Premature Ejaculation Syndromes Research Articles

Erectile dysfunction, anxiety, perceived stress, and insomnia are more common among acquired premature ejaculation patients compared to other premature ejaculation syndromes.

Premature ejaculation (PE) is the most common ejaculatory function disorder. To date, four types of PE have been identified depending on the severity, onset, and course of the problem. The aim of this study was to investigate whether or not there is a difference between these types in respect of anxiety, perceived stress, insomnia severity, and sleep chronotype. The study included 112 patients diagnosed with PE in our clinic between October 2021 and May 2022. The patients were separated into groups according to PE types of lifelong (LPE, n = 39), acquired (APE, n = 45), variable (VPE, n = 10), and subjective (SPE, n = 18). In addition to the demographic and clinical data, the scores were recorded of all participants in the International Index of Erectile Function-5, Hospital Anxiety and Depression Scale, Premature Ejaculation Diagnostic Tool (PEDT), Insomnia Severity Index (ISI), Perceived Stress Scale (PSS), and Morningness Eveningness Questionnaire (MEQ). SPE was determined more in university graduate patients (42.1% vs. LPE, 21.1%; APE, 36.8%; VPE, 0%; p = 0.01). In patients with APE, erectile dysfunction was more severe (80.0% vs. LPE, 8.0%; SPE, 12.0%; VPE, 0%; p < 0.001). The median (IQR) PEDT score was determined to be higher in APE than in LPE and SPE (16(5), 13(7), 11(5), p = 0.001, respectively). Patients with APE were determined to have higher median (IQR) ISI (21(9) vs. LPE, 8(7); SPE, 5(8); VPE 8(4), p < 0.001) and PSS scores (35(12) vs. LPE, 22 (7); SPE,22(5); VPE 21(6), p < 0.001), the sleep chronotype was more eveningness according to the MEQ (80.8% vs. LPE, 19.2%; VPE, 0%; SPE, 0%; p < 0.001), and there were seen be more anxiety symptoms (75.5% vs. LPE,12.2%; VPE, 0%; SPE, 12.2%; p < 0.001). Psychological status and sleep health were concluded to be important factors for PE patients, and the patients with acquired PE were the group most affected by these factors.

Correlations between Personality Traits, Patient-Reported Outcome, and Chronic Prostatitis Symptoms in Men with Different Premature Ejaculation Syndromes.

Although the personality traits (PT), patient-reported outcome (PRO), and chronic prostatitis (CP) symptoms in premature ejaculation (PE) have been evaluated, there was no study to assess their correlations in men with different PE syndromes. The purpose of this study was to assess the correlations between the PT, PRO, and CP symptoms in men with different PE syndromes. Between January 2019 and January 2021, a cross-sectional field study was conducted in our andrology clinic. Men with the complaints of PE were divided into lifelong PE (LPE), acquired PE (APE), variable PE (VPE), and subjective PE (SPE). All subjects were required to complete a verbal questionnaire with the PRO, National Institutes of Health Chronic Prostatitis Symptom Index (NIH-CPSI), and Temperament and Character Inventory (TCI-R). Finally, 479 men with the complaints of PE and 365 without the complaints of PE were enrolled. The incidence of PE syndromes in PE complaint group was as follows: LPE 16.70%, APE 48.85%, VPE 11.27%, and SPE 23.17%. Mean ages in PE complaint group were 42.53 ± 12.25 years. In the PE complaint group, the novelty seeking (NS) scores were strongest correlated with the personal distress and quality of life (QOL). The harm avoidance (HA) scores were strongest correlated with the severity of PE and pain syndromes. The self-transcendence (ST) scores were strongest correlated with the satisfaction with sexual intercourse and QOL. In addition, strongest association between the total scores of NIH-CPSI and the NS or ST scores was also found in the APE group. The HA scores were also strongest correlated with the total scores of NIH-CPSI in SPE. Strongest association between the total scores of NIH-CPSI and the NS/TI or ST/CI scores was also found in the APE group. The HA/TI scores were also strongest correlated with the total scores of NIH-CPSI in SPE.

