Introduction A new classification of premature ejaculation (PE) has been proposed, including the categories of lifelong PE (LPE), acquired PE (APE), natural variable PE (NVPE), and premature-like ejaculatory dysfunction (PLED). Aim The aim of this study was to evaluate the impact of intravaginal ejaculation latency time (IELT) and erectile function on anxiety and depression among patients with PE in general and according to the four types of PE. Methods Between September 2011 and September 2012, we conducted a cross-sectional study in the Anhui province of China. We enrolled 4,000 men aged over 18 years, each of whom had been in a stable, monogamous, heterosexual relationship with the same partner for at least 6 months. Main Outcome Measurements Self-estimated IELT, the International Index of Erectile Function-5 (IIEF-5) and the Zung Self-Rating Anxiety and Depression Scales (SAS/SDS) were used to measure PE, erectile dysfunction (ED), anxiety, and depression, respectively, among the entire study population. Results Of the 3,016 men evaluated, 25.80% complained of PE. Distribution of the four types of PE among men with PE was as follows: LPE, 12.34%; APE, 18.77%; NVPE, 44.09%; PLED, 24.81%. Men with PE presented lower IIEF-5 scores and higher SAS and SDS scores vs. men without PE (P < 0.001 for all). Similar findings were observed in men with APE when compared with other PE syndromes. After adjustment for age in men with PE, IELT was negatively associated with SAS and SDS scores (SAS, adjusted r = −0.42, P < 0.001; SDS, adjusted r = −0.45, P < 0.001). IIEF-5 score was negatively associated with SAS and SDS scores (SAS, adjusted r = −0.54, P < 0.001; SDS, adjusted r = −0.50, P < 0.001). These negative relationships were strongest in men with PLED (IELT vs. SAS: adjusted r = −0.63, P < 0.001; IELT vs. SDS, adjusted r = −0.60, P < 0.001; IIEF-5 vs. SAS: adjusted r = −0.57, P < 0.001; IELT vs. SDS, adjusted r = −0.55, P < 0.001). Conclusions APE patients reported higher rates of ED, anxiety, and depression than men with other types of PE. The negative relationships between IELT/IIEF-5 and SAS/SDS were strongest in men with PLED.

The purpose of this study is to investigate the effects of adult male circumcision on premature ejaculation (PE). Therefore, between December 2009 and March 2014, a total of 575 circumcised men and 623 uncircumcised men (control group) were evaluated. Detailed evaluations (including circumcision and control groups) on PE were conducted before circumcision and at the 3-, 6-, 9-, and 12-month follow-up visits after circumcision. Self-estimated intravaginal ejaculatory latency time (IELT), Patient-Reported Outcome measures, and 5-item version of the International Index of Erectile Function were used to measure the ejaculatory and erectile function for all subjects. The results showed that, during the one-year follow-up, men after circumcision experienced higher IELT and better scores of control over ejaculation, satisfaction with sexual intercourse, and severity of PE than men before circumcision (P < 0.001 for all). Similarly, when compared with the control group, the circumcised men reported significantly improved IELT, control over ejaculation, and satisfaction with sexual intercourse (P < 0.001 for all). These findings suggested that circumcision might have positive effects on IELT, ejaculatory control, sexual satisfaction, and PE severity. In addition, circumcision was significantly associated with the development of PE.

Background To report the technical feasibility and oncological safety of modified robot-assisted enucleation for highly complex renal tumors using the combined retroperitoneoscopic and transperitoneoscopic accesses. Methods The present research is a retrospective analysis of 166 cases of highly complex renal tumors that underwent a partial nephrectomy at a tertiary academic institution between September 2014 and August 2017. Consecutive consented patients were grouped into two cohorts. Seventy-two cases underwent conventional robot-assisted partial nephrectomy (C-RAPN), and 94 cases were treated with modified robot-assisted tumor enucleation (MRATE). The perioperative and oncological outcomes of both groups were reported. Furthermore, pathological examinations of 225 cases of highly complex renal tumors treated with radical nephrectomy were analyzed. Results Although preoperative clinical data were similar between the two groups, the perioperative outcomes were distinctly different. Total renal function at postoperative day 1 was better (P<0.001), and the surgical margin width was narrower (P<0.001) in the MRATE group. In addition, the MRATE group presented less blood loss (143.29 and 90.76 mL; P<0.001) and lower 30-d complication rates (4.2% and 16.7%, respectively; P=0.033). Mean ischemia time and operative time was 3 and 14 minutes shorter in the MRATE group, respectively. Finally, histopathological analysis of 225 cases of renal tumors with high surgical complexity provided objective evidence for the feasibility of MRATE. Conclusions MRATE technique may offer an efficient and safe method to treat anatomically complex renal masses in referral centers. The long-term outcome of MRATE technique merits further investigation.

Introduction Besides lifelong premature ejaculation (LPE) and acquired premature ejaculation (APE), Waldinger and Schweitzer proposed two addition PE syndromes (variable PE [VPE] and subjective PE [SPE]). Aim We assessed the associations between intravaginal ejaculatory latency time (IELT) and National Institutes of Health-Chronic Prostatitis Symptom Index (NIH-CPSI) in men with different PE syndromes. Methods From September 2011 to September 2012, a total of 4,000 men were enrolled from the Anhui province of China. Subjects were required to complete a verbal questionnaire, including demographic information, medical and sexual history (e.g., IELT), and self-estimated scales (e.g., NIH-CPSI). Main Outcome Measures IELT; NIH-CPSI; the new classification of PE syndromes. Results Of 3,016 of the men evaluated, 25.80% complained of PE. Distribution of the four PE syndromes among men with complaints of PE was as follows: LPE, 12.34%; APE, 18.77%; VPE, 44.09%; and SPE, 24.81%. Men with complaints of PE reported worse NIH-CPSI scores and lower IELT than men without complaints of PE (P &lt; 0.001 for all). Moreover, total and subdomain scores of NIH-CPSI were higher in men with APE, and IELT was higher in men with SPE. IELT was negatively associated with NIH-CPSI scores in men with complaints of PE. Negative relationships between total and subdomain scores of NIH-CPSI and IELT were stronger in men with APE (total scores: adjusted r = −0.68, P &lt; 0.001; pain symptoms: adjusted r = −0.70, P &lt; 0.001; urinary symptoms: adjusted r = −0.67, P &lt; 0.001; quality of life impact: adjusted r = −0.64, P &lt; 0.001). Conclusion Men with complaints of PE reported worse NIH-CPSI scores than men without complaints of PE. Relationships between IELT and NIH-CPSI scores were strongest in men with APE.

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