Analysis and prediction of sexual well-being variables in men with and without lifelong premature ejaculation in a non-western context

Abstract Background Premature ejaculation (PE) is often viewed as couples’ problem, with research increasingly emphasizing the importance of evaluating the man’s PE in the context of partner variables as a meaningful outcome in PE management. Aim To describe and compare differences in self and perceived partner sexual well-being in men with lifelong PE (LPE) and men without PE, and further, to understand the role of various PE symptoms (ejaculatory control, ejaculatory latency [EL], consistency of symptomology) on sexual well-being specifically within the LPE group. Methods One thousand two hundred sixty-five men visiting a urology clinic in Uzbekistan responded to validated items asking about the intensity of PE symptoms, their sex-related distress/bother, and the perceived dissatisfaction of their partner. Regression modeling was used to identify salient predictors of sexual well-being related to both the man himself and his partner. Outcomes Predictors of sexual well-being in both the overall sample (LPE and non-PE men) and in just the LPE group. Results Although both LPE (n = 187) and non-PE (n = 990) men from this clinical sample showed negative effects of urologic symptomology on their well-being, PE men’s well-being was diminished even further (P < .001, all measures). The strongest predictors of diminished well-being in the overall clinical sample were, in order of effect size, consistency of the PE problem, lack of ejaculatory control, and short ELs (R2 = .416-.197). The strongest predictor of diminished well-being within the LPE group was consistency of the PE problem, with EL playing a lesser or non-significant role (R2 = .167-.006). Clinical Translation In addition to managing PE symptoms, clinicians should help patients and their partners explore ways to address the effects of PE symptomology on their sexual well-being. Strengths and Limitations The well-validated items, multifactorial definition of groups, multiple sexual-well-being outcome variables, and well-powered analyses represented study strengths. The lack of the partner’s own assessment of sexual dissatisfaction and the lack of contextual factors such as relationship satisfaction, sexual interest, and partner sexual functioning prevented a more comprehensive view regarding patient and partner well-being. Conclusion Men with PE report greater negative effects on sexual well-being than men with other urological problems, with consistency of the PE problem standing out as the strongest factor associated with diminished sexual well-being and poor ejaculatory control and short ELs playing a lesser role. Findings highlight the importance of treatment that addresses the psychosexual well-being of both the man and his partner.

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