Premature Ejaculation: 2020 Update

Premature ejaculation (PE) is one of the most common forms of male sexual disorder. There are still different opinions and point of view regarding its definition, classification, prevalence, pathophysiology and treatment alternatives. For these reasons, we aim to recap the recently accumulated data on definition, classification, pathophysiology and treatment alternatives of PE. The literature pertaining to PE has been reviewed by the authors. All the related articles were critically analyzed and examined. Levels of evidence (Les) and grades of recommendation (Grs) are provided based on a thorough analysis of the literature and consensus. After the initial evidence-based definition developed for lifelong PE, the International Society for Sexual Medicine (ISSM) advertised another unified definition for lifelong and acquired PE and confirmed the time criterion for the diagnosis of PE. The ISSM has also acknowledged the presence of the two more PE subtypes (variable and subjective PE) underlining the fact that more research is required to develop an evidence-based definition of these sexual problems. Although the pathophysiology of these four PE syndromes has not been completely elucidated yet, pharmacotherapy must be considered the treatment of choice for lifelong PE patients whereas treating the underlying pathology must be the initial goal for patients with acquired PE. To treat PE, we can use daily or on-demand use of SSRIs, on-demand use of topical anaesthetics, on-demand tramadol or phosphodiesterase type-5 inhibitors. Psychotherapy can be offered to patients who describe variable and subjective PE. Despite the recent progress reached in the field of PE, there are on-going debates regarding the definition, classification, pathophysiology and treatment of this common problem. Future clinical trials must be performed to understand the actual aetiology of the four PE syndromes and develop more effective and safe treatment alternatives.

AB080. Relationships between intravaginal ejaculatory latency time and National Institutes of Health-Chronic Prostatitis Symptom Index in the four types of premature ejaculation syndromes: a large observational study in China

BackgroundWe assessed the associations between intravaginal ejaculatory latency time (IELT) and National Institutes of Health-Chronic Prostatitis Symptom Index (NIH-CPSI) in men with different premature ejaculation (PE) syndromes.MethodsFrom September 2011 to September 2012, a total of 4,000 men were enrolled from the Anhui province of China. Subjects were required to complete a verbal questionnaire, including demographic information, medical and sexual history [e.g., IELT, and self-estimated scales (e.g., NIH-CPSI)].ResultsOf 3,016 of the men evaluated, 25.80% complained of PE. Distribution of the four PE syndromes among men with complaints of PE was as follows: lifelong premature ejaculation (LPE), 12.34%; acquired PE (APE), 18.77%; natural variable PE (NVPE), 44.09%; premature-like ejaculatory dysfunction (PLED), 24.81%. Men with complaints of PE reported worse NIH-CPSI scores, and lower IELT than men without complaints of PE (P<0.001 for all). Moreover, total and subdomain scores of NIH-CPSI were higher in men with APE, and IELT was higher in men with PLED. IELT was negatively associated with NIH-CPSI scores in men with complaints of PE. Negative relationships between total and subdomain scores of NIH-CPSI, and IELT were stronger in men with APE (total scores: adjusted r=−0.68, P<0.001; pain symptoms: adjusted r=−0.70, P<0.001; urinary symptoms: adjusted r=−0.67, P<0.001; quality of life impact: adjusted r=−0.64, P<0.001).ConclusionsMen with complaints of PE reported worse NIH-CPSI scores than men without complaints of PE. Relationships between IELT and NIH-CPSI scores were strongest in men with APE.

