Published Paper Details:

Introduction: Premature ejaculation is one of the most commonly encountered sexual dysfunction in men. Around 30 % of men in the world suffer from premature ejaculation. One of the most frequently given pharmacological treatments are SSRI and PDE5 inhibitor. Several studies attempted to combine the two, however the results are different from each other. Therefore, this systematic review and meta-analysis aimed to evaluate the difference of efficacy and safety between on-demand PDE5 inhibitor with the combination of PDE5 inhibitor and SSRI. Materials and methods: This study is a systematic review and meta-analysis evaluating Randomized controlled trials analyzing the combination between the PDE5 inhibitor and its combination with SSRI. The results are measured in Intravaginal ejaculation latency time (IELT) and adverse effects. The search and screening process adheres to The Preffered Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA). Cochrane Risk of Bias (RoB) tool is used to analyze the bias in the studies. Results: A total of 3 RCTs, with a total of 190 patients diagnosed with premature ejaculation were analyzed in this study. The results of the analysis were statistically significant (mean difference = 1.30; 95% CI = 1.07-1.54); p <0.00001), indicating that the combined on-demand PDE5 inhibitor and SSRI increased the mean IELT 1.3 minutes compared to the on-demand PDE5 inhibitor alone. Analysis of the side effects of nausea (OR = 5.16; 95% CI = 1.58-16.78; p = 0.006) and yawning (OR = 10.98; 95% CI = 1.32-91.02; p = 0.03) showed significant results. Conclusion: The combination of on-demand PDE5 inhibitor and SSRI showed promising results in PE management compared to on-demand PDE5 inhibitor monotherapy based on the IELT with few minimal side effects, such as nausea and yawning.