Abstract

ABSTRACT:

*Department of Surgery, College of Medicine,
University of Baghdad.
**Department of Surgery, College of Medicine,
University of Baghdad.
***Department of Community Medicine, College
of Medicine, University of Baghdad.
****Consultant Urologist, Baghdad Medical City.



BACKGROUND:
Premature ejaculation (PE) is a worldwide problem. Selective serotonin reuptake inhibitors (SSRIs) are
widely used “off label” as pharmacotherapeutic agents in the treatment of PE.
OBJECTIVE:
Assess the efficacy of Tramadol for on-demand treatment of PE.
PATIENTS AND METHODS:
During the period December 2008 through November 2009, 60 married men visited the surgical
specialties hospital urology outpatient and consultancy clinics complaining of premature ejaculation
were enrolled in this study. Intravaginal ejaculation latency time (IVELT) was used as an objective tool
to assess the efficacy of the investigated treatment. Single-blind, placebo-controlled therapeutic trial
was conducted on 60 patients with lifelong PE. PE was defined as IVELT of <2 minutes in at least 80%
of intercourse episodes. The patients cohort was randomised into 2 equal sized groups. The intervention
group (n=30) used 50 mg tablet of Tramadol hydrochloride, while the control group (n=30) used a
placebo tablet for 8 weeks. Drugs were taken 1–2 hours before sexual activity, and sexual intercourse
was required at least once per week. IVELT was timed by a stopwatch at each intercourse.
RESULTS:
The mean IVELT after tramadol and placebo significantly increased from 73.1 and 67.9 seconds to
approximately 442.1 and 113.3 seconds, respectively (P < 0.001). Sexual satisfaction was used to assess
the cut-off values of IVELT in defining the minimal and best clinical response to treatment. There was
no withdrawal symptoms recorded following the use of tramadol or placebo, but more adverse events
were associated with tramadol treatment
CONCLUSION:
Tramadol seems to provide significantly better results in terms of IVELT and intercourse satisfaction
versus placebo. Further studies are required to draw final conclusions on the efficacy of this drug in
premature ejaculation