Premature ejaculation among men with erectile dysfunction-findings from a real-life cross-sectional study.

Concomitant sexual disorders have progressively shown increased prevalence in men at first outpatient presentation. We sought to i) estimate the prevalence of unreported premature ejaculation (PE) in a homogenous cohort of 1258 men seeking first medical help for erectile dysfunction (ED) as their primary compliant; ii) compare the baseline sociodemographic and clinical characteristics of men with only ED(ED-only) compared to those with ED and PE(ED + PE); and, iii) investigate the likelihood of detecting PE among men self-reporting only ED over a 16-year period at a single tertiary-referral centre. Descriptive statistics compared sociodemographic and clinical characteristics between ED-only patients and those with unreported concomitant primary/secondary PE(ED + PE). Logistic regression models predicted the risk of having ED + PE at baseline. Local polynomial regression models graphically explored the probability of reporting PE among ED men with ≤40 vs. 41-60 vs. >60 years over the analysed timeframe. Of all, 932 (74.1%) were ED-only and 326 (25.9%) ED + PE patients, respectively. ED + PE patients were younger, presented with fewer comorbidities, and lower rates of severe ED (all p ≤ 0.04). At multivariable logistic regression analysis, younger age (OR:0.98) and low sexual desire/interest (OR:1.54) were independently associated with ED + PE at first clinical assessment (all p = 0.03). The likelihood of detecting unreported concomitant primary/secondary PE among patients complaining of only ED at first presentation worrisomely increased among younger and middle-aged men over the last 16 years.

Sexual dysfunction among men with diabetes; a cross-sectional study at a specialised diabetes clinic in Sri Lanka.

BACKGROUND: Male sexual dysfunction in diabetes is often an unrevealed clinical issue. Though many publications report the prevalence, there is limited data on its associations, impact, and health-seeking behaviour. The objectives were to assess the prevalence of male sexual dysfunction, its associations, impact and treatment-seeking among men with diabetes in a selected tertiary care Diabetes Clinic. METHODS: A cross-sectional study was conducted at the Diabetes Clinic, National Hospital of Sri Lanka, from January to September 2020. Men with diabetes aged 18 to 70 years undergoing annual assessment were recruited consecutively. Socio-demographic and clinical information were collected using an interviewer-administered questionnaire. Erectile dysfunction (ED), premature ejaculation, mental health and quality of life were assessed using validated self-administered questionnaires. Cardiovascular autonomic reflex tests and total testosterone levels were performed. Penile colour Doppler ultrasonography was performed on consenting participants with erectile dysfunction. Associations were assessed using the chi-square test or Fisher's exact for dichotomous variables and independent sample t-test for continuous variables. RESULTS: Two hundred and twelve participants were recruited with a mean age of 54.1 (SD = 10.1) years. Erectile dysfunction was present in 168 (79.2%), (mild: 45, mild-moderate: 56, moderate: 26, severe: 41). Premature ejaculation was present in 26 (18.7%). Libido was low among 16%. Sexual dysfunction was not revealed to a health provider by 85.6% despite 60.5% experiencing psychological and/or relationship effects. Out of 18 who sought treatment, only 4 achieved a good response. Mean age (55.4 ± 9.5 vs 48.7 ± 10.6 years, p < 0.001) and duration of diabetes (10.9 ± 7.6 vs 5.8 ± 4.6 years, p < 0.001) were higher while eGFR was lower (73.9 ± 27.7 vs 100.51 ± 28.08 years, p < 0.008) among those with ED compared to those without. Diabetic retinopathy (4% vs 42%, p < 0.001), peripheral neuropathy (17.9% vs 38.4%, p = 0.041) and lower limb arterial disease (0% vs 12.2%, p = 0.04) were associated with ED. Arterial insufficiency was seen among 50% of the participants who underwent penile colour Doppler ultrasonography. CONCLUSIONS: Male sexual dysfunction is a pervasive yet underappreciated problem in diabetes care despite its effect on the individual. Patient and disease characteristics would guide the identification of high-risk individuals for targeted screening in clinical practice.

Sexual disorders in the men treated in a psychiatric ward. / Zaburzenia seksualne u mezczyzn leczonych w oddziale psychiatrycznym.

