Risk Factor For Premature Ejaculation Research Articles

The association between shift work, shift work sleep disorders and premature ejaculation in male workers

ObjectiveShift work and Shift Work Sleep Disorder (SWSD) are known to affect the secretion of several neurotransmitters and hormones associated with premature ejaculation (PE). However, their specific influence on the regulation of male ejaculation remains unclear. This study explores the relationship between shift work, SWSD, and PE.MethodsFrom April to October 2023, a cross-sectional survey was conducted across five regions of China to explore the work schedules, sleep quality, and sexual function of male workers. Participants' sleep quality was evaluated using a validated SWSD questionnaire, and their erectile function and ejaculatory control were assessed with the International Inventory of Erectile Function (IIEF-5) scores and Premature Ejaculation Diagnostic Tool (PEDT) scores, respectively. Univariate and multivariate linear regression analyses were employed to identify risk factors associated with PE. Confounders were controlled using multiple regression models, and clinical prediction models were developed to predict PE onset and assess the contribution of risk factors.ResultsThe study included 1239 eligible participants, comprising 840 non-shift workers and 399 shift workers (148 with SWSD and 251 without SWSD). Compared to non-shift working males, those involved in shift work (β 1.58, 95% CI 0.75 – 2.42, p < 0.001) and those suffering from SWSD (β 2.86, 95% CI 1.86 – 3.85, p < 0.001) they had significantly higher PEDT scores. Additionally, we identified daily sleep of less than six hours, depression, anxiety, diabetes, hyperlipidemia, frequent alcohol consumption (more than twice a week), and erectile dysfunction as risk factors for PE. The predictive model for PE demonstrated commendable efficacy.ConclusionBoth shift work and SWSD significantly increase the risk of premature ejaculation, with the risk magnifying in tandem with the duration of shift work. This study reveals the potential impact of shift work and SWSD on PE and provides new theoretical foundations for the risk assessment and prevention of this condition.

Male sexual dysfunction in aged 40 - 60 years with diabetes

Objectives: The aims of this research are surveying the sexual dysfunction (MSD) including erectile disorder (ED) and premature ejaculation (PE) and exploring the relative factors in men with diabetes. Materials and Methods: This is a cross-sectional descriptive study of men 40 - 60 years old, diagnosed with diabetes according to the ADA standards 2020, examined at Hue Central Hospital from May 2022 to June 2023. Based on selection and exclusion criterias, we collect the administrative information, clinical and paraclinical examination and use the IIEF-5 and PEDT-5 scales to evaluate the MSD. Results: The research included 102 patients diagnosed with diabetes, of which ED and PE accounted for 70.6% and 14.7%, respectively. The duration of diabetes lasts and the poor ability to control the level of blood glucose directly effect ED (p &lt; 0.05). Diabetes accompanied by central obesity (waist circumference ³ 90cm) is closely related to ED and PE (p &lt; 0.05). In particular, BMI is a risk factor for PE (p = 0.049). Conclusions: Diabetes and related factors such as duration of disease, ability to control blood glucose level and accompanied by central obesity is significantly impact on MSD, mainly in erectile function. Key words: diabetes, male sexual dysfunction, aged 40 - 60 years, erectile disorder, premature ejaculation.

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.

Effects and safety of combined hypericum perforatum and quercetine in premature ejaculation: A pilot study

ABSTRACT Introduction Premature ejaculation (PE) is a common, and under treated medical condition that affects men and their partners. Advances in clinical research in premature ejaculation (PE) over the last years have led to the development of a variety of new treatment options, including dietary supplements. Hypericum perforatum (HP), a natural supplement has demonstrated pharmacologic action to inhibit serotonin reuptake and that inhibits rat and human vas deferens contractility. These results might explain delayed ejaculation described in patients receiving HP. Quercetin is a naturally occurring bioflavonoid found in high concentrations in red wine, onions, and green tea. Therapy with the bioflavonoid quercetin provides significant symptomatic improvement in most men with chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS). Subjects with PE often show symptoms and signs compatible with CP/CPPS, as confirmed by many different studies, CP/CP are an organic risk factor for PE. Objective The purpose of the present investigation was to assess the safety and preliminary evidence of the effectiveness of a supplement that combined HP and quercetin for the treatment of PE. Methods A one-group pretest-posttest design was used in the current research. Main outcome measures were assessed using the mean stopwatch-measured Intravaginal Ejaculatory Latency Time (IELT) at baseline and after 12 weeks. The collected data were tabulated and analyzed using the Statistical Package for the Social Sciences version 22 (SPSS). Quantitative data are expressed as means ± standard deviations (SDs). For the comparison of paired variables the Wilcoxon test was used. Premature Ejaculation Diagnostic Tool (PEDT) was used for the diagnosis and as a secondary measure. The study inclusion criteria to be selected were as follows: Being over 18 years old, being in a heterosexual relationship for at least the last 6 months, having a score ≥ 11 in the PEDT and a mean self-reported IELT ≤ 2 minutes. Exclusion criteria included a history of alcohol abuse or dependence, having received medication or psychological treatment for PE in the last 6 months, suffering from diabetes or habitual use of recreational drugs. A total of 12 subjects, aged between 27 and 58 years of age (mean = 40.50 years, standard deviation (SD) = 8.31) were treated with 1 daily tablet of 650 mg of Myhixel Max®. Each tablet contained Hypereric dry extract 433.64mg, Sophora japonica L. (95% quercetin 72.27mg), 68.65mg quercetin and anti-caking agents (magnesium stearate and silico dioxide). Results In the present study, there was a significant improvement in mean IELT (mean pre = 69.6 seg (SD) = 37.8 mean post = 146.4 seg (SD) = 67.2, Wilcoxon test pre vs post p-value = 0.008). Conclusions Oral therapy with HP and quercetin was associated with a significant increase in mean IELT from baseline, with no adverse effects related to the treatment. We can conclude that this supplement in daily use has the potential to become an effective and safe treatment for patients suffering from PE, long-term durability of the response is yet to be determined. Future studies with, larger group of patients; larger follow-up and group control are needed. Disclosure Work supported by industry: yes, by New Wellness Concept S.L. A consultant, employee (part time or full time) or shareholder is among the authors (New Wellness Concept. S.L).

Is heart rate variability a risk factor for premature ejaculation?

The purpose of this study is to assess the parameters of heart rate variability, which is an indicator of the change in autonomic nervous system (ANS) activity, in individuals with premature ejaculation (PE). This study was performed by comparing 40 patients with PE (mean age, 31.2±4.1years) and 40 healthy individuals (mean age, 30.4±4.8years) without PE from May 2018 to December 2019. HRV parameters were compared between men with PE and healthy controls in 24-hour heart rhythm Holter examination. In the time domain analysis, which is a subgroup of HRV, square root of differences between consecutive normal NN intervals (RMSSD), which is an indicator of parasympathetic activity, was lower in patients with PE compared with controls (P=.025). Moreover, within the frequency domain analysis, high frequency (HF), another indicator of parasympathetic activity, was lower in patients compared with controls (P=.032). Finally, the LF/HF ratio, reflecting sympathetic/parasympathetic activity ratio, was significantly higher in patients compared with controls (P=.008). Furthermore, the multivariate logistic regression analysis showed that LF/HF ratio is independently associated with PE (P=.005). The ROC curve analysis showed that the optimal cut-off value of LF/HF above 2.7 predicted PE at a sensitivity of 77.5% and specificity of 82.5% (positive predictive value: 81.5% and negative predictive value: 78.5%). Different HRV parameters were exhibited in the comparison of patients with PE and normal controls. It suggests that the change in HRV parameters will be an indicator of imbalance in ANS and this imbalance may cause PE. Therefore, HRV analysis can be a diagnostic tool to assess altered ANS activity in patients with PE and may be considered as a rapid screening tool.

Different levels of estradiol are correlated with sexual dysfunction in adult men

Ejaculatory dysfunction, including premature ejaculation (PE) and delayed ejaculation (DE), as well as erectile dysfunction (ED), constitute the majority of male sexual dysfunction. Despite a fair amount of data on the role of hormones and erection and ejaculation, it is inconclusive due to controversy in the current literature. To explore the correlation of male sexual dysfunction with hormonal profile, 1,076 men between the ages of 19–60 years (mean: 32.12 years) were included in this retrospective case–control study; 507 were categorized as ED, PE and DE groups. Five hundred and sixty-nine men without sexual dysfunction were enrolled in the control group. The background characteristics and clinical features of the four groups were collected and analyzed. The estradiol value was significantly elevated in the ED group than the control group (109.44 ± 47.14 pmol/L vs. 91.88 ± 27.68 pmol/L; P < 0.001). Conversely, the DE group had significantly lower level of estradiol than control did (70.76 ± 27.20 pmol/L vs. 91.88 ± 27.68 pmol/L; P < 0.001). The PE group had similar level of estradiol (91.73 ± 31.57 pmol/L vs. 91.88 ± 27.68 pmol/L; P = 0.960) but significantly higher level of testosterone (17.23 ± 5.72 nmol/L vs. 15.31 ± 4.31 nmol/L; P < 0.001) compared with the control group. In conclusion, elevated serum testosterone concentration was an independent risk factor for PE. Besides, there was a progressively increasing graded-distribution of estradiol values from DE to PE and ED groups.

The effect of post-circumcision mucosal cuff length on premature ejaculation.

We aimed to compare the length of mucosal cuff after circumcision in patients with and without a complaint of premature ejaculation (PE). Sexually active patients without erectile dysfunction that presented to the urology polyclinic between March 2018 and June 2018 were included in this multicentered, prospective study. The circumcision age of the patients, the person who performed the procedure (surgeon, non-surgeon), penile length, and dorsal and ventral penile measurements were recorded and compared between patients with and without PE. A total of 208 patients were included in the study. The mean circumcision age of the patients was 5.7±4.2 years, and the mean dorsal and ventral mucosal sizes were 15.02±4.58 mm and 16.31±4.92 mm, respectively. PE was present in 106 of the participants. There was no statistically significant difference between the PE and non-PE groups in terms of the person who performed the procedure (surgeon, non-surgeon). However, patients with PE had statistically significantly longer dorsal and ventral mucosal measurements compared to those without PE (p<0.001). Our study showed that the dorsal and ventral lengths of mucosal tissue left behind after circumcision are a risk factor for PE. Therefore, special attention should be paid not to leave redundant dorsal and ventral mucosal tissue during this procedure.

A Multicenter Case-control Study of Risk Factors for Premature Ejaculation in China's Shaanxi Province

A Multicenter Case-control Study of Risk Factors for Premature Ejaculation in China's Shaanxi Province

Metabolic Syndrome Is an Independent Risk Factor for Acquired Premature Ejaculation.

PurposeTo determine the role of metabolic syndrome (MetS) as a risk factor for acquired premature ejaculation (PE) after considering the various risk factors, such as lower urinary tract symptoms, erectile dysfunction, hypogonadism, and prostatitis.Materials and MethodsFrom January 2012 to January 2017, records of 1,029 men were analyzed. We performed multivariate analysis to identify risk factors for PE, including the covariate of age, marital status, International Prostate Symptom Score, International Index of Erectile Function (IIEF) score, National Institutes of Health-Chronic Prostatitis Symptom Index (NIH-CPSI) score, serum testosterone levels, and all components of MetS. Acquired PE was defined as self-reported intravaginal ejaculation latency time ≤3 minutes, and MetS was diagnosed using the modified National Cholesterol Education Program Adult Treatment Panel III criteria.ResultsOf 1,029 men, 74 subjects (7.2%) had acquired PE and 111 (10.8%) had MetS. Multivariate analysis showed that the IIEF overall satisfaction score (odds ratio [OR]=0.67, p<0.001), NIH-CPSI pain score (OR=1.07, p=0.035), NIH-CPSI voiding score (OR=1.17, p=0.032), and presence of MetS (OR=2.20, p=0.022) were significantly correlated with the prevalence of acquired PE. In addition, the Male Sexual Health Questionnaire for Ejaculatory Dysfunction scores and ejaculation anxiety scores progressively decreased as the number of components of MetS increased.ConclusionsMetS may be an independent predisposing factor for the development of acquired PE. Effective prevention and treatment of MetS could also be important for the prevention and treatment of acquired PE.

Serum vitamin D level may be a novel potential risk factor for premature ejaculation: a comparative study

To compare serum level of vitamin D [25(OH)D] in patients with life-long premature ejaculation (LPE) versus healthy controls. Healthy married potent males were recruited from February 2017 to January 2018. Group A included 40 patients suffering from LPE who were compared versus 40 healthy controls (Group B). Participants suffering from hormonal disorders, obesity, neurological, psychological, or chronic diseases or taking medications that may affect ejaculatory function, serum level of vitamin D, or the accuracy of intra-vaginal ejaculation latency time (IELT) were excluded. LPE was self-reported by the patients with subsequent feelings of frustration and measured by premature ejaculation diagnostic tool (PEDT) and IELT using stopwatch handled by their partners. 25(OH)D was measured by obtaining 2ml of venous blood. Statistical analysis was performed using Student t, Mann-Whitney, Chi square tests, logistic regression analysis, and Spearman correlation. Sixteen (20%) participants had vitamin D insufficiency/deficiency. All of them were in PE group. 25(OH)D correlated significantly with IELT (r2 = 0.349; p < 0.001) and PEDT (r2 = 0.425; p < 0.001). There was no statistically significant difference in age (p = 0.341), BMI (p = 1) or IIEF-5 (p = 0.408) in both groups. 25(OH)D was significantly lower in patients than controls (35.75 vs. 58.92ng/ml, p < 0.001). ROC analysis revealed that the best cut-off value of 25(OH)D to detect patients suffering from LPE was 50.65ng/ml with a sensitivity and specificity of 85% for both. 25(OH)D remained a significant risk factor for LPE in the logistic regression analysis (p < 0.001). The current study showed that vitamin D has significant association with LPE and correlates significantly with IELT and PEDT.

045 The Fertility quality of life and Sexual dysfunction in men seeking fertility treatment

To investigate the fertility quality of life (FertiQoL) and the prevalence of erectile dysfunction (ED) and premature ejaculation (PE) in infertile men. In a cross-sectional study, a total of 351 men seeking fertility treatment completed a questionnaire about sexual experiences and quality of life. ED was evaluated through the simplified International Index of Erectile Function (IIEF-5), ejaculation status was determined by the PE diagnostic tool (PEDT), and the quality of life was measured using the FertiQoL tool. Reliability analyses for the FertiQoL tool demonstrate a sufficiently strong fit (Cronbach’s alpha=0.891). Social and relational domains of FertiQoL were lower in infertile men compared with that reported in other countries. ED and PE were found in 125 (35.6%) and 90 (25.6%) subjects respectively. The emotional, mind/body, relational and social domain scores of FertiQoL were positively associated with the IIEF-5 score whereas the scores were negatively associated with the PEDT score. In a logistic multivariate model, emotional, relational and social domains were significantly associated with ED, while only the emotional domain was related to PE. Furthermore, our data suggested that overweight, extended family, smoking, male factor infertility and primary infertility are risk factors for ED and PE, while the duration of infertility only affect erectile function. However, the education level, family income and the treatment of infertility had no significant effect on sexual experience.

714 Increased prevalence of premature ejaculation on a 10-year interval web-based survey

We performed a 10-year interval survey of prevalence and risk factors of premature ejaculation (PE) in Korean adult men. We sent e-mails to the panels registered in the internet survey agency, and asked to participate a questionnaires survey of the same design and same company as that in 2006. The total number of 900 participants were enrolled. The character and prevalence of PE were evaluated using questionnaires. PE was defined based on DSM-IV-TR and ISSM, respectively. The prevalence of self-PE after age-adjustment in the 2016 study was similar compared to that in the 2006 study (19.0 vs. 21.6%, p=0.273). The age-adjusted prevalence of DSM-IV-TR-PE (7.0 vs. 24.7, p<0.001) and ISSM-PE (1.8 vs. 4.0%, p=0.029) were significantly higher in 20016 compare to those in 2006, respectively. On multivariable analysis, masturbation (OR: 2.498, p<0.001) and self-reported erectile dysfunction (OR: 4.476, p<0.001) were risk factors for self PE although frequent conversation about sex with partner (OR: 0.597, p=0.017), unmarried state (OR: 0.484, p=0.005), Income ≥ $3521 (OR: 0.682, p=0.045), and constipation (OR: 0.484, p=0.026) decreased the probability of self-PE. On multivariable analysis, age (OR: 1.028, p=0.006), high BMI (OR: 1.075, p=0.005), unmarried state (OR: 1.648, p=0.037), and experience of rape or sexual harassment (OR: 1.496, p=0.047) were determined as the risk factors for DSM-IV-TR PE. On multivariable analysis, the history of sexual transmitted disease (OR: 17.97, p=0.035) was the only risk factor for ISSM-PE.

