(298) The Effect of Pelvic Floor Muscle Physiotherapy on Therapy-Naïve Lifelong Premature Ejaculation: Preliminary Results

Introduction Pelvic floor muscle (PFM) physiotherapy has been proposed as a treatment for lifelong premature ejaculation (PrEj). Contemporary studies have shown noticeable success with pelvic physiotherapy; even smartphone-guided at-home exercises have been shown to be beneficial. However, available studies have primarily focused on patients who had previously used other first-line options, such as local anesthetics and SSRIs. Furthermore, the available literature lacks objective EMG findings for this patient population. In this report, we present our preliminary results on the efficacy of primary PFM physiotherapy in treatment-naïve, heterosexual, male patients. Objective To report the clinical results, supported by objective EMG findings, from our clinic on treatment-naïve patients with lifelong PrEj. Methods This study retrospectively reviewed data from 14 treatment-naïve patients seen at a single physiotherapist’s private practice. All patients had initially presented to a single urologist’s office with complaints of early and uncontrollable ejaculation. Patients were included after excluding active urinary infection, concurrent erectile dysfunction, and any previous use of on-demand SSRIs or local anesthetics. Eligible patients were referred for PFM physiotherapy, which comprised a total of 6 sessions (two per week) conducted under EMG monitoring. Pre- and post-treatment comparisons were made for patient-reported benefit, Intravaginal Ejaculatory Latency Time (IELT), and pelvic floor EMG results. Results The mean age was 29 ± 3.9 years (± SD), and the mean follow-up was 6.5 months (range, 2–11 months). Overall, 9 out of 14 patients (64.3%) reported subjective benefit in ejaculatory control and an increase in IELT. Mean IELT showed a statistically significant increase from pre-treatment to post-treatment follow-up (p = 0.0009, paired-sample t-test). Basal muscle tonus, as measured by EMG, also showed a significant difference between pre- and post-treatment assessments (p = 0.002, paired-sample t-test). Three representative cases are presented in Figures 1 to 3. Conclusions Pelvic floor muscle therapy appears to be a viable option for treatment-naïve lifelong PrEj patients in the short term. Prospective studies with longer follow-up are needed to provide more solid evidence of its long-term efficacy. Disclosure No