OBJECTIVES: An attempt to assess the impact of dual diagnosis - mental illness and addiction on the occurrence of sexual dysfunctions, and evaluation of problems with sexual functioning in men treated in a psychiatric ward. METHODS: 140 psychiatrically hospitalized men (mean age 40.4 ± 12.7 years) with the diagnosis of schizophrenia, affective disorders, anxiety disorders, addiction and double diagnosis (schizophrenia and addiction) took part in the study. The Sexological Questionnaire, developed by Professor Andrzej Kokoszka, and the International Index of Erectile Function IIEF-5 were used in the study. RESULTS: The occurrence of sexual dysfunctions in the study group was reported in 83.6% of patients. The most common was reduction in sexual needs (53.6%) and orgasm delay (40%). Depending on the research tool used, erectile dysfunction appeared in 38.6% of respondents (according to Kokoszka's Questionnaire) and 61.4% of patients (IIEF-5). Severe erectile dysfunction was more common in the group of patients without a partner (12.4% vs. 0; p = 0.000) compared to people in relationships and in the group with anxiety disorders (p = 0.028) compared to groups with other mental disorders. In the group of people with dual diagnosis (DD), sexual dysfunctions were observed more frequently in comparison to patients with schizophrenia (p = 0.034). Treatment lasting over 5 years was more often associated with sexual dysfunctions (p = 0.007). In the DD group, lack of orgasm and excessive sexual needs were more frequent in comparison to people with one diagnosis (p = 0.0145; p = 0.035). CONCLUSIONS: Sexual dysfunctions are more common in patients with DD in comparison to patients diagnosed with schizophrenia. Lack of a partner and the duration of psychiatric treatment over 5 years is associated with more frequent occurrence of sexual dysfunctions.

Comparison of characteristics between Chinese diabetes mellitus-induced erectile dysfunction populations and non-diabetes mellitus-induced erectile dysfunction populations: A cross-sectional study.

Background: Erectile dysfunction (ED) is a common disease in adult men, and diabetes is an independent risk factor for ED. However, there are few reports on the distinction between diabetes mellitus-induced erectile dysfunction (DMED) and non-DMED features, as well as ED features of varying severity in the two groups. Methods: A total of 365 ED patients treated at two clinics in China from 2019 to 2022 were included. Questionnaires of the International Index of Erectile Function (IIEF-5), Erectile Hardness Score (EHS), Premature Ejaculation Diagnostic Tool (PEDT), Patient Health Questionnaire-9 (PHQ-9), and Generalized Anxiety Disorder-7 (GAD-7) were administered to the patients. They were divided into three groups according to the IIEF-5 score: 5-7 for severe ED, 8-11 for moderate ED, and 12-21 for mild ED. In addition, the patient's age, weight, height, fasting blood glucose (FBG), total cholesterol (TC), triglycerides (TG), follicle-stimulating hormone (FSH), luteinizing hormone (LH), prolactin (PRL), total testosterone (TT) and other indicators were also collected. Statistical analysis was performed using SPSS 26, comparing all parameters between groups. Results: Age (P<0.001), height (P=0.009), body mass index (BMI) (P=0.002), PEDT (P<0.001), FBG (P<0.001), FSH (P<0.001), TG (P<0.001), TT (P<0.001) and triglyceride-glucose index (TyG) (P<0.001) were significantly different between diabetic ED and nondiabetic ED subjects. The trend test in the nondiabetic ED population found a negative correlation between the IIEF-5 score and PHQ-9 (P for trend=0.15). Multivariate ordinal logistic regression in the diabetic ED population showed that elevated LH OR=11.37 (95% CI: 0.966, 3.897) and elevated PRL OR=4.10 (95% CI: 0.410, 2.411) were associated with an increased risk of more severe ED. Conclusions: The aetiology, demographic parameters, degree of premature ejaculation, and related biochemical tests were significantly different between the DMED and non-DMED populations.

The prevalence of premature ejaculation and its relationship with polygamous men: a cross-sectional observational study at a tertiary hospital in Somalia.

