Abstract Introduction Penile prosthesis implantation (PPI) represents the definitive surgical solution for men with erectile dysfunction (ED) unresponsive to pharmacotherapy or intracavernosal injections. While the efficacy of PPI in restoring erectile rigidity is well established, its broader impact on sexual function, particularly on ejaculatory control, remains underexplored. Some clinical observations and neurophysiological theories suggest that prosthesis implantation may modulate sensory feedback from the glans penis, alter penile hemodynamics, and improve sexual confidence, which together could influence ejaculatory reflex latency. However, data assessing validated premature ejaculation (PE) measures in this context are scarce. Objective To retrospectively assess the effect of PPI on PE-related outcomes and to compare changes in ejaculatory control among different surgical techniques. Methods Data from 106 men who underwent PPI between 2018 and 2024 were retrospectively reviewed. Surgical approaches included infrapubic (IP, n=21), penoscrotal (PS, n=25), and subcoronal (SC, n=7) incisions. Pre- and postoperative Premature Ejaculation Diagnostic Tool (PEDT) and Intravaginal Ejaculatory Latency Time (IELT, seconds) values were extracted from patient records. The International Index of Erectile Function-5 (IIEF-5) documented baseline erectile status. The mean postoperative follow-up period was 6 months. Data were expressed as mean ± SD (min–max). Within-group comparisons were performed using the Wilcoxon signed-rank test, and between-technique comparisons employed the Kruskal–Wallis test. A p-value 0.05 was considered statistically significant. Results The mean age of participants was 53.1 ± 13.5 years. The mean preoperative PEDT score was 12.85 ± 4.24 (5–19) and significantly decreased to 13.08 ± 14.40 (5–113) postoperatively (p 0.001), indicating a reduction in PE severity. IELT significantly increased from 160.75 ± 147.57 s (30–600) to 212.83 ± 163.29 s (30–600) (p 0.001), reflecting a meaningful prolongation of intravaginal ejaculatory latency. Within-group analysis demonstrated consistent IELT prolongation and PEDT reduction in both IP and PS subgroups, with a similar but statistically nonsignificant trend in SC cases. Kruskal–Wallis comparison of Δ(post–pre) values revealed no significant between-technique differences for either parameter (p 0.05). Conclusions PPI leads to a statistically and clinically significant increase in IELT and a decrease in PEDT scores, reflecting improved ejaculatory control and reduced PE severity. These benefits appear independent of the surgical technique and may result from a combination of reduced glans sensitivity, enhanced coital confidence, and altered afferent signaling after implantation. This retrospective analysis suggests that PPI confers functional advantages beyond erectile restoration by improving ejaculatory latency. Further prospective and mechanistic studies are warranted to elucidate the neurophysiological mechanisms underlying these observations and to assess whether PPI could serve as a potential therapeutic option for men with concomitant ED and PE. Disclosure No
Sertkaya et al. (Mon,) studied this question.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: