Premature Ejaculation Research Articles

Associations of vasectomy with sexual dysfunctions and the sex life of middle-aged men.

Vasectomy is a safe and effective form of contraception. However, fear of altered sexual function is still associated with vasectomy in many men. To assess the prevalence of vasectomy among middle-aged men in Germany and to investigate possible associations between a previous vasectomy and sexual dysfunctions. Data on lifestyle, sexual activity, satisfaction, and dysfunction from 5425 middle-aged, heterosexual men were collected. Differences between vasectomized (VM) and non-vasectomized men (NVM) were assessed. Multiple logistic regression analyses were calculated to determine variables associated with erectile dysfunction (ED), premature ejaculation (PE), and low libido. 5425 men with a mean age of 50.6±0.8 years were included in this analysis. Vasectomy was performed in 12.5% (679/5425) on average 8.6±5.8 years ago. 84.4% were sexually active in the last 3 months (93.0% in vasectomized men vs. 83.2% in non-vasectomized men; p<0.001), and 45.4% were satisfied with their sexual life (55.2% in vasectomized men vs. 44.0% in non-vasectomized men; p<0.001). The prevalence of erectile dysfunction was significantly lower in vasectomized men (12.1%vs. 20.1%; p<0.001), and a previous vasectomy was associated with a decreased risk for erectile dysfunction in multivariable regression analysis (OR: 0.65 [0.40-0.83]). The prevalence of low libido (4.7% in vasectomized men vs. 7.1% in non-vasectomized men; p=0.02) was marginally higher among non-vasectomized men. The prevalence of premature ejaculation (7.1% in vasectomized men vs. 6.1% in non-vasectomized men, p=0.5) did not differ significantly between vasectomized and non-vasectomized men. A previous vasectomy is not associated with an increased risk for sexual dysfunction, and vasectomized middle-aged men are more sexually active and satisfied compared to their non-vasectomized counterparts. The main limitations are the retrospective design and missing pre-vasectomy data. Men can be reassured that the fear of sexual dysfunctions and diminished sex life after a vasectomy is unwarranted.

Promising selective alpha-1 blocker silodosin as a new therapeutic strategy for premature ejaculation and its drug adverse effect: A systematic review and meta-analysis of randomized controlled trials

Introduction and Objectives: Premature ejaculation (PE) occurs in 31% of productive men aged 18-59 years, leading to disappointment and avoidance of sexual relations. The current guideline of treatment for PE is Dapoxetine, which possesses several adverse effects causing the limitation of long-term use. Silodosin, an alpha-1 blocker, has been proposed as a new option for treating PE due to its minimal side effects. Therefore, our study aims to assess the efficacy of silodosin in treating PE.Materials and Methods: This systematic review and meta-analysis was in accordance with Cochrane Handbook guidelines. Comprehensive literature search was conducted in several databases including PubMed, ScienceDirect, and Cochrane Central Register of Controlled Trials. The studies were included if they met the following criteria: (1) Involving premature ejaculation patients; (2) Intervention using silodosin; (3) Comparing placebo or other therapies for PE (4) Outcome includes the Intravaginal Ejaculation Latency Time (IELT) and reported adverse events related to the therapy. Study quality was assessed using Cochrane risk-of-bias criteria. Statistical analysis in this study was performed using Review Manager 5.4 Results: A total of four studies were included in this meta-analysis. Our study showed that patients who received silodosin had a significantly longer IELT compared to control (MD: 132.54, 95% CI 51.51-213.57, p&lt;0.001). However, patient treated with silodosin also possessed significantly higher risk of adverse event for developing reduced semen ejaculation (OR 10.79, 95% CI 3.46 – 33.67, p&lt;0.0001).Conclusion: Silodosin significantly increased IELT. However, it also reduced semen ejaculation as its drug adverse effect. This result supports the clinical use of silodosin as an alternative treatment for premature ejaculation.

Evaluation of the Efficacy and Safety of On-Demand Tadalafil Alone or Combined With Lidocaine Spray for Treating Patients With Comorbid Erectile Dysfunction and Premature Ejaculation: A Randomized Controlled Trial

Background To evaluate the efficacy and safety of on-demand 20 mg tadalafil alone or combined with lidocaine spray for treating patients with comorbid erectile dysfunction (ED) and premature ejaculation (PE). Methods This randomized controlled trial included 98 patients with comorbid ED and PE, randomly assigned to the experimental group (n = 50, tadalafil alone) or the active control group (n = 48, tadalafil combined with lidocaine spray). Patients took tadalafil 30 min before sexual intercourse, while the combination therapy group also used lidocaine spray 5 min before intercourse. After 12 weeks of treatment, changes in the International Index of Erectile Function (IIEF-5), Chinese Index of Premature Ejaculation (CIPE-5), Intravaginal Ejaculatory Latency Time (IELT), and Sexual Satisfaction Score (SSS) were evaluated. Results Both groups showed significant improvement in IIEF-5 scores, but the difference between groups was not significant (F = 0.89, p = 0.45). The active control group showed significant improvement in CIPE-5 scores (p < 0.001), while the experimental group showed no significant change (p > 0.05). IELT in the active control group increased significantly from 25.7 s to 198.6 s (Z = 6.03, p < 0.001), while the experimental group showed no significant change (Z = 0.74, p = 0.46). SSS improved significantly in the active control group (p < 0.001) but not in the experimental group (p > 0.05). The incidence of adverse events was similar in both groups (14% vs 20.8%, p = 0.575). Conclusion Tadalafil combined with lidocaine spray is superior to tadalafil alone in improving symptoms, prolonging IELT, and enhancing sexual satisfaction in patients with comorbid ED and PE, with comparable safety. This combination therapy provides a new approach for improving treatment strategies for patients with comorbid ED and PE. Large-scale, multi-center randomized controlled trials are needed to further validate these findings.

Comparison of economic burden of disease and quality of life in patients with premature ejaculation and erectile dysfunction

To compare the economic burden of disease and quality of life in patients with premature ejaculation (PE) and erectile dysfunction (ED). A convenience sampling method was used, and self-designed general information questionnaire, disease economic burden questionnaire, and SF-12 quality of life questionnaire were used to investigate 494 patients with ED and 285 patients with PE who attended a tertiary hospital in Taiyuan City from October 2021 to May 2023, and the relevant data were analysed using SPSS26.0 statistical software. The direct, indirect, intangible, and total economic burdens of the two groups were compared, and the differences were statistically significant (P < 0.05), and the direct, indirect, intangible, and total economic burdens of ED patients were higher than those of PE patients; the scores of the two groups in the dimensions of PF (physical function), RP (role physical), RE (role emotion), and MH (mental health) as well as in the MCS (mental component score), and overall quality of life scores, the differences were statistically significant (P < 0.05), with ED patients having lower quality of life scores than PE patients. Compared with PE patients, ED patients have a heavier economic burden of disease and lower quality of life, suggesting that the government and relevant departments of society should pay attention to the economic burden of disease and quality of life of ED patients and take appropriate measures to improve them.

Prevalence of Premature Ejaculation: A Narrative Review of National and Cultural Differences

The prevalence of premature ejaculation (PE) across different cultures and nationalities has long been a topic of debate, with early studies suggesting that men in such regions as the Middle East and Asia experience higher rates. However, the validity of these claims has been questioned due to methodological inconsistencies and the lack of comparative studies that apply uniform diagnostic criteria across different populations. This narrative review aims to analyze the existing literature to assess whether justifiable support for cultural or national differences regarding PE prevalance truly exists. The review focused on empirical studies spanning from 1995 to 2024 that included men from multiple nationalities or cultures. Studies on patient or specialized populations or that assessed only ejaculation latencies (EL) were excluded. Three categories of studies were reviewed: (1) studies including multiple nationalities within a single analysis, (2) studies from different countries that used an identical method to determine PE status, and (3) studies employing varied methodologies to determine PE status. The review found that differences in PE prevalence across cultures are more likely due to methodological variations than true cultural or national differences. While some trends, such as slightly higher rates in Latin American and Asian countries, were noted, no consistent patterns emerged. Studies using standardized methods, like the PEDT, generally showed prevalence rates between 5% and 15%, with no clear outliers across regions. Thus, current evidence does not support significant cultural or national differences in PE prevalence. Methodological inconsistencies, such as reliance on self-report and non-standardized diagnostic criteria, likely contribute to perceived differences. Future research should focus on using standardized methodologies and include more studies from underrepresented regions, such as Latin America and sub-Saharan Africa.

Cognitive behavioral therapy combined with selective serotonin reuptake inhibitors for premature ejaculation: A systematic review and meta-analysis.

Premature ejaculation (PE) remains one of the most common male disorders. Many clinical trials have shown that cognitive behavioral therapy (CBT) has significant efficacy in the treatment of PE. The purpose of this article is to review the current evidence regarding the efficacy and safety of CBT combined with selective serotonin reuptake inhibitors (SSRIs) for treating PE. We selected eligible randomized controlled trials (RCTs) from databases including Chinese National Knowledge Infrastructure (CNKI), Wanfang, VIP, China Biology Medicine (CBM), Pubmed, Embase, and Cochrane Library. All data in this paper were analyzed using STATA 17.1 software. Cochrane Evaluator's Manual 5.3 was used to assess the quality of the included literature. Data collection was conducted up until May 2024. Finally, 15 high-quality randomized controlled trials were included, with 1243 patients, 653 experimental groups and 590 control groups. The meta-analysis showed that, compared with SSRIs alone, behavioral therapy combined with SSRIs can significantly prolong the IELT of PE patients, and improve perceived control over ejaculation, Chinese Index of Premature ejaculation-5 (CIPE-5), sexual life satisfaction, and spouses' sexual life satisfaction. Furthermore, there were no significant differences in side effects between the two groups. In addition, the published bias test results showed no significant bias. CBT combined with SSRIs could be a viable alternative for the treatment of PE. Both cognitive and behavioral training or behavioral training alone as a supplement to SSRIs are effective, with no significant increase in adverse reactions.

A Linear and Stereoselective Approach for the Synthesis of Dapoxetine from Benzaldehyde

Abstract: In addition to providing a succinct pathway for the stereoselective synthesis of dapoxetine, a potent SSRI employed in the treatment of premature ejaculation, this study highlights the strategic use of Ellman's sulfinamide as a chiral auxiliary. The key method involves the diastereoselective allylation of (S,E)-N-Benzylidenesulfinamide, resulting in the desired S-configuration critical for the pharmacological activity of dapoxetine. The utilization of readily available benzaldehyde as the starting material and 1-naphthol as a late-stage coupling partner contributes to the economic feasibility of the synthesis. Especially, the linear synthetic approach adopted in this study employs simplified and more efficient protocols for various transformations, culminating in an overall yield of 26%. This research not only presents a practical synthetic route for dapoxetine, but also underscores the importance of cost-effective and streamlined methodologies in drug development processes.

Investigating the Factors Affecting Sexual Myths in Women and Men Based on the Biopsychosocial Model: A Scoping Review

Background: Sexual myths are mainly devoid of any substantial evidence and are passed on by word of mouth. Myths about sexuality may thus diminish the quality of sexual activities, cause sexual dysfunctions, including erectile dysfunction (impotence), vaginismus, difficulty reaching an orgasm, and premature ejaculation, and make individuals feel dread, anxiety, and failure or inadequacy, which can have adverse effects on their sexual identity. Objective: This study investigated the factors affecting sexual myths in women and men based on the biopsychosocial model. Methods: In this scoping review, the research databases of PubMed, Google Scholar, Magiran, PsycINFO, IranDoc, Ovid, ProQuest, Scientific Information Database (SID), and the Cochrane Library were systematically searched. For this purpose, a systematic search was conducted to retrieve the relevant articles from November 3 to 21, 2023, using the keywords of “sexual myth, sexual beliefs, wrong beliefs, dysfunctional sexual beliefs, sexuality, opinions, and associated factors.” The Newcastle-Ottawa Scale (NOS) further evaluated the quality of the included studies. The data were then extracted from all the articles that met the eligibility criteria based on the study objectives. Results: In total, 12 articles were reviewed, whose data were grouped into three general categories, viz., (i) biological factors (i.e., age and gender), (ii) psychological factors (that is, sexual dysfunction, political opinions, opinions on virginity), and (iii) social factors (namely, educational attainment, occupation, place of residence, marital status, type of marriage, age at marriage, premarital sexual experience, parents’ educational attainment, spouse’s educational attainment, number of children, parent’s employment status, spouse’s occupation, primary source of information about sex and feelings about sexual conversations, information about sexual life, academic department, sexual health assessment, and religious beliefs). Conclusion: Biopsychosocial factors could significantly affect sexual myths; therefore, considering their mediating role in providing sex education to women and men is crucial.

Tramadol-Induced Mania: A Case Report

This case report describes a rare occurrence of tramadol misuse resulting in a manic episode in a patient without a history of psychiatric disorders. The patient had used tramadol off-label for premature ejaculation. Following discontinuation of tramadol and initiation of mood stabilizer treatment, the manic symptoms resolved. Tramadol, despite its potential antidepressant properties, also poses a risk of inducing psychiatric disturbances. Diagnosis can be challenging and necessitates a thorough examination. Management involves immediate cessation of tramadol and administration of mood stabilizers. Clinicians should exercise caution and closely monitor patients when prescribing tramadol, particularly for off-label indications.

Abnormal percent amplitude of fluctuation in patients with lifelong premature ejaculation is associated with neurotransmitter profiles.

Identifying additional imaging biomarkers of lifelong premature ejaculation (LPE) may provide valuable insights into understanding the underlying neural mechanisms of this disorder. Forty-six LPE patients and thirty-five healthy controls (HCs) were enrolled in this study. The Percent Amplitude of Fluctuation (PerAF) method was used to assess differences in brain function in LPE patients compared to HCs during the resting-state. Receiver operating characteristic (ROC) analysis was used to investigate the potential biomarkers based on the imaging findings. Correlation analysis was then applied to examine the relationships between the neuroimaging findings and clinical symptoms. We also investigated whether PerAF alterations in LPE patients were associated with specific neurotransmitter systems. Compared to HCs, LPE patients showed increased PerAF in the middle cingulate cortex (MCC), supramarginal gyrus, Rolandic operculum, parahippocampus/hippocampus (ParaHIPP/HIPP) as well as insula; and decreased PerAF in the precuneus, inferior temporal cortex plus occipital cortex. The MCC and ParaHIPP/HIPP exhibited higher classification performance on ROC analysis. Positive correlations were found between the Premature Ejaculation Diagnostic Tool score and PerAF in the insula, and the International Index of Erectile Function score and PerAF in the precuneus. Additionally, altered PerAF in LPE patients correlated significantly with the spatial distribution of dopamine, acetylcholine and epinephrine pathways. Our findings indicate that LPE patients have PerAF-related changes in certain brain regions associated with visual, sensory and/or emotional processing, and reveal that the abnormal control of ejaculatory function may be related to the combined dysregulation of neurotransmitter systems in LPE patients.

Influence of personality disorders on sexual behaviours and response to treatment of psychogenic erectile dysfunction in phosphodiesterase 5 inhibitor non-responders.

Personality disorders may influence sexual behaviours and sexual dysfunction. Our main objective was to analyse the influence of personality disorders (PDs) in patients with erectile dysfunction (ED) of psychological origin that fail to respond to andrological treatment with Phosphodiesterase-5 inhibitors (IPDE5), assessing whether there are differences in sexual behaviours and response to psychosexual treatment. The research is designed as an ex post facto retrospective study with two groups. A control group of 23 men with ED without personality disorders and a group of 51 men with both ED and PDs. In the case sample, 34.30% of the participants presented more than one personality disorder. No significant differences were found in sexual behaviours except for heteromasturbation (men without PDs masturbated their partners more to satisfy them than men with PDs), and men with PDs considered themselves less premature ejaculators than the control group. Finally, 82.14% of the control group did well with psychosexual therapy compared to 53.85% of the PDs group. Psychosexual treatment of ED has a worse outcome if the men also have PDs. Strengths and Limitations: from a clinical standpoint, it is important to assess the presence of personality disorders in men with ED and to implement psychosexual strategies to improve the response to treatment in these cases. Confirmation of the results with a much larger sample becomes necessary.

Single-dose and steady-state pharmacokinetics of clomipramine, yohimbine and clomipramine/yohimbine combination: A clinical drug-drug interaction study.

Clomipramine (CLOMI) has shown effectiveness in treating premature ejaculation but is linked to erectile dysfunction and reduced libido. Yohimbine (YOH), by contrast, is effective in treating erectile dysfunction and may improve libido. Combining CLOMI and YOH could potentially leverage the benefits of both drugs. This study aimed to investigate the interactions between these drugs and to evaluate their safety profile. A prospective, open-labelled, single-centre, pharmacokinetic (PK) drug-drug interaction study was performed in 15 healthy male subjects. Single-dose and steady-state PK were investigated using noncompartmental analysis after mono- and combination therapy of the 2 orally applied drugs. Plasma sampling was performed at baseline, 0.5 (YOH), 1, 1.5 (YOH), 2, 3, 4, 5, 6, 8, 12 and 24 h (CLOMI). Differences in the area under the curve after multiple dosing (MD) were determined using an equivalence boundary of 80-125%. The geometric mean ratio of the area under the curve up to 12 h for MD CLOMI (combination vs. monotherapy) was 112% (90% confidence interval: 104-120%), whereas for MD YOH this ratio was 137% (90% confidence interval: 112-168%). The study drugs were safe and well tolerated as mono- and combination therapy, with no major adverse events reported. A PK assessment of clomipramine and yohimbine indicated a clinically significant drug-drug interaction for MD YOH in combination with CLOMI. This might be explained by competitive, CLOMI-related inhibition of YOH metabolism, probably mediated by cytochrome P450 2D6. However, according to European Medicines Agency guidelines, the effect can be classified as interaction absent (<1,25 fold) or minor (>1.25-<2-fold). Given the complimentary mechanisms of action and the favourable safety profiles, the findings pave the way for future efficacy studies.

