论文部分内容阅读
Selective serotonin reuptake inhibitors (SSRIs) are the initial treatment option for lifelong premature ejaculation (LPE).Nevertheless, unsuccessful treatment rates of up to 15-30 % have been reported.SSRIs such as dapoxetine or off-label clomipramine, paroxetine,sertraline, and fluoxetine, or with daily dosing of off-label paroxetine, clomipramine, sertraline,fluoxetine, or citalopram.This study presents the analysis of failure and clinical outcome of LPE with SSRIs.Objective To discuss the unsuccessful reasons and the preventive methods of the unsuccessful clinic cases to SSRIs.Methods The retrospective analysis was carried on 30 LPE patients from 2012 to 2014 who were suffered from lifelong premature ejaculation with unsuccessful results.Pre-assessment included history ,physical examination,diagnostic measure (Premature Ejaculation DiagnosticTool [PEDT]),and Psychological Factors.Results The average age at the time of LPE was 30.2 years (range, 18-55 years).Three main reasons for failure after treatment could be identified: failure to consider course of treatment (11/30) , psychological problems,particularly severe anxiety (8/30) , not enough doses (7/30);The rest of unrealistic patient expectations (3/30) ,other (1/30).Conclusion It is necessary to select course ,dose and psychological counseling for preventing the occurring of the unsuccessful results.Treatment failures might be due to the severity of the underlying pathophysiology, improper use of medication, unrealistic patient expectations, severe performance anxiety, and other psychological problems.Physicians must address these issues to identify true treatment failures attributable to the SSRIs.