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Although premature ejaculation (PE) is a common male sexual dysfunction, its pathophysiology has not been fully elucidated. Several medical problems such as erectile dysfunction, depression, anxiety, hormonal disorders and chronic prostatitis may play a role in the etiology of acquired PE. This study aims to evaluate the frequency of these etiologic factors among patients with acquired PE. Between May and July 2016, 53 men with acquired PE were included in the study. Self-estimated intravaginal ejaculation latency time (IELT) of these patients was recorded along with their medical history and physical examination findings. Moreover, 5-item version of the International Index of Erectile Function (IIEF-5), premature ejaculation profile (PEP), anxiety and depression scales (STAI-1, STAI-2, and BECK), and chronic prostatitis symptom index (NIH-CPSI) were administered. Fasting plasma glucose, follicle stimulating hormone (FSH), luteinizing hormone (LH), prolactin, total and free testosterone, total prostate specific antigen, thyroid and thyroid stimulating hormone levels were measured. Urine analysis and 2 cup tests were also studied. Mean age of the patients was 42.41 ± 11.14 (22–60). Mean duration of the PE complaint was 34.18 ± 36.76 (3–144) months. Mean IELT time of the patients was 38.28 ± 30.79 (3–180) s. Of the patients; 69.81%, 62.26%, 56.60%, 45.28%, 30.19%, 24.53%, 16.98%, 15.09%, and 7.55% had depression, chronic prostatitis, erectile dysfunction, anxiety, diabetes mellitus, abnormal FSH or LH, hypoprolactinemia, hyperthyroidism, and high testosterone levels, respectively. The results of our study revealed that anxiety disorders, depression, erectile dysfunction, and chronic prostatitis are common among patients with acquired PE and may play role in the etiology of this problem. There is a need for further researches related to the exact pathophysiology of acquired PE with larger number of patients.

Purpose This study aims to estimate the prevalence of sexual dysfunction in men with chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) by conducting a meta-analysis. Methods Relevant publications were searched using PubMed, Embase, CBM, China National Knowledge Infrastructure, VIP and Wanfang databases up to August 2015. Studies that reported the prevalence of erectile dysfunction, premature ejaculation and total sexual dysfunction in men with CP/CPPS were included. Results A total of 24 studies involving 11,189 men were included. Overall prevalence of sexual dysfunction in men with CP/CPPS was 0.62 (95 % CI 0.48–0.75), while the prevalence of erectile dysfunction and premature ejaculation was 0.29 (95 % CI 0.24–0.33) and 0.40 (95 % CI 0.30–0.50), respectively. From 1999 to 2010, the prevalence of sexual dysfunction, erectile dysfunction and premature ejaculation was 0.65 (95 % CI 0.45–0.83), 0.27 (95 % CI 0.22–0.33) and 0.41 (95 % CI 0.27–0.55), respectively. From 2011 to 2014, the prevalence of sexual dysfunction, erectile dysfunction and premature ejaculation was 0.50 (95 % CI 0.22–0.75), 0.35 (95 % CI 0.29– 0.40) and 0.39 (95 % CI 0.37–0.41), respectively. Conclusion The prevalence of sexual dysfunction in men with CP/CPPS was high, even though overall sexual dysfunction demonstrated a slightly decreasing trend. Furthermore, erectile dysfunction prevalence rate had an increasing trend in recent years. More prospective studies are needed to evaluate sexual dysfunction improvement with better management of CP/CPPS.

Premature ejaculation (PE) is regarded as one of the most common male sexual dysfunctions. This review introduced several pharmaceutical and surgical methods for the management of PE. The definition, etiology, behavioral, and psychological therapy of PE were also discussed. \"Premature,\" \"ejaculation,\" or \"sexual dysfuction\" were used as the medical subject headings (MeSH) to obtain relevant articles before June 2019 on Pubmed, Google Scholar and CNKI. Most articles used were written in English and several Chinese articles were also cited. Full-text articles of retrospective/prospective/randomized controlled trials were analyzed. Animal experiments and letters were excluded. There are four PE sub-types: lifelong PE, acquired PE, natural variable PE, and subjective PE. Behavioral therapy, psychotherapy, medication, topical anesthetics, and surgery are currently used for the treatment of PE. However, all the above treatments have limitations. Therefore, novel ways should be investigated to more efficiently control PE. The pharmaceutical therapy that is currently being used in clinical practice for the management of PE is still the main choice globally due to its good efficacy. Surgery may be a choice for patients who are resistant to medication. However, it should be performed cautiously.

