Evaluation of the transcutaneous posterior tibial nerve stimulation in the treatment of life long premature ejaculation: A randomized controlled trial.

Introduction: Premature ejaculation (PE) is considered one of the most prevalent sexual dysfunctions among men. The currently approved treatments sometimes have intolerable side effects. Aim: We conducted a single blinded randomized controlled trial to assess the efficacy and safety of transcutaneous posterior tibial nerve stimulation (TPTNS) for the treatment of lifelong PE. Methods: Between 2022 and 2023, 50 male patients complaining of lifelong PE were randomized into two equal blinded groups. One group underwent TPTNS while the second group underwent sham transcutaneous electrical nerve stimulation (TENS). TPTNS group underwent 10 sessions of electrical stimulation of the posterior tibial nerve three times per week for 3 weeks using cup electrodes just behind the medial malleoli, while sham TENS group underwent same sessions schedule but with electrodes behind lateral malleoli with underpowered parameters. The Arabic index of premature ejaculation and the intra-vaginal ejaculatory latency time (IELT) measured by the patients' digital hand watch were our primary outcome. Both were recorded before starting sessions (baseline), at the end of the study (after 3 weeks) and lastly after 2 months of discontinuation. Results: Sixteen patients experienced improvement in their AIPE score in TPTNS group (64%) compared to 4 in the sham TENS group (16%) ( Conclusion: TPTNS is a potentially promising procedure to treat PE being safe, non-invasive, and clinically effective.