UroToday.com- Premature Ejaculation (PE) is the most common sexual problem experienced by men with estimates that nearly 25-30% of the population may be affected. In a recent study by W. W. Dinsmore and colleagues from London UK, the efficacy and safety of a novel aerosol-delivery form of lidocaine-prilocaine (Topical eutectic mixture for premature ejaculation (TEMPE) was evaluated. The study is published in the February 2007 issue of BJU Int. Men with PE generally have abnormal autonomic reflex pathways for the ejaculatory process, including a lower vibratory threshold to ejaculation. Reducing this heightened sensitivity of the glans penis with topical desensitizing agents might therefore be a way of increasing intravaginal ejaculatory latency time (IELT). Prior attempts at delivery of these agents have been less than ideal due to anesthesia of the entire penis or messy delivery of the cream in a condom. The study group included 62 men aged 18-75 years with a history of primary premature ejaculation according to DSM-IV criteria of > 6 months in duration. All men were heterosexuals, in a stable monogamous relationship for > 3 months, and the couple had to be willing to attempt sexual intercourse at least 7 times during the 10-week study period. The treatment consisted of three self-administered actuations of TEMPE (delivering a total of 22.5 mg of lidocaine and 7.5 mg of prilocaine) onto the glans penis 15 minutes prior to intercourse. Both the active drug and the placebo were presented in a metered-dose aerosol spray device and contained a hydroflourocarbon gas as a propellant. The patient or his partner measured his intravaginal ejaculatory latency time (IELT) with a stopwatch. Patients and partners were also given questionnaires and diary cards. The mean IELT for the group prior to the study was 1 minute. Analysis of the results showed that the mean IELT from baseline to the end of the treatment period was higher in the TEMPE group than the placebo group, at 3.8 minutes vs. 0.7 minutes respectively. Overall, the mean change in IELT was 2.4 times higher in the TEMPE group than the placebo group. In all, 83% (35 of 42 patients) of patients considered the spray easy to use. There were also positive trends in other indices of erectile function with the use of TEMPE. Wallace W. Dinsmore, Geoffrey Hackett, David Goldmeier, Marcel Waldinger, John Dean, Patrick Wright, Michael Callander, Kevan Wylie, Claire Novak, Charlotte Keywood, Patricia Heath and Michael Wyllie BJU Int. 2007 Feb.; 99(2):369-75 Reviewed by UroToday.com Contributing Editor Michael J. Metro, MD UroToday - the only urology website with original content written by global urology key opinion leaders actively engaged in clinical practice. To access the latest urology news releases from UroToday, go to: