Premature Ejaculation Group Research Articles

Exploring the impact of sexual positions on ejaculation: Insights from a survey study by the Andrology Working Group of the Society of Urological Surgery in Turkey.

Sexual position is one of the several aspects that affects ejaculation control, which is essential for sexual pleasure. Still little is known, nevertheless, about the connection between sexual positions and ejaculation duration. To investigate the impact of various sexual positions on the duration of ejaculation and gain a deeper understanding of the elements that influence the ability to control ejaculation. An online survey was carried out on a sample of 1904 heterosexual men between the ages of 18-65 years. Premature ejaculation (PE) diagnostic tool was used to define PE. Demographic, behavioral, and physiological traits that are linked to PE and non-PE groups were collected. The participants listed their preferred sexual positions and the ones they changed to during ejaculating. Also, analyses were performed between male/female active or deep/shallow thrust positions and PE status. Although there were no appreciable variations in age or circumcision between PE and non-PE groups, the age of first sexual experience was associated with PE status. Groups also varied in the number of weekly ejaculations, the duration of the favored ejaculations, and the characteristics of the erection. The most preferred sexual posture was the doggy style regardless of the group. When the non-PE group felt to ejaculate, they preferred to change the position significantly more than the PE group (74%vs 67.2%; p<0.05). However, when participants felt ejaculate, non-PE participants tended to switch to shallow thrusting positions significantly more than PE participants, who preferred deeper positions (27.1%vs. 18%; p<0.05). This study underlines the relevance of considering sexual positions in controlling PE. Modifying positions during sexual intercourse may offer a non-pharmacological therapeutic alternative for improving ejaculation control. Future studies in this field might help to create tailored PE treatment strategies.

MOLECULAR APPROACH TO PREMATURE EJACULATION: A PILOT STUDY ON S1P SERUM LEVELS AND S1PR1, S1PR2, S1PR3 POLYMORPHISMS

Objective: Sphingosine-1-phosphate (S1P) and its receptors are involved in various sexual functions, particularly in smooth muscle regulation and vascular responses. However, the role of S1P and its receptors in premature ejaculation (PE) remains unclear. This study investigates the relationship between single nucleotide polymorphisms (SNPs) in the S1PR1, S1PR2, and S1PR3 genes and plasma S1P levels in individuals with PE. Materials and Methods: The study included 100 individuals with PE and 100 healthy controls recruited from urology and psychiatry clinics. DNA was isolated from blood samples, and PCR was used to identify SNPs in the S1PR1 (rs2038366), S1PR2 (rs56357614), and S1PR3 (rs7022797) genes. Plasma S1P levels were measured using ELISA. Results: A significant association was observed between the heterozygous GT genotype of the S1PR1 gene and an increased risk of PE (OR 2.25, 95% CI 1.215–4.168, p = 0.0099). No significant associations were found between S1PR2 or S1PR3 polymorphisms and PE. Plasma S1P levels were significantly lower in the PE group (median 253.25 ng/L) compared to the control group (median 430.82 ng/L) (p &lt; 0.001). Conclusion: S1PR1 gene polymorphism and reduced plasma S1P levels may be linked to the pathophysiology of PE. In contrast, S1PR2 and S1PR3 do not appear to be associated. Further research with larger samples is needed to confirm these findings.

Perception of normal and treatment level ejaculatory latency times in men with premature ejaculation

