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Background Research indicates an inconsistent relationship between age and the prevalence of premature ejaculation (PE), with studies reporting an increase, decrease, or no change with age. Aim To reexamine the possible relationship between age and PE prevalence, implementing methodological improvements that enhance the likelihood of detecting real effects. Methods From a sample of 2772 men, we analyzed a subset of 418 classified as having probable or definite PE based on the Premature Ejaculation Diagnostic Tool. We not only analyzed men with lifelong PE (LPE; n = 316) and acquired PE (APE; n = 102) separately but assessed prevalence differences across age groups using an omnibus measure to establish PE status and specific PE diagnostic criteria, individually and in multifactorial combination. Outcome Prevalence of PE in younger vs older men. Results LPE, but not APE, showed age-related differences in prevalence, with LPE being lower in the higher age group. This pattern was most discernible when a multifactorial approach was used to establish PE status. Clinical Translation Older men may be less distressed about their dysfunction or may benefit from diminishing ejaculatory function with age. Strengths and Limitations This cross-sectional study used an improved methodology to detect age-related differences in PE prevalence. Future studies would benefit from a larger sample size that enables a breakdown of prevalence using a greater number of age categories. Conclusion According to an improved methodology, men with LPE showed a decline in prevalence with aging. A methodology aimed at exploring this relationship should—at the very least—not only distinguish between LPE and APE subtypes but also consider using a multifactorial method of determining PE status that includes a measure of bother/distress. [ABSTRACT FROM AUTHOR]

Abstract Background Premature ejaculation (PE) is considered to be the most common male sexual disorder affecting 20% to 66% of sexually active men. Most of the patients had already tried on demand dapoxitine with no improvement. We aimed in the current study to assert the efficacy and safety profile of daily intake of 30 mg duloxetine in treating patients with lifelong premature ejaculation (LPE) as well as patients with acquired premature ejaculation (APE). Results The current study showed significant improvement in intravaginal ejaculatory latency time (IELT) after intake of duloxetine. All participants had a median Arabic index of premature ejaculation (AIPE) of 26, median IELT of 180 s, median male sexual quality of life (SQOL) of 43 after being treated with duloxetine (p value

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Introduction: The aim of this study was to evaluate the efficacy and safety of extracorporeal shock wave therapy (ESWT) in patients with acquired premature ejaculation (APE) due to chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS). Method: Patients with APE due to CP/CPPS between January 2020 and June 2022 were included in the study. Demographic data of the patients were recorded, and the degree of their symptoms was evaluated with the National Institutes of Health-Chronic Prostatitis Symptom Index (NIH-CPSI), premature ejaculation diagnostic tool (PEDT), and Premature Ejaculation Profile (PEP). The international prostate symptom index (IPSS) was also used for lower urinary tract symptoms (LUTS), and the international erectile function index-erectile function (IIEF-EF) was used to evaluate erectile functions. All patients received treatment with the Medispec Bold Li-ESWT device without using any anesthesia method (12 sessions). The changes in the symptom scores of the patients were evaluated before the treatment and at the 3rd month after the treatment. Results: A total of 42 patients were included in the study. The mean age of the patients was 43.75 ± 12.03 (20–55), and the mean BMI was 23.58 ± 7.61 (18.03–35.98) kg/m2. The patients' estimated mean intravaginal ejaculation latency time (IELT) before ESWT was 37.98 ± 21.87 s. After a total of 12 sessions of ESWT, the IIEF-EF, IPSS, NIH-CPSI, and PEP index scores of the patients showed significant improvements (p < 0.001 for each). The IELT mean increased to 74.81 ± 46.79 s (p < 0.001). Posttreatment IELT fold increase was determined as 3.25 ± 1.72 fold. A highly significant positive correlation (p = 0.032; r = 0.839) was found between the CPSI score difference and the posttreatment PEP index score. Conclusion: Li-ESWT treatment is an effective and safe treatment with positive effects on both LUTS and premature ejaculation in patients with APE symptoms due to CP/CPPS. Patients who benefit from CP treatment also have longer IELT times. [ABSTRACT FROM AUTHOR]

