Stopwatch-measured Intravaginal Ejaculatory Latency Time Research Articles

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).

PD28-08 NUMBER OF INTRAVAGINAL THRUSTS BEFORE EJACULATION (NITBE): A CONVENIENT AND RELIABLE TOOL FOR PREMATURE EJACULATION ASSESSMENT

You have accessJournal of UrologySexual Function/Dysfunction: Evaluation I (PD28)1 Apr 2020PD28-08 NUMBER OF INTRAVAGINAL THRUSTS BEFORE EJACULATION (NITBE): A CONVENIENT AND RELIABLE TOOL FOR PREMATURE EJACULATION ASSESSMENT Dong Fang*, Yiming Yuan, Jing Peng, and Zhichao Zhang Dong Fang*Dong Fang* More articles by this author , Yiming YuanYiming Yuan More articles by this author , Jing PengJing Peng More articles by this author , and Zhichao ZhangZhichao Zhang More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000000892.08AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Intravaginal ejaculatory latency time (IELT) is important in the evaluation of premature ejaculation (PE). However, the stopwatch-measured IELT (SW-IELT) is inconvenient in clinics while the self-estimate IELT (E-IELT) is inaccurate. This study is to evaluate the number of intravaginal thrusts before ejaculation (NITBE) in the assessment of PE. METHODS: A prospective study which included PE patients (204 couples) and comparatives (106 couples) was performed from Sep 2015 to Mar 2016. SW-IELT, E-IELT and NITBE were collected and evaluated. RESULTS: Baseline characteristics were similar between two groups. The median SW-IELT was 47.6s vs 187.2s between PE patients and comparatives (p<0.001), and the median NITBE was 41.8 vs 152.4 (p<0.001). It’s interesting that the average time of one thrust was similar (1.1±0.2 s/time vs 1.2±0.2 s/time, p>0.05) between the two groups. As for E-IELT, although patients with PE also exhibited much worse results (94.4s vs 447.5s, p<0.001), there’s significant difference between E-IELT and SW-IELT (p<0.001) and NITBE was more correlated with SW-IELT with a person correlation of 0.989. By ROC curve, 75 times would be the best cut-off value with sensitivity of 81.1% and specificity of 88.2%. CONCLUSIONS: NITBE could be used as a convenient and reliable tool for PE assessment. Source of Funding: None © 2020 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 203Issue Supplement 4April 2020Page: e615-e615 Advertisement Copyright & Permissions© 2020 by American Urological Association Education and Research, Inc.MetricsAuthor Information Dong Fang* More articles by this author Yiming Yuan More articles by this author Jing Peng More articles by this author Zhichao Zhang More articles by this author Expand All Advertisement PDF downloadLoading ...

PS-08-005 Number of intravaginal thrusts before ejaculation (NITBE), a convenient and reliable tool for premature ejaculation assessment

Intravaginal ejaculatory latency time (IELT) is an important tool for the assessment of premature ejaculation (PE), not only in diagnosis, but also in clinical trials for PE. The IELT can be measured by stopwatch which it is not practical for patients to provide in clinical practice, or can be measured by self-estimate, which is different from stopwatch-measured IELT (SW-IELT). In the current analysis, we focused Number of Intravaginal thrusts before ejaculation (NITBE), which was mentioned two decades ago but not widely used, to assess the influence of those measures in identifying PE. Data were from half a year, single center, observational study of men with (204) and without (106) premature ejaculation (diagnosed using complains from human subjects combined with questionnaire of Chinese Index of Premature Ejaculation (CIPE)), as well as their female partners. Estimated IELT (E-IELT), SW-IELT and NITBE, age, and responses to multiple item of CIPE were evaluated with stepwise logistic regression analysis.

Use of a stopwatch to measure ejaculatory latency may not be accurate among Indian patients.

