The relationship between lifelong premature ejaculation and monosymptomatic enuresis

Abstract

Introduction: Although both biological and psychological factors are important in the etiologies, the underlying physiopathologies of lifelong premature ejaculation (PE) and monosymptomatic enuresis (ME) are not completely understood.

Aim: The aim of this study is to evaluate the prevalence of ME in men diagnosed with lifelong PE and relationships of these two conditions.

Methods: Between December 2008 and November 2009, we designed a prospective randomized study in 51 patients who had presented with lifelong PE and in age-matched 106 healthy control cases without PE. If the patient declared that he ejaculated less than 1 minute more than half of his intercourse attempts, he was enrolled in the study.

Main outcome measures: All subjects included in this study underwent general and urological physical examinations and were asked about their history of ME. The frequency of enuresis was graded using the following criteria: (i) 1-2 times/week as infrequent; (ii) 3-5 times/week as moderate; and (iii) 6-7 times/week as severe. Only patients with primary ME were evaluated.

Results: Of the 51 premature ejaculator men, 19 (37.2%) had a history of ME. Among these 19 men, five (26.3%) had severe, six (31.6%) had moderate, and eight (42.1%) had infrequent enuresis. Of the 106 control cases, 16 (15.1%) had a history of ME and of these 16 patients, three (18.7%) had severe, five (31.2%) had moderate, and eight (50%) had infrequent enuresis. Compared with control population (15.1%), the prevalence of ME in the premature ejaculators (37.2%) was more than twofold higher (P < 0.005).

Conclusion: We have found a significant increase in ME prevalence in lifelong premature ejaculators. A common deficiency of inhibitory signal processing in the central nervous system may underlie both inability to inhibit the ejaculation and micturition in these patients or genetic predisposition may play a significant role. Further prospective studies are needed to explain the relationship between lifelong PE and ME.