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首页> 外文期刊>BJU international >A review of the current status of topical treatments for premature ejaculation.
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A review of the current status of topical treatments for premature ejaculation.

机译：早泄局部治疗的现状回顾。

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The three mini-reviews this month cover several areas of interest, including premature ejaculation, urological malignancies after renal transplantation and the much-vexed issue of the relevance of prostate size to prostate disease. Each of these should help to keep the readers up-to-date with each of these important topics. We examine the progress that has been made towards the development of topical treatments for premature ejaculation (PE). Although generally regarded as one of the most common male sexual problems, the lack of approved pharmacological agents for PE means that treatment options are limited to behavioural therapy, where available, and the use of drugs 'off-label'. There are various theories on the aetiology of PE, but it seems likely that both biological and psychological factors are important. One theory, that men with PE might have a heightened sensory response to penile stimulation, provides the rationale for using topical therapy; reducing the sensitivity of the glans penis with topical desensitizing agents (e.g. local anaesthetics) might improve ejaculatory latency without adversely affecting the sensation of ejaculation. Off-label topical treatments are now relatively widely used, despite limited supportive efficacy data. There are also new topical treatments in various stages of development, designed specifically for use in PE. Treatments reviewed include TEMPE spray, containing a eutectic mixture of the topical anaesthetics lidocaine and prilocaine, and several creams, including one containing natural products (SS-cream), and preliminary results from another containing the local anaesthetic dylonine, with alprostadil (prostaglandin E1). Despite wide variations in the methods of clinical trials, it is possible to conclude that all placebo-controlled studies of topical treatments have reported a significant increase in intravaginal ejaculatory latency time compared to baseline and placebo. Topical treatments for PE are appealing in that they can be applied as needed and only minimal systemic effects are likely. However, without well-controlled drug delivery there is the theoretical possibility of penile hypoaesthesia and/or transvaginal contamination. Unlike the cream formulations, the TEMPE spray has a well-controlled delivery system, making it easy to administer locally, and it appears to be well tolerated in early clinical trials. It appears that topical treatments might be able to satisfy many of the requirements of an ideal treatment for PE, and certainly have the potential for use as a first-line treatment.
机译：本月的三篇小型综述涵盖了几个令人感兴趣的领域，包括早泄，肾移植后的泌尿系统恶性肿瘤以及前列腺尺寸与前列腺疾病的相关性问题。这些中的每一个都应有助于使读者了解这些重要主题中的每个主题。我们研究了早泄局部治疗（PE）的开发进展。尽管通常被认为是最常见的男性性问题之一，但缺乏用于PE的经批准的药理学手段意味着治疗选择仅限于行为疗法（如果有）以及“标签外”使用药物。关于体育运动病因的理论多种多样，但生物学和心理因素似乎都很重要。一种理论认为PE男性可能会对阴茎刺激产生更高的感觉反应，这为使用局部疗法提供了理论依据。使用局部脱敏剂（例如局部麻醉剂）降低龟头阴茎的敏感性可能会改善射精潜伏期，而不会不利地影响射精感。尽管支持功效数据有限，但标签外局部治疗现已相对广泛使用。在发展的各个阶段，还出现了新的局部治疗方法，这些治疗方法是专门为体育锻炼设计的。所审查的治疗方法包括：TEMPE喷雾剂，其中包含局部麻醉药利多卡因和丙胺卡因的低共熔混合物;几种乳膏，其中一种包含天然产物（SS乳膏）;另一种乳膏的初步结果，其中另一种包含局部麻醉性达洛宁和前列地尔（前列腺素E1） 。尽管临床试验方法差异很大，但可以得出结论，所有与局部治疗有关的安慰剂对照研究均报告说，与基线和安慰剂相比，阴道内射精潜伏时间显着增加。 PE的局部治疗之所以吸引人，是因为它们可以根据需要进行应用，而且全身作用很小。但是，如果没有很好地控制药物输送，理论上就有阴茎感觉不足和/或经阴道污染的可能性。与乳膏剂不同，TEMPE喷雾剂具有良好控制的输送系统，使其易于局部给药，并且在早期临床试验中似乎耐受性良好。看起来局部治疗可能能够满足PE理想治疗的许多要求，并且肯定具有用作一线治疗的潜力。

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