Clinical challenges in the management of premature ejaculation

Even though premature ejaculation (PE) is the most widespread pathology of sexual behaviour, its pathophysiology and therapy are still an important challenge for the andrologist and urologist. PE is largely underdiagnosed and undertreated, while erectile dysfunction has received great scientific and clinical attention in recent years. There are plenty of reasons for this: i) PE is classically considered to be psychogenic in nature; ii) it is traditionally treated with behavioural psychotherapies; iii) clear and accepted clinical definition(s) are lacking; iv) the aetiologies are largely unknown; v) the pathogenesis is still obscure - there is a lack of awareness and acknowledgement of PE as a symptom of medical disease; vi) there is a lack of medical presence in the field as requests for help from patients are few. Finally, erectile and ejaculatory dysfunctions frequently overlap. This apparently dramatic scenario is going to rapidly change. The presence, in several countries, of the first efficacious, well-tolerated on-demand treatment explicitly tailored for PE (dapoxetine) is increasing awareness in the field. © Touch Briefings 2011.