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Aim: To investigate the relationship between hepatitis B virus (HBV) infection and premature ejaculation (PE) in a Turkish Population. Materials/methods: A total of 147 patients with chronic HBV infection and 150 healthy volunteers were included in the multi-center case-control study. PE was evaluated using the five-item Premature Ejaculation Diagnostic Tool (PEDT) validated in Turkish men. Results: The presence of PE was significantly higher in the HBV-infected group compared with the control group (32.7 vs 18.7%; p = 0.006). The METAVIR fibrosis score was significantly higher in the PE group than in the non-PE group (p = 0.028). Discussion & conclusion: PE is more common in HBV-infected patients than in healthy individuals. Chronic liver damage is more common in HBV-infected patients with PE. Plain Language Summary Premature ejaculation (PE) is when a male ejaculates earlier than desired during sex. It is not clear why this happens, but it might be related to health problems such as diabetes, poor sleep, being overweight, feeling stressed and vitamin deficiency. Hepatitis B virus (HBV) mainly affects the liver and can cause long-term illnesses. In this study, we examined whether there was a connection between HBV infection and PE in men from Türkiye. We examined 147 men with HBV infection and 150 healthy controls. We found that men with HBV infection may have a higher risk of developing PE. Early detection and control of HBV infection are important. Article highlights Introduction Hepatitis B virus (HBV) is a DNA virus can cause acute and chronic infections. Early ejaculation is defined as the ejaculation of the male within a very short period with the onset of vaginal penetration or any sexual stimulation. To the best of our knowledge, this study represents the first investigation into the relationship between HBV infection and premature ejaculation (PE). Methods This study had a multi-center and case-control design. A total of 147 patients with chronic HBV infection who underwent a liver biopsy and 150 healthy volunteers were included in the study. Premature ejaculation was evaluated with the five-item Premature Ejaculation Diagnostic Tool (PEDT). The METAVIR fibrosis scoring system was used to evaluate the liver fibrosis score. Results The median PEDT score was 10 (3–13) in the HBV-infected patients and 7 (2–11) in the controls (p < 0.0001). PE was present in 18 of the 32 HBV-infected patients (56.3%) with advanced liver fibrosis (METAVIR fibrosis score: 3–4) and 30 of the 115 HBV-infected patients (26.1%) with a METAVIR fibrosis score of 0–2 (p = 0.002). Conclusion PE is more common in HBV-infected patients than in healthy controls. Chronic liver damage is more common in HBV-infected patients with PE. Our results suggest that a multisystemic evaluation can improve the quality of life of chronic HBV-infected patients. [ABSTRACT FROM AUTHOR]

Background: Premature ejaculation (PE) is a highly prevalent male sexual dysfunction. Its current definition, together with the most used diagnostic tools, does not include nonvaginal sexual intercourse such as anal sex, self‐masturbation and/or partnered‐masturbation, and other forms of sexual stimulation. However, diagnostic psychometry currently available is exclusively evaluating PE in the vaginal coitus. Objectives: To validate a new tool, the masturbatory premature ejaculation diagnostic tool (MPEDT), by assessing the control over ejaculation and its psychological effects during self‐masturbation, rather than heterosexual vaginal intercourse. Materials and methods: We studied 135 male patients aging from 18 to 40 years seeking medical care for PE in the Infertility and Sexual Medicine Department from June to September 2020. All the participants were asked to fill the premature ejaculation diagnostic tool PEDT and MPEDT questionnaires to estimate the PE symptoms during, respectively, intercourse and self‐masturbation. The reliability/validity, the factor analysis of the tool, and the diagnostic sensitivity/specificity of MPEDT were calculated. Results: The overall Cronbach alpha was 0.884. In our adjusted model, both root mean square error of approximation (RMSEA) and standardized root mean square residual (SRMR) were lower than 0.08, while goodness of fit index, adjusted goodness of fit index, non‐normed fit index (NNFI), and comparative fit index (CFI) were higher than 0.9. The area under the ROC curve (AUC) is 0.943 ± 0.015. The results suggest MPEDT points being ≤5 as "normal," ≥7 as "PE during self‐masturbation," and 6 as "suspected PE," with the sensitivity of 91.9% and specificity of 88.1%. Discussion: An efficient diagnostic psychometric tool is needed for the individuals who, based on the impaired control over ejaculation during self‐masturbation, may also suffer from PE during partnered intercourse. MPEDT is able to evaluate the existence of PE symptoms not necessarily during heterosexual intercourse but rather during self‐masturbation, possibly aiding to the diagnosis, as well as planning and follow‐up of a prompt therapeutical strategy. Conclusion: MPEDT could be considered a new, objective, and reliable diagnostic tool for the evaluation of the existence of PE symptoms. [ABSTRACT FROM AUTHOR]