To examine the sexual and psychological conditions of men with Bilateral Congenital Bilateral Absence of the Vas Deferens (CBAVD), a rare condition that contributes to male infertility, and compare it with healthy fertile men. A total of 52 patients with CBAVD and 66 healthy, fertile men who attended our infertility and andrology clinic were included in the study. Patients with cognitive impairments, language barriers, significant comorbidities, or a history of urogenital surgery were excluded. Reproductive hormone levels and semen volumes were evaluated. In addition, sexual status was investigated with validated questionnaires such as the International Index of Erectile Function, Male Sexual Health Questionnaire, Arabic Index of Premature Ejaculation, Premature Ejaculation Diagnostic Tool, and Premature Ejaculation Profile. In the CBAVD group, median total testosterone, FSH, LH levels, and semen volume were 401 ng/dL, 3.9 mIU/ml, 3.9 mIU/ml, and 0.9 ml, respectively. These parameters were 376 (ng/dL), 4.8 mIU/ml, 5 mIU/ml, and 3 ml in the control group. Semen volume was significantly lower in CBAVD men (p < 0.001). Questionnaires assessing erectile and ejaculatory function have shown that there was no significant difference between the CBAVD and control groups in terms of erectile function, orgasmic function, and sexual relationship satisfaction. However, sexual desire (p = 0.006) and overall satisfaction (p = 0.028) were found to be higher in the CBAVD group. The study suggests that CBAVD may not be a direct etiological factor for erectile dysfunction or premature ejaculation.

Premature ejaculation (PE) has been reported in 40.6–51.5% of men affected by Parkinson’s disease (PD), however, this non-motor sexual complaint has not been studied in detail. We describe eight PD patients who asked for a sexological consultation between 2008 and 2014 because of a new-onset of PE. They were diagnosed with acquired PE (APE) according to the DSM-V criteria and the International Society for Sexual Medicine (ISSM) committee. Patients’ demographic, medical and sexual related data were retrieved and studied. The average age of onset of PD was 53.3 ± 12.7 years (range 38–77 years) and the sexual problem appeared 4.0 ± 3.1 years later. The mean intravaginal ejaculation latency (IELT) before APE onset was 7.3 (range 2–20) min. Interestingly, the ejaculatory disorder appeared abruptly, characterized by a dramatically shortened IELT in all patients, while in three of the cases ejaculation occurred before vaginal penetration, hampering sexual intercourse. Some patients had 2 additional sexual problems, (four with erectile dysfunctions, five with libido changes: increased desire in four and reduced in one). In this case series of PD patients with APE, the ejaculatory dysfunction developed when patients were on antiparkinsonian medications, suggesting a possible medication effect.

Chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS), or NIH category III prostatitis, is a common clinical syndrome characterized by genital/pelvic pain and lower urinary tract symptoms in the absence of urinary tract infection. There is also growing recognition of the association of sexual dysfunction with CP/CPPS including erectile dysfunction, ejaculatory pain, and premature ejaculation. In this review, we discuss the association between CP/CPPS and sexual dysfunction, potential mechanisms for sexual dysfunction, and treatment strategies for erectile dysfunction in CP/CPPS.

