIVE
  To compare the efficacy of sildenafil (Viagra) only, sildenafil plus topical anesthetic cream (EMLA), and topical EMLA-cream-only to that of placebo in treating premature ejaculation.
  
  
  METHODS
  A total of 84 patients were enrolled in this study. The duration of premature ejaculation in the patients ranged from 9 to 60 months (mean 32.5 +/- 14.6). Patients were randomized into four groups. Group 1 consisted of 20 patients who took placebo for 2 months. Groups 2 and 3 consisted of 20 and 22 patients, respectively, and they received 50 mg sildenafil 45 minutes before coitus for 2 months. In addition, patients in group 3 applied topical EMLA cream to the glans penis 15 minutes before coitus. The 22 patients in group 4 used topical EMLA-cream-only. After at least eight sexual attempts, the patients' clinical responses were assessed using the patient self-description method. Effectiveness was described as improvement plus cure.
  
  
  RESULTS
  The effectiveness was 40% in group 1, 55% in group 2, 86.4% in group 3, and 77.3% in group 4. Of the groups, a significant difference was found in the effectiveness of the treatments (Pearson chi-square= 0.00). No significant difference was found between groups 1 and 2 (P = 0.26). Efficacy was more successful in groups 3 and 4 than in the others (P = 0.00). The difference between groups 3 and 4 was not significant (Pearson chi-square = 0.42).
  
  
  CONCLUSIONS
  Sildenafil-only was not superior to placebo or combination treatment. Topical EMLA-cream-only had equal effectiveness to that of sildenafil plus topical EMLA treatment. The use of topical EMLA-cream-only seems to be an effective treatment of premature ejaculation.
authors.affiliation: Third Department of Urology, Ministry of Health, Ankara Numune Research and Training Hospital, Ankara, Turkey.
authors.forename: Ali
authors.initials: A
authors.lastname: Atan
authors.forename: M Murad
authors.initials: MM
authors.lastname: Basar
authors.forename: Altug
authors.initials: A
authors.lastname: Tuncel
authors.forename: Mehmet
authors.initials: M
authors.lastname: Ferhat
authors.forename: Koray
authors.initials: K
authors.lastname: Agras
authors.forename: Umit
authors.initials: U
authors.lastname: Tekdogan
mesh_terms: D000287:Administration, Topical; D000328:Adult; D000779:Anesthetics, Local / Q000008:administration & dosage*; D004359:Drug Therapy, Combination; D004542:Ejaculation / Q000187:drug effects*; D006801:Humans; D008012:Lidocaine / Q000008:administration & dosage*; D000077442:Lidocaine, Prilocaine Drug Combination; D008297:Male; D008875:Middle Aged; D009824:Ointments; D010726:Phosphodiesterase Inhibitors / Q000008:administration & dosage*; D010879:Piperazines / Q000008:administration & dosage*; D011318:Prilocaine / Q000008:administration & dosage*; D011687:Purines; D012735:Sexual Dysfunction, Physiological / Q000188:drug therapy*; D000068677:Sildenafil Citrate; D013450:Sulfones; D013997:Time Factors
chemical_list: D000779:Anesthetics, Local; D000077442:Lidocaine, Prilocaine Drug Combination; D009824:Ointments; D010726:Phosphodiesterase Inhibitors; D010879:Piperazines; D011687:Purines; D013450:Sulfones; D011318:Prilocaine; D008012:Lidocaine; D000068677:Sildenafil Citrate