Premature ejaculation (PE) is the most common sexual dysfunction in men, about 25% to 40% of men will have premature ejaculation at some point in their lives. PE can directly damage men’s self-esteem, affect the relationship between husband and wife and the stability and harmony of the family, so it is getting more and more attention. I. Definition The definition of premature ejaculation includes the following 3 aspects: (1) short intravaginal ejaculation latency time (IELT); (2) lack of control over ejaculation; (3) inability to obtain sexual satisfaction. The International Society of Sexual Dysfunction Medicine (ISSM) defined PE in 2007 as ejaculation that always or almost always occurs before or within lmin of vaginal penetration, complete or almost complete lack of ability to control ejaculation, and its own adverse consequences such as annoyance, apprehension, frustration, and/or avoidance of sexual intimacy. The mechanism of premature ejaculation was initially thought to be a type of psychological disorder caused by psychological causes. With the deepening of understanding, it was found that PE is a pathological state of short IELT, which is related to the dysfunction of regulating ejaculation and penile hypersensitivity. Ejaculation is a reflex activity consisting of receptors, motor central nerves and spinal nerves. A variety of nuclei, central neurotransmitters and their receptors play an important role in ejaculatory regulation. However, to date, the real cause of premature ejaculation is still a difficult mystery, including from the physiological, psychological, behavioral and even socio-cultural background, there are a large number of studies and research. The first thing is that the first time you have a sexual experience, you continue to have premature ejaculation, and the delay in the ball cavernous reflex (BCR) is short. These patients often have a number of characteristics, including fear of failure, self-restraint of sexual impulses, role replacement (from the participants of sexual life to observers), reduced frequency of sexual behavior, etc. The breakdown of the partnership will aggravate the situation of premature ejaculation, but all patients can not find organic pathology. 2, secondary premature ejaculation: refers to the occurrence of premature ejaculation before, there was a period of time when sexual function was normal, and the delay in its ball cavernous reflex was longer. This category of patients is generally older and often combined with erectile dysfunction or harder to achieve orgasm, and will seek treatment earlier. The diagnosis of premature ejaculation is mainly based on the patient’s medical history, and a detailed medical history is fundamental to the diagnosis and treatment of premature ejaculation. Any patient with rapid ejaculation should have a detailed medical history. The medical history can be simply divided into primary premature ejaculation and secondary premature ejaculation. Generally speaking, secondary premature ejaculation is easier to find the cause and treat, and has a better prognosis. The medical history should include the frequency and duration of premature ejaculation, the strength of sexual stimulation when premature ejaculation occurs, the specific external environment or even the specific sexual partner that is prone to premature ejaculation, and the impact of premature ejaculation on sexual behavior, etc. These are also the focus of the medical history. For example, patients with coronary artery disease may have premature ejaculation because they are afraid that excessive sexual stimulation will cause a myocardial infarction. When taking the medical history, we should also understand some of the patient’s usual sexual life, including foreplay, masturbation and intercourse, the relationship and interaction between sexual partners, as well as the patient’s interpersonal relationship and work situation, and so on, and we should ask them separately for evaluation. For patients with primary premature ejaculation, special questions should be asked about the patient’s family history and growth history, as the background of growth and trauma suffered during early childhood often affects the sexual life in adulthood. For patients with secondary premature ejaculation, special attention should be paid to identifying whether the condition is premature ejaculation or erectile dysfunction. When patients with premature ejaculation undergo physical and laboratory examinations, the findings are usually normal. Nevertheless, a simple external genital examination is necessary. If a patient has erectile dysfunction in addition to premature ejaculation, necessary auxiliary examinations such as sex hormone examination, neuromyography and penile vascular examination should be performed according to organic erectile dysfunction in order to find the exact cause of erectile dysfunction and to provide targeted treatment. Many patients with premature ejaculation and erectile dysfunction co-exist. Once erectile dysfunction is effectively treated, the patient’s confidence and ability to maintain