183 Metabolic Syndrome is an Independent Risk Factor for Acquired Premature Ejaculation

We investigated the role of metabolic syndrome (MetS) as an independent risk factor for premature ejaculation (PE), after considering various risk factors of PE. From 2010 Jan to 2016 Aug, records of 1,029 men were analyzed. We performed logistic regression analysis to identify independent risk factors for PE, including covariate of age, marital status, International Prostate Symptom Score (IPSS), International Index of Erectile Function (IIEF) score, National Institutes of Health-Chronic Prostatitis Symptom Index (NIH-CPSI) score, Androgen Deficiency in the Aging Male (ADAM) score, serum testosterone levels, and all components of MetS. Acquired PE was defined as self-reported intravaginal ejaculation latency time (IELT) ≤ 3 minute, and MetS was diagnosed by using the modified National Cholesterol Education Program Adult Treatment Panel III (NCEP ATP III) criteria. Of 1,029 men, 74 (7.2%) had PE (IELT ≤ 3 min) and 111 (10.8%) had MetS. Multivariate analysis showed that IIEF overall satisfaction score (OR 0.67, P < 0.001), NIH-CPSI pain score (OR 1.07, P = 0.045), NIH-CPSI voiding score (OR 1.18, P = 0.029), and presence of MetS (OR 2.24, P = 0.019) were significantly correlated with prevalence of PE. And also the Male Sexual Health Questionnaire for Ejaculatory Dysfunction (MSHQ-EjD) scores and ejaculation anxiety scores progressively decreased as the number of components of MetS increased.

S&T-09 THE FERTILITY QUALITY OF LIFE AND SEXUAL DYSFUNCTION IN MEN SEEKING FERTILITY TREATMENT

You have accessJournal of UrologyScience & Technology Posters1 Apr 2016S&T-09 THE FERTILITY QUALITY OF LIFE AND SEXUAL DYSFUNCTION IN MEN SEEKING FERTILITY TREATMENT Zhe Zhang, Hui Jiang, Yuzhuo Yang, Hongliang Zhang, Haocheng Lin, Lianming Zhao, Wenhao Tang, Defeng Liu, Jiaming Mao, and Kai Hong Zhe ZhangZhe Zhang More articles by this author , Hui JiangHui Jiang More articles by this author , Yuzhuo YangYuzhuo Yang More articles by this author , Hongliang ZhangHongliang Zhang More articles by this author , Haocheng LinHaocheng Lin More articles by this author , Lianming ZhaoLianming Zhao More articles by this author , Wenhao TangWenhao Tang More articles by this author , Defeng LiuDefeng Liu More articles by this author , Jiaming MaoJiaming Mao More articles by this author , and Kai HongKai Hong More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2016.02.2838AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Infertility has been reported to have a negative effects on sexual function, especially in men. With the rapid increase in the number of men seeking fertility treatment, there is urgent to better understand the interrelationship between the fertility quality of life and sexual function. The aim of this study was to investigate the fertility quality of life (FertiQoL) and the prevalence of erectile dysfunction (ED) and premature ejaculation (PE) in infertile men. METHODS In a cross-sectional study, a total of 351 men seeking fertility treatment completed a questionnaire about sexual experiences and quality of life. ED was evaluated through the International Index of Erectile Function-15 (IIEF-5), ejaculation status was determined by the PE diagnostic tool (PEDT), and the quality of life was measured using the FertiQoL tool. RESULTS Reliability analyses for the FertiQoL tool demonstrate sufficiently strong fit (Cronbach’s alpha=0.891). Social and relational domains of FertiQoL were lower in infertile men compared that reported in other countries. ED was found in 125 (35.6%) and PE in 90 (25.6%) subjects. The emotional, mind/body, relational and social domain scores of FertiQoL were positively associated with IIEF-5 score whereas scores were negatively associated with PEDT score. In a logistic multivariate model, emotion, relational and social domains were significantly associated with ED, while only emotion domain was related to PE. Furthermore, our data suggested that overweight, family type (extended family), smoking, infertility reason (male factor infertility) and infertility type (primary infertility) are risk factors for ED and PE, and duration of infertility also affect erectile function. The education level, family income and the treatment of infertility had no significant effect on sexual experience. CONCLUSIONS ED and PE are prevalent among infertile men, who also have poor FertiQoL related to social and relationships, and the emotional, mind/body, relational and social domains of FertiQoL may be associated with sexual dysfunction in infertile men. The quality of life markedly affects sexual function during fertility treatment and should be taken into adequate account and addressed as an important element of infertility health care. © 2016FiguresReferencesRelatedDetails Volume 195Issue 4SApril 2016Page: e311 Advertisement Copyright & Permissions© 2016MetricsAuthor Information Zhe Zhang More articles by this author Hui Jiang More articles by this author Yuzhuo Yang More articles by this author Hongliang Zhang More articles by this author Haocheng Lin More articles by this author Lianming Zhao More articles by this author Wenhao Tang More articles by this author Defeng Liu More articles by this author Jiaming Mao More articles by this author Kai Hong More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...

