PE diagnosis begins with IELT measurement over 4 sexual encounters (stopwatch protocol) and PEDT questionnaire classification (lifelong vs. acquired PE). On-demand dapoxetine is first-line for most patients: 3–8× IELT improvement, no downtime. Dorsal nerve block delivers 4–8× IELT improvement for severe/refractory cases. Combination therapy available for maximum effect. All consultations conducted directly in English — no interpreter required at 14F Lotte Hotel.
Why Measurement Matters: IELT as Baseline
Subjective PE ("I come too fast") is difficult to treat because "too fast" is undefined. The IELT (Intravaginal Ejaculation Latency Time) — time from vaginal penetration to ejaculation — provides an objective baseline. Without it, there is no way to measure whether treatment has worked.
Dr. Kim asks every PE patient to measure and record IELT over 4 encounters using a stopwatch before the first consultation. This takes away ambiguity and allows a precise before-and-after treatment assessment.
Treatment Options — Evidence-Ranked
Dapoxetine (Priligy) 30mg / 60mg
Short-acting SSRI taken 1–3 hours before intercourse. IELT improvement: 3–8× baseline. Approved by Korean MFDS. Prescription in clinic; prescription letter for home-country refill included. Side effects: nausea 18%, dizziness 7% — both reduce after first 3 uses.
Cost: $95–$150 consultation + prescription
Topical Anesthetic (EMLA / PSD502 Spray)
Applied 20–30 min before intercourse; wiped off before partner contact to prevent transfer. IELT improvement: 2–5×. No systemic side effects. Reduced penile sensation in 22% — most consider this the intended mechanism rather than a side effect.
Cost: $30–$60 for supply
Dorsal Nerve Block (HA Injection)
Hyaluronic acid injected around the dorsal nerve branches at the penile base, reducing glans sensitivity. IELT improvement: 4–8× in responders. Duration: 12–18 months. Risk of persistent hyposensitivity: 6% — must be counselled before proceeding. Best for severe lifelong PE where SSRI alone is insufficient.
Cost: $380–$520
Combination: Dapoxetine + Dorsal Nerve Block
Additive effect in published series: IELT improvement up to 10–14× baseline. Reserved for severe lifelong PE where single-agent therapy is confirmed insufficient.
Cost: $580–$780
PE Side Effects — Published Data
| Treatment | Side Effect | Rate | Notes |
|---|---|---|---|
| Dapoxetine | Nausea | 18% | Resolves after first 3 uses; take with food |
| Dapoxetine | Dizziness | 7% | Avoid alcohol on dosing day; sit before standing |
| Dapoxetine | Reduced libido | 3% | On-demand only — does not persist between doses |
| Topical EMLA | Reduced sensation | 22% | Dose-dependent; use minimum effective amount |
| Topical EMLA | Partner transfer | 8% | Wipe completely; use condom as backup |
| Dorsal nerve block | Transient numbness | 100% | Expected 3–7 days; resolves completely in almost all |
| Dorsal nerve block | Persistent hyposensitivity | 6% | Potentially permanent — consent essential before proceeding |
| Dorsal nerve block | Injection site bruising | 35% | Resolves 5–10 days; no clinical significance |
The 14F Lotte Hotel Advantage for PE
PE is arguably the most private men's health concern — many patients have never disclosed it to a doctor in their home country precisely because the consultation feels embarrassing. At Seomyeon L Urology:
- Hotel elevator access — no medical building lobby, no visible reception from corridor
- Consultation directly in English with Dr. Kim — no interpreter in the room
- No other patients visible in your consultation suite
- PIPA privacy law — results never shared with immigration, insurance, or family
- Prescription letter in English for home-country refill so you never have to explain your Korean prescription