Wei Zhang,1,&ast; Yuyang Zhang,1,&ast; Jingjing Gao,1 Dangwei Peng,1 Yao Zhang,1 Xu Wu,1 Guodong Liu,1 Yutian Dai,2 Hui Jiang,3 Xiansheng Zhang1 1Department of Urology, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, People’s Republic of China; 2Department of Urology, Gulou Hospital of Nanjing University, Nanjing, Jiangsu Province, People’s Republic of China; 3Department of Reproductive Medicine Center, Peking University Third Hospital, Beijing, People’s Republic of China&ast;These authors contributed equally to this workCorrespondence: Xiansheng Zhang; Hui Jiang, Email xiansheng-zhang@163.com; jianghui55@163.comPurpose: To determine the role of poor sleep quality as a risk factor for acquired premature ejaculation (APE) after considering the various risk factors, such as ages, lower urinary tract symptoms (LUTS), anxiety, depression, and erectile dysfunction.Methods: This study presents a multivariate analysis to identify risk factors for PE, including the covariate of age, International Prostate Symptom Score (IPSS), General Anxiety Disorder-7 (GAD-7) score, Patient Health Questionnaire-9 (PHQ-9) score, International Index of Erectile Function (IIEF) score, and Pittsburgh Sleep Quality Index (PSQI). Acquired PE was defined as self-reported intravaginal ejaculation latency time ≤ 3 minutes, and poor sleep quality was diagnosed using the Pittsburgh Sleep Quality Index tool.Results: A total of 349 men were enrolled in the study after completing the questionnaires and the medical history survey. Among 349 men, 203 individuals (58.17%) suffered from acquired PE. The IIEF-5 score, IPSS, GAD-7 score, PHQ-9 score, and PSQI score of the population with PE were significantly different from the non-PE group. Further multivariate analysis showed that erectile dysfunction, depression, severe prostatitis-like symptoms, and poor sleep quality were high-risk factors of APE. Additionally, our study showed that premature ejaculation diagnostic tool (PEDT) score was associated with IPSS/GAD-7/PHQ-9/PSQI scores positively and associated with IIEF-5 scores negatively. The stratified analysis of sleep quality showed that APE patients with different sleep qualities have different prevalence rates of anxiety, depression, prostatitis-like symptoms, and erectile function.Conclusion: In general, sleep quality may be a potential risk factor for patients with acquired premature ejaculation. Our research revealed the impact of sleep quality on premature ejaculation and provided new viewpoints for further understanding and perfecting the pathogenesis of premature ejaculation.Keywords: sleep quality, acquired premature ejaculation, multivariate analysis

Introduction: Premature ejaculation (PE) is classified as primary and acquired and may be facilitated by different pathophysiology. Brain plays an important role in PE, however, differences in the central neuropathological mechanisms among subtypes of PE are unknown. Materials and methods: We acquired diffusion tensor imaging (DTI) data from 44 healthy controls (HC) and 47 PE patients (24 primary PE and 23 acquired PE). Then, the whole-brain white matter (WM) structural networks were constructed and between-group differences of nodal segregative parameters were identified by the method of graph theoretical analysis. Moreover, receiver operating characteristic (ROC) curves were performed to determine the suitability of the altered parameters as potential neuroimaging biomarkers for distinguishing primary PE from acquired PE. Results: PE patients showed significantly increased clustering coefficient C(i) in the left inferior frontal gyrus (triangular part) (IFGtriang.L) and increased local efficiency Eloc(i) in the left precental gyrus (PreCG.L) and IFGtriang.L when compared with HC. Compared to HC, primary PE patients had increased C(i) and Eloc(i) in IFGtriang.L and the left amygdala (AMYG.L) while acquired PE patients had increased C(i) and Eloc(i) in IFGtriang.L, and decreased C(i) and Eloc(i) in AMYG.L. Compared to acquired PE, primary PE patients had increased C(i) and Eloc(i) in AMYG.L. Moreover, ROC analysis revealed that PreCG.L, IFGtriang.L and AMYG.L might be helpful for distinguishing different subtypes of PE from HC (PE from HC: sensitivity, 61.70-78.72%; specificity, 56.82-77.27%; primary PE from HC: sensitivity, 66.67-87.50%; specificity, 52.27-77.27%; acquired PE from HC: sensitivity, 34.78-86.96%; specificity, 54.55-100%) while AMYG.L might be helpful for distinguishing primary PE from acquired PE (sensitivity, 83.33-91.70%; specificity, 69.57-73.90%). Conclusion: These findings improved our understanding of the pathophysiological processes that occurred in patients with ejaculatory dysfunction and suggested that the abnormal segregation of left amygdala might serve as a useful marker to help clinicians distinguish patients with primary PE from those with acquired PE. [ABSTRACT FROM AUTHOR]

