Lower urinary tract symptoms and depressive symptoms among patients presenting for distressing early ejaculation

We aimed to assess the correlation between premature ejaculation (PE), lower urinary tract symptoms (LUTS), erectile dysfunction (ED), and depression in the cohort of the last 329 patients seeking medical help for distressing early ejaculation at a single tertiary-referral center. All patients completed the premature ejaculation diagnostic tool (PEDT), the International Index of Erectile Function (IIEF), the Beck's Inventory for Depression (BDI), and the International Prostate Symptom Score (IPSS) at their first assessment. Overall, 133 (0.4) patients had PEDT ≥ 11, suggestive for PE. The characteristics of patients with and without PE according to PEDT findings were compared with the Mann-Whitney and Fisher's exact tests. Linear regression analysis tested the association between LUTS and PEDT score. Patients with PE depicted lower median scores for IIEF-overall satisfaction, intercourse satisfaction and erectile function than non-PE individuals (all p < 0.004). Similarly, patients with PE showed higher median BDI scores (7 versus 4; p < 0.0002), median IPSS total score (7 versus 5), storage (4 versus 2), and voiding (3 versus 2) subscores (all p < 0.01) compared to those without PE. At linear regression analysis, IPSS storage subscore (Coeff: 0.28; 95%CI: 0.05-0.51, p = 0.01) and BDI score (Coeff: 0.10; 95%CI: 0.01-0.19, p = 0.02) were associated with higher PEDT values, after accounting for IIEF-EF score, patients' age, body mass index and Charlson Comorbidity Index. Our findings suggest that storage symptoms and depression should be carefully investigated when assessing patients complaining of PE in the real-life setting.