BERKELEY, CA (UroToday.com) - Research into the treatment and epidemiology of premature ejaculation (PE) is heavily dependent on how PE is defined. The medical literature contains several univariate and multivariate operational definitions of PE. Each of these definitions characterise men with PE using all or most of the accepted dimensions of this condition: ejaculatory latency, perceived ability to control ejaculation, reduced sexual satisfaction, personal distress, partner distress, and interpersonal or relationship distress. In the last decade, substantial progress has been made in the development of evidence-based methodology for PE epidemiologic and drug treatment research using the objective intravaginal ejaculatory latency time (IELT) and subjective validated patient-reported outcome (PRO) measures.
In October 2007, the International Society for Sexual Medicine (ISSM) convened a meeting of the first Ad Hoc ISSM Committee for the Definition of Premature Ejaculation. It was populated by 21 international experts in PE with the aim to develop the first contemporary, evidence-based definition of lifelong PE. After critical evaluation of the published data, the committee unanimously agreed that the constructs that are necessary to define lifelong PE are time from penetration to ejaculation, inability to delay ejaculation, and negative personal consequences from PE. The committee was, however, unable to identify sufficient published objective data to craft an evidence-based definition of acquired PE.
In April 2013, the International Society for Sexual Medicine (ISSM) convened a second Ad Hoc ISSM Committee for the Definition of Premature Ejaculation in Bangalore, India. The brief of the committee was to evaluate the current published data and attempt to develop a contemporary, evidence-based definition of acquired PE and/or a single unifying definition of both acquired and lifelong PE. The committee unanimously agreed that men with lifelong and acquired PE appear to share the dimensions of short ejaculatory latency, reduced or absent perceived ejaculatory control, and the presence of negative personal consequences. Men with acquired PE are older, have higher incidences of erectile dysfunction, comorbid disease, cardiovascular risk factors, and a higher intravaginal ejaculation latency time (IELT). A self-estimated or stop-watch IELT of 3 minutes was identified as a valid IELT cut-off for diagnosing acquired PE. On this basis, the committee agreed on a unified definition of both acquired and lifelong PE as “… a male sexual dysfunction characterized by
- ejaculation which always or nearly always occurs prior to or within about one minute of vaginal penetration from the first sexual experiences (lifelong PE), or, a clinically significant and bothersome reduction in latency time, often to about 3 minutes or less (acquired PE), and
- the inability to delay ejaculation on all or nearly all vaginal penetrations, and
- negative personal consequences, such as distress, bother, frustration and/or the avoidance of sexual intimacy.”
In conclusion, the ISSM unified definition of lifelong and acquired PE represents the first evidence-based definitions for these conditions. These definitions will enable researchers to design methodologically rigorous studies to improve our understanding about acquired PE.
Written by:
Ege Can Serefoglu, MD, FECSM as part of Beyond the Abstract on UroToday.com. This initiative offers a method of publishing for the professional urology community. Authors are given an opportunity to expand on the circumstances, limitations etc... of their research by referencing the published abstract.
Bagcilar Training & Research Hospital, Department of Urology, Merkez Mah. Mimar Sinan cad. 6. sok. Bagcilar, Istanbul