Identifying an optimal ejaculation latency for the diagnosis of men reporting orgasmic/ejaculation difficulty

Area of Science:

• Male sexual dysfunction
• Reproductive endocrinology
• Clinical diagnostics

Background:

• Diagnostic criteria for delayed ejaculation (DE) are currently under review.
• Accurate diagnosis of DE is essential for effective treatment and patient management.

Purpose of the Study:

• To establish an optimal ejaculation latency (EL) threshold for diagnosing delayed ejaculation (DE).
• To explore the relationship between various ELs and independent characterizations of DE.
• To determine if concomitant erectile dysfunction (ED) impacts diagnostic thresholds.

Main Methods:

• A multinational survey of 1660 men, with and without ED, was conducted.
• Participants provided data on estimated EL, DE symptomology, and relevant covariates.
• Statistical analyses were performed to identify optimal EL thresholds.

Main Results:

• An EL of ≥16 minutes offered the best sensitivity and specificity balance.
• An EL of ≥11 minutes identified the most men with severe orgasmic difficulty but had lower specificity.
• These findings remained consistent after accounting for covariates, and ED status had negligible impact.

Conclusions:

• An algorithm for DE diagnosis should incorporate an EL threshold alongside assessments of orgasmic difficulty.
• An EL of 10-11 minutes, when used with other criteria, helps minimize false negative diagnoses.
• The presence of ED does not appear to affect the utility of these diagnostic procedures.