Abstract Background Although the normal intravaginal ejaculation latency time (NIELT) as subjectively perceived by patients with premature ejaculation (PE) and expected IELT (EIELT), which represents the individual’s expectations of what treatment for PE would achieve, are critically influential in the treatment of patients with PE, there is a significant dearth of exploratory research on NIELT and EIELT among patients with PE. Aim To explore the NIELT and EIELT of patients with PE, understand why patients with PE perceive such a long IELT as normal, and identify factors associated with EIELT. Methods We recruited both patients with PE and control subjects, and analyzed the parameters related to IELT using detailed interviews and questionnaires. Outcomes Parameters related to IELT. Results A total of 592 individuals (mean age 29.6 ± 6.2) were included in the study, comprising 466 patients with PE (mean age 28.3 ± 5.4) and 126 non-PE individuals (mean age 34.6 ± 6.5). The actual perceived intravaginal ejaculation latency time (PIELT), referring to the patient’s self-assessed IELT at baseline, as well as NIELT, and EIELT of patients with PE, were 1.0 (1.0 − 2.0), 14.0 (10.0 − 15.0), and 15.0 (10.0 − 20.0), respectively. The control group’s PIELT and EIELT were 15.0 (10.0 − 20.0) and 20.0 (15.0 − 24.3), respectively, showing statistical differences compared with the PIELT and EIELT in the PE group. In the PE group and the control group, 31.5% and 57.9% of individuals, respectively, have an EIELT greater than the average actual normal ejaculatory latency time of 15.0 minutes. Among patients with PE, 51.3% expressed a NIELT &amp;gt;10 minutes, identical to the EIELT in a higher percentage (59.4%). The control group’s EIELT is 5 minutes longer than the PE group’s EIELT. Multivariable linear regression analysis showed that age, marital status, education level, BMI, satisfaction evaluation of PIELT, PEDT score, and IIEF-6 score were not associated with EIELT; only NIELT (beta = 0.817, P &amp;lt; 0.001) and PIELT (beta = 0.056, P = 0.044) were related to EIELT. Clinical implications Sexual health care providers should be aware that patients with PE have excessively high expectations for IELT. Strengths and limitation The first study explores why patients with clinically diagnosed PE perceive long IELT as normal and examines factors associated with EIELT. Further validation is needed in different cultural contexts. Conclusion Patients with PE often have excessively high expectations regarding IELT, primarily due to their insufficient understanding of IELT.

Association of redundant foreskin with sexual dysfunction: a cross-sectional study from 5700 participants.

A previous study showed that the length of the foreskin plays a role in the risk of sexually transmitted infections and chronic prostatitis, which can lead to poor quality of sexual life. Here, the association between foreskin length and sexual dysfunction was evaluated. A total of 5700 participants were recruited from the andrology clinic at The First Affiliated Hospital of University of Science and Technology of China (Hefei, China). Clinical characteristics, including foreskin length, were collected, and sexual function was assessed by the International Index of Erectile Function-5 (IIEF-5) and Premature Ejaculation Diagnostic Tool (PEDT) questionnaires. Men with sexual dysfunction were more likely to have redundant foreskin than men without sexual dysfunction. Among the 2721 erectile dysfunction (ED) patients and 1064 premature ejaculation (PE) patients, 301 (11.1%) ED patients and 135 (12.7%) PE patients had redundant foreskin, respectively. Men in the PE group were more likely to have redundant foreskin than men in the non-PE group (P = 0.004). Logistic regression analyses revealed that the presence of redundant foreskin was associated with increased odds of moderate/severe ED (adjusted odds ratio [aOR] = 1.31, adjusted P = 0.04), moderate PE (aOR = 1.38, adjusted P = 0.02), and probable PE (aOR = 1.37, adjusted P = 0.03) after adjusting for confounding variables. Our study revealed a positive correlation between the presence of redundant foreskin and the risk of sexual dysfunction, especially in PE patients. Assessment of the length of the foreskin during routine clinical diagnosis may provide information for patients with sexual dysfunction.

Altered brain activity associated with premature ejaculation improved by electroacupuncture in rats.

Premature ejaculation (PE) is linked with abnormal brain activity that is modifiable by electroacupuncture (EA). In this study we aimed to explore the central pathological mechanism underlying EA in treating PE. Six-week-old male Sprague-Dawley rats were divided into a PE group (n = 8) and a control group (n = 8) according to ejaculatory frequency during copulatory behavior. All rats underwent EA at the Zusanli acupoint (ST-36) for 4weeks. Magnetic resonance imaging data were collected before and after EA. The behavioral parameters, plasma norepinephrine levels, fractional amplitude of low frequency fluctuation (fALFF), and regional homogeneity (ReHo) were evaluated. The PE group ejaculated more times with shorter latency compared with controls. After EA, the ejaculation frequency of the PE group decreased, and the ejaculation latency period increased, with no changes observed in the control group. Norepinephrine levels were higher in the PE group than in the controls and were positively correlated with ejaculation frequency and negatively correlated with ejaculation latency. The PE group showed lower fALFF in the right striatum and higher ReHo in the brainstem compared with controls. After EA, controls showed decreased fALFF in the right striatum, left olfactory bulb, and dorsal fornix and increased ReHo in the right interpeduncular nucleus, as well as decreased ReHo in the left striatum, prelimbic system, right basal forebrain region, septal region, and olfactory bulb, while the model group exhibited increased fALFF in the right hypothalamic region, decreased fALFF in the left globus pallidum and right basal forebrain region and increased ReHo in the right interpeduncular nucleus, as well as decreased ReHo in the left striatum, olfactory bulb, basal forebrain region, dentate gyrus, right dysgranular insular cortex, and striatum. Compared with the controls after EA, the model group showed increased ReHo of the right hypothalamic region and decreased ReHo of the right dysgranular insular cortex. These findings might enhance the understanding of PE and contribute to new, targeted therapies for PE. The therapeutic effects might be achieved by EA inhibiting the activity in brain regions involved in ejaculatory behavior. However, the curative effect of acupuncture might be underestimated due to some curative effects of sham acupuncture used in the control group. In conclusion, the ejaculatory frequency of rats may be reduced and ejaculation latency could be extended by EA at ST-36, which might be achieved by the effects of this treatment on brain activity.