Introduction:Although the use of a stopwatch is recommended to record intravaginal ejaculatory latency time (IELT) for premature ejaculation, there is no Indian literature which assesses the reliability of this method among our patients. Hence, we assessed the accuracy of stopwatch-measured IELT and compared it with other methods such as number of thrusts and self-assessed IELT in an Indian context.Methods:Between January 2015 and December 2015, couples with premature ejaculation (PE) confirmed with the Premature Ejaculation Diagnostic Tool were enrolled in this study. They were asked to report self-assessed IELT for the first 2 weeks, number of thrusts before ejaculation following vaginal penetration for the next 2 weeks, and stopwatch-clocked IELT for the last 2 weeks. At each 2-week interval, the couples answered erectile/ejaculatory performance anxiety index questionnaire (EPAI). The data were analyzed at the end of 6 weeks.Results:A total of 42 couples with an average married life of 5.53 years were included in the study. Average stopwatch-clocked IELT was almost 1 min more than the self-reported IELT, which was statistically significant. The average number of thrusts reported was 6.31. Anxiety on the EPAI scale was maximum while using stopwatch to measure IELT.Conclusion:Use of stopwatch to clock the IELT does not appear to represent true IELT in Indian patients. Self-assessed IELT correlated more accurately with symptoms of PE.

Complementary and Alternative Medicine for Management of Premature Ejaculation: A Systematic Review.

IntroductionPremature ejaculation (PE) is defined as ejaculation within 1 minute (lifelong PE) or 3 minutes (acquired PE), inability to delay ejaculation, and negative personal consequences. Management includes behavioral and pharmacologic approaches.AimTo systematically review effectiveness, safety, and robustness of evidence for complementary and alternative medicine in managing PE.MethodsNine databases including Medline were searched through September 2015. Randomized controlled trials evaluating complementary and alternative medicine for PE were included.Main Outcome MeasuresStudies were included if they reported on intravaginal ejaculatory latency time (IELT) and/or another validated PE measurement. Adverse effects were summarized.ResultsTen randomized controlled trials were included. Two assessed acupuncture, five assessed Chinese herbal medicine, one assessed Ayurvedic herbal medicine, and two assessed topical “severance secret” cream. Risk of bias was unclear in all studies because of unclear allocation concealment or blinding, and only five studies reported stopwatch-measured IELT. Acupuncture slightly increased IELT over placebo in one study (mean difference [MD] = 0.55 minute, P = .001). In another study, Ayurvedic herbal medicine slightly increased IELT over placebo (MD = 0.80 minute, P = .001). Topical severance secret cream increased IELT over placebo in two studies (MD = 8.60 minutes, P < .001), although inclusion criteria were broad (IELT < 3 minutes). Three studies comparing Chinese herbal medicine with selective serotonin reuptake inhibitors (SSRIs) favored SSRIs (MD = 1.01 minutes, P = .02). However, combination treatment with Chinese medicine plus SSRIs improved IELT over SSRIs alone (two studies; MD = 1.92 minutes, P < .00001) and over Chinese medicine alone (two studies; MD = 2.52 minutes, P < .00001). Adverse effects were not consistently assessed but where reported were generally mild.ConclusionThere is preliminary evidence for the effectiveness of acupuncture, Chinese herbal medicine, Ayurvedic herbal medicine, and topical severance secret cream in improving IELT and other outcomes. However, results are based on clinically heterogeneous studies of unclear quality. There are sparse data on adverse effects or potential for drug interactions. Further well-conducted randomized controlled trials would be valuable.

Can Estimated Intravaginal Ejaculatory Latency Time Be Used Interchangeably With Stopwatch-measured Intravaginal Ejaculatory Latency Time for the Diagnosis of Lifelong Premature Ejaculation?

To examine the correlation between estimated intravaginal ejaculatory latency time (eIELT) and stopwatch-measured intravaginal ejaculatory latency time (sIELT), and to assess the clinical utility of eIELT in identifying men more likely to have lifelong premature ejaculation (PE). A prospective, observational, multicenter study was conducted. Between July 2010 and August 2011, 118 healthy men aged 30-70years, more likely to have lifelong PE, were recruited from 5 institutions in Korea. All patients underwent preliminary assessments including collection of medical and sexual history, physical examination, determination of eIELT, and the Premature Ejaculation Profile questionnaire. During the 1-week study period, patients were requested to engage in sexual intercourse at least twice and to record the sIELT. eIELT and sIELT correlated well (r= 0.512; P< .001). However, eIELT was overestimated by a mean of 1.2 ± 0.2minutes (median, 1.0minutes) compared with sIELT (P= .046). eIELT showed a reduced correlation with the Premature Ejaculation Profile measures, compared with sIELT (each P-value< .05). The diagnostic accuracy of eIELT was 67.9% (P= .001), and an eIELT of 2minutes was the acceptable cutoff value to diagnose lifelong PE. Although eIELT correlated well with sIELT, it was overestimated by approximately 1minute and had lower clinical utility than sIELT. Our study suggests that eIELT and sIELT cannot be directly interchanged and that caution should be used when substituting sIELT with eIELT to identify men who are more likely to have lifelong PE.