The Global Online Sexuality Survey (GOSS): The United States of America in 2011 Chapter III—Premature Ejaculation Among English-Speaking Male Internet Users

The Global Online Sexuality Survey (GOSS) is a worldwide epidemiologic study of sexuality and sexual disorders. In 2010, the first report of GOSS came from the Middle East. This report studies the prevalence rate of premature ejaculation (PE) in the U.S. as of 2011-2012 and evaluates risk factors for PE. GOSS was randomly deployed to English-speaking male web surfers in the USA via paid advertising on Facebook®, comprising 146 questions. Prevalence of PE as per the International Society of Sexual Medicine's (ISSM) definition. With a mean age of 52.38 years ± 14.5, 1,133 participants reported on sexual function. As per the ISSM definition of PE, the prevalence rate of PE in the USA as of 2011 was 6.3%. This is in contrast to 49.6% as per the Premature Ejaculation Diagnostic Tool (PEDT), 77.6% as per unfiltered subjective reports, and 14.4% as per subjective reporting on more consistent basis. 56.3% of the latter reported lifelong PE. 63.2% could be classified as having natural variable PE. Erectile dysfunction is a possible predisposing factor for acquired PE, while genital size concerns may predispose to lifelong PE. Age, irregular coitus, circumcision, and the practice of masturbation did not pose a risk for PE, among other risk factors. Oral treatment for PE was more frequently used and reported to be more effective than local anesthetics, particularly in those with lifelong PE. Applying the ISSM definition, prevalence of PE is far less than diagnosed by other methods, 6.3% among Internet users in USA as of the year 2011. PEDT measures both lifelong and acquired PE, in addition to 35% men with premature-like ejaculatory dysfunction, making it inaccurate for isolating lifelong and acquired PE cases.

Urological risk factors for premature ejaculation

Premature ejaculation (PE) is considered the most common form of male sexual dysfunction, and the prevalence of PE complaints range from 20% to 40% among sexually active men. Acquired PE, which occurs due to an underlying organic and/or psychological cause, may be a treatable condition. Recent evidence has suggested that certain medical conditions such as hyperthyroidism may cause PE. In addition to hyperthyroidism, the literature has also revealed several urologic risk factors that may predispose a man to acquired PE; these include erectile dysfunction, prostatic diseases and chronic pelvic pain syndrome, varicocele, monosymptomatic enuresis and circumcision. This review aims to provide a systematic analysis of the literature regarding these urological risk factors of acquired PE.

The Relationship Between Premature Ejaculation and Hyperthyroidism

We determine the prevalence of premature ejaculation in patients with hyperthyroidism and observed intravaginal ejaculation latency time alterations before and after hyperthyroidism treatment. Between January 2004 and June 2007, 49 patients with hyperthyroidism and no history of hyperthyroidism treatment were enrolled in the study. After obtaining a detailed sexual anamnesis an erectile function questionnaire was completed and a patient self-reported outcome measure of difficult control over ejaculation was examined. We assessed stopwatch measurements of intravaginal ejaculation latency time performed by the patient or partner. Patient anxiety status was also evaluated. Changes in the mentioned measurements induced by hyperthyroidism treatment were examined 8 weeks after the achievement of euthyroidism. In the 43 eligible patients mean +/- SD age was 48.0 +/- 8.8 years. Premature ejaculation was observed in 31 of the 43 patients (72.1%). Mean intravaginal ejaculation latency time in patients with hyperthyroidism was 72.8 +/- 83.3 seconds. Of the 43 patients 30 (69.8%) were considered to have definite premature ejaculation according to stopwatch measurements. In patients with hyperthyroidism who had definite premature ejaculation anxiety scores were determined to be higher. A positive correlation was noted between serum thyroid stimulating hormone and intravaginal ejaculation latency time in the patients. In 24 patients who completed the followup visits we noted statistically significant improvement in intravaginal ejaculation latency time after the achievement of euthyroidism. Excess thyroid hormone and premature ejaculation are clinically interrelated conditions. Hyperthyroidism should be considered a novel and reversible etiological risk factor for premature ejaculation.