(215) Investigating if Hormonal Dysfunctions are Risk Factors in Men Complaining of Premature Ejaculation

Abstract Introduction Most epidemiological studies suggest that premature ejaculation (PE), also referred to as early ejaculation and rapid ejaculation, may be the most common male sexual disorder. The exact etiology of PE is unknown. Psychological/behavioristic and biogenic etiologies have been proposed. Objective Initial reports indicate that there are hormone differences between men with primary (lifelong) and secondary (acquired) PE. This study was designed to investigate hormone profiles of these two subgroups. Methods Men who presented to our outpatient clinic with PE were enrolled in this study. The diagnosis and classification (primary or secondary) of PE was based on patient medical and sexual history according to guidelines of international society of sexual medicine (ISSM) and European association of urology (EAU). Complete physical examination was done and we measured thyroid stimulating hormone (TSH), testosterone (T), and prolactin (P) for all patients. Statistical analyses included descriptive statistics and independent-measures t-test for univariate analyses. Analysis of covariance was used for multivariable analyses. Results 506 men were included in this analysis. The average age of these men was 44±12 years old and the mean body mass index (BMI) was 26.7±5.5. The mean levels of T, TSH, and P for the entire sample was 4.38±1.69, 2.31±3.56, and 10.56±11.04, respectively. There were 267 men in the primary PE group and 239 men in the secondary PE group. The men with primary PE were significantly younger than those with secondary PE (37±11 vs. 52±12, p=0.001). There were no significant differences in BMI between the groups. On univariate analyses, there was no differences between the primary PE and secondary PE groups in T (4.39±1.66 vs. 4.38±1.84, p=0.94), TSH (2.31±4.89 vs. 2.20±2.07, p=0.76), and P (10.65±8.13 vs. 10.46±13.46, p=0.86). When controlling for age in multivariable analyses, there continued to be no differences between the two groups (p values ranging from p=0.56 to 0.81). Conclusions hormonal profile including T, TSH and P seem to be in the normal range in men with PE and there is no statistical difference in these hormones between primary and secondary PE Disclosure No.

Analysis of orthostatic intolerance symptoms in patients with premature ejaculation.

The autonomic nervous system (ANS) plays an important role in maintaining physiological regulation. It regulates the body's response to many variable situations. Orthostatic intolerance (OI) is one of the most important signs of autonomic dysfunction. Autonomic dysfunction is known to cause premature ejaculation (PE) by disturbing the balance in erection and ejaculation cycles. Considering that OI may develop due to autonomic dysfunction in patients with PE, we hypothesized that OI symptoms would increase in these patients. The aim of our study was to investigate the relationship between orthostatic intolerance and PE. This case-control study included a total of 39 patients with PE and 47 volunteers without PE. All subjects were assessed using the self-reported Orthostatic Grading Scale (OGS). In addition, the validated five-item Turkish version of the Premature Ejaculation Diagnostic Tool (PEDT) was used to evaluate PE. The PE group included patients with a PEDT score ≥ 11. The mean ages of the PE and control groups were 38.2 ± 7.8 and 40.5 ± 9.1 years, respectively (p = 0.137). The mean PEDT scores of the PE and control groups were 13.9 ± 3.6 and 6.6 ± 2.9, respectively (p < 0.0001), and their mean OGS scores were 5.6 ± 2.4 and 1.6 ± 1.3, respectively (p < 0.0001). A statistically significant correlation was found between the PEDT and OGS scores (r: 0.686, p < 0.0001). The orthostatic intolerance symptoms of patients with PE were higher than those of the control group. There was a correlation between the severity of PE and the severity of orthostatic intolerance. This is the first study in the literature to reveal a relationship between orthostatic intolerance and PE.