BACKGROUND: Premature ejaculation (PE) is the most common and prevalent sexual disorder among men. To the best of our knowledge, this is the first study aimed at evaluating the relationship of PE among polygamous men. METHOD: Over a 1-year period, a cross-sectional observational study was carried out among 202 married men who visited the urology polyclinic due to different clinical conditions and contributed by completing a standardized structured questionnaire regarding their sociodemographic data, as well as sexual and past medical history. RESULTS: In our study, the prevalence of PE was 37.1%; half of the monogamous men (50%) complained of PE, while 22% of men with two wives, 20% of men with three wives, and 12% of men with four wives complained of PE (p < 0.0001, 95% CI 0.122-1.920). Seventy percent of erectile dysfunction (ED) patients had PE concurrence (p < 0.0001, 95% CI 0.057-5.543). Regarding frequency of sexual intercourse, 48% of patients who complained of PE performed sexual intercourse less than two times/week, while two-thirds of the participants who did not complain of PE had sexual intercourse two to four times/week (p < 0.0001, 95% CI 0.203-0.568). Among the men who reported ED, 42% had one wife, 21.5% had two wives, 40% had three wives, and 12.5% had four wives (p < 0.029, 95% CI 0.417-0.962). CONCLUSIONS: We report that polygamous men have a lower incidence of premature ejaculation and higher sexual satisfaction than monogamous men. There is a significant association between ED and PE, showing a complex and bidirectional relationship between the two conditions. The new taxonomic entity called loss of control of erection and ejaculation (LCEE) views the two sexual symptoms as deeply interrelated. The study results indicate that a sexual intercourse frequency of two or more times per week significantly lowers the risk of PE.

Premature ejaculation in patients with lower urinary tract symptoms: a systematic review.

Lower urinary tract symptoms (LUTS) refer to a group of symptoms related to bladder, prostate, and urethra. LUTS are common in men and the severity increases with age. LUTS are frequently associated with sexual dysfunction, such as premature ejaculation (PE), standing as the most common sexual dysfunction in men. Both LUTS and PE cause distress and dissatisfaction for the patient and his partner. This systematic review aims to determine the relationship between LUTS and PE in men. Two reviewers independently conduct a literature search in five online databases (PubMed, Scopus, Proquest, ClinicalKey, and ScienceDirect). In addition, reviewers also reviewed the reference list of chosen articles to identify additional relevant studies. Twelve articles were included in this systematic review that consists of one cohort study and 11 cross-sectional studies. The total scores of each identified study ranged from "poor" to "good." The prevalence of PE in LUTS ranged from 12 to 77%. Most of the studies showed a significant relationship between LUTS and PE. PE is more common in older age with the peak prevalence in age of 60-69 years old. There is a possible association between PE and LUTS. Further research using cohort or case-control study design on this topic is needed.

Lower urinary tract symptoms and depressive symptoms among patients presenting for distressing early ejaculation.

We aimed to assess the correlation between premature ejaculation (PE), lower urinary tract symptoms (LUTS), erectile dysfunction (ED), and depression in the cohort of the last 329 patients seeking medical help for distressing early ejaculation at a single tertiary-referral center. All patients completed the premature ejaculation diagnostic tool (PEDT), the International Index of Erectile Function (IIEF), the Beck's Inventory for Depression (BDI), and the International Prostate Symptom Score (IPSS) at their first assessment. Overall, 133 (0.4) patients had PEDT ≥ 11, suggestive for PE. The characteristics of patients with and without PE according to PEDT findings were compared with the Mann-Whitney and Fisher's exact tests. Linear regression analysis tested the association between LUTS and PEDT score. Patients with PE depicted lower median scores for IIEF-overall satisfaction, intercourse satisfaction and erectile function than non-PE individuals (all p < 0.004). Similarly, patients with PE showed higher median BDI scores (7 versus 4; p < 0.0002), median IPSS total score (7 versus 5), storage (4 versus 2), and voiding (3 versus 2) subscores (all p < 0.01) compared to those without PE. At linear regression analysis, IPSS storage subscore (Coeff: 0.28; 95%CI: 0.05-0.51, p = 0.01) and BDI score (Coeff: 0.10; 95%CI: 0.01-0.19, p = 0.02) were associated with higher PEDT values, after accounting for IIEF-EF score, patients' age, body mass index and Charlson Comorbidity Index. Our findings suggest that storage symptoms and depression should be carefully investigated when assessing patients complaining of PE in the real-life setting.

Efficacy and safety of dapoxetine/sildenafil combination tablets in the treatment of men with premature ejaculation and concomitant erectile dysfunction-DAP-SPEED Study.

