Abstract

IntroductionThe interplay between erectile dysfunction (ED) and premature ejaculation (PE) needs more studies to clarify.AimTo evaluate the risk factors and temporal relationship for the coexistence of ED and PE.MethodsThe data were derived from clinical history.Main Outcome MeasureThe diagnosis of ED and PE was based on self-report and validated questionnaires.ResultsBased on the chief complaint, 1,893 participants were recruited as ED group and 483 participants as PE group from 2014 to 2020. One third of ED and PE groups reported comorbid PE and ED. Of the ED group, 4.1% (n = 77) had lifelong PE, 18.0% (n = 341) had acquired PE and 9.7% (n = 184) had subjective or natural variable PE. Of the PE group, ED was reported in 22.0% (n = 40) of lifelong PE, 33.9% (n = 65) of acquired PE, and 37.6% (n = 41) of subjective or natural variable PE, P < .01. With adjustment of potential confounders, the ED severity was associated with increased risk of acquired PE, while acquired PE was associated with higher risk of ED than lifelong PE. In cases of comorbid lifelong PE and ED (n = 117), 22.2% reported the onset of both dysfunctions being about the same time, whereas 77.8% reported ED occurred behind PE with an average 23.3 years lag. In cases of comorbid acquired PE and ED (n = 406), 52.2% reported the onset of both dysfunctions being about the same time, 34.2% reported ED happened behind PE and 13.5% reported PE emerged behind ED.ConclusionOrganic pathogenesis was least likely to be responsible for the link between PE and ED. When acquired PE and ED coexist, treating ED first or concomitantly according to their temporal order is an appropriate management algorithm.Chieh‑Wen Chin, Chia Mu Tsai, Jen-Tai Lin, et al. A Cross-Sectional Observational Study on the Coexistence of Erectile Dysfunction and Premature Ejaculation. Sex Med 2021;9:100438.

Highlights

  • The interplay between erectile dysfunction (ED) and premature ejaculation (PE) needs more studies to clarify

  • The definition of PE has gone through evolution in the past decade when more strict diagnostic criteria of PE was initiated by the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) in 20134 and the International Society for Sexual Medicine (ISSM) in 2014,5 and the most up to date by the American Urological Association (AUA) guideline in 2020.6 The new criteria of PE has never been applied in clinical studies to investigate the coexistence of ED and PE

  • After excluding 42 subjects who met the exclusion criteria and 8 subjects who had incomplete Sexual Health Inventory for Men (SHIM) or Premature Ejaculation Diagnostic Tool (PEDT) score, 2376 subjects were eligible for analysis (Figure 1)

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Summary

Introduction

The interplay between erectile dysfunction (ED) and premature ejaculation (PE) needs more studies to clarify. Of the ED group, 4.1% (n = 77) had lifelong PE, 18.0% (n = 341) had acquired PE and 9.7% (n = 184) had subjective or natural variable PE. Of the PE group, ED was reported in 22.0% (n = 40) of lifelong PE, 33.9% (n = 65) of acquired PE, and 37.6% (n = 41) of subjective or natural variable PE, P < .01. In cases of comorbid acquired PE and ED (n = 406), 52.2% reported the onset of both dysfunctions being about the same time, 34.2% reported ED happened behind PE and 13.5% reported PE emerged behind ED. The definition of PE has gone through evolution in the past decade when more strict diagnostic criteria of PE was initiated by the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) in 20134 and the International Society for Sexual Medicine (ISSM) in 2014,5 and the most up to date by the American Urological Association (AUA) guideline in 2020.6 The new criteria of PE has never been applied in clinical studies to investigate the coexistence of ED and PE

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