Evaluating the Role of Subcoronal Botulinum Toxin Injection in the Management of Premature Ejaculation.

Background: Premature ejaculation (PE) is the most common male sexual dysfunction, which often causes significant psychological problems. Although botulinum toxin A (Botox) has shown promise for delaying ejaculation through chemodenervation, the optimal anatomical target remains uncertain. This stud...

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Published in:Clinical Medicine Insights: Case Reports Vol. 19; pp. 1 - 7
Main Authors: Hosseini, Seyed Reza, Najarzadegan, Mahdi, Mehrabi, Mohammad Mahdi, Chivaee, Hossein, Mohammadi, Abdolreza, Ashtari, Sara, Guitynavard, Fateme, Nikoufar, Parsa, Aghamir, Seyed Mohammad Kazem
Format: research tables/charts Journal Article
Published: Sage Publications Inc. 5/26/2026
Online Access:View this record in EBSCOhost
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      jtl: Clinical Medicine Insights: Case Reports
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      dt: 5/26/2026
      vid: 19
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      pub: Sage Publications Inc.
      place: Thousand Oaks, California
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        atl: Evaluating the Role of Subcoronal Botulinum Toxin Injection in the Management of Premature Ejaculation.
      aug:
        au:
          Hosseini, Seyed Reza
          Najarzadegan, Mahdi
          Mehrabi, Mohammad Mahdi
          Chivaee, Hossein
          Mohammadi, Abdolreza
          Ashtari, Sara
          Guitynavard, Fateme
          Nikoufar, Parsa
          Aghamir, Seyed Mohammad Kazem
        affil: Urology Research Center, Tehran University of Medical Sciences, Iran
      sug:
        subj:
          Premature Ejaculation Drug Therapy
          Botulinum Toxins Administration and Dosage
          Neuromuscular Agents Administration and Dosage
          Injections, Subcutaneous
          Penis
          Patient Safety Evaluation
          Drug Efficacy Evaluation
          Men's Health
          Human
          Male
          Adult
          Middle Age
          Prospective Studies
          Case Studies
          Descriptive Statistics
          Data Analysis Software
          Paired T-Tests
          Clinical Assessment Tools
          Questionnaires
          Adult: 19-44 years
          Middle Aged: 45-64 years
          Male
      ab: Background: Premature ejaculation (PE) is the most common male sexual dysfunction, which often causes significant psychological problems. Although botulinum toxin A (Botox) has shown promise for delaying ejaculation through chemodenervation, the optimal anatomical target remains uncertain. This study evaluated the efficacy and safety of Botox injection into the penile prepuce and subcoronal region as a novel approach for lifelong PE. Methods: A prospective case series was conducted in 7 adult men (mean age 54.7 ± 6.5 years) diagnosed with lifelong PE (intravaginal ejaculatory latency time <1 minute, PEDT ⩾11). Participants received a single 100-unit Botox injection, administered subcutaneously into the prepuce and subcoronal region. The Premature Ejaculation Diagnostic Tool (PEDT) and Male Sexual Health Questionnaire (MSHQ) were completed before, 4 weeks, and 6 months after treatment to assess the efficacy. Results: Seven patients were included in the analysis. No significant changes were observed in PEDT scores at 4 weeks (18.00 ± 0.9; P =.7358) or at 6 months (17.71 ± 0.4; P =.762) compared with baseline. Similarly, MSHQ erection scores (5.00 ± 2.0 at 4 weeks; 4.85 ± 2.2 at 6 months), ejaculation scores (23.43 ± 3.8 at 4 weeks; 23.42 ± 3.1 at 6 months), and satisfaction scores (10.71 ± 4.07 at 4 weeks; 10.14 ± 3.5 at 6 months) did not differ significantly from baseline values (P >.05 for all comparisons). No adverse events or treatment-related side effects were reported throughout the study period. Conclusions: Subcoronal Botox injection was safe and well-tolerated, but it did not show significant improvements in ejaculatory control or sexual function scores. The findings suggest that sensory-targeted Botox administration alone is insufficient to enhance the ejaculatory reflex.
      pubtype: Academic Journal
      doctype:
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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