Premature ejaculation (PE) and erectile dysfunction (ED) are the most prevalent sexual disorders in men. ED is commonly reported among patients with PE. Although recent guidelines recommend to treat ED first in men with both PE and ED, this recommendation is not based on evidence and there are limited data about the efficacy and safety of dapoxetine/sildenafil combination therapy for these patients. The aim of this study is to evaluate the clinical efficacy and safety of the dapoxetine/sildenafil combination (Dapoxil® 30/50 mg film-coated tablet) in the treatment of patients with PE and concomitant ED. In a single-center, single-arm, open-label clinical study conducted between October 2016 and September 2017, 74 patients with lifelong or acquired PE and ED were included. All patients were instructed to record their intravaginal ejaculatory latency time (IELT) with a stopwatch for 4 weeks. After the screening, they were requested to complete Premature Ejaculation Diagnostic Tool (PEDT), Premature Ejaculation Profile (PEP), and International Index of Erectile Function-Erectile Function (IIEF-EF) questionnaires before the treatment. The patients received on demand Dapoxil® 1-3 h before sexual intercourse for the next 4 weeks (2 days a week and no more than once a day). The patients were also assessed with global impression of change (GIC) question for the treatment satisfaction and the side effects were recorded. The study was completed with 53 patients (53/74, 71.62%). Mean age of the patients was 45.32 ± 10.05 years. At the end of the 4-week treatment period, the geometric mean IELT of the patients significantly increased (from 22.72 ± 15.16 to 68.25 ± 82.33 s; p < 0.001). Similarly, significant improvements were observed in the mean PEP index score (0.86 ± 0.72 vs. 2.36 ± 1.13; p < 0.001) and mean IIEF-EF domain score (13.17 ± 3.33 vs. 24.60 ± 3.96; p < 0.001). According to the GIC results, 81.13% of the patients were satisfied with the treatment. Non-serious adverse events occurred in 10 patients (18.87%) and 4 (7.55%) of these patients dropped out of the treatment. The most common adverse events were headache, palpitation, and flushing. The dapoxetine/sildenafil combination therapy significantly improves the IELT values and patient reported outcome measures of PE patients who also suffer from ED. Although several side effects were reported, these were mild and transient.

Clinical characteristics of men complaining of premature ejaculation together with erectile dysfunction: a cross-sectional study.

BACKGROUND: Premature ejaculation (PE) is present in up to 30% of men with erectile dysfunction (ED). OBJECTIVES: To assess the clinical features of men complaining of both ED and PE (ED-PE) as compared to men reporting only ED or PE. MATERIALS AND METHODS: A consecutive series of 4024 men (mean age 51.2 ± 13.2 years) consulting for sexual dysfunction was studied. The population was categorized into ED-only (n = 2767; 68.8%), PE-only (n = 475; 1.8%), and ED-PE (n = 782; 19.4%). Sexual symptoms were evaluated using the structured interviews SIEDY and ANDROTEST. Penile color Doppler ultrasound (PDCU) parameters were also assessed. RESULTS: When compared to PE alone, ED-PE reported more sexual complaints, including impaired morning erections [OR = 5.8 (4.1; 8.3)], decreased sexual desire [OR = 2.6 (1.8; 3.7)], decreased ejaculate volume [OR = 2.7 (1.8; 4.0)], and reduced frequency of sexual intercourse [OR = 1.4 (1.0; 2.0)]. Conversely, ED-PE and ED-only men had a similar prevalence of sexual symptoms. In ED-PE men, the characteristics of ED were similar to ED-only men, whereas the characteristics of PE were milder than in PE-only men. ED-PE men had a significantly higher prevalence of hypertension, diabetes, and cardiovascular (CV) diseases [OR = 1.8 (1.1; 3.0), 2.7 (1.3; 5.6) and 2.7 (1.1; 6.5), respectively] than PE-only subjects. Moreover, ED-PE men showed worse dynamic peak systolic velocity at PDCU [B = -12.0 (-17.7; -6.2)] and a greater 10-year estimated CV risk [B = 3.8 (2.5; 5.1)] than PE-only patients. Conversely, comorbidities and PDCU parameters were similar in ED-PE and ED-only men. DISCUSSION: The present results suggest that men reporting ED and PE should be considered as patients with ED-only, at least at first glance. Consequently, the diagnosis-including the CV risk stratification-and treatment should be primarily focused on the erectile problem. CONCLUSIONS: Erectile dysfunction-PE patients present several similarities with those consulting only for ED, whereas their characteristics are different from PE-only men. In agreement with the guidelines, our results confirm that ED-PE men might be considered (and managed) primarily as patients with ED.

[Acupoint injection of Shuxuetong for chronic prostatitis / chronic pelvic pain syndrome complicated by premature ejaculation].