PS-08-007 Relationships between intravaginal ejaculatory latency time and national institutes of health-chronic prostatitis symptom index in the four types of premature ejaculation syndromes: A large observational study in China

PS-08-007 Relationships between intravaginal ejaculatory latency time and national institutes of health-chronic prostatitis symptom index in the four types of premature ejaculation syndromes: A large observational study in China

231 Distribution and Factors Associated With Four Premature Ejaculation Syndromes in Outpatients Complaining of Ejaculating Prematurely

Because available definitions of premature ejaculation (PE) were unable to encompass the various forms of PE, Waldinger et al. proposed a new classification that distinguished four PE syndromes. However, few studies have examined the prevalence rates of these four PE syndromes. The study aims to analyze the prevalence of and factors associated with four PE syndromes in outpatients who complained of ejaculating prematurely. Between December 2009 and December 2011, outpatients who complained of PE completed a detailed verbal questionnaire regarding their demographic data and medical and sexual history. Each patient was classified as having one of four PE subtypes: lifelong PE (LPE), acquired PE (APE), natural variable PE (NVPE), or premature-like ejaculatory dysfunction (PLED). Based on the new classification scheme, PE was classified into four subtypes. The anxiety/depression status of patients was assessed by the Zung self-rating anxiety/depression scales, and erectile function was assessed by the International Index of Erectile Function-5 instrument.

113 Relationships Between Intravaginal Ejaculatory Latency Time and National Institutes of Health-Chronic Prostatitis Symptom Index in the Four Types of Premature Ejaculation Syndromes: A Large Observational Study in China

113 Relationships Between Intravaginal Ejaculatory Latency Time and National Institutes of Health-Chronic Prostatitis Symptom Index in the Four Types of Premature Ejaculation Syndromes: A Large Observational Study in China

AB226. The relationship between self-estimated intravaginal ejaculatory latency time and International Prostate Symptom Score in middle-aged men complaining of ejaculating prematurely in China

ObjectiveWe performed this study to evaluate the association between International Prostate Symptom Score (IPSS) and intravaginal ejaculatory latency time (IELT) in men with the four premature ejaculation (PE) syndromes.MethodsFrom June 2012 to January 2014, a total of 690 men aged 40–59 years complaining of ejaculating prematurely and another 452 male healthy subjects of the same age without these complaints were included in this study. Men with the complaints of ejaculating prematurely were classified as one of the four PE syndromes: lifelong PE, acquired PE (APE), variable PE, and subjective PE. Each of them completed a detailed questionnaire including information on demographics, medical and sexual history (e.g., self-estimated IELT), IPSS, and International Index of Erectile Function-5.ResultsMen complaining of ejaculating prematurely reported higher IPSS (11.2±6.0 vs. 5.5±3.3) and shorter self-estimated IELT (2.1±1.6 vs. 4.8±3.3 min) than men without complaints (P<0.001 for each). By unilabiate analysis, self-estimated IELT in men with the four PE syndromes showed significant correlations with IPSS (P<0.001 for all). After adjusting for age, self-estimated IELT was negatively associated with IPSS in men with PE complaints (adjusted r=−0.378, P<0.001). Also, the association was stronger in men with APE (adjusted r=−0.502, P<0.001).ConclusionsMen complaining of ejaculating prematurely reported worse IPSS than men without these complaints. Self-estimated IELT was negatively associated with IPSS in men complaining of ejaculating prematurely, and the correlation was the strongest in men with APE.

AB220. Relationships between intravaginal ejaculatory latency time and National Institutes of Health-Chronic Prostatitis Symptom Index in the four types of premature ejaculation syndromes: a large observational study in China

ObjectiveWe assessed the associations between intravaginal ejaculatory latency time (IELT) and National Institutes of Health-Chronic Prostatitis Symptom Index (NIH-CPSI) in men with different PE syndromes.MethodsFrom September 2011 to September 2012, a total of 4,000 men were enrolled from the Anhui province of China. Subjects were required to complete a verbal questionnaire, including demographic information, medical and sexual history (e.g., IELT), and self-estimated scales (e.g., NIH-CPSI).ResultsOf 3,016 of the men evaluated, 25.80% complained of premature ejaculation (PE). Distribution of the four PE syndromes among men with complaints of PE was as follows: LPE, 12.34%; APE, 18.77%; VPE, 44.09%; and SPE, 24.81%. Men with complaints of PE reported worse NIH-CPSI scores and lower IELT than men without complaints of PE (P<0.001 for all). Moreover, total and subdomain scores of NIH-CPSI were higher in men with APE, and IELT was higher in men with SPE. IELT was negatively associated with NIH-CPSI scores in men with complaints of PE. Negative relationships between total and subdomain scores of NIH-CPSI and IELT were stronger in men with APE (total scores: adjusted r=−0.68, P<0.001; pain symptoms: adjusted r=−0.70, P<0.001; urinary symptoms: adjusted r=−0.67, P<0.001; quality of life impact: adjusted r=−0.64, P<0.001).ConclusionsMen with complaints of PE reported worse NIH-CPSI scores than men without complaints of PE. Relationships between IELT and NIH-CPSI scores were strongest in men with APE.

