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Ejaculatory Dysfunction in Patients Presenting to a Men's Health Clinic: A Retrospective Cohort Study
Alex M Kasman1, Hriday P Bhambhvani1, Michael L Eisenberg2
1Department of Urology, Stanford University School of Medicine, Stanford, CA, USA.
Insights
Ejaculatory dysfunction (EjD) affects 24% of men in a men's health clinic, often linked to erectile dysfunction and older age. Screening for EjD is recommended in this population.
Area of Science:
- Urology
- Men's Health
- Sexual Health
Background:
- Ejaculatory dysfunction (EjD) prevalence and bother are understudied in men's health settings.
- Understanding EjD is crucial for men's health management.
Purpose of the Study:
- To determine the prevalence of EjD in men attending a men's health clinic.
- To identify risk factors associated with EjD in this population.
Main Methods:
- Retrospective review of patients in an outpatient men's health clinic.
- Utilized Sexual Health Inventory for Men and the Male Sexual Health Questionnaire Ejaculatory Dysfunction (MSHQ-EjD) Short Form.
- Demographics, comorbidities, and medications were analyzed using descriptive statistics and multivariable logistic regression.
Main Results:
- 24% of patients presented with EjD.
- Men with EjD were older (mean age 53.8 vs 42.6 years) and more likely to have erectile dysfunction (77.8%) and a history of pelvic cancer (20.6%).
- Erectile dysfunction (OR: 15.04) and alpha-inhibitor use (OR: 6.82) were significantly associated with EjD.
Conclusions:
- EjD is prevalent in men's health clinics, particularly in men over 50.
- EjD is associated with erectile dysfunction, pelvic cancer history, and alpha-inhibitor use.
- This population warrants consideration for EjD screening.
Introduction:
Prevalence and bother of ejaculatory dysfunction (EjD) has yet to be evaluated in a men's health referral population.
Aim:
To evaluate the prevalence and associated risk factors of EjD in men presenting to a men's health clinic.
Methods:
A retrospective review examined patients presenting to an outpatient men's health clinic who completed the Sexual Health Inventory for Men and the Male Sexual Health Questionnaire Ejaculatory Dysfunction (MSHQ-EjD) Short Form. Patient factors including demographics, comorbidities, and medication were examined. Descriptive statistics and multivariable logistic regression were used.
Main Outcome Measures:
The main outcomes of this study are Sexual Health Inventory for Men and MSHQ-EjD scores.
Results:
A total of 63 (24%) of patients presenting to the urology clinic were characterized as having EjD based on questionnaire responses. The mean age for men with EjD was 53.8 years, while those without was 42.6 years (P < .001). Of men with EjD, 74.6% were at least moderately bothered (MSHQ-EjD ≥3). Men with EjD were more likely to have erectile dysfunction (77.8%) compared with those without (21%, P < .001) as well as a history of a pelvic cancer (20.6% vs 6%, P = .001). On multivariable regression, erectile dysfunction (odds ratio: 15.04, 95% confidence interval: 6.76-35.92, P < .0001) and alpha inhibitor prescription (odds ratio: 6.82, 95% confidence interval: 1.57-30.16, P = .01) were associated with a higher odds of EjD. ED was found to be a mediator of the relationship between EjD and age, as the age association was lost in the ED population on multivariable regression compared with the non-ED population where it remained significant.
Conclusions:
EjD is common among patients presenting to a men's health clinic and may present at varying ages, though it is more common in those aged 50 years or older; it is independent of age and race. EjD is associated with erectile dysfunction, pelvic cancer history, and use of alpha inhibitors, presenting a population that could be considered for screening. Kasman AM, Bhambhvani HP, Eisenberg ML. Ejaculatory Dysfunction in Patients Presenting to a Men's Health Clinic: A Retrospective Cohort Study. J Sex Med 2020;8:454-460.
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