OBJECTIVE: To observe the clinical efficacy of acupoint injection of Shuxuetong (SXT) in the treatment of chronic prostatitis / chronic pelvic pain syndrome (CP/CPPS) complicated by premature ejaculation (PE). METHODS: A total of 78 cases of CP/CPPS complicated by PE were randomly assigned to receive acupuncture injection of SXT (n = 38) and placebo acupuncture as the control (n = 40) for two 15-day courses. The therapeutic effects were evaluated based on the patients' scores on National Institutes of Health-Chronic Prostatitis Symptom Index (NIH-CPSI) and Premature Ejaculation Diagnostic Tool (PEDT) before and after treatment. RESULTS: Compared with the controls, the SXT group showed a significantly higher total effectiveness rate based on either NIH-CPSI (27.5% vs 63.2%, P < 0.05) or PEDT (25% vs 47.4%, P < 0.05) and a lower deterioration rate (17.5% vs 7.9%, P < 0.05). Statistically significant differences were observed between the baselines and post-treatment scores on NIH-CPSI in the SXT group (24.82 ± 5.89 vs 15.45 ± 6.74, P < 0.05) and the controls (26.10 ± 6.59 vs 22.10 ± 8.42, P < 0.05) as well as on PEDT in the SXT group (14.87 ± 3.70 vs 10.29 ± 4.25, P < 0.05) and the controls (14.98 ± 3.09 vs 13.00 ± 4.53, P < 0.05), and both the NIH-CPSI and PEDT scores were markedly lower in the SXT than in the control group after treatment (P < 0.05). Linear regression analysis exhibited a positive correlation between the NIH-CPSI and PEDT scores before and after treatment in the SXT group (R = 0.340, P < 0.037) but not in the control group (R = 0.133, P < 0.413). CONCLUSIONS: Acupoint injection of Shuxuetong can significantly improve the symptoms of CP/CPPS and CP/CPPS-induced PE as well.

[Correlation between the phenotypic domains of the UPOINT system and sexual dysfunction in men with chronic prostatitis/chronic pelvic pain syndrome].

OBJECTIVE: To investigate the correlation of the six phenotypic domains of the UPOINT (urinary, psychosocial, organ-specific, infection, neurologic/systemic, and tenderness) system with premature ejaculation (PE) and ED in male patients with chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS). METHODS: We collected the clinical data on 453 cases of CP/CPPS from December 2016 to December 2017, including the general information, CP symptoms, sexual life history, intravaginal ejaculatory latency time (IELT), NIH-CPSI, and IIEF-5 scores. We classified the patients according to the UPOINT system. RESULTS: The CP/CPPS patients were aged 32.75 ± 6.85 years, of whom 45.03% (204/453) were diagnosed with ED and 43.27% (196/453) with PE. The positive rates of the six phenotypic domains of the UPOINT system were 68.78% (U), 60.21% (P), 77.45% (O), 20.34% (I), 46.83% (N), and 65.12% (T), respectively. Multivariate logistic regression analysis showed psychosocial (P) abnormality to be an independent risk factor for PE (OR = 4.55, 95% CI: 2.75－8.06, P < 0.05) and ED (OR = 3.35, 95% CI: 2.02－6.25, P < 0.05). CONCLUSIONS: The psychosocial (P) factor in the UPOINT system plays an important role in the pathogenesis of PE and ED in patients with CP/CPPS.

General and sex profile of women with partner affected by premature ejaculation: results of a large observational, non-interventional, cross-sectional, epidemiological study (IPER-F).

BACKGROUND: Couple distress is a crucial point in premature ejaculation (PE). PE has been associated with significant bother, interpersonal problems, and dissatisfaction with sexual intercourse for both men and their partners. OBJECTIVES: The primary objective of this study was to assess the effect of PE on female sexuality in female partners of men affected from PE. Secondary objectives were to assess the impact of PE on female sexual quality of life, to assess the presence of sexual problems of the male partner, and to evaluate the prevalence and characteristics of comorbidities. MATERIALS AND METHODS: Adult women aged 18 to 80 years old, sexually active, were randomly sampled from the patient lists of General Practitioners in Italy and were included in this observational, non-interventional, cross-sectional epidemiological study. Subjects were asked to fill: a general questionnaire regarding anthropometric data, lifestyle, marital status, education, occupation, economic conditions, general health status, comorbidities, and sexual habits; the Sexual Quality of Life Questionnaire-Female (SQoL-F); the Female Sexual Distress Scale (FSDS-R-PE); the Self-rating Depression Scale (SDS); and Self-rating Anxiety Scale (SAS). In addition, females reported about their partner's ejaculation time and the presence of sexual dysfunctions. RESULTS: A total of 3,104 women were included. Mean age was 45.1 years. Woman with PE partners presented a higher percentage of sexual dysfunction and reported more anxiety compared with female partners of men not affected from PE (42.69% vs. 20.56% and 30.95% vs. 15,34%, respectively). In addition, they referred more sexual dysfunction in their partners. Hypertension, hypercholesterolemia, arthritis, heart diseases, thyroid disease, a history of menopause, or hysterectomy resulted in significantly more prevalence in women with PE partners. DISCUSSION AND CONCLUSIONS: Female partners of PE patients present an increased prevalence of sexual distress, a reduced quality of sexual life, and an increased anxiety score when compared to women whose partners are not affected from PE.

