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1 Department of UrologySisli Etfal Training and Research HospitalIstanbulTurkey.

There are three basic mechanisms involved in normal ante-grade ejaculationemissionexpulsionand orgasmand each of these components possesses separate neural pathwaysEjaculatory dysfunction can result from disruption of any point in this cascade of eventsSeveral recent studies have clarified some aspects of the physiology of ejaculationEmissionwhich begins with closure of the bladder neck to prevent retrograde flow of seminal fluid and sperm into the bladderrefers to the deposition of seminal fluid and sperm from the distal epididymisvas deferensseminal vesiclesand prostate into the posterior urethraWitt and Grantmyre 1993

A quarter of the men stopped taking dapoxetine because they were disappointed that PE was incurable and that dapoxetine had to be taken before sex.

Thirty-percent of the men who discontinued dapoxetine did so because of high costThe study authors noted that dapoxetinewhen prescribed for sexual disordersis not covered by national health insurance in South Korea.

Past studies have revealed high discontinuation rates among men taking dapoxetine for PEeven though trials have shown effectivenessThe current study reported on discontinuation rates and reasons during a 2-year period.

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