The association of reproductive hormones, thyroid function, and vitamin levels with premature ejaculation: A prospective case-control study.

To investigate whether serum hormone (testosterone, prolactin, gonadotropins, and thyroid hormones) and vitamin (vitamin B12, folic acid, and vitamin D) levels are associated with premature ejaculation (PE). This prospective case-control study included 126 patients with PE (lifelong PE [LPE] in 94 and acquired PE [APE] in 32) who presented to the urology outpatient clinic between April 2016 and January 2023 and 92 healthy men as a control group. The diagnosis of PE was based on the criteria defined by the International Society for Sexual Medicine. Serum total testosterone (TT), free and bioavailable testosterone, follicle-stimulating hormone, luteinizing hormone, prolactin, thyroid-stimulating hormone, free triiodothyronine, thyroxine (fT4), vitamin B12, folic acid, and vitamin D levels were measured. Serum TT, fT4, and vitamin D levels were significantly higher in patients with PE than in the control group (p=0.022, p=0.002, and p=0.044, respectively). However, the serum vitamin B12 level was significantly lower in the PE group (p=0.021). In the multivariate logistic regression analysis, only vitamin B12 was found to be an independent risk factor for PE, with an estimated odds ratio of 0.997 (95% confidence interval 0.994-0.999, p=0.036). This study demonstrated that lower vitamin B12 levels are associated with the presence of PE. Therefore, we believe that it would be beneficial to consider vitamin B12 levels in the evaluation of patients with PE.

Do Ejaculation Latency and Other Sexual Measures Differ Between Men With Lifelong and Acquired Premature Ejaculation?

To determine whether men with lifelong vs acquired premature ejaculation (PE) subtypes differ on their estimated ejaculation latencies (EL) and related sexual, relationship, and behavioral parameters. Of 2679 men who responded to an online multinational survey about sexual health and met inclusion criteria, 540 reported "probable" or "definite" PE, as assessed by the Premature Ejaculation Diagnostic Tool. Lifelong and acquired PE subtypes were compared on multiple measures related to EL, as well as on sets of demographic, diagnostic, relationship, sexual behavioral, and sexual functioning measures during both partnered sex and masturbation. Nearly 73% of men with PE in this sample reported the lifelong subtype. No differences emerged in EL measures between subtypes, even when parsed according to age. Specifically, men 37years or under with either definite lifelong or acquired PE reported ELs of 1.9 minutes (SD=1.3). For men over 37, lifelong ELs were 2.0 minutes (SD=1.3), acquired ELs 2.4 minutes (SD=1.4). While the lifelong subgroup was younger and reported lower erectile functioning, these differences occurred only in the probable PE group and not the definite PE group. Our data do not support different EL criteria for men with acquired vs lifelong PE, as suggested by several professional definitions. Furthermore, differences in age and erectile functioning between the groups, often reported in clinical samples though not in our definite PE group, may be an artifact of the general health/patient characteristics that lead such men to seek medical assistance.

Abnormal cortical surface-based spontaneous and functional connectivity in the whole brain in lifelong premature ejaculation patients.

Recent research has highlighted structural and functional abnormalities in the cerebral cortex of patients with premature ejaculation (PE). These anomalies could play a pivotal role in the physiological mechanisms underlying PE. This study leveraged functional magnetic resonance imaging (fMRI), a noninvasive technique, to explore these neural mechanisms. We conducted resting-state fMRI scans on 36 PE patients and 22 healthy controls (HC), and collected data on Premature Ejaculation Diagnostic Tool (PEDT) scores and intravaginal ejaculation latency time (IELT). Employing a surface-based regional homogeneity (ReHo) approach, we analyzed local neural synchronous spontaneous activity, diverging from previous studies that utilized a volume-based ReHo method. Areas with significant ReHo differences between PE and HC groups underwent surface-based functional connectivity (FC) analysis. Significant discrepancies in ReHo and FC across the cortical surface were observed in the PE cohort. Notably, PE patients exhibited decreased ReHo in the left triangular inferior frontal gyrus and enhanced ReHo in the right middle frontal gyrus. The latter showed heightened connectivity with the left lingual gyrus and the right orbital superior frontal gyrus. Furthermore, a correlation between ReHo and FC values with PEDT scores and IELT was found in the PE group. Our findings, derived from surface-based fMRI data, underscore specific brain regions linked to the neurobiological underpinnings of PE.

