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2 Department of UrologyTulane University Health Sciences CenterNew OrleansLAUSA.

Expulsion refers to the forcible antegrade propulsion of semen through the urethral meatuswhich is caused by contractions of the periurethral and pelvic floor muscles and concurrent relaxation of the external urethral sphincter and urogenital diaphragmThe sympathetic nervous system controls both emission and bladder neck closureand acts through alpha adrenergic receptorsThe neural signals that lead to ejaculation originate from afferent-sensory stimuli in the glans penis and genitaliaThese stimuli are transmitted by means of the pudendal nerve to higher centers in the brainWitt and Grantmyre 1993

Dapoxetine is a safe and effective treatment for premature ejaculationPEbut it has a high discontinuation rateaccording to new research.

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