ABSTRACT
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. Assess the efficacy of Tramadol for on-demand treatment of PE. 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. 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. 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.