Penile sensory thresholds in subtypes of premature ejaculation: implications of comorbid erectile dysfunction.

Penile hypersensitivity plays an important role in premature ejaculation (PE), but differences in penile sensitivity among subtypes of PE are unknown. Therefore, we compared penile sensory thresholds in PE subtypes of lifelong and acquired PE, PE with and without erectile dysfunction (ED), PE with an intravaginal ejaculation latency time ≤1 min and >1 min, and PE with and without orgasmic pleasure perceptual dysfunction. During August 2014 to January 2016, 136 patients with PE were included. Penile warm, cold, and vibratory thresholds were measured. Data of clinical characteristics, sexual life, Premature Ejaculation Diagnostic Tool (PEDT) score, and the 5-item version of the International Index of Erectile Function (IIEF-5) score were collected. Vibratory thresholds of the PE with ED group were higher in the right coronal sulcus (median amplitude: 4.92 vs 3.65 µ m, P = 0.02) and the right penile shaft (median amplitude: 3.87 vs 3.30 µ m, P = 0.03), while differences in penile sensory thresholds between other subtypes were not significant. The median PEDT score was lower in the PE without ED group (12 vs 14, P < 0.001). The IIEF-5 and PEDT scores were negatively correlated (r = -0.29, P < 0.001). Patients with orgasmic pleasure perceptual dysfunction had a lower median IIEF-5 score (20 vs 21, P = 0.02). Patients with PE and ED had lower penile sensitivity, and ED was associated with more severe symptoms and weaker orgasmic pleasure perception. In men with PE, management of comorbid ED is necessary. In case of side effects in erectile function, topical anesthetics should be cautiously used in men with PE and ED.

Visceral adiposity index is associated with premature ejaculation inversely: a cross-sectional study.

OBJECTIVE: Visceral adiposity index (VAI) is a novel indicator for the assessment of visceral obesity. In this study, we aimed to evaluate the relationship between VAI and premature ejaculation (PE). MATERIALS AND METHOD: A total of 300 men were included in the study. Hundred and fifty men with PE and 150 men without PE (control). All men were evaluated for PE by premature ejaculation diagnostic tool (PEDT). VAI levels were calculated using body mass index (BMI), high density lipoprotein and triglyceride (TG) levels. RESULTS: Mean age of the study groups was 34.3 ± 5.2 (30-60) years and the mean age of the controls were 35.9 ± 5.3 (30-60) years. The men with PE had lower BMI, TG levels, waist circumference (WC) and higher high-density lipoprotein-cholesterol (HDL-C) levels. Mean VAI level was 4.13 ± 0.7 in study group and 5.72 ± 1.6 in control group, respectively. VAI levels were statistically higher in men without PE (p < .001). DISCUSSION: Our cross-sectional study demonstrated a negative correlation between VAI and PE. VAI is superior index for the evaluation and calculation the relationship between obesity and PE.

Prevalence of Prostatitis-Like Symptoms and Outcomes of NIH-CPSI in Outpatients with Lifelong and Acquired PE: Based on a Large Cross-Sectional Study in China.

Premature ejaculation (PE) is one of the most common sexual dysfunctions, which were associated with prostatitis-like symptoms (PLS). We intended to explore the prevalence of prostatitis-like symptoms and outcomes of National Institutes of Health-Chronic Prostatitis Symptom Index (NIH-CPSI) scores in outpatients with lifelong (LPE) and acquired premature ejaculation (APE). From December 2013 to December 2015, a total of 498 consecutive heterosexual men with PE and 322 male healthy subjects without PE were enrolled. Each of them completed a detailed questionnaire on demographics information, sexual and medical histories, and the NIH-CPSI. Assessment of NIH-CPSI and definition of PLS and PE were used to measure the PLS and NIH-CPSI scores and ejaculatory function for all subjects. Finally, a total of 820 subjects (including 498 men in PE group and 322 men in control group) were enrolled in our study. The mean ages were significantly different between PE and no PE groups. Men with PE reported worse PLS and higher NIH-CPSI scores (P < 0.001 for all). Similar findings were also observed between men with LPE and APE. Men with APE also reported higher rates of PLS and scores of NIH-CPSI (P < 0.001 for all). Multivariate analysis showed that PLS and NIH-CPSI scores were significantly associated with PE.