The relationship between self-estimated intravaginal ejaculatory latency time and International Prostate Symptom Score in middle-aged men complaining of ejaculating prematurely in China.

Some factors associated with the four premature ejaculation (PE) syndromes have been studied, but the association between International Prostate Symptom Score (IPSS) and the four PE syndromes has not been investigated. We performed this study to evaluate the association between IPSS and intravaginal ejaculatory latency time (IELT) in men with the four PE syndromes. From June 2012 to January 2014, a total of 690 men aged 40-59 years complaining of ejaculating prematurely and another 452 male healthy subjects of the same age without these complaints were included in this study. Men with the complaints of ejaculating prematurely were classified as one of the four PE syndromes: lifelong PE, acquired PE (APE), variable PE, and subjective PE. Each of them completed a detailed questionnaire including information on demographics, medical and sexual history (e.g., self-estimated IELT), IPSS, and International Index of Erectile Function-5. Associations between IPSS and self-estimated IELT in middle-aged men with the four PE syndromes. Men complaining of ejaculating prematurely reported higher IPSS (11.2 ± 6.0 vs. 5.5 ± 3.3 ) and shorter self-estimated IELT (2.1 ± 1.6 minutes vs. 4.8 ± 3.3) than men without complaints (P < 0.001 for each). By unilabiate analysis, self-estimated IELT in men with the four PE syndromes showed significant correlations with IPSS (P < 0.001 for all). After adjusting for age, self-estimated IELT was negatively associated with IPSS in men with PE complaints (adjusted r = -0.378, P < 0.001). Also, the association was stronger in men with APE (adjusted r = -0.502, P < 0.001). Men complaining of ejaculating prematurely reported worse IPSS than men without these complaints. Self-estimated IELT was negatively associated with IPSS in men complaining of ejaculating prematurely, and the correlation was the strongest in men with APE.

Relationships between intravaginal ejaculatory latency time and national institutes of health-chronic prostatitis symptom index in the four types of premature ejaculation syndromes: a large observational study in China.

Besides lifelong premature ejaculation (LPE) and acquired premature ejaculation (APE), Waldinger and Schweitzer proposed two addition PE syndromes (variable PE [VPE] and subjective PE [SPE]). We assessed the associations between intravaginal ejaculatory latency time (IELT) and National Institutes of Health-Chronic Prostatitis Symptom Index (NIH-CPSI) in men with different PE syndromes. From September 2011 to September 2012, a total of 4,000 men were enrolled from the Anhui province of China. Subjects were required to complete a verbal questionnaire, including demographic information, medical and sexual history (e.g., IELT), and self-estimated scales (e.g., NIH-CPSI). IELT; NIH-CPSI; the new classification of PE syndromes. Of 3,016 of the men evaluated, 25.80% complained of PE. Distribution of the four PE syndromes among men with complaints of PE was as follows: LPE, 12.34%; APE, 18.77%; VPE, 44.09%; and SPE, 24.81%. Men with complaints of PE reported worse NIH-CPSI scores and lower IELT than men without complaints of PE (P < 0.001 for all). Moreover, total and subdomain scores of NIH-CPSI were higher in men with APE, and IELT was higher in men with SPE. IELT was negatively associated with NIH-CPSI scores in men with complaints of PE. Negative relationships between total and subdomain scores of NIH-CPSI and IELT were stronger in men with APE (total scores: adjusted r = -0.68, P < 0.001; pain symptoms: adjusted r = -0.70, P < 0.001; urinary symptoms: adjusted r = -0.67, P < 0.001; quality of life impact: adjusted r = -0.64, P < 0.001). Men with complaints of PE reported worse NIH-CPSI scores than men without complaints of PE. Relationships between IELT and NIH-CPSI scores were strongest in men with APE.

