An evidence-based unified definition of lifelong and acquired premature ejaculation: report of the second International Society for Sexual Medicine Ad Hoc Committee for the Definition of Premature Ejaculation.
BACKGROUND
The International Society for Sexual Medicine (ISSM) Ad Hoc Committee for the Definition of Premature Ejaculation developed the first evidence-based definition for lifelong premature ejaculation (PE) in 2007 and concluded that there were insufficient published objective data at that time to develop a definition for acquired PE.


OBJECTIVE
The aim of this article is to review and critique the current literature and develop a contemporary, evidence-based definition for acquired PE and/or a unified definition for both lifelong and acquired PE.


METHODS
In April 2013, the ISSM convened a second Ad Hoc Committee for the Definition of Premature Ejaculation in Bangalore, India. The same evidence-based systematic approach to literature search, retrieval, and evaluation used by the original committee was adopted.


RESULTS
The committee unanimously agreed that men with lifelong and acquired PE appear to share the dimensions of short ejaculatory latency, reduced or absent perceived ejaculatory control, and the presence of negative personal consequences. Men with acquired PE are older, have higher incidences of erectile dysfunction, comorbid disease, and cardiovascular risk factors, and have a longer intravaginal ejaculation latency time (IELT) as compared with men with lifelong PE. A self-estimated or stopwatch IELT of 3 minutes was identified as a valid IELT cut-off for diagnosing acquired PE. On this basis, the committee agreed on a unified definition of both acquired and lifelong PE as a male sexual dysfunction characterized by (i) ejaculation that always or nearly always occurs prior to or within about 1 minute of vaginal penetration from the first sexual experience (lifelong PE) or a clinically significant and bothersome reduction in latency time, often to about 3 minutes or less (acquired PE); (ii) the inability to delay ejaculation on all or nearly all vaginal penetrations; and (iii) negative personal consequences, such as distress, bother, frustration, and/or the avoidance of sexual intimacy.


CONCLUSIONS
The ISSM unified definition of lifelong and acquired PE represents the first evidence-based definition for these conditions. This definition will enable researchers to design methodologically rigorous studies to improve our understanding of acquired PE.
Department of Urology, Bagcilar Training & Research Hospital, Istanbul, Turkey.
Ege Can
EC
Serefoglu
Chris G
CG
McMahon
Marcel D
MD
Waldinger
Stanley E
SE
Althof
Alan
A
Shindel
Ganesh
G
Adaikan
Edgardo F
EF
Becher
John
J
Dean
Francois
F
Giuliano
Wayne J G
WJ
Hellstrom
Annamaria
A
Giraldi
Sidney
S
Glina
Luca
L
Incrocci
Emmanuele
E
Jannini
Marita
M
McCabe
Sharon
S
Parish
David
D
Rowland
R Taylor
RT
Segraves
Ira
I
Sharlip
Luiz Otavio
LO
Torres
D000368:Aged; D002908:Chronic Disease; D004542:Ejaculation / Q000502:physiology; D007172:Erectile Dysfunction / Q000503:physiopathology; D019317:Evidence-Based Medicine; D005260:Female; D006801:Humans; D008297:Male; D061686:Premature Ejaculation / Q000175:diagnosis* / Q000503:physiopathology / Q000523:psychology; D011930:Reaction Time / Q000502:physiology; D012649:Self Concept; D013315:Stress, Psychological
Acquired Premature Ejaculation; Definition; Ejaculatory Control; Interpersonal Distress; Intravaginal Ejaculatory Latency Time; Lifelong Premature Ejaculation; Negative Personal Psychological Consequences; Personal Distress; Premature Ejaculation; Sexual Satisfaction