Role of Postcircumcision Mucosal Cuff Length in Lifelong Premature Ejaculation: A Pilot Study

Premature ejaculation (PE) is the most prevalent sexual dysfunction among men. Several theories about its etiology have been made. One of the conflicting factors is the effect of circumcision on ejaculation, and there are some concerns about leaving so much mucosa during circumcision. In our study the relationship between mucosal cuff length and PE was investigated. Eighty-four circumcised men were studied, including 42 men with PE and 42 men without. The following data and measurements were investigated: age, education, smoking, intravaginal ejaculation latency time (IELT), circumcision timing, stretched penile, penile skin, and mucosal cuff lengths. Penile, mucosal cuff, and penile skin lengths, the IELT. The mean penile, mucosal cuff, and penile skin lengths were 121.1 +/- 12.8, 15.4 +/- 4.8, and 80.8 +/- 21.0 mm in PE men, respectively, and were 130.1 +/- 10.4, 14.7 +/- 3.4, and 88.7 +/- 12.2 mm in the control group, respectively. No statistically significant differences were seen regarding the length of the penis (P = 0.80), mucosal cuff (P = 0.84), and penile skin (P = 0.99). The two groups were not different regarding education (P = 0.90), smoking (P = 0.70), and circumcision timing (P = 0.65). Postcircumcision mucosal cuff length is not a risk factor for PE.

Dysregulation of Emotions and Premature Ejaculation (PE): Alexithymia in 100 Outpatients

There is still a lack of agreement on etiology, definition, and mechanisms that underlie premature ejaculation (PE) as well as on the different role and interaction between psychological and biological factors. Alexithymia is a deficit in identifying and communicating emotions that is presumed to play an important role in psychosomatic diseases. The influences of alexithymic features on sexuality are still understudied. Following a previous report on the relationship between alexithymia and erectile dysfunction, the objective of this study was the investigation of alexithymic features in patients with lifelong PE compared with controls, and the relationship between alexithymia level and PE severity. We assessed 100 consecutive outpatients with lifelong PE (age range 20-60). A control group of 100 male volunteers was recruited for the control group. The two groups were comparable in age, marital status, and socioeconomic characteristics. The Toronto Alexithymia Scale (TAS-20) was employed for the assessment of alexithymia. The premature ejaculation severity index was used as self-report measure of PE severity on a multidimensional perspective. Our data show significantly higher scores of alexithymia in patients with PE than in the control group (P < 0.001), and a positive correlation between alexithymia level and PE severity (P < 0.002). With regard to TAS-20 subfactors, an externally oriented cognitive style shows the highest correlation with PE severity (P < 0.001) and the most significant difference in the comparison between PE and control group (P < 0.001). These findings suggest that alexithymic features, and in particular, an externally oriented cognitive style, can be seen as possible risk and/or maintenance factors for PE, and may contribute to a more serious manifestation of this condition. Alexithymia could represent an important variable for an integrated diagnosis and treatment of PE in a modern somatopsychic and holistic viewpoint.

Premature ejaculation: definition and prevalence

Premature ejaculation (PE) is likely the most common sexual dysfunction in men, with a worldwide prevalence of approximately 30%. To date, the lack of a universally acknowledged definition of PE has complicated the examination and analysis of PE in clinical and research-related settings. The impact of PE on men and their partners also needs to be clearly defined. Clearly, a better understanding of the epidemiology of this disorder, especially with regard to prevalence and risk factors, is necessary. The prevalence of PE appears to vary across socio-cultural and geographic populations. The elucidation of the etiology of PE and risk factors associated with PE has been difficult. However, several risk factors for PE exist that have strong support in the literature. Clearly, an improved and universal definition and understanding of PE and its epidemiology will improve the clinical management of PE and the success of future epidemiologic studies and clinical trials.