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Rosen RC, McMahon CG, Niederberger C, Broderick GA, Jamieson C, Gagnon DD. Correlates to the clinical diagnosis of premature ejaculation: results from a large observational study of men and their partners. J Urol 2007;177:1059-1064.

Purpose and back ground: It is considered to be a common problem that an assessment of premature ejaculation (PE) by self-estimated or stopwatch measured intravaginal ejaculatory latency time (IELT) is not optimal for assigning premature ejaculation status in clinical practice. This multicenter observational clinical study aimed to determine whether the combination of self-estimated or stopwatch measured IELT with responses to single item questionnaire (control over ejaculation, personal distress, satisfaction with sexual intercourse and interpersonal difficulty) and multiple item (male and female Golombok-Rust Inventory of Sexual Satisfaction, male Self-Esteem and Relationship questionnaire) is more efficient to diagnose PE.

Methods: Men with PE(207) were compared to men without PE (1,380) (diagnosed using The DSM IV-R). The female partners in both groups were also assessed.

Results: Self-estimated and stopwatch measured intravaginal ejaculatory latency time were interchangeable, correctly assigning premature ejaculation status with 80% sensitivity and 80% specificity, increasing to 80% sensitivity and 96% specificity when combined with single item patient reported outcomes. Subject reported control over ejaculation and personal distress most strongly indicated premature ejaculation status. Partner personal distress was more influential in determining premature ejaculation status than estimated or measured intravaginal ejaculatory latency time, and single item measures were more influential than multiple item measures. Age was not influential in assigning premature ejaculation status.

CONCLUSIONS: Neither estimated nor measured IELT alone is optimal for correctly classifying subjects diagnosed with PE. Results suggest that a combination of estimated IELT and 4 simple, subject assessed, single item PRO measures (control over ejaculation, personal distress, satisfaction with sexual intercourse and interpersonal difficulty) can adequately identify men diagnosed with PE according to the DSM IV-R criteria.