RESUMO
Background: There are only a few studies about the prevalence and correlates of premature ejaculation (PE) among men who have sex with men (MSM). Aim: (1) To estimate PE prevalence according to 3 assessment methods: self-reported time from penetration to ejaculation (ejaculation latency time [ELT]); Premature Ejaculation Diagnostic Tool (PEDT); and a direct question about the self-perception of ejaculation as being normal, too early (premature), or retarded. (2) To assess the agreement of the 3 assessment methods and identify factors associated with PE according to each method and their combination. Methods: We evaluated data from 226 MSM who participated in a cross-sectional study about sexual behavior among men living in the metropolitan region of São Paulo, Brazil. They responded anonymously to an online survey between May 2019 and March 2020. We calculated the agreement of the 3 assessment methods and their association with other characteristics using logistic regression models. Outcomes: Outcomes included the prevalence of PE according to the assessment methods and the association measures (PE vs sociodemographic characteristics and sexual behavior). Results: The prevalence of PE among MSM was 21.2% (95% CI, 16.1%-27.1%) according to the PEDT, 17.3% (95% CI, 12.6%-22.8%) per self-report, and 6.2% (95% CI, 3.4%-10.2%) by estimated ELT ≤2 minutes. The agreement among the 3 assessments was fair (kappa, 0.31; 95% CI, 0.25-0.37; P < .001). Association with PE varied by assessment method: obesity and shorter time for ejaculation with anal sex vs masturbation were associated with PE according to the PEDT and ELT but not self-evaluation. Perception about ideal time to ejaculate ≤5 minutes increased the chance of PE based on ELT. Higher chances of self-reported PE were associated with trying to hold back ejaculation, and lower chances were associated with higher frequencies of masturbation. Clinical Implications: Combining tools to investigate PE allows the identification of characteristics associated with this condition and may result in improvement in the care of MSM. Strengths and Limitations: This anonymous online survey provided the privacy necessary for participants to respond freely about sensitive questions, with a low risk of social adequacy bias. However, as it was a secondary analysis of a larger study, it could not evaluate comorbidities (eg, erectile dysfunction, prostatitis, depression) and the use of condoms. Conclusion: The prevalence of PE among MSM is high and varies according to the instrument used for the assessment, and the agreement among the 3 assessments was only fair.
RESUMO
Com o advento da estimulação cardíaca artificial, surgiu a preocupação em expor seus princípios de maneira simples e prática. Em 1974, a Inter-Society Commission for Heart Disease Resources [ICHD] tomou essa iniciativa, ao desenvolver um código de três letras baseado no conceito sugerido por Nicholas P. D. Smyth, quatro anos antes. Ao longo dos anos, novos equipamentos cardio-estimuladores entraram no mercado, criando a necessidade de novas designações para as funções e os modos de operação, cada vez mais complexos. Em 1981, a revista PACE publicou a revisão do código ICHD, que passou a apresentar cinco letras. Outras nomenclaturas foram propostas pelo comitê composto por NASPE e BPEG, na tentativa de abranger dispositivos antibradicardia e antitaquicardia, por meio dos códigos NBG e NBD. Contradizendo todas as versões subsequentes ao código proposto por Nicholas Smyth, que objetivavam incluir o que de mais novo havia no assunto, foi proposta nova revisão do código NBG em 2002, que se mostra bastante simplificada e prática. Conclusão: A partir deste estudo, percebe-se que, independente das decisões dos fabricantes e do surgimento de novas tecnologias, o código de nomenclatura visa facilitar o entendimento das especificações dos dispositivos cardioestimuladores.
