Clinical Presentation & Protocol
Patient Usually Complains Of
Patient presents with a lifelong history of premature ejaculation, consistently occurring within <1 minute of vaginal penetration. Symptoms have been present since the onset of sexual activity, causing significant personal distress and interpersonal difficulty. No history of erectile dysfunction or secondary causes. IELT (Intravaginal Ejaculatory Latency Time) is consistently low.
Clinical Examination Findings
Genitourinary examination: Normal penile anatomy, no evidence of phimosis, balanitis, or urethral discharge. Testicular examination reveals normal size, consistency, and no palpable masses. Prostate examination (if indicated) reveals normal size, smooth contour, and no tenderness. Neurological assessment: Normal bulbocavernosus reflex and intact perineal sensation.
Treatment Protocol
Initiate behavioral therapy (stop-start and squeeze techniques). Pharmacological management: On-demand or daily SSRI (e.g., Dapoxetine or Paroxetine) or topical desensitizing agents (lidocaine/prilocaine spray). Follow-up scheduled in 4 weeks to assess efficacy and side effects.