Real-World Clinical Practices for Premature Ejaculation: A National Survey of Chinese Physicians

Premature ejaculation is a prevalent male sexual dysfunction, yet real-world clinical practices in China remain poorly characterized.

To evaluate current premature ejaculation management practices among Chinese physicians.

A nationwide cross-sectional survey of 1000 physicians was conducted using a structured, self-administered questionnaire exploring diagnostic practices, treatment modalities, and perceived therapeutic effectiveness. Associations between physician characteristics and treatment choices were analyzed using chi-square tests.

Diagnostic reliance on clinical history (67.4%) exceeded that on standardized tools (32.6%). Around 46.5% of physicians reported treating intravaginal ejaculation latency time < 1 min without distress, while 32.6% reported treating intravaginal ejaculation latency time > 10 min with distress. Oral dapoxetine (59.7%) and psychotherapy (92.1%) were preferred first-line therapies, followed by long-acting selective serotonin reuptake inhibitors (13.7%). Prescriptions for long-acting selective serotonin reuptake inhibitors were primarily driven by guideline adherence (25.95%), anxiety/depression comorbidity (17.56%), dapoxetine inefficacy (6.11%), and clinician experience (6.11%). Combination therapy was common (52.1%), whereas surgical interventions remained rare (14.7%) but more prevalent among andrologists than among non-andrologists (p < 0.001). Compared with non-andrologists, andrologists demonstrated greater use of behavioral therapy (p = 0.001) and topical agents (p = 0.006) than non-andrologists. Drug selection (54.5%) and psychological factors (16.6%) were identified as key efficacy determinants.

Chinese physicians commonly use combined pharmacological and psychological approaches for premature ejaculation treatment, but significant challenges persist, including inappropriate treatment of non-premature ejaculation cases, unwarranted surgical interventions, and insufficient utilization of evidence-based selective serotonin reuptake inhibitors, highlighting the need for standardized diagnostic criteria and enhanced physician education on guideline-recommended therapies.