Effectiveness of masturbation Premature ejaculation diagnostic tool in diagnosing premature ejaculation in men without vaginal intercourse over the past six months: an observational study

Background Premature ejaculation (PE) is a common concern for men and their partners, but current diagnostic tools mainly focus on men who have vaginal intercourse. The Masturbation Premature Ejaculation Diagnostic Tool (MPEDT) was created to address this gap, but its effectiveness for men who only engage in self-masturbation has not been studied. This research aimed to determine the frequency of self-reported PE patients who do not have vaginal intercourse and to evaluate the diagnostic accuracy of MPEDT for this group. Method The study involved 446 male patients aged 18 to 40, and 40 non-self-reported-PE and non-vaginal-intercourse healthy males. Participants completed the MPEDT questionnaire and reported their recent six-months sex frequency. Result Among the patients seeking treatment for PE, 21.75% had not engaged in vaginal intercourse in the past six months. Of the PE patients who completed the MPEDT questionnaire (86 patients), 90.7% were diagnosed with masturbatory-PE (MPE). The sensitivity for self-reported MPE and specificity for self-reported non-MPE were 93.02% and 72.5%, respectively. Discussion For patients who have not had vaginal intercourse in the past six months but engage in masturbation and seek treatment for PE, the PEDT may not effectively assess their ejaculatory function. The MPEDT, however, can effectively evaluate their ejaculatory function. This study also emphasizes the need for diagnostic tools tailored to this population.

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.

Menopause and Sexual Life Amongst Older Men: A Review Study

Objectives: To determine factors affecting the quality of men’s sexual life during menopause and identify the existing challenges. Design: A review study. Setting(s): Older people living in public institutions and living in their own homes. Participants: Older adults over 60 years of age. Outcome measures: All factors affecting the quality of sexual life of postmenopausal men in old age have been investigated in three physical, psycho-emotional, and social domains. Results: In the physical field, factors such as age, general health, disease, exercise, impotence, erectile dysfunction, genital warts, surgery of total hip arthroplasty, surgery of prostate, cancer radiotherapy, alopecia, and disorder in ejaculation, urinary disorders, and physical rehabilitation were known factors affecting the quality of men’s sexual life. The impacts of factors such as sleep problems, stressors, self-image, depression, alcohol addiction, premature ejaculation, emotional divorce, marital satisfaction, and fear of sexual activity were confirmed in the psycho-emotional field of studies. In the social field, factors such as education, duration of the marriage, marital status, income, life partners, number of sexual relations with spouse, the presence of multiple sexual partners, body mass of spouse (female), sex education and health literacy, sexual awareness, and quality of life related to health were recognized to be effective. Conclusions: Promoting sexual awareness through educational programs, providing opportunities for frequent sexual relationships, and addressing physical, psychological, emotional, cognitive, and social factors, and andropause could contribute to a more desirable sexual life quality in men during andropause.

The correlation between premature ejaculation and a high incidence of erectile dysfunction and its research progress: a narrative review.

Premature ejaculation (PE) and erectile dysfunction (ED) are two common sexual symptoms of male sexual dysfunction that can strongly affect men's mental health and quality of life, and they often coexist. This aim of this study was to explore the causes and relationships between PE and ED, with a focus on the progression of PE accompanied by high-frequency ED. A deeper understanding of the causes and treatments for PE combined with ED will help improve clinical diagnosis and treatment. We conducted a literature review of the most relevant articles related to the outlined topic in the PubMed, Google Scholar, and Web of Science databases. We did not limit language, covering both English and non-English publications, and include Chinese and English papers published between January 1996 and March 2024. The incidence of PE and ED increases with age. Approximately one-third of patients who complain of ED suffer from PE. Similarly, in a large-scale survey in the Asia-Pacific region, more than 30% of patients with PE reported concurrent ED. Various research findings indicate a strong correlation between PE and ED. Some scholars speculate that there is a vicious cycle between PE and ED. Men who attempt to control ejaculation can reduce the level of arousal, leading to ED, whereas men who try to achieve an erection will attempt to increase the level of arousal, which can lead to PE. This cycle of mutual influence may lead to reciprocal aggravation and persistence of sexual dysfunction in both parties. Although some studies have explored the relationship between PE and ED, the specific determinants and underlying factors have not yet been clarified. There is a close interrelationship between PE and ED, and a vicious cycle may exist between the two. This cycle of mutual influence may lead to the mutual aggravation and persistence of both sexual dysfunctions. However, the specific determining factors and potential factors underlying the correlation between the two have not been clearly identified and require further exploration.