Perceived intravaginal ejaculation latency time: The diagnosis of premature ejaculation among Vietnamese men.

Premature ejaculation (PE) is a prevalent sexual dysfunction in men that greatly affects their quality of life. In PE, the duration of sexual performance is considered an important aspect. However, a self-estimated value of intravaginal ejaculation latency time (perceived IELT, PIELT) as a criterion for diagnosis has not been specified. This study aimed to determine the validity and a threshold value for PIELT in PE diagnosis. In our cross-sectional study, we recruited 550 men from March 2019 to January 2020 and interviewed them regarding their general demographic characteristics, sexual habits, PIELT and completed a premature ejaculation diagnostic tool (PEDT) questionnaire. Eventually, a combination of a clinical diagnosis and PEDT score was used, in which those with PEDT ≥ 11 and diagnosed with possible PE were assigned to the final PE(+) group; those with PEDT score ≤ 8 and diagnosed with no PE were included in the final PE(-) group. Men PE(-) had more frequent sexual intercourse (9.74±5.38vs. 6.69±5.38 episodes per month, p<0.001) and had higher marriage rate (72.7%vs. 60.4%, p=0.002) than PE(+) patients. No significant difference was noted regarding age, smoking habit, age of first sexual experience, and number of sexual partners between the two groups. The mean PIELT of control subjects and PE(+) patients were 11.69±6.83 min and 2.01±1.21 min, respectively. On receiver operating characteristic curve analysis, the cut-off value of PIELT of 3.75 min can be used to distinguish PE men (area under the curve=0.982, sensitivity/specificity=0.961/0.909), which means that men with a PIELT ≤ 3.5 min is suggestive of PE. The impact of PE is dramatic both from a social and a personal perspective. PE(+) patients married significantly less and have significantly lower sexual activity compared to a PE(-) population. Furthermore, a PIELT of ≤ 3.5 min predicts PE demonstrating the need to revise its taxonomy and definition.

Is there any relationship between premature ejaculation and the age of first sexual intercourse in men?

There are few studies on the association between male sexual health and the age at first sexual experience (FSE), and the results are mixed. Furthermore, there is no research regarding premature ejaculation (PE) on this topic. In this study, we aimed to evaluate the relationship between PE and the age at FSE in men. The study consisted of a total of 136 males, including 66 PE patients and 70 control groups. The age, body mass index (BMI), duration of education, marital status, age at circumcision, age of FSE, and estimated intravaginal ejaculation latent time (eIELT) of the individuals were all recorded. All participants completed the Premature Ejaculation Diagnostic Tool (PEDT), the Beck Depression Inventory (BDI), and the Beck Anxiety Inventory (BAI). The mean age of the PE and control groups was 38.27 ± 8.47 and 33.66 ± 8.04 years, respectively (p<0.05). The mean BMI values of the groups were comparable (p>0.05). The education duration of the control group was substantially longer than the PE group (p<0.001). The marriage rate was 57/66 (86.36%) in the PE group, while it was 49/70 (70%) in the control group (p<0.05). The mean eIELT for the PE and control groups was 64.89 ± 41.91sec and 608.64 ± 369.04 sec, respectively (p<0.001). The PE group had significantly higher PEDT, BDI, and BAI scores than the control group (p<0.001; p<0.01; p<0.01, respectively). In terms of circumcision age and age of FSE, there was no significant difference between the groups (p>0.05). According to our findings, there was no link between PE and the age of FSE. Future large-scale studies on the subject could provide more exact and reliable knowledge. All authors declare no conflict of interest.

Evaluation of the quality of life of patients with premature ejaculation (lifelong and acquired).

