title: Selective Serotonin Reuptake Inhibitors Plus Phosphodiesterase-5 Inhibitors for Premature Ejaculation: A Systematic Review and Meta-analysis.
abstract: OBJECTIVE
  To evaluate the efficacy and safety of combination therapy with selective serotonin reuptake inhibitors (SSRIs) and phosphodiesterase-5 (PDE-5) inhibitors for the treatment of premature ejaculation (PE).
  
  
  METHODS
  A systematic search of EMBASE, MEDLINE, the Cochrane Central Register of Controlled Trials, and the Cochrane Database of Systematic Reviews was undertaken to identify articles that referred to the use of a combination of SSRIs and PDE-5 inhibitors for the treatment of PE. A meta-analysis of these clinical studies was performed. The post-treatment intravaginal ejaculatory latency time (IELT) and adverse events (AEs) were used in this meta-analysis.
  
  
  RESULTS
  Six publications involving 971 patients were included in the meta-analysis. In the analysis, we found significantly improved IELT in the combination use group compared with the use of SSRIs (mean differences [MD], 1.01; 95% confidence interval [CI], 0.61-1.41; P <.01) or PDE-5 inhibitors alone (MD, 1.11; 95% CI, 0.79-1.43; P <.01) for PE whether or not these patients suffered from erectile dysfunction. Combined treatment was more efficacious than use of PDE-5 inhibitors alone on sexual satisfaction. Although the occurrence of drug-related AEs in the combination use group was higher than that in the use of SSRIs or PDE-5 inhibitors alone group (37.5% vs 25.63%, P <.01), the most common AEs were mild and tolerable.
  
  
  CONCLUSIONS
  The combined use of SSRIs and PDE-5 inhibitors provided additive favorable effects in men with PE compared with SSRIs or PDE-5 inhibitors monotherapy and was generally well tolerated.
authors.affiliation: Department of Urology, West China Hospital, Sichuan University, Chengdu, China.
authors.forename: Yunjin
authors.initials: Y
authors.lastname: Bai
authors.affiliation: Department of Urology, West China Hospital, Sichuan University, Chengdu, China.
authors.forename: Chunxiao
authors.initials: C
authors.lastname: Pu
authors.affiliation: Department of Urology, West China Hospital, Sichuan University, Chengdu, China. Electronic address: hanpinghxyy@163.com.
authors.forename: Ping
authors.initials: P
authors.lastname: Han
authors.affiliation: Department of Urology, West China Hospital, Sichuan University, Chengdu, China.
authors.forename: Jinhong
authors.initials: J
authors.lastname: Li
authors.affiliation: Department of Urology, West China Hospital, Sichuan University, Chengdu, China; Department of Urology, Peking University Shenzhen Hospital, Shenzhen, Guangdong Province, China.
authors.forename: Haichao
authors.initials: H
authors.lastname: Yuan
authors.affiliation: Department of Urology, West China Hospital, Sichuan University, Chengdu, China.
authors.forename: Yin
authors.initials: Y
authors.lastname: Tang
authors.affiliation: Department of Urology, West China Hospital, Sichuan University, Chengdu, China.
authors.forename: Xiaoming
authors.initials: X
authors.lastname: Wang
authors.affiliation: Department of Urology, West China Hospital, Sichuan University, Chengdu, China.
authors.forename: Qiang
authors.initials: Q
authors.lastname: Wei
mesh_terms: D054706:Cyclic Nucleotide Phosphodiesterases, Type 5 / Q000627:therapeutic use*; D004359:Drug Therapy, Combination; D004542:Ejaculation / Q000187:drug effects*; D006801:Humans; D008297:Male; D061686:Premature Ejaculation / Q000188:drug therapy* / Q000503:physiopathology; D017367:Selective Serotonin Reuptake Inhibitors / Q000627:therapeutic use*; D016896:Treatment Outcome
chemical_list: D054706:Cyclic Nucleotide Phosphodiesterases, Type 5; D017367:Selective Serotonin Reuptake Inhibitors