Background: Premature ejaculation (PE), affecting approximate 5%, has an unclear pathogenesis, limited treatment efficacy, and a lack of effective diagnostic methods., Aim: This prospective diagnostic study aimed to compare segmental dorsal penile nerve somatosensory evoked potentials (DNSEP) differences among patients with acquired premature ejaculation (APE), primary premature ejaculation (PPE), and healthy controls., Method: This prospective diagnostic study examined patients suffering from PE who visited the outpatient clinic of the Department of Urology of the Second Affiliated Hospital of Zhejiang University School of Medicine from January 1, 2022 to February 28, 2023. According to the definition of PE by the ISSM, 16 cases comprised the healthy control group, 31 in the APE group, and 28 in the PPE group. Each group was examined based on the segmental DNSEP with electrodes recording at multiple locations (the selected location was at the Cz and the C7). The latency time of the evoked potential obtained at Cz was P40, and that obtained at C7 was P30. The P30/P40 ratios of P40, P30, and DNSEP wave amplitudes at C7 and Cz were compared among the 3 groups of patients., Result: No group differences were found in P40 latency at Cz. However, PPE showed higher DNSEP amplitude at Cz, while APE showed lower amplitudes compared with controls. Both APE and PPE had significantly shorter P30 latency at C7 than controls. SEP amplitude at C7 was similar in APE and PPE but lower than in controls. The P30/P40 ratio was lower in APE compared with PPE and controls., Clinical Implications: Segmental SEP may offer more assistance in localizing neurological lesions, potentially guiding clinical treatment., Strengths and Limitations: In this study, the innovative use of the P30/P40 ratio was proposed, maintaining consistency in emotional states and measurement conditions for the same patient. However, limitations include a restricted number of patient cases and challenges in obtaining a diverse control group, potentially introducing bias. In addition, not considering subclinical premature ejaculation and the comorbidity of PE + ED (LCEE) in patient stratification is another limitation of this study. Results suggest a correlation between secondary PE and underlying conditions, such as obesity and lumbar spine injuries. The study validates multi-site somatosensory-evoked potential examination for locating neural lesions but acknowledges the need for future invasive needle electrode AEP testing to analyze neuropathological changes more comprehensively., Conclusion: In conclusion, segmental DNSEP examination aids in localizing neuropathy in APE patients, and the P30/P40 ratio proves more accurate in diagnosing APE than P40 alone., Competing Interests: None declared., (© The Author(s) 2024. Published by Oxford University Press on behalf of The International Society for Sexual Medicine.)

IntroductionThe International Society for Sexual Medicine (ISSM) Ad Hoc Committee for the Definition of Premature Ejaculation developed the first evidence-based definition for lifelong premature ejaculation (PE) in 2007 and concluded that there were insufficient published objective data at that time to develop a definition for acquired PE.AimThe aim of this article is to review and critique the current literature and develop a contemporary, evidence-based definition for acquired PE and/or a unified definition for both lifelong and acquired PE.MethodsIn April 2013, the ISSM convened a second Ad Hoc Committee for the Definition of Premature Ejaculation in Bangalore, India. The same evidence-based systematic approach to literature search, retrieval, and evaluation used by the original committee was adopted.ResultsThe committee unanimously agreed that men with lifelong and acquired PE appear to share the dimensions of short ejaculatory latency, reduced or absent perceived ejaculatory control, and the presence of negative personal consequences. Men with acquired PE are older, have higher incidences of erectile dysfunction, comorbid disease, and cardiovascular risk factors, and have a longer intravaginal ejaculation latency time (IELT) as compared with men with lifelong PE. A self-estimated or stopwatch IELT of 3 minutes was identified as a valid IELT cut-off for diagnosing acquired PE. On this basis, the committee agreed on a unified definition of both acquired and lifelong PE as a male sexual dysfunction characterized by (i) ejaculation that always or nearly always occurs prior to or within about 1 minute of vaginal penetration from the first sexual experience (lifelong PE) or a clinically significant and bothersome reduction in latency time, often to about 3 minutes or less (acquired PE); (ii) the inability to delay ejaculation on all or nearly all vaginal penetrations; and (iii) negative personal consequences, such as distress, bother, frustration, and/or the avoidance of sexual intimacy.ConclusionThe ISSM unified definition of lifelong and acquired PE represents the first evidence-based definition for these conditions. This definition will enable researchers to design methodologically rigorous studies to improve our understanding of acquired PE. Serefoglu EC, McMahon CG, Waldinger MD, Althof SE, Shindel A, Adaikan G, Becher EF, Dean J, Giuliano F, Hellstrom WJG, Giraldi A, Glina S, Incrocci L, Jannini E, McCabe M, Parish S, Rowland D, Segraves RT, Sharlip I, and Torres LO. An evidence-based unified definition of lifelong and acquired premature ejaculation: Report of the second International Society for Sexual Medicine Ad Hoc Committee for the Definition of Premature Ejaculation. Sex Med 2014;2:41-59.

