Understanding the Effects of Establishing Various Cutoff Criteria in the Definition of Men with Premature Ejaculation

INTRODUCTION: Over the past decade, professional organizations and consensus groups have offered a variety of definitions for premature ejaculation (PE), all generally including a set of common concepts but all varying in specific language and operationalization. Clearly articulated definitions of such conditions are important because they not only affect prevalence rates but also diagnostic inclusion-who is deemed to have the condition and therefore who might be eligible for treatment. AIM: The current study had two goals: (i) to examine the effects on prevalence rates of moving the cutoff points from more stringent to less stringent for each of three PE criteria-ejaculatory latency, distress, and ejaculating before desired; and (ii) to explore in detail the relationships among the three criteria. METHODS: Using an Internet-based sample of 1,183 men, we examined the responses of 374 with PE-type symptoms based on consensus definitions, and determined the effect of decreasing restrictions on the cutoff criteria. In addition, we calculated both correlations and concordance rates among criteria. RESULTS: Numeric and graphic depiction of the effects of moving the cutoff point for each of the three criteria is provided in the URL "PE Prevalence," a dynamic tool developed specifically for this study (https://sites.google.com/a/valpo.edu/PEprevalence/). In addition, statistical relationships among the PE criteria suggest sufficient independence to warrant inclusion of all three in a diagnostic procedure as well as to consider a 2-minute ejaculatory latency as the threshold for a PE diagnosis. CONCLUSIONS: Based on our data, clinicians should approach the 1-minute ejaculatory latency time (ELT) criterion with flexibility, considering ELTs up to 2 minutes for a PE diagnosis. At the same time, frequency of occurrence of either ejaculating before desired or of distress about the condition, as long as they reach at least 50% of the time, had only minor impact on PE diagnostic inclusion.