AB203. Distribution and factors associated with four premature ejaculation syndromes in outpatients complaining of ejaculating prematurely

BackgroundBecause available definitions of premature ejaculation (PE) were unable to encompass the various forms of PE, Waldinger et al. proposed a new classification that distinguished four PE syndromes. However, few studies have examined the prevalence rates of these four PE syndromes.AimsThe study aims to analyze the prevalence of and factors associated with four PE syndromes in outpatients who complained of ejaculating prematurely.MethodsBetween December 2009 and December 2011, outpatients who complained of PE completed a detailed verbal questionnaire regarding their demographic data and medical and sexual history. Each patient was classified as having one of four PE subtypes: lifelong PE (LPE), acquired PE (APE), natural variable PE (NVPE), or premature-like ejaculatory dysfunction (PLED).Main Outcome Measures. Based on the new classification scheme, PE was classified into four subtypes. The anxiety/depression status of patients was assessed by the Zung self-rating anxiety/depression scales, and erectile function was assessed by the International Index of erectile function-5 instrument.ResultsThis study included 1,988 male outpatients who complained of PE, with mean ages and body mass index (BMI) scores of 35.52±10.38 years and 25.34±4.51 kg/m, respectively. Prevalence rates of PE syndromes were 35.66% for LPE, 28.07% for APE, 12.73% for NVPE, and 23.54% for PLED. Patients with APE had the highest mean ages and BMI scores, and they more frequently reported several comorbidities, including sexual desire disorder, hypertension, diabetes mellitus, chronic prostatitis, and erectile dysfunction. The PLED group had a lower mean frequency of sexual intercourse than other groups and higher rates of anxiety and depression.ConclusionsThe prevalence of LPE was higher than that of other PE subtypes in an outpatient setting. Several comorbidities were more common in patients with APE and PLED. In particular, a lower frequency of intercourse and higher frequencies of anxiety and depression were found in patients with PLED.

The Impact of Intravaginal Ejaculatory Latency Time and Erectile Function on Anxiety and Depression in the Four Types of Premature Ejaculation: A Large Cross-Sectional Study in a Chinese Population

A new classification of premature ejaculation (PE) has been proposed, including the categories of lifelong PE (LPE), acquired PE (APE), natural variable PE (NVPE), and premature-like ejaculatory dysfunction (PLED). The aim of this study was to evaluate the impact of intravaginal ejaculation latency time (IELT) and erectile function on anxiety and depression among patients with PE in general and according to the four types of PE. Between September 2011 and September 2012, we conducted a cross-sectional study in the Anhui province of China. We enrolled 4,000 men aged over 18 years, each of whom had been in a stable, monogamous, heterosexual relationship with the same partner for at least 6 months. Self-estimated IELT, the International Index of Erectile Function-5 (IIEF-5) and the Zung Self-Rating Anxiety and Depression Scales (SAS/SDS) were used to measure PE, erectile dysfunction (ED), anxiety, and depression, respectively, among the entire study population. Of the 3,016 men evaluated, 25.80% complained of PE. Distribution of the four types of PE among men with PE was as follows: LPE, 12.34%; APE, 18.77%; NVPE, 44.09%; PLED, 24.81%. Men with PE presented lower IIEF-5 scores and higher SAS and SDS scores vs. men without PE (P < 0.001 for all). Similar findings were observed in men with APE when compared with other PE syndromes. After adjustment for age in men with PE, IELT was negatively associated with SAS and SDS scores (SAS, adjusted r = -0.42, P < 0.001; SDS, adjusted r = -0.45, P < 0.001). IIEF-5 score was negatively associated with SAS and SDS scores (SAS, adjusted r = -0.54, P < 0.001; SDS, adjusted r = -0.50, P < 0.001). These negative relationships were strongest in men with PLED (IELT vs. SAS: adjusted r = -0.63, P < 0.001; IELT vs. SDS, adjusted r = -0.60, P < 0.001; IIEF-5 vs. SAS: adjusted r = -0.57, P < 0.001; IELT vs. SDS, adjusted r = -0.55, P < 0.001). APE patients reported higher rates of ED, anxiety, and depression than men with other types of PE. The negative relationships between IELT/IIEF-5 and SAS/SDS were strongest in men with PLED.

Validity of the Premature Ejaculation Diagnostic Tool in four subgroups of premature ejaculation syndrome: data from the Korean Internet Sexuality Survey – part 1

Background The premature ejaculation diagnostic tool (PEDT) is a brief, multidimensional validated instrument devised for diagnosing premature ejaculation (PE). However, there is insufficient evidence regarding its ability to differentiate subgroups of PE. We assessed the ability of the PEDT to differentiate four subgroups of PE (lifelong, acquired, variable and subjective PE). An internet-based survey was conducted with a population-based sample of males aged 20-59 years. Participants were asked to complete a questionnaire requesting detailed medical and sexual histories. The questionnaire including questions from the PEDT and from the Medical Outcome Study Short-form 36-Item Health Survey (SF-36). Using the PEDT, PE was defined as a cutoff score of ≥11. In this study, 443 subjects (mean age 39.3±10.1 years) were included. PEDT-PE prevalence was 14.6%. The proportions of PE subgroups and their mean PEDT scores were: lifelong PE, 2.9% and 15.5; acquired PE, 7.0% and 11.2; variable PE, 7.4% and 10.4; subjective PE, 3.2% and 9.0. PEDT scores were significantly higher in the lifelong PE group than in other the subgroups of PE (P<0.001). The subjective PE group had the lowest PEDT score, and their physical and mental component scores for the SF-36 were similar to those of non-PE subjects. This population-based cross-sectional survey has demonstrated that the PEDT is not appropriate for research into four subgroups of PE when used in an general male population study, unless the PEDT is combined with an additional questionnaire with specific questions on the four PE subgroups.

Prevalence and Factors Associated with the Complaint of Premature Ejaculation and the Four Premature Ejaculation Syndromes: A Large Observational Study in China

Although the new classification of premature ejaculation (PE) has been proposed by Waldinger et al., there have been few studies investigating the four PE syndromes in China. We investigated the prevalence and factors associated with the complaint of PE and the four PE syndromes in Anhui province, China. Between September 2011 and September 2012, subjects were selected from five cities in Anhui province, China. They participated in this survey by completing a detailed verbal questionnaire regarding their demographic data and medical and sexual history. Men with PE complaint were diagnosed as lifelong PE (LPE), acquired PE (APE), natural variable PE (NVPE), or premature-like ejaculatory dysfunction (PLED). PE complaint was divided into four PE syndromes. Anxiety, depression, and erectile dysfunction were independently assessed by the self-rating anxiety/depression scale and the international index of erectile function-5, respectively. Of the 3,016 men evaluated, 25.80% complained of PE. The distribution of the four PE syndromes in men with PE complaint was in the order of NVPE (44.09%), PLPE (24.81%), APE (18.77%), and LPE (12.34%). Patients with PE complaint were older and more likely to smoke, had more comorbidities, and a higher body mass index (BMI) than patients without the complaint (P < 0.001 for all). Similar findings were also observed in patients with APE compared with other PE patients (depression P = 0.012, cardiovascular P = 0.003, others P < 0.001). In addition, the rates of counseling by a doctor in men with LPE and APE were higher than those in men with NVPE and PLED (P < 0.001). The prevalence of PE complaint in male population of Anhui province, China, was 25.80%, with the highest PE syndromes being NVPE and PLPE. Patients with PE complaint or APE were older and more likely to smoke, had more comorbidities, and a higher BMI.

Distribution and Factors Associated with Four Premature Ejaculation Syndromes in Outpatients Complaining of Ejaculating Prematurely

IntroductionBecause available definitions of premature ejaculation (PE) were unable to encompass the various forms of PE, Waldinger et al. proposed a new classification that distinguished four PE syndromes. However, few studies have examined the prevalence rates of these four PE syndromes. AimsThe study aims to analyze the prevalence of and factors associated with four PE syndromes in outpatients who complained of ejaculating prematurely. MethodsBetween December 2009 and December 2011, outpatients who complained of PE completed a detailed verbal questionnaire regarding their demographic data and medical and sexual history. Each patient was classified as having one of four PE subtypes: lifelong PE (LPE), acquired PE (APE), natural variable PE (NVPE), or premature‐like ejaculatory dysfunction (PLED). Main Outcome MeasuresBased on the new classification scheme, PE was classified into four subtypes. The anxiety/depression status of patients was assessed by the Zung self‐rating anxiety/depression scales, and erectile function was assessed by the International Index of Erectile Function‐5 instrument. ResultsThis study included 1,988 male outpatients who complained of PE, with mean ages and body mass index (BMI) scores of 35.52 ± 10.38 years and 25.34 ± 4.51 kg/m2, respectively. Prevalence rates of PE syndromes were 35.66% for LPE, 28.07% for APE, 12.73% for NVPE, and 23.54% for PLED. Patients with APE had the highest mean ages and BMI scores, and they more frequently reported several comorbidities, including sexual desire disorder, hypertension, diabetes mellitus, chronic prostatitis, and erectile dysfunction. The PLED group had a lower mean frequency of sexual intercourse than other groups and higher rates of anxiety and depression. ConclusionThe prevalence of LPE was higher than that of other PE subtypes in an outpatient setting. Several comorbidities were more common in patients with APE and PLED. In particular, a lower frequency of intercourse and higher frequencies of anxiety and depression were found in patients with PLED.

Relationship between circumcision scar thickness, postcircumcision mucosal cuff length measures and premature ejaculation

Objective. The etiology of premature ejaculation (PE) is unknown. Over the past two decades several studies have suggested that lifelong and acquired PE may be caused by somatic disorders and/or neurobiological disturbances. One controversial factor is the effect of circumcision on ejaculation. This prospective study investigated the relationship between postcircumcision penile mucosal cuff length, circumcision scar thickness and the PE syndromes. Features of PE patients were compared with those of a normal healthy control (NHC) group. Material and methods. In total, 160 circumcised men were studied: 80 men with PE and 80 men in the NHC group. The following data and measurements were evaluated: age, type of PE syndrome, intravaginal ejaculation latency time (IELT), circumcision scar thickness and postcircumcision mucosal cuff length. Results. In terms of the mean IELT, a statistically significant difference was detected between the PE syndromes (p < 0.05), and between the PE patients and the control group (p < 0.05). Among the four PE syndromes, there was no significant difference related to the mean mucosal cuff length and mean circumcision scar thickness (p > 0.05). No significant difference was observed between the two groups for mean mucosal cuff length (p > 0.05) or mean circumcision scar thickness (p > 0.05). Conclusion. In this study, no relationship was observed between PE and postcircumcision penile mucosal cuff length and circumcision scar thickness. Further studies are required to evaluate the positive and negative effects of circumcision on PE syndromes.