Dapoxetine: a new option in the medical management of premature ejaculation

Premature ejaculation (PE) is a common male sexual disorder which is associated with substantial personal and interpersonal negative psychological consequences. Pharmacotherapy of PE with off-label antidepressant selective serotonin reuptake inhibitors (SSRIs) is common, effective and safe. Development and regulatory approval of drugs specifically for the treatment of PE will reduce reliance on off-label treatments and serve to fill an unmet treatment need. The objective of this article is to review evidence supporting the efficacy and safety of dapoxetine in the treatment of PE. MEDLINE, Web of Science, PICA, EMBASE and the proceedings of major international and regional scientific meetings were searched for publications or abstracts published during the period 1993-2012 that used the word 'dapoxetine' in the title, abstract or keywords. This search was then manually cross referenced for all papers. This review encompasses studies of dapoxetine pharmacokinetics, animal studies, human phase I, II and III studies, independent postmarketing and pharmacovigilance efficacy and safety studies and drug-interaction studies. Dapoxetine is a potent SSRI which is administered on demand 1-3 h prior to planned sexual contact. It is rapidly absorbed and eliminated, resulting in minimal accumulation, and has dose-proportional pharmacokinetics which are unaffected by multiple dosing. Dapoxetine 30 mg and 60 mg has been evaluated in five industry-sponsored randomized, double-blind, placebo-controlled studies in 6081 men aged at least 18 years. Outcome measures included stopwatch-measured intravaginal ejaculatory latency time (IELT), Premature Ejaculation Profile (PEP) inventory items, Clinical Global Impression of Change (CGIC) in PE, and adverse events. Mean IELT, all PEP items and CGIC improved significantly with both doses of dapoxetine versus placebo (all p <0.001). The most common treatment-related adverse effects included nausea (11.0% for 30 mg, 22.2% for 60 mg), dizziness (5.9% for 30 mg, 10.9% for 60 mg), and headache (5.6% for 30 mg, 8.8% for 60 mg), and evaluation of validated rated scales demonstrated no SSRI class-related effects with dapoxetine use. Dapoxetine, as the first drug developed for PE, is an effective and safe treatment for PE and represents a major advance in sexual medicine.

Efficacy and Safety of Dapoxetine for the Treatment of Premature Ejaculation: Integrated Analysis of Results from Five Phase 3 Trials

Dapoxetine has been evaluated for the on-demand treatment of premature ejaculation (PE) in five phase 3 studies in various populations worldwide and has recently been approved in several countries. To present integrated efficacy and safety data from phase 3 trials of dapoxetine. Data were from five randomized, multicenter, double-blind, placebo-controlled studies conducted in over 25 countries. Men (N=6,081)≥18 years who met the Diagnostic and Statistical Manual of Mental Disorders, fourth edition, text revision criteria for PE; four studies required a baseline intravaginal ejaculatory latency time (IELT) of ≤2 minutes. Dapoxetine 30 and 60 mg on demand (prn; 1-3 hours before intercourse) were evaluated for either 12 or 24 weeks in four studies; one study evaluated dapoxetine 60 mg daily (qd; included in safety assessments only) or prn for 9 weeks. End points included stopwatch-measured IELT, Premature Ejaculation Profile (PEP) items, clinical global impression of change (CGIC) in PE, and adverse events (AEs). Average IELT (mean [standard deviation], geometric mean [standard error]) increased from baseline (across groups, 0.9 [0.49] minutes, 0.8 [1.01] minutes) to a significantly greater extent with dapoxetine 30 (3.1 [3.91] minutes, 2.0 [1.03] minutes) and 60 mg (3.6 [3.85] minutes, 2.3 [1.03] minutes) vs. placebo (1.9 [2.43] minutes, 1.3 [1.02] minutes; P<0.001 for all) at week 12 (geometric mean fold increase, 2.5, 3.0, and 1.6, respectively). All PEP items and CGIC improved significantly with both doses of dapoxetine vs. placebo (P<0.001 for all). The most common AEs included nausea, dizziness, and headache, and evaluation of validated instruments demonstrated no anxiety, akathisia, suicidality, or changes in mood with dapoxetine use and no discontinuation syndrome following abrupt withdrawal. In this diverse population, dapoxetine significantly improved all aspects of PE and was generally well tolerated.