Objectives: Incidence and prevalence of patients in dialytic therapy increased considerably in recent years. The onset of new issues, once overshadowed, linked to a lower quality of life like sexual dysfunction became increasingly common. The first study in this area, dating back to the 1970s, shows the high prevalence of sexual dysfunction among patients in dialytic therapy of both sexes. Later studies proved an association of sexual dysfunction with psyche disorders, anxiety, depression and lack of self-confidence. The aim of this study is to describe the incidence of male and female sexual main dysfunctions, the latter not least in literature, in patients in hemodialytic therapy. With this aim two dialytic centers have been compared, one located in northern Italy and one in southern Italy, and the different prevalence has been compared to the general population. Methods: We conducted a prospective cross-sectional observational study in patients undergoing dialytic therapy in two hemodialysis centers, one located in Palermo and one in Lecco. Male sexual dysfunction was investigated by the International Index of Erectile Function-15 (IIEF15) questionnaire and the Premature Ejaculation Diagnotic Tool (PEDT) questionnaire, and the female dysfunction by Female Sexual Function Index (FSFI) questionnaire. Criteria for inclusion in our study were: age < 75 years and dialytic age > 3 months; exclusion criteria were: advanced cancer diseases, life expectancy < 6 months, previous urological manipulation, anti-androgenic therapy, sexual dysfunction unrelated to kidney disease, psychiatric disorders. Data were compared with mean-standard deviation (SD) and with the variance analysis (ANOVA). A value of p < 0.05 is considered significant. Discrete data were analyzed with contingency analysis. A chi2 < 0.05 was considered significant. Results: Data of 78 patients have been collected. Mean age and dialytic time were 54 ± 12 years and 42 ± 35 month; 33 patients were from Palermo and 24 from Lecco; 21 patients were excluded. Age and dialytic age of the two subgroups did not demonstrate statistically significant differences. Between the two centers there was a statistically significant difference (p < 0.005) in the distribution of basic nephropathy: an higher incidence of diabetic and obstructive nephropathy has been observed in the southern center compared to northern center, while glomerulonephritis and polycystic kidney disease had an higher incidence in the northern center compared to southern one. The main sexual dysfunctions in both sexes, erectile dysfunction (ED) and premature ejaculation (PE) in men and orgasm disorder and pelvic pain in women, have been investigated. ED was present in 70% of hemodialyzed patients, which is an higher incidence compared to the general population. The severity of ED between patients of the two groups was significantly different (chi2 < 0.001) with higher incidence of moderate/severe forms in northern Italy. The score, in addition to discrete data (severe, moderate, mild, absence), of ED was significantly different (p < 0.001) between patients of the two centers (22 ± 7 Palermo vs. 9 ± 8, Lecco). The PE was absent in 20 patients (54%), present in 12 patients (32%) and probable in 5 patients (14%) (scores of 7.6 ± 4.0 and 8.9 ± 6.8, respectively in Palermo and Lecco patients). For women, orgasmic dysfunction was severe in 10 patients (50%), mild in 4 patients (20%), very mild in 5 patients (25%), while it was normal in 1 patient (5%), with a statistically significant difference (p< 0.05) between Palermo and Lecco patients (3.0 ± 1.4 vs 1.2 ± 2.0). Sexual pain in women was severe in 11 patients (55%), moderate in 4 patients (20%) and mild in 5 patients (25%). Sexual pain was present in all patients (p < 0.05). Conclusions: Regardless of sex, sexual dysfunction is one of the most common side effect in patients with end stage renal disease in dialytic therapy. Our study confirms literature data. The growing number of the dialytic population with sexual disorders needs specialist support to improve quality of life of these patients. [ABSTRACT FROM AUTHOR]

