Lower urinary tract symptoms among patients presenting for premature ejaculation
Chierigo, F1; Capogrosso, P1; Ventimiglia, E1; Boeri, L2; Cazzaniga, W1; Pederzoli, F1; Frego, N1; Pozzi, E1; Abbate, C1; Dehò, F1; Montanari, E2; Gaboardi, F1; Mirone, V3; Montorsi, F1; Salonia, A1
1: Division of Experimental Oncology/Unit of Urology; URI; IRCCS Ospedale San Raffaele, Milan, Italy; 2: Department of Urology, IRCCS Fondazione Ca’ Granda – Ospedale Maggiore Policlinico, University of Milan, Milan, Italy ; 3: Department of Urology, School of Medicine and Surgery, University of Naples Federico II, Naples, Italy
Objectives: Lower urinary tract symptoms (LUTS) have been previously associated with premature ejaculation (PE). We looked at the correlation between PE and storage phase symptoms in a homogeneous cohort of Caucasian-European men seeking medical help for PE as a primary compliant at a single tertiary-referral center.
Materials and Methods: Complete data were available for the last 306 consecutive patients. All patients completed the Premature Ejaculation Diagnostic Tool (PEDT), the International Index of Erectile Function (IIEF), the Beck’s Inventory for Depression (BDI) and the International Prostate Symptom Score (IPSS) questionnaires at their first assessment. The characteristics of patients with and without PE (defined as PEDT≥11) were compared with the Mann-Whitney and Fisher’s exact tests. Logistic regression analysis tested the association between predictors and the likelihood of having PE.
Results: Median (IQR) age was 44 (35-54) years; median (IQR) PEDT score was 9 (4-13). Of all, PE was diagnosed in 124 (41%) patients. Patients with PE depicted lower median scores for IIEF-overall satisfaction (OS: 4 vs. 6, p<0.001), intercourse satisfaction (IS: 15 vs. 20, p<0.004) and erectile function (EF: 15 vs. 20, p<0.004). Similarly, higher BDI scores were reported among men with PE (7 vs 4; p<0.0002) as compared with those without PE. Of note, IPSS total score (7 vs. 5), the storage (4 vs. 2) and the voiding phase (3 vs. 2) subscores were higher for PE patients (all p<0.02). At logistic regression analysis, IPSS storage subscore (OR: 1.1; 95%CI: 1-1.2, p=0.04) and BDI score (OR: 1.05; 95%CI: 1.01-1.09, p=0.007) were independently associated with PEDT-diagnosed PE after accounting for IIEF-EF score, patients’ age and BMI.
Conclusions: Patients with PE defined according to PEDT scores are more likely to suffer from storage LUTS and depressive symptoms. Both conditions should be carefully investigated when assessing patients complaining for PE in the real-life setting.
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