Relationship between premature ejaculation and depression: A PRISMA-compliant systematic review and meta-analysis.

BACKGROUND: Premature ejaculation (PE) is the most prevalent male sexual dysfunction. Epidemiologic findings are inconsistent concerning the risk for depression associated with PE. OBJECTIVE: The aim of this study was to investigate the potential association between between depression and risk of PE. DATA SOURCES: We conducted a literature search of PubMed, Embase, and the Cochrane Library from these databases' inception through June 2014 for observational epidemiological studies examining the association between depression on risk of PE. STUDY ELIGIBILITY CRITERIA: Studies were selected if they reported the risk estimates for PE associated with depression. PARTICIPANTS: patients>18 years of age suffering from PE. INTERVENTIONS: a history of depressive disorder. STUDY APPRAISAL AND SYNTHESIS METHODS: These odds ratios (ORs) were pooled using a random or fixed effects model and were tested for heterogeneity. Subgroup analysis was employed to explore heterogeneity. RESULTS: Eight trials involving 18,035 patients were included in the meta-analysis. Depression were statistically significantly associated with the risk of PE (OR = 1.63, 95% CI:1.42-1.87). There was no evidence of between-study heterogeneity (P = 0.623, I = 0.0%). The association was similar when stratified by mean age, geographical area, study design, sample size, publication year, and controlling key confounders. LIMITATIONS: The severity of depression and PE could not be identified due to unavailable data of trials. No evidence of publication bias was observed. CONCLUSIONS: These findings provide evidence that depression is associated with a significantly increased risk of PE. In addition, more prospective studies are necessary to evaluate the association and identify the ideal treatment. SYSTEMATIC REVIEW REGISTRATION NUMBER: CRD42016041272.

Is it only a sleeping disorder or more? Restless legs syndrome and erectile function.

OBJECTIVE: Sexual dysfunction and restless legs syndrome (RLS) have similar pathophysiological properties. This study evaluated the presence of erectile dysfunction (ED) and premature ejaculation (PE) in patients with RLS. MATERIALS AND METHODS: Fifty patients in the RLS group and 50 in the control group were included in the study. The International Restless Legs Syndrome Study Group rating scale, the five-item International Index of Erectile Function and the Premature Ejaculation Diagnostic Tool were used to define the RLS and erectile function of both the study and control groups. A stopwatch technique was used to evaluate the intravaginal ejaculatory latency time of patients in the study. RESULTS: The mean age of patients in the RLS and control groups was 53.5 ± 9.9 and 53.2 ± 8.8 years, respectively (p = 0.527). None of the patients in either group had diabetes mellitus. There was no difference between the groups in terms of history of hypertension, body mass index and total testosterone level. There were 27 patients (54%) in the RLS group and 17 patients (34%) in the control group with PE (p = 0.008). There were 26 patients (52%) with ED in the RLS group and 17 (34%) in the control group (p = 0.069). The prevalence of moderate and severe ED was significantly higher in the RLS group (p = 0.045). CONCLUSIONS: PE was more prevalent in RLS than in control patients. On the other hand, the rate of ED did not differ between the groups. In addition to receiving a neurological evaluation, RLS patients must be evaluated for sexual function.

[New data on the effectiveness of Tadalafil alone and in combination with NeyroDoz in treating erectile dysfunction associated with secondary premature ejaculation].