Objective: To explore the clinical effect of warm acupuncture with large-quantity moxibustion on primary premature ejaculation (kidney deficiency and liver stagnation)., Methods: A total of 240 patients with primary premature ejaculation (kidney deficiency and liver stagnation) were randomly divided into a warm acupuncture group (80 cases, 5 cases dropped out), an acupuncture group (80 cases, 4 cases dropped out) and a western medication group (80 cases, 6 cases dropped out). In the warm acupuncture group, a large quantity of moxibustion was delivered after acupuncture at Baihui (GV 20), Qihai (CV 6), Guanyuan (CV 4) and Zhongji (CV 3), as well as bilateral Fengchi (GB 20), lateral line 3 of forehead (MS 4), neishengzhiqi (TF 2 ), Ganshu (BL 18), Shenshu (BL 23), and etc. One treatment with warm acupuncture took 40 min, once daily; five treatments were given per week and 4 weeks of treatment was required. In the acupuncture group, moxibustion was not delivered, and the rest operation of acupuncture was same as the warm acupuncture group. In the western medication group, dapoxetine hydrochloride tablets were administered orally, 30 mg each time, taken with warm water 1 h to 3 h before sexual intercourse. Medication was administered at most once within 24 h, twice per week, and 6 times within 4 weeks. Before and after treatment, the score of TCM symptoms, the score of premature ejaculation diagnostic tool (PEDT), intravaginal ejaculation latency time (IELT) and the serum sex hormone content (testosterone [T], luteinizing hormone [LH] and follicule stimulating hormone [FSH]) were observed and the clinical effect was evaluated in the three groups., Results: After treatment, the scores for less duration of intercourse (<1 min), post-ejaculation fatigue, low spirit and decreased libido, and the total scores of TCM symptoms, as well as PEDT scores were reduced when compared with those before treatment in each group ( P <0.01, P <0.05), and IELT was prolonged ( P <0.01) in the three groups. The serum T content was increased when compared with that before treatment in the warm acupuncture group ( P <0.05). After treatment, in comparison with the acupuncture group and the western medication group, the scores for post-ejaculation fatigue, soreness and weakness in the lumbar region and knee joints, decreased libido, insomnia, dream-disturbed sleep and frequent nocturnal enuresis, as well as the total score of TCM symptoms were lower ( P <0.05, P <0.01) and the serum T content was increased ( P <0.05) in the warm acupuncture group. When compared with the acupuncture group, PEDT scores were lower and IELT prolonged in the warm acupuncture group and the western medication group ( P <0.05, P <0.01). The total effective rate was 82.7% (62/75) in the warm acupuncture group, higher than that of the acupuncture group (68.4%, 52/76) and the western medication group (64.9%, 48/74, P <0.05) respectively., Conclusion: Warm acupuncture with large-quantity moxibustion ameliorates the clinical symptoms and increases intravaginal ejaculation latency time and the levels of sex hormone in the patients with primary premature ejaculation (kidney deficiency and liver stagnation).

To assess the frequency of premature ejaculation (PE) in patients with genital warts (GWs) and to hypothesize the potential relation between GWs and PE. Materials and Methods: This study was designed as a pilot prospective cross-sectional clinical study. It was done on 56 male patients with GWs and 50 male healthy control subjects. All included patients and controls were assessed by intravaginal ejaculatory latency time (IELT), Premature Ejaculation Diagnostic Tool (PEDT), sexual satisfaction and Beck Anxiety Inventory (BAI). Results: According to PEDT, 37 (66.07%) patients with GWs diagnosed with PE and 19 (33.92%) patients with GWs had no PE. This study showed that the means of BAI and PEDT total scores were statistically significant higher in patients with GWs and PE than patients with GWs and no PE, and healthy control subjects (P value =0.001). There was a positive correlation between PEDT total scores and BAI total scores in patients with GWs and PE (P value = 0.001). Conclusion: This study concluded that PE is a frequent male sexual dysfunction among male patients with GWs. Patients with PE and GWs have high rates of anxiety and psychological stress. [ABSTRACT FROM AUTHOR]

