Peripheral electrical stimulation for premature ejaculation: a systematic review of clinical studies.

Background: Premature ejaculation (PE) is a common sexual disorder characterized by a lack of voluntary control over ejaculation. Current treatments often fail to produce consistently satisfactory outcomes. Peripheral electrical stimulation (PES) is an emerging neuromodulation technique that applies electrical currents to targeted body areas and has shown promise across various conditions. Objectives: Although the use of PES for PE is relatively underexplored, this study aimed to synthesize existing research to better understand its potential as a treatment option. Design: Systematic review. Data sources and methods: A systematic search was conducted in PubMed, Embase, Scopus, Web of Science, and Google Scholar using relevant keywords. Studies were included if they investigated PES as a treatment for PE and reported outcomes such as intravaginal ejaculatory latency time (IELT) or other clinical measures. Results: Ten studies met the eligibility criteria. Due to the limited number and heterogeneity of studies, a meta-analysis was not feasible, and a narrative synthesis was performed. Stimulation was applied transcutaneously in various ways, including at acupuncture points, the dorsal penile nerve, and the posterior tibial nerve. Protocols varied considerably, though commonly reported parameters included a pulse frequency of 20 Hz and a pulse width of 200 µs, typically administered in 30-min sessions. Some studies lacked detailed descriptions of stimulation settings. Overall, the studies demonstrated a positive trend in favor of PES for prolonging IELT, and no consistent or significant adverse events were reported. Conclusion: The findings suggest that PES may be a promising adjunctive therapy for men with PE by prolonging IELT. Further high-quality research using validated patient-reported outcomes is needed to clarify the impact of PES on perceived ejaculatory control and sexual satisfaction. Trial registration: The study protocol was prospectively registered in PROSPERO (ID: CRD42024551360).