Revisiting Controversial Areas in the Management of Premature Ejaculation

초록

The cause of premature ejaculation (PE) is often multifactorial in nature, and effective management of PE is complex and should involve multimodal approaches. This narrative review examines the ongoing controversies surrounding key areas in the diagnosis and treatment of PE with an emphasis on future research directions to align clinical care with patient needs and expectations. By addressing both established and emerging perspectives, this article seeks to contribute to a more nuanced understanding of how PE should be managed in contemporary sexual medicine. A literature review using the PubMed database was performed to identify pertinent peer-reviewed, English-language articles relating to PE, with specific emphasis on key controversial areas. Clinicians should consider various factors such as the severity of symptoms, patient preference for a type of treatment and likely side effects of each treatment modality. Additional studies are needed to obtain objective data for evidence-based definitions of various subtypes of PE. There is a need to incorporate more novel and innovative diagnostic tools to assist in the clarification and diagnosis of PE. Furthermore, the severity of each subtype requires specific management algorithms. Presently, psychosexual behavioural counselling and medical therapy remain the standard of care, with contemporary guidelines advocating caution on surgical interventions. Given the controversies and complex nature of PE, it is critical to have a comprehensive and structured multi-modal management approach to this common sexual dysfunction condition.

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