The premature ejaculation diagnostic tool (PEDT) is a brief diagnostic measure to assess premature ejaculation (PE). However, there is insufficient evidence regarding its validity in the new evidence-based-defined PE. This study was performed to evaluate the validity of PEDT and its association with IIEF-15 in different types of evidence-based-defined PE. From June 2015 to January 2016, a total of 260 men complaining of PE and defined as lifelong PE (LPE)/acquired PE (APE) according to the evidence-based definition from Andrology Clinic of the First Affiliated Hospital of Anhui Medical University, along with 104 male healthy controls without PE from a medical examination center, were enrolled in this study. All individuals completed questionnaires including demographics, medical and sexual history, as well as PEDT and IIEF-15. After statistical analysis, it was found that men with PE reported higher PEDT scores (14.28 ± 3.05) and lower IIEF-15 (41.26 ± 8.20) than men without PE (PEDT: 5.32 ± 3.42, IIEF-15: 52.66 ± 6.86, P < 0.001 for both). It was suggested that a score of ≥9 indicated PE in both LPE and APE by sensitivity and specificity analyses (sensitivity: 0.875, 0.913; specificity: 0.865, 0.865, respectively). In addition, IIEF-15 were higher in men with LPE (42.64 ± 8.11) than APE (39.43 ± 7.84, P < 0.001). After adjusting for age, IIEF-15 was negatively related to PEDT in men with LPE (adjust r = −0.225, P < 0.001) and APE (adjust r = −0.378, P < 0.001). In this study, we concluded that PEDT was valid in the diagnosis of evidenced-based-defined PE. Furthermore, IIEF-15 was negatively related to PEDT in men with different types of PE.

The aim of the study was to evaluate the long-term outcomes of pelvic floor muscle (PFM) rehabilitation in males with lifelong premature ejaculation (PE), using intravaginal ejaculatory latency time (IELT) and the self-report Premature Ejaculation Diagnostic Tool (PEDT) as primary outcomes. A total of 154 participants were retrospectively reviewed in this study, with 122 completing the training protocol. At baseline, all participants had an IELT ≤60 s and PEDT score >11. Participants completed a 12-week program of PFM rehabilitation, including physio-kinesiotherapy treatment, electrostimulation, and biofeedback, with three sessions per week, with 20 min for each component completed at each session. The effectiveness of intervention was evaluated by comparing the change in the geometric mean of IELT and PEDT values, from baseline, at 3, 6, and 12 months during the intervention, and at 24 and 36 months postintervention, using a paired sample 2-tailed t-test, including the associated 95% confidence intervals. Of the 122 participants who completed PFM rehabilitation, 111 gained control of their ejaculation reflex, with a mean IELT of 161.6 s and PEDT score of 2.3 at the 12-week endpoint of the intervention, representing an increase from baseline of 40.4 s and 17.0 scores, respectively, for IELT and PEDT (P < 0.0001). Of the 95 participants who completed the 36-month follow-up, 64% and 56% maintained satisfactory ejaculation control at 24 and 36 months postintervention, respectively.

