Associations Between Premature Ejaculation, Lower Urinary Tract Symptoms, and Erectile Dysfunction in Middle-Aged Korean Policemen

Abstract

Introduction There is controversy concerning the relationship between premature ejaculation (PE) and erectile dysfunction (ED), as well as the scan data regarding the association between PE and lower urinary tract symptoms (LUTS). Aims We performed this study to evaluate the association between PE and ED or LUTS. Methods A total of 2,591 policemen aged 40–59 years who had participated in a health examination were included in this study. PE, LUTS, and ED were evaluated using the premature ejaculatory diagnostic tool (PEDT), the International Prostate Symptoms Score (IPSS), and the International Index of Erectile Function questionnaire-5 (IIEF), respectively. Spearman's correlation test, the multiple linear regression test, and logistic regression analyses were used to evaluate the relationship between PE and ED or LUTS. Main Outcome Measures Associations between PEDT, IPSS, and IIEF. Results The middle age of the study group was 49.1 years, and the middle PEDT, IIEF, and IPSS was 7.5, 17.0, and 10.7, respectively. By univariate analysis, PEDT showed a significant correlation with IPSS (r = 0.310, P < 0.001) and IIEF (r = −0.413, P < 0.001). After adjusting for age, components of metabolic syndrome, testosterone, and IIEF, PEDT was significantly correlated with IPSS (Beta = 0.166, P < 0.001). PEDT was also significantly correlated with IIEF after adjusting for age, components of metabolic syndrome, testosterone, and IPSS (Beta = −0.274, P < 0.001). Additionally, the severity of LUTS or ED was associated with the PE positive ratio (P trend < 0.001). The odds ratio (OR) for PE also increased with the severity of LUTS or ED after adjusting for potential confounding factors. Conclusions ED and LUTS were significantly and independently correlated with PE.

Selective Serotonin Reuptake Inhibitors Plus Phosphodiesterase-5 Inhibitors for Premature Ejaculation: A Systematic Review and Meta-analysis

“…Several theories have tried to elucidate the associations between ED and PE, for example, a M A N U S C R I P T A C C E P T E D ACCEPTED MANUSCRIPT 9 compensatory mechanism for the inability to maintain the erection, reduction of nitric oxide (NO), and NO synthase and autonomic hyperactivity theory [22][23] . In addition, metabolic syndrome and testosterone may play an important role in ED and PE 6,24 . Convincing evidence show that PDE-5 inhibitors provide meaningful treatment benefit in a population of men with PE and comorbid ED 19 .However, a potential role for PDE-5 inhibitors in the treatment of PE without ED is controversial.…”

“…However, many patients, might not respond adequately to SSRIs, particularly those with erectile dysfunction(ED), likely because PE and ED are associated with each other 4,6 .Several recent studies have investigated the role of phosphodiesterase type 5(PDE-5) inhibitors, which are the first-line treatment for ED, reporting efficacy in the treatment of PE in the absence ofED [7][8] . It is noteworthy that PDE-5 inhibitors do not pharmacokinetically interact with SSRIs, and the combination of both is well tolerated 9 .In addition, efficacy and safety regarding the combination of PDE-5 inhibitors and SSRIs versus PDE-5 inhibitors or SSRIs monotherapy have also been investigated in the past decade [10][11][12][13] .…”

The characterization, current medications, and promising therapeutics targets for premature ejaculation

“…Besides the improvement of LUTS, tamsulosin can help the subjective symptoms of PE in patients with LUTS + PE (Choi et al, 2014). In recent clinical trial, LUTS and ED were significantly and independently correlated with PE (Lee, 2014). Retrograde or abnormal ejaculation was the most commonly reported side effect in the patients treated with silodosin (Cho & Yoo, 2014).…”

The drug treatment of premature ejaculation

“…Recently Lee et al reported that PE in Korean policemen is associated with ED and lower urinary tract symptoms (LUTS) including prostatic disease, which might be the important disease background for the PE (41). Alpha-1 adrenoceptor antagonist (alpha-1 blocker) is widely accepted as the first-line treatment for LUTS caused by benign prostatic hyperplasia.…”