Male sexual dysfunction is an increasing problem across a variety of general and clinical populations, such as cancer populations; especially among prostate cancer patients who tend to receive treatments that often result in erectile dysfunction (ED) and/or premature ejaculation (PE). Therefore, in order to diagnose ED and PE in these populations, adequate and efficient instruments such as the International Index of Erectile Function 5-item version (IIEF-5) and the Premature Ejaculation Diagnostic Tool (PEDT) are needed. However, since this is an important topic additional evidence of psychometric properties of the IIEF-5 and the PEDT in such samples are required. Thus the aim of the present study was to use Rasch models to investigate the construct validity, local dependency, score order, and differential item functioning (DIF) of both questionnaires in a sample of prostate cancer patients. Prostate cancer patients (n = 1058, mean±SD age = 64.07±6.84 years) who visited urology clinics were invited to fill out the IIEF-5 and the PEDT. Construct validity was examined using infit and outfit mean square (MnSq) and local dependency using correlations between each two residual Rasch scores. Score order was investigated using step and average measures of difficulty and DIF using DIF contrast. All IIEF-5 and PEDT items had acceptable infit and outfit MnSq. Step measures revealed that all but two items had disordered categories in terms of scores 1 to 3. Only one local dependency was found, and no items displayed DIF across age, educational level, and help seeking. The results showed that both the IIEF-5 and the PEDT had sound psychometric properties in the Rasch analyses, although some score disordering could be detected in both instruments. The results of no DIF items in both instruments suggest using them to compare ED and PE across age and educational level is adequate.

This meta-analysis was performed to assess sexual functions following adult male circumcision. We searched the Cochrane Central Register of Controlled Trials, PUBMED, EMBASE, the Cochrane Database of Systematic Review and Web of Science from their inception until January 2013 to identify all eligible studies that reported on men＇s sexual function after circumcision. The Cochrane Collaboration＇s RevMan 5.2 software was employed for data analysis, and the fixed or the random effect model was selected depending on the proportion of heterogeneity. We identified 10 studies, which described a total of 9317 circumcised and 9423 uncircumcised men who were evaluated for the association of circumcision with male sexual function. There were no significant differences in sexual desire （odds ratio （OR）： 0.99; 95% confidence interval （CI）： 0.92-1.06）, dyspareunia （OR： 1.12; 95% Ch 0.52-2.44）, premature ejaculation （OR. 1.13; 95% Ch 0.83-1.54）, ejaculation latency time （OR： 1.33; 95% Ch 0.69-1.97）, erectile dysfunctions （OR： 0.90; 95% Ch 0.65-1.25） and orgasm difficulties （OR： 0.97; 95% Ch 0.83-1.13）. These findings suggest that circumcision is unlikely to adversely affect male sexual functions. However, these results should be evaluated in light of the low quality of the existing evidence and the significant heterogeneity across the various studies. Well-designed and prospective studies are required for a further understanding of this topic.

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. 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, insame 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). 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). The study results demonstrated that PE was less frequent in men that perform regular physical activitycompared 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.

Introduction Chronic prostatitis (CP) is a frequent prostate-related complaint, impacts negatively on quality of life and is mostly of unclear etiology. Increasing attention has been paid to the prevalence of sexual dysfunctions in CP patients; however, the impact of specific types of CP and the correlation of sexual dysfunctions with psychological disorders associated with CP are not well understood. Type IIIa CP is characterized by chronic pelvic pain, urination symptoms and white blood cells in expressed prostatic secretion, but free of bacterial infection. Methods A population of 600 type IIIa CP patients were randomly selected and 40 normal man were included as the control group. Queries were conducted by urologists. The National Institute of Health Chronic Prostatitis Symptom Index (NIH-CPSI), the International Index of Erectile Function (IIEF-5) and the Symptom Checklist 90-R were used to evaluate the symptoms and severity of prostatitis, erectile dysfunctions and psychological problems, respectively. Scores of ejaculatory pain and premature ejaculation were also collected. Results Our study revealed that sexual dysfunctions are frequently associated with this specific type of CP. The prevalence of erectile dysfunction, premature ejaculation and ejaculatory pain was 19, 30 and 30 %, respectively. A variety of psychological problems exist among type IIIa CP patients, including depression, anxiety, somatization, obsessive–compulsive and interpersonal sensitivity. In particular, the severity of erectile dysfunctions, but not premature ejaculation and ejaculatory pain, correlated significantly with depression and anxiety. Conclusion Our data indicate that a moderate level of sexual dysfunctions exists among the type IIIa CP patients, and highlight the association of depression and anxiety with erectile dysfunction in CP patients, suggestting that special attention should be paid to these psychological issues in clinical treatments of the prostatitis symptoms and the associated erectile dysfunctions.