Kermanshah University of Medical Sciences-Department of Urology, Kermanshah, Iran.
J Sex Med. 2009 Dec;6(12):3478-89. doi: 10.1111/j.1743-6109.2009.01468.x. Epub 2009 Aug 28.
Complaints of premature ejaculation (PE) and its repercussions are culture-dependent.
To report the measured intravaginal ejaculatory latency time (IELT) and the impact of PE in Kermanshah, Iran.
From November 1996 through October 2008, 3,458 patients presented to us with self-diagnosed PE. In the first visit, after obtaining a psychosocial and sexual history, PE-specific bother was self-rated by the patients and the patients were advised to measure their IELTs over the next 2-3 weeks. In the second visit, the measured IELTs were reported by the patients.
Patients' measured IELT and bother score.
Age range was 17-80 years (mean 34.1, standard deviation [SD] 9.1, median 32). Sixty-five percent were married. Primary and secondary PE was reported by 2,105 (60.8%) and 1,353 (39.1%) patients, respectively. Occasional PE was reported by 36 (0.01%). Of those with multiple partners, 6% had partner-specific PE. IELT distribution was positively skewed. Anteportal ejaculation was reported by 97 (2.8%). In 3,458 self-reported PE patients, IELT was 1-15 seconds in 542 (15.7%), 16-30 seconds in 442 (12.8%), 31-60 seconds in 978 (28.3%), > 1 <or= 2 minutes in 551 (15.9%), > 2 <or= 5 minutes in 712 (20.6%), and >5 minutes in 136 (3.9%). IELTs of <or=1 minutes and <or=2 minutes were reported by 59.5% and 75.5%, respectively. Median bother score was 3 of 4. Pearson's correlation between IELT and bother (r = -0.607) was highly negative, with shorter IELTs being correlated with more bother. Six hundred forty-three patients (18.6%) always consumed opium to lengthen their IELTs. All 21 patients who started to use Tramadol as a PE treatment became addicted to it. Of 168 divorced couples due to PE, 23 divorced because the sexually dissatisfied wives became involved in extramarital affairs. Applying the Diagnostic and Statistical Manual of Mental Disorders criteria for PE and a cutoff IELT point of <or=2 minutes, and thus excluding the patients with IELTs of longer than 2 minutes, the patients with occasional PE, and the patients who reported no personal bother, of 3,458 self-reported PE patients, 2,571 (74.3%) had PE. Including the 97 patients with anteportal ejaculation, arithmetic mean IELT in 2,571 patients was 45.87 seconds, SD 36.1, median 40, and range 0-120. Excluding the anteportal ejaculation, arithmetic mean IELT in the remaining 2,474 patients was 47.67 seconds, SD 35.71, median 42, range 1-120, and geometric mean 31.06.
PE has a devastating impact. In clinical practice, primary lifelong PE is by far the most common variety of PE. Occasional PE is a very rare cause of presentation. A significant proportion of the patients who consider themselves as premature ejaculators have IELTs of more than 2 minutes; the sexual medicine community should reach a consensus on the clinical diagnostic and therapeutic approach to these patients who consider themselves as premature ejaculators. The most important cause of bother in PE is the briefness of the ejaculatory latency, rather than the lack of control. Second-round ED (pseudoED) was reported for the first time. The worst type of PE, i.e., anteportal ejaculation, is not very rare; thus, geometric mean that excludes anteportal ejaculation is not suitable statistics to report the ejaculatory latency time; instead, median is the best measure of IELT reporting. Cutoffs of 0.5-2.5 percentiles are not suitable means to diagnose PE.
早泄（PE）的抱怨及其影响与文化有关。
报告伊朗克尔曼沙赫的阴道内射精潜伏期时间（IELT）的测量值和 PE 的影响。
从 1996 年 11 月至 2008 年 10 月，3458 名患者自我诊断为 PE 前来就诊。在第一次就诊时，在获得社会心理和性史之后，患者自行评定 PE 对其造成的困扰程度，并建议他们在接下来的 2-3 周内测量自己的 IELTs。在第二次就诊时，患者报告了他们的测量 IELTs。
患者的测量 IELT 和困扰评分。
年龄范围为 17-80 岁（平均 34.1，标准差 [SD] 9.1，中位数 32）。65%已婚。2105 名（60.8%）和 1353 名（39.1%）患者分别报告了原发性和继发性 PE。36 名（0.01%）患者报告了偶发性 PE。在有多个伴侣的患者中，6%的患者存在伴侣特异性 PE。IELT 分布呈正偏态。97 名（2.8%）患者报告了前射精。在 3458 名自我报告的 PE 患者中，IELT 在 1-15 秒的有 542 名（15.7%），16-30 秒的有 442 名（12.8%），31-60 秒的有 978 名（28.3%），>1<2 分钟的有 551 名（15.9%），>2<5 分钟的有 712 名（20.6%），>5 分钟的有 136 名（3.9%）。IELT 小于等于 1 分钟和小于等于 2 分钟的患者分别占 59.5%和 75.5%。中位数困扰评分是 4 分中的 3 分。IELT 和困扰之间的 Pearson 相关系数（r=-0.607）为高度负相关，即 IELT 越短，困扰越大。643 名患者（18.6%）经常吸食鸦片来延长他们的 IELTs。所有 21 名开始使用曲马多治疗 PE 的患者都上瘾了。在 168 对因 PE 而离婚的夫妻中，有 23 对是因为性不满意的妻子有了外遇。根据精神障碍诊断与统计手册（DSM）的 PE 诊断标准和小于等于 2 分钟的 IELT 截断点，排除 IELT 大于 2 分钟的患者、偶发性 PE 患者和报告个人无困扰的患者，在 3458 名自我报告的 PE 患者中，2571 名（74.3%）有 PE。包括 97 名前射精患者在内，2571 名患者的平均 IELT 为 45.87 秒，SD 为 36.1，中位数为 40，范围为 0-120。排除前射精患者后，2474 名患者的平均 IELT 为 47.67 秒，SD 为 35.71，中位数为 42，范围为 1-120，几何均数为 31.06。
PE 具有破坏性的影响。在临床实践中，原发性终身性 PE 是最常见的 PE 类型。偶发性 PE 是一种非常罕见的引起就诊的原因。很大一部分认为自己是早泄的患者的 IELT 超过 2 分钟；性医学社区应该就这些认为自己是早泄的患者的临床诊断和治疗方法达成共识。PE 造成困扰的最重要原因是射精潜伏期的短暂，而不是缺乏控制。第二轮 ED（假性 ED）首次被报道。最严重的 PE 类型，即前射精，并不是很罕见；因此，排除前射精的几何平均值并不适合报告射精潜伏期时间的统计学；相反，中位数是报告 IELT 的最佳测量方法。0.5-2.5 百分位数的截断值不适合用于诊断 PE。
