Chlamydia trachomatis infection is related to premature ejaculation in chronic prostatitis patients: results from a cross-sectional study

J Sex Med. 2014 Dec;11(12):3085-92. doi: 10.1111/jsm.12699. Epub 2014 Sep 25.


Introduction: Chronic bacterial prostatitis (CBP) is reported to be a common finding in men with acquired premature ejaculation (PE). The impact of different pathogens on PE development in chronic prostatitis patients is, however, unknown.

Aim: To assess a possible link between CBP caused by Chlamydia trachomatis (Ct) and PE.

Methods: A consecutive series of 317 patients with clinical and instrumental diagnosis of CBP due to Ct was enrolled (group A) and compared with data obtained from a control group of 639 patients with CBP caused by common uropathogen bacteria (group B). Prostatitis symptoms were investigated with the National Institutes of Health-Chronic Prostatitis Symptom Index (NIH-CPSI), while the ejaculatory status of patients was assessed using the PE Diagnostic Tool (PEDT).

Main outcome measures: All participants were asked to complete the NIH-CPSI, the International Index of Erectile Function-15 erectile function domain (IIEF-15-EFD), the PEDT, and the Short Form (SF)-36 questionnaires.

Results: Patient groups A and B had comparable scores of NIH-CPSI (P = 0.07), IPSS (P = 0.32), and IIEF-15-EFD (P = 0.33) tests. PE was assessed in 118 patients in group A (37.2%) and in 73 subjects in group B (11.5%). The two groups are different in terms of PE prevalence (P < 0.0002). Compared with group B, group A showed significantly higher scores of the PEDT test (11.3 [±2.6] vs. 4.5 [±2.9], P < 0.0001) and lower scores of the SF-36 tool (96.5 [±1.1] vs. 99.7 [±1.3], P < 0.0001). In our multivariate model assessment, being positive for a Ct infection marker was independently associated with the PEDT score even after adjusting for age, smoking habit, body mass index, and education level (adjusted odds ratio = 3.21; 95% confidence interval: 2.02-4.27; P < 0.003).

Conclusions: Patients affected by CBP due to Ct infection reported higher prevalence of PE and lower quality of life when compared with patients affected by CBP caused by traditional uropathogenic bacteria.

Keywords: Acquired Early Ejaculation; Chlamydia trachomatis; NIH-CPSI; PEDT; Premature Ejaculation; Quality of Life.

Publication types

  • Comparative Study

MeSH terms

  • Adult
  • Antibodies, Bacterial / metabolism
  • Chlamydia Infections / complications*
  • Chlamydia trachomatis* / genetics
  • Chlamydia trachomatis* / immunology
  • Chronic Disease
  • DNA, Bacterial / metabolism
  • Epidemiologic Methods
  • Humans
  • Immunoglobulin A / metabolism
  • Male
  • Middle Aged
  • Premature Ejaculation / microbiology*
  • Prostatitis / complications*
  • Quality of Life
  • Young Adult


  • Antibodies, Bacterial
  • DNA, Bacterial
  • Immunoglobulin A