IntroductionThe International Society for Sexual Medicine (ISSM) Ad Hoc Committee for the Definition of Premature Ejaculation developed the first evidence-based definition for lifelong premature ejaculation (PE) in 2007 and concluded that there were insufficient published objective data at that time to develop a definition for acquired PE.AimThe aim of this article is to review and critique the current literature and develop a contemporary, evidence-based definition for acquired PE and/or a unified definition for both lifelong and acquired PE.MethodsIn April 2013, the ISSM convened a second Ad Hoc Committee for the Definition of Premature Ejaculation in Bangalore, India. The same evidence-based systematic approach to literature search, retrieval, and evaluation used by the original committee was adopted.ResultsThe committee unanimously agreed that men with lifelong and acquired PE appear to share the dimensions of short ejaculatory latency, reduced or absent perceived ejaculatory control, and the presence of negative personal consequences. Men with acquired PE are older, have higher incidences of erectile dysfunction, comorbid disease, and cardiovascular risk factors, and have a longer intravaginal ejaculation latency time (IELT) as compared with men with lifelong PE. A self-estimated or stopwatch IELT of 3 minutes was identified as a valid IELT cut-off for diagnosing acquired PE. On this basis, the committee agreed on a unified definition of both acquired and lifelong PE as a male sexual dysfunction characterized by (i) ejaculation that always or nearly always occurs prior to or within about 1 minute of vaginal penetration from the first sexual experience (lifelong PE) or a clinically significant and bothersome reduction in latency time, often to about 3 minutes or less (acquired PE); (ii) the inability to delay ejaculation on all or nearly all vaginal penetrations; and (iii) negative personal consequences, such as distress, bother, frustration, and/or the avoidance of sexual intimacy.ConclusionThe ISSM unified definition of lifelong and acquired PE represents the first evidence-based definition for these conditions. This definition will enable researchers to design methodologically rigorous studies to improve our understanding of acquired PE. Serefoglu EC, McMahon CG, Waldinger MD, Althof SE, Shindel A, Adaikan G, Becher EF, Dean J, Giuliano F, Hellstrom WJG, Giraldi A, Glina S, Incrocci L, Jannini E, McCabe M, Parish S, Rowland D, Segraves RT, Sharlip I, and Torres LO. An evidence-based unified definition of lifelong and acquired premature ejaculation: Report of the second International Society for Sexual Medicine Ad Hoc Committee for the Definition of Premature Ejaculation. Sex Med 2014;2:41-59.

Background and objective: Premature ejaculation is one of the most common and complex sexual diseases among men. Although there are four defined subtypes of premature ejaculation, the most common subtype is acquired premature ejaculation. This study investigated the association between serum vitamin D levels and acquired premature ejaculation. Material and methods: This retrospective cross-sectional study included 94 patients with a complaint of acquired premature ejaculation (the study group) and 92 patients without a complaint of premature ejaculation (the control group) between June 2018 and March 2020. Patients’ demographic characteristics, laboratory results, intravaginal ejaculatory latency time, Turkish validated premature ejaculation diagnostic tool (PEDT), International Index of Erectile Function-5 (IIEF-5) and Beck Depression scores were statistically compared between groups. Results: The patients’ mean age was 49.10 ± 14.85 years. There were differences between the two groups regarding serum vitamin D levels, dehydroepiandrosterone sulfate, total testosterone, and follicle-stimulating hormone levels. Upon comparing the questionnaire scores, the PEDT, intravaginal ejaculatory latency time, and Beck depression scores were clinically significant between groups. The cut-off value for serum vitamin D levels was 8.37 ng/mL, with a sensitivity of 93% and specificity of 92%. Conclusion: We revealed that serum vitamin D and follicle-stimulating hormone levels were independent risk factors according to the multivariate analysis. Measurement of serum vitamin D levels in patients with acquired premature ejaculation may be useful for treatment.

