The impact of transcutaneous posterior tibial nerve stimulation in patients with premature ejaculation

Year 2020, Volume: 6 Issue: 5, 457 - 463, 04.09.2020

Mustafa Murat Aydos İdris Nas Efe Önen

https://doi.org/10.18621/eurj.565190

Cited By: 3

Abstract

Objectives: Approximately 30-40% of men worldwide are affected by premature ejaculation. Despite much research on this subject, there is still little information about the cause and treatment of premature ejaculation. The aim of this study was to evaluate the therapeutic aspect of transcutaneous posterior tibial nerve stimulation (PTNS) in patients with premature ejaculation.

Methods: The study included 60 PE patients, aged 20-50 years, divided into 2 groups as the treatment group (n = 30) and the control group (n = 30). Transcutaneous PTNS was applied to patients in the treatment group for 30 minutes once a week for 12 weeks. In the control group, a stimulation probe was placed on the posterior tibial nerve without giving any stimulation, to provide a placebo effect. The Arabic Index of Premature Ejaculation (AIPE) scale and Intravaginal Ejaculation Latency Time (IELT) measurements were used before and after the procedure.

Results: In both groups, the mean IELT duration and AIPE scale scores were statistically significantly increased after the procedure (p < 0.05). The percentage change in the AIPE scale scores after the procedure was found to be higher in the treatment group than in the control group (p = 0.007).

Conclusions: The results of the study showed a statistically significant increase in the duration of the time to ejaculation with PTNS, and a significant improvement was obtained in the post-treatment AIPE scale scores. There is a need for further research to achieve more robust results to contribute to premature ejaculation treatment. 

