Premature ejaculation: Is an ideal therapy on the horizon?

Physicians have long been frustrated by less than adequate solutions to this problem. Oral medications, mainly the selective serotonin reuptake inhibitor class of antidepressants, require ingestion hours before sexual activity and may have unwanted side effects. Creams applied to the penis require a prolonged period to become effective and reduce sensitivity in both partners. Exercises prescribed by therapists to reduce PE meet with varying compliance and efficacy.

Recent trials with PSD502, an aerosol spray containing prilocaine and lidocaine applied to the glans penis, have yielded very promising results in the treatment of PE (see articles, pages 16 and 18). The research suggests that this compound may provide an ideal treatment for this common malady. It's simple to apply, is truly an on-demand therapy that takes effect in less than 5 minutes, prolongs intravaginal ejaculatory latency in the range of five fold, and does not seem to reduce sensitivity. Side effects have been infrequent and tolerable, and there is little worry about systemic toxicity. Questions remain about its long-term effects to the penis over years of frequent application.

The media blitz that will surely accompany approval of this compound will create awareness that PE can be helped. Physicians who are now not aware of the nature and magnitude of the problem will rapidly become educated in this area, as they were about ED when sildenafil citrate (Viagra) was introduced, and will be better able to provide treatment.

Dr. Mulcahy, a member of the Urology Times Editorial Council, is in private practice in Madison, AL.