We conducted the study to investigate the association between metabolic syndrome (MetS) and acquired premature ejaculation (APE). From January 2017 to December 2019, 1,000 subjects, 500 men with APE (APE group) and 500 men without APE (control group), were selected. Self‐estimated intravaginal ejaculatory latency time (IELT) and Premature Ejaculation Diagnostic Tool (PEDT) were recorded from each participant to evaluate APE. Detailed physical examinations, body composition analysis and blood tests were all assessed. The neck circumference, waist circumference, visceral fat rating, fat mass, fasting blood glucose (FBG) and highly sensitive C‐reactive protein (hs‐CRP) in the APE group were significantly higher than the control group (p <.05 for all). Furthermore, the APE population had a higher prevalence of MetS than the control group (49.4% versus 35.6%, p =.000). Consistent results could also be observed in terms of the number of MetS components and each component of the MetS (both p <.05). Moreover, both the prevalence of APE and the severity of PE increased significantly as the number of MetS components increased. Finally, in the multivariate analysis, we found that both MetS and hs‐CRP were independent risk factors for APE (both p <.01). The results indicated that APE was related to MetS but not its components. [ABSTRACT FROM AUTHOR]

Introduction: In 2014, new evidence-based definitions of lifelong premature ejaculation (LPE) and acquired premature ejaculation (APE) were proposed by the International Society for Sexual Medicine. Based on the new PE definitions, the prevalence of and factors associated with LPE and APE have not been investigated in China. Aim: To evaluate the prevalence of and factors associated with LPE and APE in men with the complaint of PE in China. Methods: From December 2011 to December 2015, a cross-sectional field survey was conducted in five cities in the Anhui province of China. Questionnaire data of 3,579 men were collected in our database. The questionnaire included subjects' demographic information and medical and sexual histories. Men who were not satisfied with their time to ejaculate were accepted as having the complaint of PE. Men with the complaint of PE who met the new definition of PE were diagnosed as having LPE or APE. Main Outcome Measures: New definition of LPE and APE. Results: Of 3,579 men who completed the questionnaire, 34.62% complained of PE. Mean age, body mass index, and self-estimated intravaginal ejaculatory latency time for all subjects were 34.97 ± 9.02 years, 23.33 ± 3.56 kg/m2, and 3.09 ± 1.36 minutes, respectively. The prevalences of LPE and APE in men with the complaint of PE were 10.98% and 21.39%, respectively. LPE and APE were associated with age, body mass index, and smoking and exercise rates (P < .001 for all comparisons). Men with APE reported more comorbidities than men with LPE, especially in the presence of hypertension, diabetes mellitus, and heart disease (P < .001 for all comparisons). Conclusion: In this study, the prevalences of LPE and APE in men with the complaint of PE were 10.98% and 21.39%, respectively. Patients with APE were older and more likely to smoke, had more comorbidities, and had a higher body mass index than patients with LPE.