AIM: To compare the effectiveness of the phosphodiesterase type 5 inhibitor (PDE-5i) tadalafil alone and in combination with a biologically active dietary supplement (BADS) NeyroDoz, containing the precursors of serotonin in patients with erectile dysfunction (ED) associated with secondary premature ejaculation (SPE). MATERIAL AND METHODS: 105 patients (mean age 36.2+/-9.1 years) with concomitant ED and SPE were included in a prospective study and divided into 2 groups. The patients of group 1 (n=47) received PDE-5i 5 mg daily for 1 month. In patients of group 2 (n=58) PDE-5i was co-administered with BADS 2 capsules twice daily. Treatment efficacy was evaluated using "Criteria for premature ejaculation" (CriPE) and IIEF-5 questionnaires at baseline and on completion of the treatment course. Besides, a polymorphism in the serotonin transporter gene (5-HTTLPR) was tested. RESULTS: The treatment was effective in 35 (74.5%) and 48 (82.7%) patients of group 1 and 2, respectively (p<0.0001) with similar statistically significant (p<0.001) improvement in erectile function. According to CriPE scores, 6.4, 8.5, 23.4, 10.6 and 12.8% patients of group 1 and 10.3, 1.7, 40.0, 25.9, 10.3 and 31.0% patients of group 2 with LaLa, LaLg, LgLg, Sla, SLg, SS genotypes were rendered free of SPE, respectively. CONCLUSION: Treating ED-associated SPE with the combination of serotonin precursors and tadalafil can better improve ejaculatory function recovery compared with PDE-5i monotherapy.

Bias in Evaluating Erectile Function in Lifelong Premature Ejaculation Patients with the International Index of Erectile Function-5.

INTRODUCTION: Lifelong premature ejaculation (LPE) is the most important ejaculating dysfunction. Relatively little is known about erectile function in this population. AIMS: We attempted to evaluate the erectile function of patients with LPE using the International Index of Erectile Function-5 (IIEF-5) to determine if it is sufficiently reliable and accurate to make such an assessment. METHODS: A total of 406 patients with LPE were enrolled in our study. The participants voluntarily answered the Premature Ejaculation Diagnostic Tool (PEDT) and IIEF-5 questionnaires and underwent a full history evaluation and clinical examination by doctors. Their answers were converted into data analyzed by a statistic software. MAIN OUTCOME MEASURES: The patients were diagnosed with LPE based on the diagnostic criteria and PEDT scores. The intravaginal ejaculation latency time was recorded according to patient self-reports. The IIEF-5 was used to evaluate their erectile function. Thorough history and clinical examination helped doctors make more correct diagnoses of erectile dysfunction (ED). RESULTS: Of the 406 patients, 70 (17.24%) patients had ED, as confirmed by doctors. IIEF-5 was accurate for the assessment of the erectile function of LPE patients when the cutoff was decreased to 15.5. Question 5 (1.34 ± 0.53) was the main reason for the drop in the total IIEF-5 score. Questions 1 and 5 shared low consistency with the other three IIEF-5 items, thus they lowered the reliability of the IIEF-5 scores. These questions created a confounding bias that decreased the diagnostic threshold of IIEF-5. However, they could not be removed from the IIEF-5 because they did not reduce its diagnostic accuracy in patients with LPE. CONCLUSIONS: Bias from questions 1 and 5 lowered the reliability of the IIEF-5 scores; however, it did not reduce the diagnostic accuracy of the IIEF-5. The recommendation is to edit questions 1 and 5 when they are applied to populations with LPE.

Comorbidity, knowledge and attitude towards sex among patients with Dhat syndrome: A retrospective study.

This study aimed to assess the knowledge about sex, attitude towards sex, prevalence of psychiatric comorbidity and relationship of the comorbidity with onset of symptoms of Dhat syndrome. Treatment records of 264 patients diagnosed with Dhat syndrome were reviewed for clinical profile including psychiatric comorbidity and sexual dysfunction and information on sexual knowledge and attitude using Sex Knowledge and Attitude Questionnaire (SKAQ-II). None of the patients gave all the correct responses on the SKAQ-II. Poor knowledge about sexual matters was not limited to the semen formation only, but also involved other aspects of sexuality, like masturbation, relationship of pregnancy with orgasm in women, breast feeding and pregnancy, relationship of sexual desire with addictive drugs and sexually transmitted diseases can be cured by having sex with a virgin girl. Higher level of education showed significant association with better sexual knowledge and liberal attitude. There was significant positive correlation between sexual knowledge and attitude. About half (51.9%) of patients had at least one comorbid psychiatric disorder and/or sexual dysfunction. Among the psychiatric disorders, depressive disorders were the most common and premature ejaculation was the most common comorbid sexual dysfunction. Among those with comorbidity, symptoms of Dhat syndrome preceded the onset of other disorders. Patients with Dhat syndrome have high rates of comorbidity and poor sexual knowledge and less liberal attitude, which was not only limited to loss of semen but also involves other spheres of sexuality. Accordingly psychoeducation in patients of Dhat syndrome should not be limited to addressing the myths and lack of knowledge about semen formation, but also should address poor sexual knowledge on all the aspects related to sexuality and the negative attitude towards sex.