Efficacy of Dapoxetine in the Treatment of Premature Ejaculation

IntroductionPremature ejaculation (PE) is a common male sexual disorder which is associated with substantial personal and interpersonal negative psychological factors. Pharmacotherapy of PE with off-label antidepressant SSRI drugs is common. Development and regulatory approval of drugs specifically for the treatment of PE will reduce reliance on off-label treatments and serve to fill a unmet treatment need.AimTo review evidence supporting the efficacy and safety of dapoxetine in the treatment of PE.MethodsMEDLINE and the proceedings of major international and regional scientific meetings during the period 1994–2010 were searched for publications or abstracts using the word dapoxetine in the title, abstract or keywords. This search was then manually cross-referenced for all papers. This review encompasses studies of dapoxetine pharmacokinetics, animal studies, human phase 1, 2 and 3 efficacy and safety studies and drug-interaction studies.ResultsDapoxetine is a potent selective serotonin re-uptake inhibitor, which is administered on-demand 1–3 hours prior to planned sexual contact. Dapoxetine is rapidly absorbed and eliminated, resulting in minimal accumulation and has dose-proportional pharmacokinetics, which are unaffected by multiple dosing. Dapoxetine 30 mg and 60 mg has been evaluated in 5 randomized, double-blind, placebo-controlled studies in 6081 men aged ≥18 years. Outcome measures included stopwatch-measured intravaginal ejaculatory latency time (IELT), Premature Ejaculation Profile (PEP) inventory items, clinical global impression of change (CGIC) in PE, and adverse events. Mean IELT, all PEP items and CGIC improved significantly with both doses of dapoxetine vs. placebo (P < 0.001 for all). The most common treatment related adverse effects included nausea (11.0% for 30 mg, 22.2% for 60 mg), dizziness (586% for 30 mg, 10.9% for 60 mg), and headache (5.6% for 30 mg, 8.8% for 60 mg), and evaluation of validated rated scales demonstrated no SSRI class-related effects with dapoxetine use.ConclusionDapoxetine, as the first drug developed for PE, is an effective and safe treatment for PE and represents a major advance in sexual medicine.

Dapoxetine for premature ejaculation

Importance of the field: Premature ejaculation (PE) is a common male sexual disorder which is associated with substantial personal and interpersonal negative psychological factors. Drug treatment of PE with an off-label antidepressant selective serotonin reuptake inhibitor (SSRI) drug is common. The lack of an approved drug and total reliance on off-label treatment represents a substantial unmet treatment need.Areas covered in this review: Medline and the proceedings of major international and regional scientific meetings during the period 1994 – 2010 were searched for publications or abstracts using the word ‘dapoxetine’ in the title, abstract or keywords. This search was then manually cross-referenced for all papers. This review encompasses studies of dapoxetine pharmacokinetics, animal studies, human phase I, II and III efficacy and safety studies and drug-interaction studies. Dapoxetine is a potent SSRI, which is administered on demand 1 – 3 h before planned sexual contact. Dapoxetine is rapidly absorbed and eliminated, resulting in minimal accumulation and has dose-proportional pharmacokinetics, which are unaffected by multiple dosing. Dapoxetine 30 and 60 mg has been evaluated in five randomized, double-blind, placebo-controlled studies in 6,081 men aged ≥ 18 years. Outcome measures included stopwatch-measured intravaginal ejaculatory latency time (IELT), Premature Ejaculation Profile (PEP) items, clinical global impression of change (CGIC) in PE, and adverse events. Mean IELT, all PEP items and CGIC improved significantly with both doses of dapoxetine versus placebo (p < 0.001 for all). The most common adverse events included nausea, dizziness and headache, and evaluation of validated rated scales demonstrated no SSRI class-related effects with dapoxetine use.What the reader will gain: Readers will gain insight into the epidemiology, pathophysiology and contemporary drug treatment of premature ejaculation.Take home message: Dapoxetine, as the first drug developed for PE, is an effective and safe treatment for PE and represents a major advance in sexual medicine.