Introduction: The International Society for Sexual Medicine (ISSM) Ad Hoc Committee for the Definition of Premature Ejaculation developed the first evidence-based definition for lifelong premature ejaculation (PE) in 2007 and concluded that there were insufficient published objective data at that time to develop a definition for acquired PE. Aim: The aim of this article is to review and critique the current literature and develop a contemporary, evidence-based definition for acquired PE and/or a unified definition for both lifelong and acquired PE. Methods: In April 2013, the ISSM convened a second Ad Hoc Committee for the Definition of Premature Ejaculation in Bangalore, India. The same evidence-based systematic approach to literature search, retrieval, and evaluation used by the original committee was adopted. Results: The committee unanimously agreed that men with lifelong and acquired PE appear to share the dimensions of short ejaculatory latency, reduced or absent perceived ejaculatory control, and the presence of negative personal consequences. Men with acquired PE are older, have higher incidences of erectile dysfunction, comorbid disease, and cardiovascular risk factors, and have a longer intravaginal ejaculation latency time (IELT) as compared with men with lifelong PE. A self-estimated or stopwatch IELT of 3 minutes was identified as a valid IELT cut-off for diagnosing acquired PE. On this basis, the committee agreed on a unified definition of both acquired and lifelong PE as a male sexual dysfunction characterized by (i) ejaculation that always or nearly always occurs prior to or within about 1 minute of vaginal penetration from the first sexual experience (lifelong PE) or a clinically significant and bothersome reduction in latency time, often to about 3 minutes or less (acquired PE); (ii) the inability to delay ejaculation on all or nearly all vaginal penetrations; and (iii) negative personal consequences, such as distress, bother, frustration, and/or the avoidance of sexual intimacy. Conclusion: The ISSM unified definition of lifelong and acquired PE represents the first evidence-based definition for these conditions. This definition will enable researchers to design methodologically rigorous studies to improve our understanding of acquired PE. Serefoglu EC, McMahon CG, Waldinger MD, Althof SE, Shindel A, Adaikan G, Becher EF, Dean J, Giuliano F, Hellstrom WJG, Giraldi A, Glina S, Incrocci L, Jannini E, McCabe M, Parish S, Rowland D, Segraves RT, Sharlip I, and Torres LO. An evidence-based unified definition of lifelong and acquired premature ejaculation: Report of the second International Society for Sexual Medicine Ad Hoc Committee for the Definition of Premature Ejaculation. Sex Med 2014;2:41–59.

Introduction: Premature ejaculation (PE) is classified as primary and acquired and may be facilitated by different pathophysiology. Brain plays an important role in PE, however, differences in the central neuropathological mechanisms among subtypes of PE are unknown., Materials and Methods: We acquired diffusion tensor imaging (DTI) data from 44 healthy controls (HC) and 47 PE patients (24 primary PE and 23 acquired PE). Then, the whole-brain white matter (WM) structural networks were constructed and between-group differences of nodal segregative parameters were identified by the method of graph theoretical analysis. Moreover, receiver operating characteristic (ROC) curves were performed to determine the suitability of the altered parameters as potential neuroimaging biomarkers for distinguishing primary PE from acquired PE., Results: PE patients showed significantly increased clustering coefficient C ( i ) in the left inferior frontal gyrus (triangular part) (IFGtriang.L) and increased local efficiency E loc ( i ) in the left precental gyrus (PreCG.L) and IFGtriang.L when compared with HC. Compared to HC, primary PE patients had increased C ( i ) and E loc ( i ) in IFGtriang.L and the left amygdala (AMYG.L) while acquired PE patients had increased C ( i ) and E loc ( i ) in IFGtriang.L, and decreased C ( i ) and E loc ( i ) in AMYG.L. Compared to acquired PE, primary PE patients had increased C ( i ) and E loc ( i ) in AMYG.L. Moreover, ROC analysis revealed that PreCG.L, IFGtriang.L and AMYG.L might be helpful for distinguishing different subtypes of PE from HC (PE from HC: sensitivity, 61.70-78.72%; specificity, 56.82-77.27%; primary PE from HC: sensitivity, 66.67-87.50%; specificity, 52.27-77.27%; acquired PE from HC: sensitivity, 34.78-86.96%; specificity, 54.55-100%) while AMYG.L might be helpful for distinguishing primary PE from acquired PE (sensitivity, 83.33-91.70%; specificity, 69.57-73.90%)., Conclusion: These findings improved our understanding of the pathophysiological processes that occurred in patients with ejaculatory dysfunction and suggested that the abnormal segregation of left amygdala might serve as a useful marker to help clinicians distinguish patients with primary PE from those with acquired PE., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2022 Chen, Wang, Huang, Xu, Xiang, Liu, Yang and Chen.)