SUMMARYOBJECTIVE:The aim of this study was to evaluate the quality of life of patients with lifelong and acquired premature ejaculation and to examine its relationship with depression and anxiety.METHODS:Between February 2017 and January 2018, a total of 175 patients with premature ejaculation and 132 control men who applied to the urology department of the training and research hospital with the complaint of Premature Ejaculation were included. Patients were divided into three groups according to International Society for Sexual Medicine (ISSM) criteria as follows: Group 1, lifelong premature ejaculation; Group 2, acquired premature ejaculation, and Group 3, control group without premature ejaculation. A detailed medical history of patients was obtained and physical examinations were performed. Intravaginal ejaculation latency time (IELT) was recorded and patients were administered International Erectile Function Index-5 (IIEF-5), Premature Ejaculation Diagnostic Tool (PEDT), Sexual Health Inventory for Men (SHIM), Beck Depression Inventory (BDI), State-Trait Anxiety Inventory (STAI)-1 and STAI-2, and Short Form-36 (SF-36).RESULTS:The mean mental component score (MCS) of the SF-36 was 51.65±6.57 in the lifelong premature ejaculation group, 49.33±8.65 in the acquired premature ejaculation group, and 61.12±11.09 in the control group (p<0.0001). The mean physical component score (PCS) was 50.99±7.43 in the lifelong premature ejaculation group, 48.32±11.58 in the acquired premature ejaculation group, and 55.17±8.10 in the control group (p<0.0001). Quality of life of premature ejaculation patients as assessed by SF-36 was lower in the subscales of physical functioning, general health perception, vitality, and role limitations due to emotional functioning, compared to the control group.CONCLUSIONS:Lifelong and acquired premature ejaculation patients deteriorate their quality of life: the deterioration in these patients’ quality of life also negatively affects their depression and anxiety states.

Does Bother/Distress Contribute to the Diagnosis of Premature Ejaculation?

IntroductionThe role of bother/distress in the diagnosis of premature ejaculation (PE) has received minimal investigation compared with the 2 other diagnostic criteria, ejaculatory control and ejaculatory latency (EL).AimThis study assessed (i) the added variance explained by bother/distress to the diagnostic accuracy of PE and (ii) determined its overall contribution to a PE diagnosis.MethodsThe 3 diagnostic criteria for PE were assessed in 2,589 men (mean age = 38.2 years, SD = 13.5) in order to determine the contribution of each factor to a dysfunctional diagnosis. A series of regression and discriminant analyses were used to assess the value of bother/distress in explaining ejaculatory control and in predicting accuracy of PE group status. Commonality analysis was used to determine the relative contribution of each of these factors to the diagnosis of PE.Main Outcome MeasureThe major outcome was the quantified contribution of “bother/distress” to a PE diagnosis.ResultsBother/distress accounted for about 3–4% of the variation in ejaculatory control and added only minimally to the prediction accuracy of PE group status (no, probable, definite PE). Commonality analysis indicated that bother/distress comprised about 3.6% of the unique explained variation in the PE diagnosis, compared with ejaculatory control and EL which contributed 54.5% and 26.7%, respectively. Common variance among factors contributed the remaining 15.5% to the PE diagnosis.Clinical TranslationBother/distress contributes least to the determination of a PE diagnosis. Its contribution is largely redundant with the unique and combined contributions of ejaculatory control and EL.Strengths and LimitationsUsing a well-powered and multivariate analysis, this study parsed out the relative contributions of the 3 diagnostic criteria to a PE diagnosis. The study is limited by its use of estimated EL, a single item assessment of bother/distress, and the lack of differentiation of PE subtypes, lifelong and acquired.ConclusionBother/distress contributes minimally to the PE diagnosis, yet its assessment may be key to understanding the experiences of the patient/couple and to developing an effective treatment strategy.Rowland DL, McNabney SM, Hevesi K. Does Bother/Distress Contribute to the Diagnosis of Premature Ejaculation?. Sex Med 2022;10:100548.

Assessing the nitric oxide and asymmetric dimethylarginine levels in lifelong premature ejaculation: A prospective study

ObjectiveTo evaluate nitric oxide (NO) and asymmetric dimethylarginine (ADMA) levels in men with premature ejaculation (PE), which is a common condition that adversely affects quality of life. Material and methodOf the 20–50-year old men presenting to the urology clinic, who were married or had regular sexual intercourse, 40 that were diagnosed with lifelong PE according to the Premature Ejaculation Diagnostic Tool (PEDT) and intravaginal ejaculation latency time (IELT) measured by a stopwatch were included in the study. The results of the PE group were compared to those of the control group formed with 40 healthy hospital personnel. Venous blood samples were centrifuged and stored at −80°C. The NO and ADMA values were compared between the individuals with and without PE. ResultsThere was no statistically significant difference between the groups in terms of age, body mass index (BMI), and The International Erectile Dysfunction Index-5 (IIEF-5) questionnaire scores. The NO and ADMA values were significantly lower in the PE group than in the control group (29.76±13.26μmol/L vs. 48.27±22.71μmol/L; p<0.001 and 1.01±0.49nmol/ml vs. 1.83±1.06nmol/ml; p<0.001, respectively). There was a significant correlation between IELT and NO levels (r=0.407, p=0.001). ConclusionOur study can contribute to the explanation of the pathophysiology of PE having unclear etiology and treatment. Further studies on these molecules with larger case series are required for the diagnosis and treatment of PE.