Validity of the Patient-Reported Clinical Global Impression of Change as a Measure of Treatment Response in Men with Premature Ejaculation

The Clinical Global Impression of Change (CGIC) measures have high utility in clinical practice. However, it is unknown whether the CGIC is valued for assessing premature ejaculation (PE) symptoms and/or the relationship between CGIC and other validated PE patient-reported measures. The study aims to assess the validity of the patient-reported CGIC measure in men with PE and to examine the relationship between CGIC ratings and assessments of control, satisfaction, personal distress, and interpersonal difficulty. Data from a randomized, double-blind, 24-week phase 3 trial in 1,162 men with PE who received dapoxetine (30 mg or 60 mg) or placebo on demand provided the basis for the analysis. Patients were ≥18 years, in a stable monogamous relationship for ≥6 months, met the Diagnostic and Statistical Manual of Mental Disorders-Fourth Edition-Text Revision criteria for PE for ≥6 months, and had an intravaginal ejaculatory latency time (IELT) ≤2 minutes in ≥75% of intercourse episodes. The CGIC asked patients to rate improvement or worsening of their PE compared with the start of the study using a 7-point response scale; other patient-reported measures were control over ejaculation, satisfaction with sexual intercourse, interpersonal difficulty, and personal distress related to ejaculation. Stopwatch-measured IELT was recorded. Associations between CGIC and change in other measures at study end point were assessed. The magnitude of IELT increased for each category of improvement on the CGIC: 1.63, 4.03, and 7.15 minutes for slightly better, better, and much better, respectively. Higher CGIC ratings were correlated with greater improvement in control (r = 0.73), satisfaction (r = 0.62), greater reduction in distress (r = -0.52), and interpersonal difficulty (r = -0.39). Total variance accounted for was 57.4%: control (48.7%), satisfaction (4.5%), IELT (2.8%), and distress (1.15%). The analyses support the validity of the CGIC measure in men with PE. The CGIC can provide clinicians in practice with a valid and brief outcome assessment of their patient's condition.

Perceived control over ejaculation is central to treatment benefit in men with premature ejaculation: results from phase III trials with dapoxetine

To assess the utility of perceived control over ejaculation ('control') in the evaluation of treatment benefit in men with premature ejaculation (PE), and to compare effects associated with a two-category or greater increase in this variable between men receiving dapoxetine and placebo. This subanalysis used combined data from all treatment groups in an integrated analysis of two identically designed, 12-week, double-blind, randomized, placebo-controlled trials of dapoxetine. Men (2614) met the Diagnostic and Statistical Manual of Mental Disorders (fourth edition, text revision) criteria for PE, had a stopwatch-measured intravaginal ejaculatory latency time (IELT) of < or =2 min in > or =75% of events in a 2-week baseline period, and self-reported moderate or severe PE. Men received placebo or dapoxetine 30 or 60 mg, 1-3 h before intercourse. The stopwatch-measured IELT was recorded for each episode; the patient-reported global impression of change (PGI; 7-point scale, 'much worse' to 'much better'), control and satisfaction with sexual intercourse (5-point scales, 'very poor' to 'very good') were assessed monthly. The utility of a two-category or greater increase in control was evaluated by examining the relationship of this variable with IELT and satisfaction with sexual intercourse. Of 2341 men with baseline and endpoint assessments, 96.8% reported 'very poor' or 'poor' control at baseline, and 748 (32%) reported a two-category or greater increase in control after treatment. More than 95% of those men rated their PE as 'slightly better', 'better', or 'much better' on the PGI; 67.1% gave ratings of 'better' or 'much better.' They also had greater improvements in IELT than men with less than a two-category increase in control, with a mean (sd) change from baseline of 3.7 (4.3) vs 0.77 (1.8) min, respectively, and a greater percentage reported good or very good satisfaction with sexual intercourse than men with less than a two-category increase in control (74% vs 19%, respectively). Nausea, headache and upper respiratory tract infection were the most common adverse events reported by men with a two-category or greater increase in control (15.8%, 7.4% and 6.6%, respectively) and those without (8.5%, 5.5% and 6.5%, respectively). The proportions of men with a two-category or greater increase in control with dapoxetine 30 and 60 mg were 36.3% and 44.5%, respectively (vs 15% with placebo). A two-category or greater increase in control (5-point scale) is useful for assessing the treatment benefit in men with PE; it corresponds with improvements in the man's perception of his condition, substantially greater prolongation of IELT, and higher levels of satisfaction with sexual intercourse.

