Association of Erectile Dysfunction and Premature Ejaculation in Men with Chronic Prostatitis

Main Article Content

Min Ho Lee
Deok Ha Seo
Chun Woo Lee
Jae Hwi Choi
Seong Uk Jeh
Sin Woo Lee
See Min Choi
Jeong Seok Hwa
Jae Seog Hyun
Ky Hyun Chung
Sung Chul Kam


Prostatitis, Sexual Dysfunction, Premature Ejaculation, Erectile Dysfunction, Questionnaires


Background and objective

Although several studies have reported that sexual dysfunction is associated with chronic prostatitis (CP), specific differences in self-reported questionnaires and correlation with CP are not well-known. This study aimed to evaluate the prevalence and correlation of sexual dysfunction in men with CP.

Material and methods
This cross-sectional study included 892 men who visited our health care center, who were then divided into two groups. In Group 1, subjects are characterized with National Institutes of Health Chronic Prostatitis Symptom Index (NIH-CPSI) pain score ≥4, and Group 2 subjects are characterized with NIH-CPSI<4. Intravaginal Ejaculation Latency Time, Premature Ejaculatory Diagnostic Tool (PEDT), Male Sexual Health Questionnaire-ejaculation, International Index of Erectile Function (IIEF), and IIEF-5 were self-reported by participants. Total testosterone (TT) level was also checked. Data obtained were compared between the groups and the relationships identified.

The mean age was 52.8±7.3 years, and CP was prevalent in 136 (15.2%) of the 892 participants. All questionnaire scores showed worse results in Group 1 compared to those in Group 2 (p<0.05). In total, the prevalence of erectile dysfunction (IIEF-5≤21) and premature ejaculation (PEDT≥9) were 508 (56.3%) and 290 (32.5%), respectively. A higher prevalence of erectile dysfunction (71.3% vs. 53.6%, p<0.001) and premature ejaculation (44.8% vs. 30.3%, p=0.001) was identified in Group 1 than in Group 2. By correlation analysis, IIEF-5 (r=−0.208, p=0.015) and TT (r=−0.331, p=0.011) showed correlation with NIH-CPSI pain score in Group 1.

The prevalence and severity of erectile dysfunction and premature ejaculation were higher in Group 1. Moreover, the IIEF-5 showed correlation with NIH-CPSI pain score. These results indicate that screening for erectile dysfunction and premature ejaculation in men with CP is useful for early detection of comorbidities.


