Introduction: Premature ejaculation (PE) is the most common sexual problem, and chronic prostatitis is an important cause of PE.
Aim: The aim of this study was to determine which clinical parameters predict successful outcomes following treatment of men with PE and chronic prostatitis (category II and IIIa).
Main outcome measure: Change in intravaginal ejaculatory latency time (IELT) and its relation to different clinical parameters.
Methods: This study included 210 heterosexual men with PE and inflammatory prostatitis. PE was found to be acquired in 155 men (A-PE) and lifelong in 55 (LL-PE). All participants were asked to complete the National Institutes of Health-Chronic Prostatitis Symptom Index (NIH-CPSI). Sequential microbiologic specimens were obtained. Antibiotics were given to 184 men for 4 weeks, guided by sensitivity tests. Twenty-six men refused or did not comply with the antimicrobial therapy and were used as the untreated group. Clinical reevaluation was conducted after 28 days.
Results: Two of the 26 men (7.7%) from the untreated group experienced an increase in their ejaculatory latency compared with 109 of the 184 men (59.0%) who received antimicrobial therapy (P = 0.0001). After treatment, 90 of 155 men (58.0%) with A-PE reported ILET > 2 minutes compared with 21 of 55 men (38.2%) with LL-PE (P = 0.012). Based on a receiver operating characteristic curve, antimicrobial therapy is most effective if there are > or =19 pus cells per high-power field (HPF) in the expressed prostatic secretion (EPS) analysis, with a sensitivity of 85.6% and a specificity of 70.7% (area under the curve 0.783, 95% CI 0.716-0.850). Other clinical parameters were not useful in predicting outcomes.
Conclusions: Antimicrobial therapy is useful in the treatment of PE associated with inflammatory prostatitis. The treatment is most effective in men with A-PE and when there are > or =19 pus cells per HPF in an EPS analysis.