Keywords

premature ejaculation, posterior tibial nerve stimulation, sexual disorder, male

References

• 1. Laumann EO, Nicolosi A, Glasser DB, Paik A, Gingell C, Moreira E, et al. GSSAB Investigators' Group. Sexual problems among women and men aged 40-80 y: prevalence and correlates identified in the Global Study of Sexual Attitudes and Behaviors. Int J Impot Res 2005;17:39-57.
• 2. Porst H, Montorsi F, Rosen RC, Gaynor L, Grupe S, Alexander J. The premature ejaculation prevalence and attitudes (PEPA) survey: Prevalence, comorbidities and professional help-seeking. Eur Urol 2007;51:816-24.
• 3. Laumann E, Paik A, Rosen R. Sexual dysfunction in the United States: prevalence and predictors. J Am Med Assoc 1999;281:537-44.
• 4. Serefoglu EC, McMahon CG, Waldinger MD, Althof SE, Shindel A, Adaikan G, et al. An evidence-based unified definition of lifelong and acquired premature ejaculation: report of the second International Society for Sexual Medicine Ad Hoc Committee for the Definition of Premature Ejaculation. J Sex Med 2014;11:1423-41.
• 5. Gruenwald I, Serefoglu EC, Gollan T, Springer S, Meiry G, Appel B, et al. Transcutaneous neuromuscular electrical stimulation may be beneficial in the treatment of premature ejaculation. Med Hypotheses 2017;109:181-3.
• 6. Arafa M, Shamloul R. Development and evaluation of the Arabic Index of Premature Ejaculation (AIPE). J Sex Med 2007;4:1750-6.
• 7. Serefoglu EC, Yaman O, Cayan S, Asci R, Orhan I, Usta MF, et al. The comparison of premature ejaculation assessment questionnaires and their sensitivity for the four premature ejaculation syndromes: results from the Turkish Society of Andrology Sexual Health Survey. J Sex Med 2011;8:1177-85.
• 8. Serefoglu EC, Saitz TR. New insights on premature ejaculation: a rewiew of definition, classification, prevalance and treatment. Asian J Androl 2012;14:822-9.
• 9. Montorsi F. Prevalence of premature ejaculation. A global and regional perspective. J Sex Med 2005;2:96-102.
• 10. Symonds T, Roblin D, Hart K, Althof S. How does premature ejaculation impact a mans life? J Sex Marital Ther 2003;29:361-70.
• 11. Dunn KM, Croft PR, Hackett GI. Association of sexual problems with social, psychological and physical problems in men and women. A crosssectional population survey. J Epidem Comm Health 1999;53:144-8.
• 12. Patrick DL, Althof SE, Pryor JL, Rosen R, Rowland DL, Ho KF, et al. Premature ejaculation: an observational study of men and their partners. J Sex Med 2005;2:358-67.
• 13. Erol H. Prematur ejakulasyon - Erektil disfonksiyon iliskisi. Androloji Bülteni 2006;25:102-5.
• 14. Malavige LS, Jayaratne SD, Kathriarachchi ST, Sivayogan S, Fernando DJ, Levy JC. Erectile dysfunction among men with diabetes is strongly associated with premature ejaculation and reduced libido. J Sex Med 2008;5:2125-34.
• 15. Littara A, Palmieri B, Rottigni V, Iannitti T. A clinical study to assess the effectiveness of a hyaluronic acid-based procedure for treatment of premature ejaculation. Int J Impot Res 2013;25:117-20.
• 16. Yavuz A, Serefoglu EC. Prematur ejakulasyon: Oral ve topikal ilaç dışı tedaviler. Androloji Bülteni 2011;17:102-5.
• 17. Metin A, Ozyalvaclı ME. Prematür ejakülasyon tedavisinde güncel yaklaşım. Androloji Bülteni 2016;18:4-7.
• 18. Abdel-Hamid IA, El Naggar EA, El Gilany AH. Assessment of as needed use of pharmacotherapy and the pause-squeeze technique in premature ejaculation. Int J Impot Res 2001;13:41-5.
• 19. Busato W, Galindo CC. Topical anaesthetic use for treating premature ejaculation: a double‐blind, randomized, placebo‐controlled study. BJU Int 2004;93;1018-21.
• 20. Raffa RB. Basic pharmacology relevant to drug abuse assessment: tramadol as example. J Clin Pharmacol 2008;33:101-8.
• 21. Waldinger MD, Zwinderman AH, Schweitzer DH, Olivier B. Relevance of methodological design for the interpretation of efficacy of drug treatment of premature ejaculation: a systematic review and meta-analysis. Int J Impot Res 2004;16:369-81.
• 22. Xin ZC, Choi YD, Rha KH, Choi HK. Somatosensory evoked potentials in patients with primary premature ejaculation. J Urol 1997;158:451-5.
• 23. Martellucci J. Electrical stimulation in sexual dysfunction. In: Martellucci J, editor. Electrical Stimulation for Pelvic Floor Disorders. Springer International Publishing: Switzerland, 2015: p. 201-23.
• 24. Escortell-Mayor E, Riesgo-Fuertes R, Garrido-Elustondo S, Asúnsolo-Del Barco A, Díaz-Pulido B, Blanco-Díaz M, et al. Primary care randomized clinical trial: manual therapy effectiveness in comparison with TENS in patients with neck pain. Man Ther 2011;16:66-73.
• 25. Deyo RA, Walsh NE, Martin DC, Schoenfeld LS, Ramamurthy S. A controlled trial of transcutaneous electrical nerve stimulation (TENS) and exercise for chronic low back pain. N Engl J Med 1990;322:1627-34.
• 26. Levin MF, Hui-Chan CW. Relief of hemiparetic spasticity by TENS is associated with improvement in reflex and voluntary motor functions. Electroencephalogr Clinl Neurophysiol. 1992;85:131-42.
• 27. Kabay SKSC, Kabay SC. Posterior Tibial Sinir Stimülasyonu; Nasıl Yapıyorum, Sonuçlarımız. Kadın ve İşlevsel Üroloji Dergisi 2014;2:53-7.
• 28. Yurtkuran M, Kocagil T. TENS, electroacupuncture and ice massage: comparison of treatment for osteoarthritis of the knee. Am J Acupunct 1999;27:133-40.
• 29. Brosseau L, Yonge KA, Welch V, Marchand S, Judd M, Wells GA, et al. Transcutaneous electrical nerve stimulation (TENS) for the treatment of rheumatoid arthritis in the hand. Cochrane Database Syst Rev 2003;(3):CD004377.
• 30. Sunay D, Sunay M, Aydogmus Y, Bagbanci S, Arslan H, Karabulut A, et al. Acupuncture versus paroxetine for the treatment of premature ejaculation: a randomized, placebo-controlled clinical trial. Eur Urol 2011;59:765-71.
• 31. Franco I. Pediatric overactive bladder and lower urinary tract dysfunctions: diagnosis and treatment. Pediatric Health 2008;2:189-203.
• 32. Geirsson G, Wang YH, Lindström S, Fall M. Traditional acupuncture and electrical stimulation of the posterior tibial nerve: a trial in chronic interstitial cystitis. Scand J Urol Nephrol 1993;27:67-70.