Abstract: Ejaculatory disorders and orgasm - take home messages - Ejaculatory Disorders & Orgasm Take Home Messages. Taxonomy of Ejaculatory disorders. ISSM’s Guidelines for the Diagnosis and Treatment of Premature Ejaculation. ISSM Definition of Lifelong PE Male sexual dysfunction characterized by ... [1] ejaculation which always or nearly always occurs prior to or within about one minute of vaginal penetration, and the inability to delay ejaculation on all or nearly all vaginal penetrations, and negative persona consequences, such as distress, bother, frustration and/or the avoidance of sexual intimacy. What about Acquired PE ? ISSM Definition regarding Acquired PE-Concluded that there was insufficient published objective data to propose a new evidence-based definition And believed the proposed criterion for lifelong PE might be applied to acquired PE as well. No distinction between LL- and A-PE. Delayed Ejaculation most sexually functional men ejaculate≈4-10 mins A man with DEis expected to: have IELT >20 -30 mins (21-23 min represents 2SD above the mean) cease sexual activity due to exhaustion or irritation report relationship distress/frustration/performance anxiety seek help for his sexual dissatisfaction (despite good erections!!). Some papers presented during the ISSM2012 Meeting. Btx‐A injection into the BSM is a safe and effective treatment which can lengthen the latency time to ejaculate in rats, without suppressing sexual behavior. PSD502 (TEMPE):Has similar efficacy in life-long and acquired premature ejaculation. BUT This study did not start with the baseline IELT defining PE~Negative Recommendations1.LIMITED USE PDE-5 inhibitors alone or in combination with SSRIs or topical anaesthetics should be limited tomen with acquired PE secondary to co-morbid ED 1.NOT RECOMMENDED Tramadol / penile injection therapy are not recommended for the treatment of PE. DISCOURAGED:Surgery for the treatment of PE should be discouraged.