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1. Schaeffer AJ, Datta NS, Fowler JE, et al. Overview summary statement. Urology 2002;60:1–4. https://
2. McNaughton Collins M, Pontari MA, O’Leary MP, et al. Quality of life is impaired in men with  chronic prostatitis the chronic prostatitis collaborative research network. J Gen Intern Med  2004;16:656–62. https://doi. org/10.1111/j.1525-1497.2001.01223.x
3. Litwin MS, McNaughton-Collins M, Fowler FJ, Jr, et al. The National Institutes of Health chronic prostatitis symptom index: Development and val-idation of a new outcome measure. Chronic Prostatitis Collaborative Research Network. J Urol 1999;162:369–75. S0022-5347(05)68562-X
4. Bartoletti R, Cai T, Mondaini N, et al. Prevalence, incidence estimation, risk factors and character-ization of chronic prostatitis/chronic pelvic pain syndrome in urological hospital outpatients in Italy: Results of a multicenter case-control observational study. J Urol 2007;178:2411–15.
5. Lee SW, Liong ML, Yuen KH, et al. Adverse impact of sexual dysfunction in chronic prostati-tis/chronic pelvic pain syndrome. Urology 2008;71:79–84. 2007.08.043
6. Jeh SU, Yoon S, Choi JH, et al. Metabolic syndrome is an independent risk factor for acquired premature ejaculation. World J Mens Health 2019;37:226–33.
7. Cho IC, Kim SB, Kim YS, et al. Analysis of cor-relation between The National Institutes of Health Chronic Prostatitis Symptom Index (NIH-CPSI) and International Index of Erectile Function (IIEF-5) among Korean males aged 40–50s. Korean J UTII 2012;7:164–71.
8. Song WH, Park J, Yoo S, et al. Changes in the prevalence and risk factors of erectile dysfunction during a decade: The Korean Internet Sexuality Survey (KISS), a 10-year-interval web-based sur-vey. World J Mens Health 2019;37:199–209.
9. Johannes CB, Araujo AB, McKinlay JB, et al. Incidence of erectile dysfunction in men 40 to 69 years old: Longitudinal results from the Massachusetts male aging study. J Urol 2000;163: 460–3. https://doi. org/10.1016/S0022-5347(05)67900-1
10. Besiroglu H, Otunctemur A1, Ozbek E. The relation-ship between metabolic syndrome, its components, and erectile dysfunction: A systematic review and a meta-analysis of observational studies. J Sex Med 2015;12:1309–18.
11. Cho JW, Duffy JF. Sleep, sleep disorders, and sex-ual dysfunction. World J Mens Health 2019;37: 261–75.
12. Binmoammar TA, Hassounah S, Majeed A, et al. The impact of poor glycaemic control on the prev-alence of erectile dysfunction in men with type 2 diabetes mellitus: A systematic review. JRSM Open 2016;7:2054270415622602. https://doi. org/10.1177/2054270415622602
13. Rosen R, Altwein J, Boyle P, et al. Lower urinary tract symptoms and male sexual dysfunction: The multinational survey of the aging male (MSAM-7). Eur Urol 2003;44:637–49. 1016/j.eururo.2003.08.015
14. Laumann EO, Nicolosi A, Glasser DB, et al. Sexual problems among women and men aged 40–80 y: Prevalence and correlates identified in the Global Study of Sexual Attitudes and Behaviors. Int J Impot Res 2005;17:39–57. https://doi. org/10.1038/sj.ijir.3901250
15. Corona G, Rastrelli G, Maggi M, et al. Interplay between premature ejaculation and erectile dysfunc-tion: A systematic review and meta-analysis. J Sex Med 2015;12:2291–300. jsm.13041
16. McMahon CG, Jannini E, Rowland D, et al. Standard operating procedures in the disorders of orgasm and ejaculation. J Sex Med 2013;10:204–29.
17. Serefoglu EC, McMahon CG, Waldinger MD, et al. An evidence-based unified definition of life-long and acquired premature ejaculation: Report of the second International Society for Sexual Medicine Ad Hoc Committee for the Definition of Premature Ejaculation. J Sex Med 2014;11: 1423–41.
18. Althof SE, McMahon CG, Waldinger MD, et al. An update of the International Society of Sexual Medicine’s guidelines for the diagnosis and treat-ment of premature ejaculation (PE). J Sex Med 2014;11:1392–22.
19. Montague DK, Jarow J, Broderick GA, et al. AUA Erectile Dysfunction Guideline Update Panel. AUA guideline on the pharmacologic management of premature ejaculation. J Urol 2004;172:290–4.
20. Jannini EA, Burri A, Novelli G, et al. Genetics of human sexual behavior: Where we are, where we are going. Sex Med Rev 2015;6:65–77. https://doi. org/10.1002/smrj.46
21. Screponi E, Carosa E, Jannini EA, et al. Prevalence of chronic prostatitis in men with premature ejac-ulation. Urology 2001;58:198–202. https://doi. org/10.1016/S0090-4295(01)01151-7
22. Lotti F, Corona G, Maggi M, et al. Clinical cor-relates of erectile dysfunction and premature ejaculation in men with couple infertility. J Sex Med 2012;9:2698–707. j.1743-6109.2012.02872.x
23. Collins MM, Stafford RS, O'Leary MP, et al. How common is prostatitis? A national survey of physi-cian visits. J Urol 1998;159:1224–8. https://doi. org/10.1016/S0022-5347(01)63564-X
24. Zhang Z, Li Z, Yu Q, et al. The prevalence of and risk factors for prostatitis-like symptoms and its relation to erectile dysfunction in Chinese men. Andrology 2015;3:1119–24. https://doi. org/10.1111/andr.12104
25. Liang CZ, Li HJ, Wang ZP, et al. The preva-lence of prostatitis-like symptoms in China. J Urol 2009;182:558–63. juro.2009.04.011
26. Hao ZY, Li HJ, Wang ZP, et al. The prevalence of erectile dysfunction and its relation to chronic pros-tatitis in Chinese men. J Androl 2011;32:496–501.
27. Li HJ, Kang DY. Prevalence of sexual dysfunc-tion in men with chronic prostatitis/chronicpelvic pain  syndrome: A meta-analysis. World J Urol 2016;34:1009–17. s00345-015-1720-3
28. Tan JK, Png DJ, Liew LC, et al. Prevalence of prostatitis-like symptoms in Singapore: A popula-tion-based study. Singapore Med J 2002;43: 189–93.
29. Chung SD, Keller JJ, Lin HC. A case-control study on the association between chronic prostatitis/chronic pelvic pain syndrome and erec-tile dysfunction. BJU Int 2012;110:726–30.
30. Shoskes DA, Prots D, Karns J, et al. Greater endo-thelial dysfunction and arterial stiffness in men with  chronic prostatitis/chronic pelvic pain syn-drome—A possible link to cardiovascular disease. J  Urol 2011;186:907–10. juro.2011.04.063

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