title: Efficacy and safety of phosphodiesterase type 5 inhibitors on primary premature ejaculation in men receiving selective serotonin reuptake inhibitors therapy: a systematic review and meta-analysis.
abstract: We performed a systematic review and meta-analysis to assess whether selective serotonin reuptake inhibitors (SSRIs) and phosphodiesterase type 5 inhibitors (PDE5-Is) may have an additive therapeutic effect. A literature review was performed to identify all published randomised controlled trials (RCT) that used SSRIs combined with PDE5-Is therapy for the treatment of primary PE. The search included the following databases: EMBASE, MEDLINE and the Cochrane Controlled Trials Register. The reference lists of the retrieved studies were also investigated. Five publications involving a total of 419 patients were used in the analysis, including 5 RCTs that compared PDE5-Is plus SSRIs with SSRIs treating primary PE. Primary efficacy endpoints: IELT (the standardised mean difference (SMD) = 1.07, 95% confidence interval (CI) = 1.00 to 1.14, P < 0.00001) indicated that utilisation of PDE5-Is and SSRIs was more effective than the SSRIs alone for a long time in patients with primary PE. Safety assessments included headache (odds ratio (OR) = 3.16, 95% CI = 1.63 to 6.11, P = 0.0006), and flushing indicated that PDE5-Is plus SSRIs were well tolerated. This meta-analysis indicates that PDE5-Is combined with SSRIs seem to provide significantly better ejaculatory latency time as compared with SSRIs alone in patients with primary PE.
authors.affiliation: Department of Urology, Yantai Yuhuangding Hospital, Yantai, China.
authors.forename: C
authors.initials: C
authors.lastname: Men
authors.affiliation: Department of Urology, Yantai Yuhuangding Hospital, Yantai, China.
authors.forename: L
authors.initials: L
authors.lastname: Yu
authors.affiliation: Department of Urology, Yantai Yuhuangding Hospital, Yantai, China.
authors.forename: H
authors.initials: H
authors.lastname: Yuan
authors.affiliation: Department of Urology, Yantai Yuhuangding Hospital, Yantai, China. doctorcuiys@163.com.
authors.forename: Y
authors.initials: Y
authors.lastname: Cui
mesh_terms: D004357:Drug Synergism; D006801:Humans; D008297:Male; D058986:Phosphodiesterase 5 Inhibitors / Q000008:administration & dosage* / Q000009:adverse effects; D061686:Premature Ejaculation / Q000188:drug therapy* / Q000503:physiopathology; D016032:Randomized Controlled Trials as Topic; D017367:Selective Serotonin Reuptake Inhibitors / Q000008:administration & dosage* / Q000009:adverse effects; D016896:Treatment Outcome
chemical_list: D058986:Phosphodiesterase 5 Inhibitors; D017367:Selective Serotonin Reuptake Inhibitors
keywords: Meta-analysis; PDE5-Is; PE; SSRIs; randomised controlled trial