Treatment Shows Promise for Premature Ejaculation

Does the story adequately discuss the costs of the intervention?

Not Satisfactory

The company estimates that this procedure costs about $3500 — a cost which obviously would rise if the procedure has to be repeated in order to maintain efficacy as suggested in the story. But we wish the story had more explicitly addressed this:  costs that could reach $14,000 a year if effects wear off within 3 months.  It also would have been interesting to see some comparison of this cost with that of drug therapy and/or psychological counseling.

Does the story adequately quantify the benefits of the treatment/test/product/procedure?

Not Satisfactory

The story tells us that men in the study lasted three times longer after the procedure, an increase from 36 seconds to 110 seconds. While this is important information to communicate, it is arguably just as important to tell us how this increase in stamina affected the men’s satisfaction with their performance. While definitions vary, ejaculation is typically considered “premature” only if it causes distress or dissatisfaction. So treatments need to be judged on the basis of whether they improve the individual’s subjective perception of their performance. Is an additional 80 seconds of intercourse enough to make a difference in how these men felt about their sexual experiences? (Or how their partners felt?) The story does tell us that all men “improved on at least one sexual-related symptom,” but it doesn’t tell us which symptoms were affected or how much improvement was seen.

Does the story seem to grasp the quality of the evidence?

Not Satisfactory

The story gets far ahead of itself when it allows “supporters” of the procedure to claim that it “could someday become a standard treatment for” PE. (We note that this is the second story by WebMD within a few days out of the same conference that allowed supporters of a new idea to claim their idea could become a standard treatment someday. Here’s the other one.) The statement is technically correct, but then again it’s also true that the reviewers of this story “could someday” be voted “sexiest men alive” by People Magazine, too. But you wouldn’t want to go public with such a prediction. Similarly, we think it’s too early to talk about a new standard of treatment when the best available supporting evidence comes from a small, uncontrolled experiment — the kind that can be easily skewed by placebo effects. We would be much more confident in the study’s findings had it compared the treatment against a “sham” cryoablation procedure performed on a control group. And we wish the story had warned readers about the limitations of uncontrolled studies when evaluating a treatment’s potential benefits.

Does the story commit disease-mongering?

Not Satisfactory

The story’s estimate of PE prevalence (20% to 38%) is in line with the figures reported in a 2006 review of the literature.  We wish such stories would cite prevalence sources – as we just did.

We also think the story could have mentioned that there is considerable uncertainty about these numbers due to the fact that there is no standard definition of PE. We think that estimates at the higher end of this range are likely overstating the scope of the problem. In one study that reported a 32.5% overall prevalence of PE, for example, about half of participants said that their PE symptoms caused them little or no distress. And if you’re including men who suffer no distress in your population of PE “sufferers,” that smacks of medicalizing people who are exhibiting a normal range of behavior. In other words, disease-mongering.