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Atan A, Basar MM, Tuncel A, Ferhat M, Agras K, Tekdogan U. Comparison of efficacy of sildenafil-only, sildenafil plus topical EMLA cream, and topical EMLA-cream-only in treatment of premature ejaculation. Urology 2006;67:388-391.

84 men with premature ejaculation (mean duration 32.5 months, range 9-60) were enrolled in this study to compare the efficacy of sildenafil (Viagra) only, sildenafil plus topical anesthetic cream (EMLA), and topical EMLA-cream-only to that of placebo in treating premature ejaculation. Patients were randomized into four groups. Group 1 consisted of 20 patients who took placebo for 2 months. Groups 2 and 3 consisted of 20 and 22 patients, respectively, and they received 50 mg sildenafil 45 minutes before coitus for 2 months. In addition, patients in group 3 applied topical EMLA cream to the glans penis 15 minutes before coitus. The 22 patients in group 4 used topical EMLA-cream-only. After at least eight sexual attempts, the patients’ clinical responses were assessed using the patient self-description method. Effectiveness was described as improvement plus cure.

The effectiveness was 40% in group 1, 55% in group 2, 86.4% in group 3, and 77.3% in group 4. Of the groups, a significant difference was found in the effectiveness of the No significant difference was found between groups 1 and 2 (P _ 0.26). Efficacy was more successful in groups 3 and 4 than in the others (P _ 0.00). The difference between groups 3 and 4 was not significant.

In conclusion, Sildenafil-only was not superior to placebo or combination treatment. Topical EMLA-cream only had equal effectiveness to that of sildenafil plus topical EMLA treatment. The use of topical EMLA cream- only seems to be an effective treatment of premature ejaculation.