ABSTRACT

Background: Premature ejaculation (PE) is one of the most prevalent yet under-treated sexual dysfunctions. Current treatment methods have proven insufficient, with no single approach being universally effective. Alternative therapies, such as Botulinum neurotoxin-A injections, are being explored to address the inadequacies of conventional treatments. Aim of the Study: To evaluate the effectiveness of frenular and ventral glans penis intradermal injections of 50 IU Botulinum neurotoxin-A in patients with PE who have not responded to traditional therapies. Patients and Methods: A clinical trial involving 200 male patients with complaints of PE, dissatisfied with standard treatments due to either side effects or lack of efficacy. All patients received frenular and ventral glans penis intradermal injections of 50 IU Botulinum neurotoxin-A. Intravaginal ejaculatory latency time (IELT) was measured before and after the treatment using a stopwatch. Results: The IELT increased significantly post-treatment. Before injection, IELT ranged from 1 to 4 minutes (mean 1.86 minutes), while post-injection it ranged from 1 to 45 minutes (mean 10.6 minutes). The statistical analysis showed a significant improvement in IELT (p=0.001), indicating that Botulinum neurotoxin-A significantly extended the IELT in patients with PE. Conclusion: Frenular and ventral glans penis injection of Botulinum neurotoxin-A improves IELT and enhances sexual quality of life in patients with PE. However, further research is needed to identify factors that could optimize the treatment’s efficacy and make Botulinum neurotoxin-A a recommended option for PE management.