Response to Letter to the Editor on “Efficacy and safety of pharmacological treatments in patients with premature ejaculation: an umbrella review of meta-analyses of randomized controlled trials”: reexamining the clinical weight of intravaginal ejaculatory latency time after pharmacological therapy for premature ejaculation
Abstract
Dear Editor of the Journal of Sexual Medicine, we would like to thank readers for their knowledgeable comments on our manuscript.1 We appreciate the readers’ comments regarding the limited association between stopwatch Intravaginal Ejaculatory Latency Time (IELT) and patient- or partner-reported distress. Although we were unable to identify the referenced specific population-based cohort study, the general point is clear: IELT alone does not adequately reflect patients' distress or sense of control. Since our umbrella review was based on published meta-analyses, IELT was the most consistently available outcome measure across studies. As noted in our manuscript, patient-reported outcomes, including the Clinical Global Impression of Change and perceived control over ejaculation, were evaluated only in a limited number of primary studies (seven trials with Selective Serotonin Reuptake Inhibitors). These results were summarized in the main text and detailed in Supplementary Table S1, which demonstrated significant improvements with SSRIs, particularly dapoxetine. Nevertheless, the relatively small number of trials reporting PROs underscores the current evidence gap. This limitation was acknowledged in our manuscript and emphasizes that the exclusive use of IELT in most meta-analyses may reduce the clinical relevance of the pooled results. We believe that future studies should include validated patient-reported outcomes, such as the Premature Ejaculation Profile (PEP), which…
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