Giovanni Corona1, Giulia Rastrelli2, Erika Limoncin3, Alessandra Sforza1, Emmanuele A Jannini3,4, Mario Maggi2. 1. Endocrinology Unit, Medical Department, Azienda Usl Bologna Maggiore-Bellaria Hospital, Bologna, Italy. 2. Sexual Medicine and Andrology Unit, Department of Experimental, Clinical, and Biomedical Sciences, University of Florence, Florence, Italy. 3. School of Sexology, Department of Clinical, Applied, and Biotechnological Sciences, University of L'Aquila, L'Aquila, Italy. 4. Endocrinology, Andrology, and Medical Sexology, Department of Systems Medicine, Tor Vergata University of Rome, Rome, Italy.
Abstract
INTRODUCTION: The specific determinants and underlying factors linking erectile dysfunction (ED) and premature ejaculation (PE) have yet to be clearly identified. AIM: The aim of this study was to review and meta-analyze all available data regarding the link between ED and PE. METHODS: An extensive Medline Embase and Cochrane search was performed including the following words: "premature ejaculation" and "erectile dysfunction". MAIN OUTCOME MEASURES: All observational trials comparing the risk of ED in relation to PE were included. Data extraction was performed independently by two of the authors (G.R, G.C.), and conflicts resolved by the third investigator (M.M.). RESULTS: Out of 474 retrieved articles, 18 were included in the study for a total of 57,229 patients, of which 12,144 (21.2%) had PE. The presence of PE, however defined, was associated with a significant increase in ED risk (odds ratio: 3.68[2.61;5.18]; P < 0.0001). Meta-regression analysis showed that the risk of ED in PE subjects was higher in older individuals as well as in those with a lower level of education and in those who reported a stable relationship less frequently. In addition, subjects with PE and ED more often reported anxiety and depressive symptoms and a lower prevalence of organic associated morbidities, including diabetes mellitus, hypertension and dyslipidemia. All the latter associations were confirmed even after adjustment for age. Finally the risk of PE-related ED increased with the increased proportion of acquired ejaculatory problems (adj r = 0.414; P < 0.0001 after the adjustment for age). CONCLUSIONS: In conclusion, the present data showed that ED and PE are not distinctly separate entities, but should be considered from a dimensional point of view. Understanding this dimensional perspective might help sexual health care professionals in providing the most appropriate therapeutic approach to realistically increase patient related outcomes in sexual medicine.
INTRODUCTION: The specific determinants and underlying factors linking erectile dysfunction (ED) and premature ejaculation (PE) have yet to be clearly identified. AIM: The aim of this study was to review and meta-analyze all available data regarding the link between ED and PE. METHODS: An extensive Medline Embase and Cochrane search was performed including the following words: "premature ejaculation" and "erectile dysfunction". MAIN OUTCOME MEASURES: All observational trials comparing the risk of ED in relation to PE were included. Data extraction was performed independently by two of the authors (G.R, G.C.), and conflicts resolved by the third investigator (M.M.). RESULTS: Out of 474 retrieved articles, 18 were included in the study for a total of 57,229 patients, of which 12,144 (21.2%) had PE. The presence of PE, however defined, was associated with a significant increase in ED risk (odds ratio: 3.68[2.61;5.18]; P < 0.0001). Meta-regression analysis showed that the risk of ED in PE subjects was higher in older individuals as well as in those with a lower level of education and in those who reported a stable relationship less frequently. In addition, subjects with PE and ED more often reported anxiety and depressive symptoms and a lower prevalence of organic associated morbidities, including diabetes mellitus, hypertension and dyslipidemia. All the latter associations were confirmed even after adjustment for age. Finally the risk of PE-related ED increased with the increased proportion of acquired ejaculatory problems (adj r = 0.414; P < 0.0001 after the adjustment for age). CONCLUSIONS: In conclusion, the present data showed that ED and PE are not distinctly separate entities, but should be considered from a dimensional point of view. Understanding this dimensional perspective might help sexual health care professionals in providing the most appropriate therapeutic approach to realistically increase patient related outcomes in sexual medicine.
Authors: A Sansone; A Aversa; G Corona; A D Fisher; A M Isidori; S La Vignera; E Limoncin; M Maggi; M Merico; E A Jannini Journal: J Endocrinol Invest Date: 2020-10-30 Impact factor: 4.256
Authors: Paolo Verze; Davide Arcaniolo; Alessandro Palmieri; Tommaso Cai; Roberto La Rocca; Marco Franco; Luca Venturino; Marco De Sio; Vincenzo Mirone Journal: Sex Med Date: 2018-05-24 Impact factor: 2.491