Clinical Parameters that Predict Successful Outcome in Men with Premature Ejaculation and Inflammatory Prostatitis

Abstract

Premature ejaculation (PE) is the most common sexual problem, and chronic prostatitis is an important cause of PE. The aim of this study was to determine which clinical parameters predict successful outcomes following treatment of men with PE and chronic prostatitis (category II and IIIa). Change in intravaginal ejaculatory latency time (IELT) and its relation to different clinical parameters. This study included 210 heterosexual men with PE and inflammatory prostatitis. PE was found to be acquired in 155 men (A-PE) and lifelong in 55 (LL-PE). All participants were asked to complete the National Institutes of Health-Chronic Prostatitis Symptom Index (NIH-CPSI). Sequential microbiologic specimens were obtained. Antibiotics were given to 184 men for 4 weeks, guided by sensitivity tests. Twenty-six men refused or did not comply with the antimicrobial therapy and were used as the untreated group. Clinical reevaluation was conducted after 28 days. Two of the 26 men (7.7%) from the untreated group experienced an increase in their ejaculatory latency compared with 109 of the 184 men (59.0%) who received antimicrobial therapy (P = 0.0001). After treatment, 90 of 155 men (58.0%) with A-PE reported ILET > 2 minutes compared with 21 of 55 men (38.2%) with LL-PE (P = 0.012). Based on a receiver operating characteristic curve, antimicrobial therapy is most effective if there are > or =19 pus cells per high-power field (HPF) in the expressed prostatic secretion (EPS) analysis, with a sensitivity of 85.6% and a specificity of 70.7% (area under the curve 0.783, 95% CI 0.716-0.850). Other clinical parameters were not useful in predicting outcomes. Antimicrobial therapy is useful in the treatment of PE associated with inflammatory prostatitis. The treatment is most effective in men with A-PE and when there are > or =19 pus cells per HPF in an EPS analysis.