In addition to the previously defined 'lifelong' and 'acquired' premature ejaculation (PE), the existence of two more subtypes of PE, namely 'natural variable PE' and 'premature-like ejaculatory dysfunction,' has been proposed. To evaluate the diagnostic value of the Premature Ejaculation Diagnostic Tool (PEDT) and Arabic Index of Premature Ejaculation (AIPE) in a population-based study, in relation to their sensitivity across these four different PE syndromes and to assess the Premature Ejaculation Profile (PEP) scores of patients with lifelong, acquired, natural variable PE and premature-like ejaculatory dysfunction. Between June 2009 and December 2009, couples were randomly selected from 17 provinces of Turkey. Subjects with the complaint of ejaculating prematurely were classified as lifelong, acquired, natural variable PE, and premature-like ejaculatory dysfunction according to the medical and sexual history they described. PE status was also assessed with PEDT, AIPE and PEP. The sensitivity, specificity, positive predictive value and negative predictive value were calculated for PEDT and AIPE in the study population whereas detection rates of these two questionnaires were also compared among the four PE syndromes. Moreover, PEP scores of patients with lifelong, acquired, natural variable PE and premature-like ejaculatory dysfunction were compared. Significance level was considered as P < 0.05. Scores obtained from PEDT, AIPE, and PEP questionnaires. A total of 2,593 couples were enrolled where 512 (20.0%) male subjects reported PE. PEDT, AIPE, and PEP measures of the PE patients indicated worse sexual function ( P < 0.001 each). Mean scores obtained from questionnaires were significantly better in patients with premature-like ejaculatory dysfunction and they were the worst in patients with acquired PE ( P < 0.001 each). The sensitivity values of PEDT and AIPE were 89.3 and 89.5, whereas their specificity values were 50.5 and 39.1, respectively. There were statistically significant differences in detection rates of PEDT and AIPE among the four PE syndromes ( P = 0.006 and P < 0.001). They were higher in acquired and lifelong PE and lower in premature-like ejaculatory dysfunction. PEDT and AIPE can diagnose PE with high sensitivity, especially in patients with lifelong and acquired PE. The complaint of patients with acquired PE seems to be more severe than those complaining of lifelong, natural variable PE and premature-like ejaculatory dysfunction patients. [ABSTRACT FROM AUTHOR]

Introduction: In 2014, new evidence-based definitions of lifelong premature ejaculation (LPE) and acquired premature ejaculation (APE) were proposed by the International Society for Sexual Medicine. Based on the new PE definitions, the prevalence of and factors associated with LPE and APE have not been investigated in China., Aim: To evaluate the prevalence of and factors associated with LPE and APE in men with the complaint of PE in China., Methods: From December 2011 to December 2015, a cross-sectional field survey was conducted in five cities in the Anhui province of China. Questionnaire data of 3,579 men were collected in our database. The questionnaire included subjects' demographic information and medical and sexual histories. Men who were not satisfied with their time to ejaculate were accepted as having the complaint of PE. Men with the complaint of PE who met the new definition of PE were diagnosed as having LPE or APE., Main Outcome Measures: New definition of LPE and APE., Results: Of 3,579 men who completed the questionnaire, 34.62% complained of PE. Mean age, body mass index, and self-estimated intravaginal ejaculatory latency time for all subjects were 34.97 ± 9.02 years, 23.33 ± 3.56 kg/m 2 , and 3.09 ± 1.36 minutes, respectively. The prevalences of LPE and APE in men with the complaint of PE were 10.98% and 21.39%, respectively. LPE and APE were associated with age, body mass index, and smoking and exercise rates (P < .001 for all comparisons). Men with APE reported more comorbidities than men with LPE, especially in the presence of hypertension, diabetes mellitus, and heart disease (P < .001 for all comparisons)., Conclusion: In this study, the prevalences of LPE and APE in men with the complaint of PE were 10.98% and 21.39%, respectively. Patients with APE were older and more likely to smoke, had more comorbidities, and had a higher body mass index than patients with LPE., (Copyright © 2016 The Authors. Published by Elsevier Inc. All rights reserved.)

Objective: To investigate the correlation between the premature ejaculation diagnostic tool (PEDT) and International Index of Erectile Function-15 (IIEF-15) in different types of premature ejaculation (PE)., Methods: We performed a cross-section survey among 352 PE patients received in the andrology clinic from December 2014 to December 2015 and 104 healthy men from the health examination center using basic demographic information (as on age, height, weight, education status, occupation, income, etc.), PEDT results, and IIEF-15 scores of the subjects., Results: The PE patients had remarkably higher PEDT and lower IIEF-15 scores than the healthy men (P<0.01). The PEDT score of the PE patients was negatively correlated with their total IIEF-15 score as well as with the scores in the domains of erectile function, sexual intercourse satisfaction, and overall satisfaction after adjusted for age (P<0.01). The patients with acquired PE (APE) showed a lower IIEF-15 score than those with lifelong PE (LPE) (P<0.01). The PEDT score of the APE patients was correlated negatively with the total IIEF-15 score (r=－0.391, P<0.01) and the scores in the domains of erectile function (r=－0.362, P<0.01) and overall satisfaction (r=－0.621, P<0.01), but not correlated with intercourse satisfaction, sexual orgasm, or sexual desire. The PEDT score of the LPE group was correlated negatively with intercourse satisfaction (r=－0.286, P<0.05) but not correlated with either the total IIEF-15 score or the scores in the domains of erectile function, overall satisfaction, sexual orgasm, or sexual desire., Conclusions: PE patients have a higher PEDT score and a lower IIEF-15 score than normal males. The PEDT score of APE patients is significantly correlated with the total IIEF-15 score, while that of LPE patients is correlated not with the total IIEF-15 score but with intercourse satisfaction.

Introduction: The International Society for Sexual Medicine (ISSM) Ad Hoc Committee for the Definition of Premature Ejaculation developed the first evidence-based definition for lifelong premature ejaculation (PE) in 2007 and concluded that there were insufficient published objective data at that time to develop a definition for acquired PE., Aim: The aim of this article is to review and critique the current literature and develop a contemporary, evidence-based definition for acquired PE and/or a unified definition for both lifelong and acquired PE., Methods: In April 2013, the ISSM convened a second Ad Hoc Committee for the Definition of Premature Ejaculation in Bangalore, India. The same evidence-based systematic approach to literature search, retrieval, and evaluation used by the original committee was adopted., Results: The committee unanimously agreed that men with lifelong and acquired PE appear to share the dimensions of short ejaculatory latency, reduced or absent perceived ejaculatory control, and the presence of negative personal consequences. Men with acquired PE are older, have higher incidences of erectile dysfunction, comorbid disease, and cardiovascular risk factors, and have a longer intravaginal ejaculation latency time (IELT) as compared with men with lifelong PE. A self-estimated or stopwatch IELT of 3 minutes was identified as a valid IELT cut-off for diagnosing acquired PE. On this basis, the committee agreed on a unified definition of both acquired and lifelong PE as a male sexual dysfunction characterized by (i) ejaculation that always or nearly always occurs prior to or within about 1 minute of vaginal penetration from the first sexual experience (lifelong PE) or a clinically significant and bothersome reduction in latency time, often to about 3 minutes or less (acquired PE); (ii) the inability to delay ejaculation on all or nearly all vaginal penetrations; and (iii) negative personal consequences, such as distress, bother, frustration, and/or the avoidance of sexual intimacy., Conclusion: The ISSM unified definition of lifelong and acquired PE represents the first evidence-based definition for these conditions. This definition will enable researchers to design methodologically rigorous studies to improve our understanding of acquired PE., (© 2014 International Society for Sexual Medicine.)

Introduction: Premature ejaculation (PE) is the most common masculine sexual disorder with a potentially deleterious effect on the patient's morale and the relationship with the partner. It is underdiagnosed, or self-diagnosed, and as patients hesitate to confide in their doctor, and doctors do not enquire about it, it is rarely treated. Effective medication does exist, in particular serotonin reuptake inhibitors., Methods: Medical literature was reviewed and combined with expert opinion of the authors., Results: The distinction is rarely made between lifelong, primary and acquired PE but this distinction determines the choice and efficacy of the therapeutic strategy. Originally seen from a psychoanalytical viewpoint, it was later seen from a behavioral angle. For primary PE, according to Kaplan and contemporary sexology, a psycho-sexological concept has been evoked: sinful stain and symbolic frustration of the woman following an unresolved conflict, revived by a conflict with the partner. For primary PE, a pathophysiological origin with the notion of genetic susceptibility with possible variation of the central serotoninergic neurotransmission has been suggested. We give here the different etiological hypotheses, the clinical types and the different therapeutic strategies for management of PE (a more precise etio-pathological diagnosis). Some key points are highlighted: factors related to the partner are underestimated, her 'use' as therapy is underexploited, an integrated or combined approach which is potentially more efficacious can go beyond the prolongation of the ejaculation time lapse to optimize the patient's relationship and equilibrium. Maintaining the results over time is however problematic., Conclusion: When rapid ejaculation causes a distress, it is a sexual dysfunction deserving medical and/or psycho-sexological management currently evidence-based., (Copyright © 2013 Elsevier Masson SAS. All rights reserved.)