(109) Effect of Pelvic Rehabilitation with Transcutaneous Neuromuscular Electrical Stimulation on Ejaculatory Latency in Patients with Lifelong Premature Ejaculation

Introduction Premature ejaculation (PE) is the most common type of sexual dysfunction in men. Currently treatment options are limited and adherence to them is generally low. Objective We designed this prospective study to investigate the effect of neuromuscular electrical stimulation (NMES) applied to the perineal region on ejaculatory latency time in patients with lifelong PE, and to determine whether this intervention is more effective when used on-demand before intercourse or as a regular therapy. Methods This prospective, single-blind, randomized study included 103 patients with lifelong PE, 42 or which met the inclusion criteria. In the first group (Pelvic Rehabilitation group – PR), patients received regular pelvic floor muscle exercises (PFME) combined with perineal NMES for 3 months; 12 patients completed the treatment. In the second group (On-Demand group – OD), patients performed regular PFME and applied perineal NMES on-demand before intercourse; 30 patients completed the treatment. Intravaginal ejaculatory latency time (IELT), Premature ejaculation diagnostic tool (PEDT), and International index of erectile function- 5 items (IIEF-5) scores were recorded before and after treatment. Results Statistical analyses showed no significant differences in descriptive variables or baseline IELT, PEDT, and IIEF-5 scores between the two groups. Pre- vs. post-treatment comparison in the first group In the PR group, the mean IELT increased from 26.92 ± 19.07 seconds to 82.17 ± 54.31 seconds after treatment (p=0.001), representing a 205% improvement (approximately 4.1-fold increase). PEDT scores decreased from 18.4 ± 1.6 to 12.8 ± 5.1 (p=0.005). IIEF-5 scores increased by a mean of 1 point, from 23.4 ± 1.3 to 24.4 ± 1.0 (p=0.015). Pre- vs. post-treatment comparison in the second group In the OD group, the mean IELT increased from 29.90 ± 17.07 seconds to 47.30 ± 33.98 seconds (p=0.001), representing a 58% improvement (approximately 1.9-fold increase). PEDT scores decreased from 18.4 ± 1.9 to 17.1 ± 3.4 (p=0.008). IIEF-5 scores did not significantly change (24.0 ± 1.2 vs. 24.0 ± 1.4, p=1). Intergroup comparison Although baseline IELT values were similar between groups, post-treatment IELT values diverged, with higher IELT in the PR group (82.17 ± 54.31 sec) compared to the OD group (47.30 ± 33.98 sec), though the difference was not statistically significant (p=0.057). However, the absolute IELT gain and IELT ratio were significantly higher in the PR group (p=0.009 and p=0.001, respectively). The post-treatment PEDT score was significantly lower in the PR group compared to the on-demand group, and the reduction in PEDT scores was also significantly greater in the PR group (p=0.006 and p=0.005, respectively). No significant differences were found between groups in post-treatment IIEF-5 scores (p=0.303). The statistical analysis results of post-treatment changes between the groups are presented in Table 1. Conclusions Both treatment groups demonstrated a significant increase in IELT and a decrease in PEDT scores. When comparing the groups, the PR group achieved greater improvements in all measured parameters. Disclosure Any of the authors act as a consultant, employee or shareholder of an industry for: Ege Can Serefoglu shareholder of Virility.