Re: Prevalence of ejaculatory disorders in urban men-results of a random-sample survey

With great interest, we read the article by Vakalopouloset al. (2011), which evaluated the prevalence of ejacula-tory disorders in Greek urban men. After reflection, thereare several concerns that deserve further discussion andexplanation.First, the title is inaccurate. The authors use the term‘ejaculatory disorders’, but should consider using the term‘early ejaculation disorders’ (EED), as ejaculatory disorderis too broad in respect to this article. ‘Ejaculatory disor-ders’ encompasses not only EED, but also anejaculation,delayed ejaculation, retrograde ejaculation and painfulejaculation (Colpi et al., 2004). The authors state that thedefinition of the prevalence of lifelong PE according tothe International Society for Sexual Medicine has not yetbeen determined. However, in a recent peer-reviewedpublication, the prevalence of lifelong PE was noted to be2.3% (Serefoglu et al., 2011), which also matches thefindings of Waldinger (2008) who estimated the preva-lence at 2–5%. In the present study, the authors deter-mine the prevalence of lifelong PE to be 17.7%, which ismuch higher than expected and determined by otherrecent research. Further clarification is needed to explainthis discrepancy.In conclusion, we have a number of questions that theauthors should address to help the readers interpret thedata. What differentiates lifelong PE from the other PEsyndromes? Similarly, what were the criteria for definingEED? What were the ranges of intravaginal ejaculationlatency times (IELT) for EED and lifelong PE?A. Gokce, E. C. Serefoglu & W. J. G. HellstromTulane University School of Medicine – Urology,New Orleans, LA, USAE-mail: whellst@tulane.eduReferenceColpi G, Weidner W, Jungwirth A, Pomerol J, Papp G, Harg-reave T, Dohle G (2004) EAU guidelines on ejaculatory dys-function. Eur Urol 46:555–558.Serefoglu EC, Yaman O, Cayan S, Asci R, Orhan I, Usta MF,Ekmekcioglu O, Kendirci M, Semerci B, Kadioglu A (2011)Prevalence of the complaint of ejaculating prematurely andthe four premature ejaculation syndromes: results from theTurkish Society of Andrology Sexual Health Survey. J SexMed 8:540–548.Vakalopoulos I, Dimitriadis G, Varnava C, Herodotou Y,Gkotsos G, Radopoulos D (2011) Prevalence of ejaculatorydisorders in urban men: results of a random-sample survey.Andrologia 43:327–333.Waldinger MD (2008) Premature ejaculation: advantages of anew classification for understanding etiology and prevalencerates. Sexologies 17:30–35.

587 Validity of the premature ejaculation diagnostic tool (PEDT) in four subgroups of premature ejaculation syndrome: Data from the Korean Internet Sexuality Survey – Part I

587 Validity of the premature ejaculation diagnostic tool (PEDT) in four subgroups of premature ejaculation syndrome: Data from the Korean Internet Sexuality Survey – Part I

Premature ejaculation in patients with ankylosing spondylitis

We aimed to evaluate the premature ejaculation (PE) among ankylosing spondylitis (AS) patients. Fifty male patients with AS who were diagnosed according to the modified New York criteria and fifty normal healthy controls (NHC) were included in this study. The details of patient age, disease duration, morning stiffness, laboratory activity, disease severity and medication use were obtained by reviewing the medical record. The Bath AS Functional Index (BASFI) was used to measure the functional status of the patients with AS. By taking a careful medical and sexual history, patients were classified as lifelong, natural variable, acquired PE or premature ejaculatory dysfunction. In addition to medical and sexual history, self-estimated intravaginal ejaculatory latency times (IELT) of patients were used in the classification of patients. To our knowledge, this is the first study of frequency of PE in men with AS. The prevalence rates of PE in patient and healthy controls were 32 and 30%, respectively (p = 0.331). The prevalence of PE was not significantly different between AS patients and NHC groups as regards the four PE syndromes. Average estimated IELT was 10,009 ± 51.9 sec in the PE group and 145.26 ± 43.01 sec in the non-PE group (p = 0.000). Patients with lifelong PE had a significantly lower mean estimated IELT than the other group (p = 0.000). Patients with premature-like ejaculatory dysfunction had the highest estimated IELT (p = 0.000). There was a significant association between self-estimated IELT and distribution of the patients according to the four PE syndromes (p = 0.01). Both AS patients and NHC groups have the same results. The present study demonstrates that PE in men with AS is as prevalent as it is in the general population. Although this study is restricted in terms of the number of patients, it is the first study ever conducted. For more meaningful results, multi centred studies with more patients are required.