Lifelong Premature Ejaculation and Attention-Deficit Hyperactivity Disorder: A Controlled Study.

In males, one of the most common sexual dysfunction is lifelong premature ejaculation. Sexual dysfunctions, including premature ejaculation, are highly prevalent in adults with attention-deficit hyperactivity disorder. This study aimed to examine the prevalence and symptoms of attention-deficit hyperactivity disorder in patients with lifelong premature ejaculation. In this study, 48 patients diagnosed with lifelong premature ejaculation and 40 controls were included. All patients and controls were asked to fill out Wender-Utah Rating Scale-25 and Adult Attention-Deficit Hyperactivity Disorder Self-Report Scale. Patients also filled out the Arabic Index of Premature Ejaculation and Premature Ejaculation Diagnostic Tool. Totally 20 patients (41.66%) with lifelong premature ejaculation and 2 (5%) controls were diagnosed with attention-deficit hyperactivity disorder. The mean scores of the Wender-Utah Rating Scale-25, Adult Attention-Deficit Hyperactivity Disorder Self-Report Scale, and Adult Attention-Deficit Hyperactivity Disorder Self-Report Scale-hyperactivity-impulsivity subscale were higher in the case group (P = .001, P = .001, and P < .001, respectively). No difference was found between the 2 groups in terms of the Adult Attention-Deficit Hyperactivity Disorder Self-Report Scale-Inattention subtype (P = .492). In the lifelong premature ejaculation group, 13 patients (65%) diagnosed with attention-deficit hyperactivity disorder were found to be attention-deficit hyperactivity disorder-predominantly hyperactivity/impulsivity subtype. The findings of the current study reveal that patients with lifelong premature ejaculation should be assessed carefully in terms of attention-deficit hyperactivity disorder, especially hyperactive and impulsive characteristics, and the relationship between lifelong premature ejaculation and attention-deficit hyperactivity disorder should be examined by further studies with large samples.

The importance of inquiring the ejaculation function in men with premature ejaculation who do not actively seek treatment.

To evaluate the clinical characteristics of men presenting for other complaints whose ejaculatory function inquiry indicated premature ejaculation (PE). The data of 536 PE patients, including those who presented with the complaint of PE (group 1) and those presenting with other complaints who were diagnosed with PE (group 2) as a result of ejaculatory function inquiry using estimated intravaginal ejaculation latency time (IELT) and Premature Ejaculation Diagnostic Tool (PEDT), were retrospectively evaluated. Age, PE type, comorbidities, recommended treatments, and treatment acceptance status of all patients were recorded. These characteristics were compared for each group. Among all the patients, those who presented with PE complaints constituted 22.4%. Among the patients with both PE and ED, 98.1% applied with ED complaint and only 1.9% with PE complaint. The percentage of patients with one comorbidity was significantly higher in group 2 (p = 0.032). 90.1% of all patients and 88.5% of patients in group 2 accepted the recommended treatment for PE. The mean age and comorbidities were significantly higher in patients that refused the treatment. The most common reason for treatment refusal was the patients' lack of expectation for treatment. This study shows that men more frequently tend to seek treatment for ED than PE, and treatment acceptance rate may be higher when the patients with PE complaints who don't seek treatment are reached through ejaculatory function inquiry. The presence of comorbidities negatively affects the treatment expectation and acceptance as well as treatment seeking behavior of men with PE.

