Introduction: The aim of this study was to compare the efficacy of fluoxetine alone and combined with sildenafil in patients complaining of premature ejaculation. Patients and Methods: Ninety-one married potent men, 21–43 years old, with premature ejaculation but without any obvious organic cause were enrolled. Pretreatment evaluation included history, physical examination, and self-administration of the International Index of Erectile Function questionnaire. The patients were randomly divided into two groups: group A patients (n = 48) received 20 mg fluoxetine daily for 4 weeks and then 20 mg as needed 2–3 h before sexual activity for 4 months, and group B patients (n = 43) received group A regimen plus 50 mg sildenafil as needed 1 h before sexual activity for 4 months. Results: Ejaculatory latency time and intercourse satisfaction significantly improved in group B as compared with group A (p < 0.05). Conclusion: Fluoxetine combined with sildenafil seems to provide significantly better ejaculatory latency time and intercourse satisfaction as compared with fluoxetine alone in patients with premature ejaculation.

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