Patients with premature ejaculation (PE) often complain of difficulty in having second erection, which is not yet investigated using scientific methodology. Evaluation of the association between post-ejaculation refractory time (PERT) with PE by comparing PERT in premature ejaculators with their age-matched control subjects. After ethical committee approval and written informed consent from the participants were obtained, men in a monogamous stable sexual relationship and reporting PE were recruited into the study. Sexually active, matched control subjects were recruited for comparison. Exclusion criteria were erectile dysfunction, diabetes mellitus, cardiovascular diseases, hypogonadism, psychiatric conditions, instrumentation of the genitourinary tract, genitourinary anomalies, and genitourinary infections. Both the premature ejaculators and their control subjects were evaluated with the PE diagnostic tool before initiation of the study. They were asked to record their IELT and PERT over 4 weeks. The statistical analysis was done to obtain descriptive statistics, namely, mean and SD, paired t -tests, and logistic regression analysis. P <.001 was considered significant. There was a statistically significant association between prolonged PERT and PE in patients with PE compared with their age-matched control subjects. 102 premature ejaculators and an equal number of matched control subjects were evaluated from January 2016–December 2017. The average PERT in premature ejaculators and control subjects was 330 ± 296.63 minutes and 105.64 ± 98.59 minutes, respectively (P <.0001). Increasing age was associated with increasing PERT. PE was more common in patients when PERT exceeded a threshold of 590 minutes. Until now, the association between PE and PERT with matched-pair analysis was not reported. Our study addresses this association, which can add a new paradigm in the evaluation and management of PE. The association between PE and prolonged PERT using a statistically appropriate, adequately powered methodology is the strength of the study. The inability to address the causal association between prolonged PERT and PE because of the paucity of evidence at present is the limitation of the study. We believe that the results of this study could trigger further research into such an association, so the mystery of such an association can be unraveled. The association between prolonged PERT and PE, as seen in our study, is a finding, that needs further research to establish a causal association. However, reporting such an association is necessary because it is contrary to the present understanding. Bhat GS, Shastry A. Association Between Post-Ejaculatory Refractory Time (PERT) and Premature Ejaculation (PE). J Sex Med 2019;16:1364–1370. [ABSTRACT FROM AUTHOR]

Purpose: Premature ejaculation (PE) is a prevalent disorder in males leading to sequelae such as lack of self-confidence, anxiety, depression and unsatisfactory intercourse for these men and their partners. The aim of this study was to evaluate the relationship between ejaculation and physical activity. Materials and Methods: Group 1 comprised 112 participants who took regular physical activity and Group 2 comprised 126 participants with a sedentary lifestyle. The participants were 18-45 years old, same ethnic origin, in same location and had regular sexual activity for at least 6 months. A comparison was made by metabolic equivalents (MET), premature ejaculation diagnostic tool (PEDT) and intravaginal ejaculatory latency time (IELT). Result: The mean age of Groups 1 and 2 was 25.34 years (range, 18-41 years) and 28.49 years (range, 19-45 years), respectively (P = .21). The mean PEDT score was 6.18 in Group 1, and 10.02 in Group 2. Significant differences were found between Groups 1 and 2 (P = .001). The mean MET score of Group 1 was 3448.23 METmin/ week (3012-4496 MET- min/week) while the MET score of Group 2 was 201.87 MET- min/week (66-744 MET- min/week) (P = .001). The mean IELT of Groups 1 and 2 were 316.42 s (120-1530 s) and 189.32 s (20-450 s), respectively. The mean IELT was significantly higher in Group 1 (P = .001). Conclusion: The study results demonstrated that PE was less frequent in men that perform regular physical activity compared to those with a sedentary lifestyle. It can be assumed that regular physical activity may be effectual in gaining a sexual life of higher quality. Prospective studies with longitudinal data are needed to further understand the potential relationship between regular physical activity and premature ejaculation. [ABSTRACT FROM AUTHOR]

Abstract Introduction Several recent neuroimaging studies have identified functional and structural abnormalities in the cerebral cortex of lifelong premature ejaculation (LPE) patients, including task-related and resting-state brain function, and cortical thickness, although changes in white matter microstructure have not been reported. Aim To assess the differences in white matter microstructure between LPE patients and healthy controls. Methods Diffusion tensor imaging (DTI) and tract-based spatial statistical analysis were used to detect differences in white matter microstructure between 32 LPE patients and 32 matched healthy controls. We also analyzed correlations of clinical indices with significant DTI–based features. Main Outcome Measures DTI–based features (including fractional anisotropy [FA], mean diffusivity, axial diffusivity, and radial diffusivity) were assessed in LPE patients and controls, as well as the correlation of white matter changes in LPE patients with clinical data (including the premature ejaculation diagnostic tool score and the International Index of Erectile Function). Results LPE patients showed widespread increases in FA and axial diffusivity values compared with controls, including in the right posterior thalamic radiation, posterior corona radiata, bilateral posterior limb of the internal capsule, superior corona radiata, and external capsule. Further, FA in the right posterior thalamic radiation was positively correlated with the premature ejaculation diagnostic tool score in LPE patients. Clinical Implications Changes of white matter microstructure may be an underlying marker for evaluating sensory conduction efficiency in LPE patients. Strengths & Limitations There are no previous studies examining white matter microstructure in LPE patients. The present study furthers our understanding of the etiology of LPE. Limitations include a cross-sectional study design without causal information, and no measurement of conduction efficiencies such as cortical somatosensory-evoked potential from the penis, or psychosocial factors. Conclusion Our findings show potential microstructural white matter abnormalities related to LPE, suggesting that changes in fiber pathways connecting the cerebral cortex and the thalamus may play roles in the etiology of LPE. Gao M, Yang X, Liu L, et al. Abnormal White Matter Microstructure in Lifelong Premature Ejaculation Patients Identified by Tract-Based Spatial Statistical Analysis. J Sex Med 2018;15:1272–1279. [ABSTRACT FROM AUTHOR]

