A Cross-Sectional Observational Study on the Coexistence of Erectile Dysfunction and Premature Ejaculation

Introduction The interplay between erectile dysfunction (ED) and premature ejaculation (PE) needs more studies to clarify. Aim To evaluate the risk factors and temporal relationship for the coexistence of ED and PE. Methods The data were derived from clinical history. Main Outcome Measure The diagnosis of ED and PE was based on self-report and validated questionnaires. Results Based on the chief complaint, 1,893 participants were recruited as ED group and 483 participants as PE group from 2014 to 2020. One third of ED and PE groups reported comorbid PE and ED. Of the ED group, 4.1% (n = 77) had lifelong PE, 18.0% (n = 341) had acquired PE and 9.7% (n = 184) had subjective or natural variable PE. Of the PE group, ED was reported in 22.0% (n = 40) of lifelong PE, 33.9% (n = 65) of acquired PE, and 37.6% (n = 41) of subjective or natural variable PE, P < .01. With adjustment of potential confounders, the ED severity was associated with increased risk of acquired PE, while acquired PE was associated with higher risk of ED than lifelong PE. In cases of comorbid lifelong PE and ED (n = 117), 22.2% reported the onset of both dysfunctions being about the same time, whereas 77.8% reported ED occurred behind PE with an average 23.3 years lag. In cases of comorbid acquired PE and ED (n = 406), 52.2% reported the onset of both dysfunctions being about the same time, 34.2% reported ED happened behind PE and 13.5% reported PE emerged behind ED. Conclusion Organic pathogenesis was least likely to be responsible for the link between PE and ED. When acquired PE and ED coexist, treating ED first or concomitantly according to their temporal order is an appropriate management algorithm.