On-demand silodosin 4 mg vs dapoxetine 60 mg in treatment of primary premature ejaculation: A prospective randomized study

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Objectives To evaluate the efficacy and tolerability of Silodosin 4 mg and Dapoxetine 60 mg in the treatment of primary premature ejaculation.Methods This is a prospective study that was carried out on 95 adult sexually active patients with PE (IELT < 1 min) attending outpatient clinic, Urology Department, Benha University Hospitals. Patients with primary PE were randomly assigned to two groups; group A: 48 patients who took silodosin 4 mg 2 h before intercourse (on demand) at least 6 times intercourse/month for 2 months and group B: 47 patients who took dapoxetine 60 mg the same like silodosin. Throughout the research, eight patients in silodosin group and seven patients in dapoxetine group were lost to follow-up and subsequently excluded from the study.Results The average age of primary PE patients included in the study was 33.4 ± 2.9. IELT significantly increased from 21.4 ± 13.8 to 275 ± 63.4 s in group A and significantly increased from 24.9 ± 14.3 to 293.5 ± 54.3 s in group B. Also both studied groups showed significant improvements in premature ejaculatory profile (PEP), the premature ejaculation diagnostic tool (PEDT), and the Arabic index of premature ejaculation (AIPE) with fewer side effects in group A.Conclusion Both Silodosin 4 mg and Dapoxetine 60 mg significantly improved IELT and sexual function scores in primary PE patients. However, Silodosin exhibited a more favorable tolerability profile with fewer side effects, making it a safer, clinically effective alternative.