Efficacy and safety of phosphodiesterase type 5 inhibitors on primary premature ejaculation in men receiving selective serotonin reuptake inhibitors therapy: a systematic review and meta‐analysis

Summary We performed a systematic review and meta‐analysis to assess whether selective serotonin reuptake inhibitors ( SSRI s) and phosphodiesterase type 5 inhibitors ( PDE 5‐Is ) may have an additive therapeutic effect. A literature review was performed to identify all published randomised controlled trials ( RCT ) that used SSRI s combined with PDE 5‐Is therapy for the treatment of primary PE . The search included the following databases: EMBASE , MEDLINE and the Cochrane Controlled Trials Register. The reference lists of the retrieved studies were also investigated. Five publications involving a total of 419 patients were used in the analysis, including 5 RCT s that compared PDE 5‐Is plus SSRI s with SSRI s treating primary PE . Primary efficacy endpoints: IELT (the standardised mean difference ( SMD ) = 1.07, 95% confidence interval ( CI ) = 1.00 to 1.14, P  < 0.00001) indicated that utilisation of PDE 5‐Is and SSRI s was more effective than the SSRI s alone for a long time in patients with primary PE . Safety assessments included headache (odds ratio ( OR ) = 3.16, 95% CI = 1.63 to 6.11, P  = 0.0006), and flushing indicated that PDE 5‐Is plus SSRI s were well tolerated. This meta‐analysis indicates that PDE 5‐Is combined with SSRI s seem to provide significantly better ejaculatory latency time as compared with SSRI s alone in patients with primary PE.