Ates Erhan, Gok Mustafa, Kazici Hakan Gorkem, Kol Arif, Sahin Tuna, Erol Haluk
Department of Urology, Aydin Adnan Menderes University School of Medicine, Aydin 09010, Turkey.
Department of Radiology, Aydin Adnan Menderes University School of Medicine, Aydin 09010, Turkey.
J Sex Med. 2024 Apr 30;21(5):391-398. doi: 10.1093/jsxmed/qdae037.
Although premature ejaculation (PE) is the most common male sexual dysfunction, the underlying mechanisms are not fully understood.
The study sought to evaluate the possible associations among glans penis volume and tissue stiffness measured using penile ultrasonography and penile shear wave elastography (SWE) with PE.
Men 18 to 65 years of age with normal International Index of Erectile Function scores (>25) and who were diagnosed with PE between June 2021 and June 2022 were enrolled. The Premature Ejaculation Diagnostic Tool score and intravaginal ejaculation latency times were recorded. Healthy volunteers constituted the control group. The study group was divided into lifelong PE (LLPE) and acquired PE (AqPE) subgroups. In all groups, the glans penis volume was measured via penile ultrasonography and tissue stiffness of the glans penis, penile frenulum, postcircumcision mucosal cuff, and penile shaft were measured via SWE. The findings of the groups were compared using appropriate statistical methods.
The outcomes included ultrasonographic and elastographic measurements of the glans penis.
Data on 140 men, including 70 PE patients and 70 healthy volunteers, were evaluated. Of the patients, 20 had LLPE and 50 had AqPE. The median glans penis volume was significantly greater in the LLPE group (14.1 [range, 6.6-19] mm3) compared with the AqPE group (11.7 [range, 5.1-27] mm3) and control group (11.4 [range, 6.1-32] mm3) (P = .03). According to the Youden index, the best cutoff value for glans penis volume in LLPE compared with non-LLPE (AqPE + control) was 12.65 mm3 (area under the curve, 0.684; 95% confidence interval, 0.556-0.812; P = .009). The risk of having LLPE in those with a glans penis volume ≥12.65 mm3 was 3.326 (95% confidence interval, 1.234-8.965) times higher than the non-LLPE group (P = .014). There were no significant differences between the groups in the SWE evaluation of glans penis, penile frenulum, mucosal cuff, and penile shaft tissue stiffness.
The high incidence of PE in those with high glans penis volume may make glans penis volume a predictor for the development of LLPE.
This was the first study to show that PE is more common in individuals with a high glans penis volume. It was also the first to perform a penile elastographic evaluation in patients with PE. The most important limitation was that we did not evaluate glans penile nerve function with a test, but rather we made an indirect inference about the density of free nerve endings based on increased glans penile volume.
Glans penis volume was a significant predictor for LLPE. However, there are no associations between PE and the glans penis, postcircumcision mucosal cuff, penile frenulum, or penile shaft tissue stiffness and development.
尽管早泄（PE）是最常见的男性性功能障碍，但其潜在机制尚未完全明确。
本研究旨在评估使用阴茎超声和阴茎剪切波弹性成像（SWE）测量的阴茎头体积和组织硬度与早泄之间可能存在的关联。
纳入年龄在18至65岁之间、国际勃起功能指数评分正常（>25）且在2021年6月至2022年6月期间被诊断为早泄的男性。记录早泄诊断工具评分和阴道内射精潜伏期。健康志愿者作为对照组。研究组分为终身早泄（LLPE）和获得性早泄（AqPE）亚组。在所有组中，通过阴茎超声测量阴茎头体积，并通过SWE测量阴茎头、阴茎系带、包皮环切术后黏膜袖套和阴茎体的组织硬度。使用适当的统计方法比较各组的结果。
评估了140名男性的数据，其中包括70名早泄患者和70名健康志愿者。在患者中，20例为LLPE，50例为AqPE。LLPE组阴茎头体积中位数（14.1[范围，6.6 - 19]mm³）显著大于AqPE组（11.7[范围，5.1 - 27]mm³）和对照组（11.4[范围，6.1 - 32]mm³）（P = .03）。根据约登指数，LLPE与非LLPE（AqPE + 对照组）相比，阴茎头体积的最佳截断值为12.65mm³（曲线下面积，0.684；95%置信区间，0.556 - 0.812；P = .009）。阴茎头体积≥12.65mm³者患LLPE的风险比非LLPE组高3.326倍（95%置信区间，1.234 - 8.965）（P = .014）。在阴茎头、阴茎系带、黏膜袖套和阴茎体组织硬度的SWE评估中，各组之间无显著差异。
阴茎头体积大的人群中早泄的高发病率可能使阴茎头体积成为LLPE发生的一个预测指标。
这是第一项表明早泄在阴茎头体积大的个体中更常见的研究。也是第一项对早泄患者进行阴茎弹性成像评估的研究。最重要的局限性是我们没有通过测试评估阴茎头神经功能，而是基于阴茎头体积增加对游离神经末梢密度进行间接推断。
阴茎头体积是LLPE的一个重要预测指标。然而，早泄与阴茎头、包皮环切术后黏膜袖套、阴茎系带或阴茎体组织硬度及发生之间无关联。
