title: Distribution and factors associated with four premature ejaculation syndromes in outpatients complaining of ejaculating prematurely.
abstract: BACKGROUND
  Because available definitions of premature ejaculation (PE) were unable to encompass the various forms of PE, Waldinger et al. proposed a new classification that distinguished four PE syndromes. However, few studies have examined the prevalence rates of these four PE syndromes.
  
  
  OBJECTIVE
  The study aims to analyze the prevalence of and factors associated with four PE syndromes in outpatients who complained of ejaculating prematurely.
  
  
  METHODS
  Between December 2009 and December 2011, outpatients who complained of PE completed a detailed verbal questionnaire regarding their demographic data and medical and sexual history. Each patient was classified as having one of four PE subtypes: lifelong PE (LPE), acquired PE (APE), natural variable PE (NVPE), or premature-like ejaculatory dysfunction (PLED).
  
  
  METHODS
  Based on the new classification scheme, PE was classified into four subtypes. The anxiety/depression status of patients was assessed by the Zung self-rating anxiety/depression scales, and erectile function was assessed by the International Index of Erectile Function-5 instrument.
  
  
  RESULTS
  This study included 1,988 male outpatients who complained of PE, with mean ages and body mass index (BMI) scores of 35.52 ± 10.38 years and 25.34 ± 4.51 kg/m(2), respectively. Prevalence rates of PE syndromes were 35.66% for LPE, 28.07% for APE, 12.73% for NVPE, and 23.54% for PLED. Patients with APE had the highest mean ages and BMI scores, and they more frequently reported several comorbidities, including sexual desire disorder, hypertension, diabetes mellitus, chronic prostatitis, and erectile dysfunction. The PLED group had a lower mean frequency of sexual intercourse than other groups and higher rates of anxiety and depression.
  
  
  CONCLUSIONS
  The prevalence of LPE was higher than that of other PE subtypes in an outpatient setting. Several comorbidities were more common in patients with APE and PLED. In particular, a lower frequency of intercourse and higher frequencies of anxiety and depression were found in patients with PLED.
authors.affiliation: Department of Urology, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China.
authors.forename: Xiansheng
authors.initials: X
authors.lastname: Zhang
authors.forename: Jingjing
authors.initials: J
authors.lastname: Gao
authors.forename: Jishuang
authors.initials: J
authors.lastname: Liu
authors.forename: Lei
authors.initials: L
authors.lastname: Xia
authors.forename: Jiajia
authors.initials: J
authors.lastname: Yang
authors.forename: Zongyao
authors.initials: Z
authors.lastname: Hao
authors.forename: Jun
authors.initials: J
authors.lastname: Zhou
authors.forename: Chaozhao
authors.initials: C
authors.lastname: Liang
mesh_terms: D000328:Adult; D001007:Anxiety / Q000453:epidemiology; D002681:China / Q000453:epidemiology; D003075:Coitus; D015897:Comorbidity; D003430:Cross-Sectional Studies; D003863:Depression / Q000453:epidemiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D010045:Outpatients; D010410:Penile Erection; D061686:Premature Ejaculation / Q000145:classification* / Q000175:diagnosis / Q000453:epidemiology*; D015995:Prevalence; D012307:Risk Factors; D011795:Surveys and Questionnaires