A diagnostic study on the application of segmental somatosensory evoked potential examination to acquired premature ejaculation.

Premature ejaculation (PE), affecting approximate 5%, has an unclear pathogenesis, limited treatment efficacy, and a lack of effective diagnostic methods. This prospective diagnostic study aimed to compare segmental dorsal penile nerve somatosensory evoked potentials (DNSEP) differences among patients with acquired premature ejaculation (APE), primary premature ejaculation (PPE), and healthy controls. This prospective diagnostic study examined patients suffering from PE who visited the outpatient clinic of the Department of Urology of the Second Affiliated Hospital of Zhejiang University School of Medicine from January 1, 2022 to February 28, 2023. According to the definition of PE by the ISSM, 16 cases comprised the healthy control group, 31 in the APE group, and 28 in the PPE group. Each group was examined based on the segmental DNSEP with electrodes recording at multiple locations (the selected location was at the Cz and the C7). The latency time of the evoked potential obtained at Cz was P40, and that obtained at C7 was P30. The P30/P40 ratios of P40, P30, and DNSEP wave amplitudes at C7 and Cz were compared among the 3 groups of patients. No group differences were found in P40 latency at Cz. However, PPE showed higher DNSEP amplitude at Cz, while APE showed lower amplitudes compared with controls. Both APE and PPE had significantly shorter P30 latency at C7 than controls. SEP amplitude at C7 was similar in APE and PPE but lower than in controls. The P30/P40 ratio was lower in APE compared with PPE and controls. Segmental SEP may offer more assistance in localizing neurological lesions, potentially guiding clinical treatment. In this study, the innovative use of the P30/P40 ratio was proposed, maintaining consistency in emotional states and measurement conditions for the same patient. However, limitations include a restricted number of patient cases and challenges in obtaining a diverse control group, potentially introducing bias. In addition, not considering subclinical premature ejaculation and the comorbidity of PE + ED (LCEE) in patient stratification is another limitation of this study. Results suggest a correlation between secondary PE and underlying conditions, such as obesity and lumbar spine injuries. The study validates multi-site somatosensory-evoked potential examination for locating neural lesions but acknowledges the need for future invasive needle electrode AEP testing to analyze neuropathological changes more comprehensively. In conclusion, segmental DNSEP examination aids in localizing neuropathy in APE patients, and the P30/P40 ratio proves more accurate in diagnosing APE than P40 alone.

The surface-based degree centrality of patients with lifelong premature ejaculation: A resting-state fMRI study

The aim of this study was to investigate alterations in the resting-state brain functional network characteristics of lifelong premature ejaculation (PE) patients using surface-based degree centrality (DC), and to analyze the correlation between these alterations and clinical symptoms in PE patients. The study included individuals with lifelong PE (patient group, n = 36) and a control group matched by age and education level (control group, n = 22). Resting-state functional magnetic resonance imaging (fMRI) scans were performed on all participants. Surface-based degree centrality analysis was conducted and the differences between the two groups were compared using t-tests. Further, the DC values of brain regions showing significant differences were correlated with clinical symptoms. Compared to the control group, the patient group exhibited significantly reduced degree centrality (DC) values in the left precuneus and significantly increased DC values in the right supplementary motor area (SMA). Furthermore, intravaginal ejaculatory latency time (IELT) and Chinese Index of Premature Ejaculation (CIPE) values were positively correlated with left precuneus DC values and negatively correlated with right SMA DC values. Patients with primary lifelong ejaculation demonstrate abnormalities in key brain network nodes and their connections with relevant brain regions, which are strongly associate with clinical symptoms. These findings enhance our understanding of the neuronal pathological changes in PE patients.

197 - Multicentre study on premature ejaculation treatment with pelvic floor muscle rehabilitation: analysis of 5 years follow-up outcomes

197 - Multicentre study on premature ejaculation treatment with pelvic floor muscle rehabilitation: analysis of 5 years follow-up outcomes

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.