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Summary: Previous studies have investigated whether physical activity increases serotonin hormone levels. Serotonin receptor dysfunction is one of the frequently accused factors of premature ejaculation (PE). Nevertheless, no studies up to date have demonstrated that the association between physical activity and premature ejaculation. We aimed to investigate the relationship between physical activity and PE and determine whether moderate physical activity might delay ejaculation time or be an alternative treatment for PE. A total of 105 patients diagnosed with PE were enrolled in this study. Of the patients, 35 were treated with dapoxetine, (30 mg) on demand (Group 1), 35 performed moderate physical activities (Group 2), and 35 performed minimal physical activity (Group 3‐sham). Demographic characteristics, metabolic equivalents (MET), premature ejaculation diagnostic tool (PEDT) and intravaginal ejaculatory latency time (IELT) were recorded. There were no significant differences among three groups in terms of age, BMI, MET, PEDT or IELT before treatment. At the end of the study, there was significant decrease in PEDT scores, and increase in IELT in groups 1 and 2 as compared to Group 3. In conclusion, a moderate physical activity longer than 30 min at least 5 times a week leads to ejaculation delay, and appears as an alternative to dapoxetine on demand for the treatment of PE. [ABSTRACT FROM AUTHOR]

Objective: To observe the effificacy and safety of Qiaoshao Formula (翘芍方, QSF) on patients with lifelong premature ejaculation (LPE) of Gan (Liver) depression and Shen (Kidney) defificiency syndrome. Methods: A total of 60 LPE patients were randomly divided into treatment (QSF) and control (dapoxetine) groups. The treatment group received QSF twice a day and the control group received dapoxetine 1 to 2 h prior to planned sexual intercourse for 4 weeks. The outcomes included intra-vaginal ejaculation latency time (IELT), premature ejaculation diagnostic tool (PEDT), clinical global impression of change (CGIC), scores of Chinese medicine symptoms (CMSS), sex life satisfaction (SLS) and adverse events (AEs). Results: In the treated group, the median IELT was 3 min vs. 1.5 min before and after treatment ( P<0.05). PEDT in the treated group was reduced to 11.76±1.68 from 15.83±2.30 after treatment ( P<0.05). Besides, patient's SLS was improved from 1.30±0.05 to 6.30±0.04 ( P<0.05), and spouse's SLS was increased from 1.30±0.to 6.10±0.06 ( P<0.05); CMSS was decrease from 14.86±3.02 to 9.62±2.87 ( P<0.05). In addition, no significant AE was observed in both groups. Conclusion: QSF may be effective and safe on LPE patients with Gan depression and Shen defificiency syndrome. [ABSTRACT FROM AUTHOR]