erection will be enhanced and the problem of premature ejaculation will be solved. V. Treatment of premature ejaculation There are many treatment methods for premature ejaculation. Before treatment, discuss all the treatment options with the patient, as well as the benefits and disadvantages of various treatment methods, followed by the satisfaction of the patient and sexual partner to assess the success of the treatment. Behavioral therapy: Behavioral therapy includes increasing the frequency of ejaculation, adopting a female on male sexual position, stop and start (stop and start) ejaculation, squeeze method (squeeze technique), pelvic floor muscle contraction exercises, etc. The short-term success rate is 95%, but long-term follow-up results found that 75% of patients are still the same as before treatment after 3 years, therefore, the Therefore, behavioral therapy still has long-term effects on only a small percentage of premature ejaculation patients. Masters and Johnson proposed a male-under-female position, in which the man pauses when he feels he is about to ejaculate, and the woman lifts her body off the man’s, and even presses the glans three to four times below the glans. The woman can even press on the underside of the glans for three to four seconds to reduce arousal, and then continue after a break of 15 to 30 seconds. Other methods include distraction, change of position, etc. can also be used. In addition, the improvement of the relationship between husband and wife or sexual partners, emotional rapport, open communication, mutual understanding of the sexual sensitive areas of both sides, as much as possible some sexual foreplay and care after sex, can improve the satisfaction of sexual life, natural solution to premature ejaculation on both sides of the sexual life caused by the tension and impact. The actual fact is that you can find a lot of people who have been in the business for a long time. For patients with premature ejaculation, a comprehensive and detailed assessment of their physiological and psychological factors is required before appropriate treatment can be given. The research in basic medicine, especially the progress in neuropharmacology, can provide several effective drugs to treat premature ejaculation caused by physiological factors or other diseases, in the hope that patients with premature ejaculation can return to a normal sexual life. With the discovery of the efficacy of selective pentraxin reuptake inhibitors (SSRIs) in prolonging ejaculation, the problem of premature ejaculation in men has been brought to a new era, where the psychological and physical components are no longer separate, but complement each other to provide a more complete and individualized assessment and treatment strategy for premature ejaculation patients. There are two main types of medications commonly used to treat premature ejaculation: oral medications and topical medications. Oral medications are mainly selective pentraxin reuptake inhibitors (SSRI), which were originally used to treat depression, but after long-term clinical application, several drugs were found to cause significant delayed ejaculation after administration, and male specialists became interested in the side effects of this drug and soon used it to treat premature ejaculation. The commonly used ones are Zoloft, Prozac, and Sellett. Dapoxetine also belongs to selective pentothal reuptake inhibitors, and this drug has now been adopted by the American Urological Association as the drug of choice for the treatment of premature ejaculation, and the drug has the potential to become the first antidepressant drug for premature ejaculation to be approved by the U.S. Food and Drug Administration (FDA). Topical topical medications are primarily local anesthetics. Local anesthetics (commonly used as gels) applied to sensitive areas such as the glans, coronal sulcus, and ties of the penis 20 to 30 minutes before sexual intercourse can prolong the ejaculatory latency with no significant side effects. After applying local anesthetics, it is possible to use condoms or not. If a condom is not used, the residual drug can be washed off the penis before intercourse. It should be noted that excessively prolonged anesthesia (30 to 45 minutes) can lead to loss of erection because the prolonged anesthesia can make the penis feel numb in a significant number of people. If the residual medication on the penis is not thoroughly washed before intercourse (without the use of a condom), the spread of local anesthetic residue on the penis can also lead to numbness of the vaginal wall of the female partner and reduce sexual pleasure. If the patient or sexual partner is allergic to local anesthetic drugs, the treatment is contraindicated. 3.Surgical treatment: If the above treatments are not effective, surgical treatment can also be considered. Commonly used surgical methods are selective dorsal penile nerve amputation and penile prosthesis implantation. Since surgical treatment is somewhat invasive, doctors and patients should be cautious before choosing surgical treatment.