Оценка эффективности дапоксетина при первичной и вторичной формах преждевременной эякуляции

to compare the efficacy of dapoxetine in treatment of primary and secondary premature ejaculation.The study included 60 patients with premature ejaculation (PE). Depending on the form of premature ejaculation they were divided into two groups: 27 patients with primary PE (group 1) and 33 patients with secondary PE (group 2). Patients were recommended to take dapoxetine 30 mg 1 hour before intercourse. A follow-up visit was scheduled on day 30 after receiving the drug. The intravaginal ejaculation latency time (IELT) and the Premature ejaculation diagnostic tool (PEDT) score were evaluated before dapoxetine was given and after 30 days from the start of the study. The significance of differences between baseline and follow-up values were compared using Wilcoxons test. In both groups, the proportion of patients with an incomplete response (IELT less than 2 minutes, PEDT more than 10) to symptomatic therapy with dapoxetine was evaluated. The proportion of patients with incomplete response to therapy was compared using the chi-square test.The median IELT among all patients before starting therapy was 63 seconds (interquartile interval [IQR]: 28.75-94). After one month of therapy median IELT increased to 119 seconds (IQR: 58.75-321.75). Median PEDT score was 16 (IQR: 13-19) at baseline and 7 (IQR: 4-12) at follow-up. In group 1, the median IELT increased from 57 to 83 seconds (p = 0.02088), and in group 2, the median IELT increased from 70 to 173 seconds (p<0.00001). The mean PEDT score decreased to 7 in both groups (p<0.00001). Incomplete response to therapy was observed in 66.7% of patients in group 1 and in 39.4% of patients in group 2. The difference between two groups was statistically significant (p=0.035456).Symptomatic therapy with dapoxetine has a positive effect on the intravaginal ejaculation latency time and patient satisfaction in both primary and secondary premature ejaculation. However, the incidence of incomplete response to therapy is higher in patients with primary premature ejaculation, which may be due to characteristic differences in the pathogenesis of primary and secondary premature ejaculation.

Efficacy evaluation of thickened condom in the treatment of premature ejaculation.

BackgroundThis study aimed to evaluate the efficacy of thickened condoms in the treatment of premature ejaculation.MethodsFrom August to December 2021, patients with premature ejaculation treated in the Urology and Andrology Center of the First Affiliated Hospital of Medical College of Zhejiang University were selected for a clinical controlled study. A total of 100 patients with premature ejaculation were enrolled as the premature ejaculation group and 30 normal men as the control (normal married men, age <30 years, normal sexual life). Each patient’s ejaculation latency, contraceptive safety, comfort, glans sensitivity, dorsal nerve conduction velocity, serum reproductive hormone level, penile hardness, and penile erection were measured in the premature ejaculation and normal control groups.ResultsThe comfortability associated with thickened condoms in the premature ejaculation group was poor (P<0.05). After using a thickened condom, the time to ejaculate of the premature ejaculation group was significantly prolonged (P<0.05). Meanwhile, the penis vibration threshold increased significantly, indicating that the nerve sensitivity decreased (P<0.05). In the premature ejaculation group, the total erection time and the average hardness of coronary sulcus in the thickened condom group were significantly higher than those in the ordinary condom group (P<0.05), and the serum androgen level could be significantly increased after using the thickened condom (P<0.05).ConclusionsThe thickened condom can effectively maintain and prolong the hyperemia state of the penis and enhance the intensity of penile erection. Thickened condoms physically preserve and extend the time of penile erection, resist and overcome premature ejaculation, and improve the ejaculation condition to improve the quality of sexual intercourse.

Evidence for the Association between Chronotype and Lifelong Premature Ejaculation

Purpose: This study aimed to investigate the relationships between intravaginal ejaculatory latency time (IELT), severity of disease, and chronotype in lifelong premature ejaculation (PE). Materials and Methods: Evaluation was made of 114 males with PE and 103 healthy individuals, and comparisons were made of self-estimated IELT, Arabic Index of Premature Ejaculation (AIPE), Pittsburg Sleep Quality Index (PSQI), and Morningness-Eveningness Questionnaire (MEQ). Results: The frequency of morningness chronotype (78.1%) was significantly higher, and Morningness-Eveningness Questionnaire (MEQ) scores were negatively correlated with both IELT (r = −0.490, p < 0.001) and Arabic Index of Premature Ejaculation (AIPE) scores (r = −0.639, p < 0.001) in the PE group. MEQ scores significantly predicted IELT (t = −2.465, p = 0.015) and AIPE scores (t = −4.003, p = 0.000) in the PE group but not in the control group. Conclusion: It can be asserted that morningness chronotype is more common, and ejaculatory latency time and PE severity are associated with chronotype in males with PE.