We evaluated the impact of total prostate volume (TPV) on the international index of erectile function-5 (IIEF) and the premature ejaculation diagnostic tool (PEDT). A cross-sectional study was conducted that included 8336 men who had participated in a health examination. PEDT, IIEF and transrectal ultrasonography were used. A full metabolic work-up and serum testosterone level checks were also performed. The median age of participants was 51.0 years. In total, 40.1% had IIEF scores ≤16. Additionally, 24.7% were classified as demonstrating premature ejaculation (PE) (PEDT > 10). The severity of erectile dysfunction (ED) significantly increased with the TPV (ptrend < 0.001). After adjusting for potential confounding factors, the odds ratio (OR) for IIEF scores ≤ 16 significantly increased in the group with TPVs of 30–39 cm3and the group with TPVs ≥ 40 cm3compared with the group with TPVs ≤ 19 cm3(TPV 30–39 cm3, OR: 1.204, 95% confidence interval: 1.034–1.403; TPV ≥ 40 cm3, OR: 1.326: 95% confidence interval: 1.051–1.733) and this relationship was maintained after adjusting for propensity score (TPV ≥ 30 cm3, OR: 1.138: 95% confidence interval: 1.012–1.280). However, neither PEDT nor PE was correlated with TPV. In conclusion, TPV is significantly and independently correlated with IIEF but not with PEDT. Future investigations should explore the temporal relationship between TPV and ED. [ABSTRACT FROM PUBLISHER]

Introduction The premature ejaculation diagnostic tool ( PEDT) was developed to standardize the diagnosis of PE and has been applied in many countries. However, a linguistic validation of the Chinese version of PEDT does not exist. Aims This study aims to undertake the Chinese validation of the PEDT and to evaluate its association with self-estimated intravaginal ejaculatory latency time ( IELT) and clinical expert diagnosis of PE. Methods A Chinese version of PEDT was confirmed by andrologist and bilingual linguist. Participants were recruited among seven different communities of Shanghai from 2011 to 2012, and their information regarding self-reported PE, self-estimated IELT, expert diagnosis of PE, and PEDT scores were collected. Main Outcome Measures Validity of the PEDT and its association with clinical expert diagnosis of PE and self-estimated IELT were analyzed. Results A total of 143 patients without PE (mean age 55.11 ± 7.65 years) and 100 men with PE (mean age 53.07 ± 8.08 years) were enrolled for validation. Of the patients in PE group, the number of men reporting self-estimated IELTs of ≤1, 1-2, and >2 minutes were 34 (34.0%), 22 (22.0%), and 44 (44.0%), respectively. The Cronbach's alpha score (α = 0.77) showed adequate internal consistency, and the test-retest correlation coefficients of each item (r ≥ 0.70, P < 0.001) indicated excellent stability over time. The frequency of agreement showed that there was excellent concordance between PEDT diagnosis and clinician diagnosis when the PEDT scores ≥11. An adequate correlation was found between total PEDT score and self-estimated IELT (ρ = −0.396, P < 0.001), and sensitivity and specificity analyses suggested a score of ≤8 indicated no time-defined PE (self-estimated IELT ≤1 minute). Conclusions The Chinese version of PEDT is valid in screening the presence of PE among Chinese men. The PEDT showed an adequate negative correlation with self-estimated IELT and an excellent concordance with clinician diagnosis of PE. Huang Y-P, Chen B, Ping P, Wang H-X, Hu K, Zhang T, Yang H, Jin Y, Yang Q, and Huang Y-R. The premature ejaculation diagnostic tool (PEDT): Linguistic validity of the Chinese version. J Sex Med 2014;11:2232-2238. [ABSTRACT FROM AUTHOR]

What is known and objective This study aimed at evaluating the safety and efficacy of an improved dosage regimen of sertraline in patients with premature ejaculation ( PE) and to examine whether the premature ejaculation diagnostic tool ( PEDT) can be used as a measure of treatment response in these patients. Methods A total of 218 PE patients were randomized into control ( n = 61) and treatment ( n = 157) groups to receive mycelium of cordyceps sinensis C4 and sertraline 50 mg daily for 8 weeks, respectively. Following this blinded stage, sixty-three patients chose to take sertraline 100 mg daily for an additional 4-week period, and 80 other patients continued treatment with sertraline 50 mg. Main outcome measures include intravaginal ejaculatory latency time ( IELT), PEDT score and Clinical Global Impression of Change ( CGIC) score. Results At weeks 4 and 8, mean IELT of patients who subsequently chose to take 100 mg of sertraline was significantly lower than that of patients who continued taking 50 mg of sertraline, although the IELT value was comparable between the two groups of patients at baseline. However, with an additional 4-week treatment, the mean IELT increased significantly more in the 100-mg group than in the 50-mg continuation group. Similar results were also obtained in the analyses of the PEDT and CGIC scores. Both regimens were well tolerated, and relapse rate did not differ significantly between the two groups. What is new and conclusion These findings suggest that PE patients not responding to an 8-week treatment with sertraline 50 mg can benefit from an additional 4-week treatment with sertraline 100 mg and that the PEDT may be a valid measure of treatment response in PE patients. [ABSTRACT FROM AUTHOR]

Although in females of infertile couples abnormal prolactin ( PRL) has a definitive role in the medical flowchart, its role in males is less clear. Animal models suggest that PRL does not play a major role in male reproduction, although its trophic action on male accessory glands was often observed. Studies in humans are scanty. We systematically evaluated possible clinical and ultrasound correlates of PRL in males of infertile couples. Of 288 consecutive males of infertile couples, 269 (36.6 ± 4.4 years) without genetic abnormalities were studied. All men underwent physical, biochemical, seminal evaluation and scrotal and transrectal ultrasound before and after ejaculation. Ejaculatory and erectile functions were assessed by Premature Ejaculation Diagnostic Tool ( PEDT) and International Index of Erectile Function ( IIEF)-15 respectively; prostate-related symptoms by National Institutes of Health-Chronic Prostatitis Symptom Index and International Prostate Symptom Score; psychological symptoms by Middlesex Hospital Questionnaire. Among semen parameters, only the positive association between PRL and ejaculate volume was significant, even adjusting for age, total testosterone and thyroid-stimulating hormone (adj. r = 0.126, p < 0.05). In a logistic ordinal model, adjusting for the aforementioned confounders and ejaculate volume, PRL was negatively associated with delaying ejaculation according to PEDT#1 score (Wald = 4.65, p < 0.05). In an age- and ejaculate volume-adjusted, iterative binary logistic model, low PRL was associated with a fivefold risk of any failure in controlling ejaculation ( HR = 5.15 [1.15-23], p < 0.05). Among scrotal and transrectal ultrasound features, we found a significant positive association between PRL and seminal vesicles ( SV) volume and inhomogeneity, before and after ejaculation, and with deferential ampullas diameter. Associations with PRL were confirmed in nested 1 : 1 case-control analysis. No significant associations were found between PRL and other clinical parameters. For the first time, this study extends the concept of a trophic effect of PRL on male accessory glands from animals to humans. We report a positive association among PRL and ejaculate and SV volume, before and after ejaculation. Low PRL is associated with a lessened ability to control ejaculation. [ABSTRACT FROM AUTHOR]

Objectives: This study aimed to determine the prevalence of premature ejaculation and its associated factors among men attending a primary healthcare clinic in Kota Bharu, Kelantan, Malaysia., Methods: A cross-sectional study was conducted on 18- to 60-year-old sexually active men during at least the past 6 months. Patients with unstable psychiatric illnesses, mental retardation, and illiteracy were excluded. A questionnaire on sociodemographic factors, Malay version Premature Ejaculation Diagnostic Tool, and Malay version International Index Erectile Function-5 were distributed. Premature ejaculation was defined as a Premature Ejaculation Diagnostic Tool score of 9 and above. Descriptive analysis and simple and multiple logistic regression analyses were performed using SPSS version 22., Results: A total of 294 of 313 eligible men responded, with a response rate of 93.9%. The prevalence of premature ejaculation was 21.4% (n = 63). The multiple logistic regression analysis showed that mild [adj. OR (95% CI): 5.6 (1.89, 16.91); P  = 0.002], mild-moderate [adj. OR (95% CI): 8.2 (2.72, 24.46); P  < 0.001], and moderate-severe [adj. OR (95% CI): 6.0 (1.15, 31.23); P  = 0.03] erectile dysfunctions were significantly associated with premature ejaculation., Conclusion: Promoting awareness on premature ejaculation among the society and healthcare providers would increase the detection rate of this disorder. Such data will also help provide better sexual health services. Research on the underlying comorbidities among men with premature ejaculation is recommended owing to its negative impact on psychosocial aspects and quality of life.

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.