Premature Ejaculation: Results from a Five-Country European Observational Study

ObjectivesTo characterize premature ejaculation (PE) in five European countries using intravaginal ejaculatory latency time (IELT) and the Premature Ejaculation Profile (PEP). MethodsThis 8-wk, multicenter, observational study enrolled men ≥18 yr of age and their female partners. Clinicians diagnosed PE using the DSM-IV-TR criteria and at least moderate, subject-reported, ejaculation-related personal distress or interpersonal difficulty. The PEP was administered at baseline and weeks 4 and 8. Partners measured IELT; the average stopwatch-measured IELT for each 4-wk period was calculated and compared with the man's screening-estimated IELT. Relationships between individual PEP measures and IELT were assessed with path analysis. ResultsPE was diagnosed in 201 of 1115 men. Findings were similar to those in a similarly conducted US study. Mean IELT was lower in the PE versus the non-PE group (3.3 vs. 10.0min, respectively), but substantial overlap was observed. Men with PE and their partners reported significantly worse control over ejaculation, ejaculation-related personal distress, satisfaction with sexual intercourse, and ejaculation-related interpersonal difficulty than men without PE and their partners. Path analysis showed that perceived control over ejaculation had a significant effect on ejaculation-related personal distress and satisfaction with sexual intercourse; IELT had an effect on control over ejaculation, no direct effect on satisfaction with sexual intercourse, and a small direct effect on ejaculation-related personal distress. ConclusionsNo major cultural differences existed between EU and US men with and without PE and their female partners. These results emphasize the importance of the PEP measures, especially perceived control over ejaculation, in characterizing PE.

ORIGINAL RESEARCH—EJACULATORY DISORDERS: Interrelationships Among Measures of Premature Ejaculation: The Central Role of Perceived Control

ABSTRACT Introduction Domains of premature ejaculation (PE) include short intravaginal ejaculatory latency time (IELT), poor perceived control over ejaculation, decreased satisfaction with sexual intercourse, and personal distress and interpersonal difficulty related to ejaculation. How these measures interrelate is unknown. Aim Here, we evaluated the interrelationships between these PE-specific variables, applying cross-sectional data from a large U.S. observational study of men with PE. Methods We analyzed data from men with PE identified in a previously reported observational study. PE was diagnosed by experienced clinicians using the criteria specified in the Diagnostic and Statistical Manual of Mental Disorders, fourth edition, text revision. Main Outcome Measures Subjects reported their stopwatch-measured IELT, perceived control over ejaculation, satisfaction with sexual intercourse, personal distress related to ejaculation, and interpersonal difficulty related to ejaculation. Relationships between variables were assessed using bivariate correlations, and the strength and significance of direct or indirect effects between variables were evaluated using a form of regression analysis known as path analysis. Results Bivariate Pearson correlation coefficients for all relationships were significant at the P ≤ 0.05 level, with the exception of IELT and interpersonal difficulty related to ejaculation. When all variables were included in the model, IELT showed a significant direct effect on perceived control over ejaculation but did not show a significant direct effect on ejaculation-related personal distress or satisfaction with sexual intercourse. Perceived control over ejaculation showed a significant direct effect on both ejaculation-related personal distress and satisfaction with sexual intercourse, which each showed direct effects on interpersonal difficulty related to ejaculation. Conclusion The patient's perception of control over ejaculation is central to understanding how PE is associated with satisfaction with sexual intercourse and ejaculation-related distress. In contrast, the association of IELT with satisfaction with sexual intercourse and distress related to ejaculation is mediated by perceived control over ejaculation.