Abstract：
Criteria for the definition and diagnosis of delayed ejaculation (DE) are yet under consideration.
This study sought to determine an optimal ejaculation latency (EL) threshold for the diagnosis of men with DE by exploring the relationship between various ELs and independent characterizations of delayed ejaculation.
In a multinational survey, 1660 men, with and without concomitant erectile dysfunction (ED) and meeting inclusion criteria, provided information on their estimated EL, measures of DE symptomology, and other covariates known to be associated with DE.
We determined an optimal diagnostic EL threshold for men with DE.
The strongest relationship between EL and orgasmic difficulty occurred when the latter was defined by a combination of items related to difficulty reaching orgasm and percent of successful episodes in reaching orgasm during partnered sex. An EL of ≥16 minutes provided the greatest balance between measures of sensitivity and specificity; a latency ≥11 minutes was the best threshold for tagging the highest number/percentage of men with the severest level of orgasmic difficulty, but this threshold also demonstrated lower specificity. These patterns persisted even when explanatory covariates known to affect orgasmic function/dysfunction were included in a multivariate model. Differences between samples of men with and without concomitant ED were negligible.
In addition to assessing a man\'s difficulty reaching orgasm/ejaculation during partnered sex and the percent of episodes reaching orgasm, an algorithm for the diagnosis of DE should consider an EL threshold in order to control diagnostic errors.
This study is the first to specify an empirically supported procedure for diagnosing DE. Cautions include the use of social media for participant recruitment, relying on estimated rather than clocked EL, not testing for differences between DE men with lifelong vs acquired etiologies, and the lower specificity associated with using the 11-minute criterion that could increase the probability of including false positives.
In diagnosing men with DE, after establishing a man\'s difficulty reaching orgasm/ejaculation during partnered sex, using an EL of 10 to 11 minutes will help control type 2 (false negative) diagnostic errors when used in conjunction with other diagnostic criteria. Whether or not the man has concomitant ED does not appear to affect the utility of this procedure.
This study sought to determine an optimal ejaculation latency (EL) threshold for the diagnosis of men with DE by exploring the relationship between various ELs and independent characterizations of delayed ejaculation.
In a multinational survey, 1660 men, with and without concomitant erectile dysfunction (ED) and meeting inclusion criteria, provided information on their estimated EL, measures of DE symptomology, and other covariates known to be associated with DE.
We determined an optimal diagnostic EL threshold for men with DE.
The strongest relationship between EL and orgasmic difficulty occurred when the latter was defined by a combination of items related to difficulty reaching orgasm and percent of successful episodes in reaching orgasm during partnered sex. An EL of ≥16 minutes provided the greatest balance between measures of sensitivity and specificity; a latency ≥11 minutes was the best threshold for tagging the highest number/percentage of men with the severest level of orgasmic difficulty, but this threshold also demonstrated lower specificity. These patterns persisted even when explanatory covariates known to affect orgasmic function/dysfunction were included in a multivariate model. Differences between samples of men with and without concomitant ED were negligible.
In addition to assessing a man\'s difficulty reaching orgasm/ejaculation during partnered sex and the percent of episodes reaching orgasm, an algorithm for the diagnosis of DE should consider an EL threshold in order to control diagnostic errors.
This study is the first to specify an empirically supported procedure for diagnosing DE. Cautions include the use of social media for participant recruitment, relying on estimated rather than clocked EL, not testing for differences between DE men with lifelong vs acquired etiologies, and the lower specificity associated with using the 11-minute criterion that could increase the probability of including false positives.
In diagnosing men with DE, after establishing a man\'s difficulty reaching orgasm/ejaculation during partnered sex, using an EL of 10 to 11 minutes will help control type 2 (false negative) diagnostic errors when used in conjunction with other diagnostic criteria. Whether or not the man has concomitant ED does not appear to affect the utility of this procedure.
摘要：
背景：延迟射精（DE）的定义和诊断标准仍在考虑中。
目的：本研究旨在通过探索各种EL与延迟射精的独立特征之间的关系来确定诊断男性DE的最佳射精潜伏期（EL）阈值。
方法：在一项跨国调查中，1660人，有或没有伴随的勃起功能障碍（ED）并符合纳入标准，提供了关于他们估计的EL的信息，DE症状学的测量，和其他已知与DE相关的协变量。
结果：我们确定了男性DE的最佳诊断EL阈值。
结果：EL与性高潮困难之间的关系最强，当性高潮困难与性伴侣达到性高潮的成功发作百分比相关的项目组合来定义性高潮困难时。≥16分钟的EL在敏感性和特异性之间提供了最大的平衡；潜伏期≥11分钟是标记性高潮困难程度最高的男性人数/百分比最高的最佳阈值，但该阈值也显示出较低的特异性。即使将已知影响高潮功能/功能障碍的解释性协变量包括在多变量模型中，这些模式仍然存在。有和没有伴随ED的男性样本之间的差异可以忽略不计。
结论：除了评估男性在伴侣性交中达到性高潮/射精的困难以及达到性高潮的百分比之外，诊断DE的算法应考虑EL阈值以控制诊断错误。
■这项研究是第一个指定诊断DE的经验支持程序的研究。注意事项包括使用社交媒体进行参与者招募，依靠估计的而不是计时的EL，没有测试患有终身病因和获得性病因的DE男性之间的差异，以及与使用11分钟标准相关的较低特异性，这可能会增加包括假阳性的概率。
结论：在诊断患有DE的男性时，在确定男人在伴侣性交中难以达到性高潮/射精后，与其他诊断标准一起使用时,使用10~11分钟的EL有助于控制2型(假阴性)诊断错误.该男子是否患有ED似乎不会影响该程序的实用性。
目的：本研究旨在通过探索各种EL与延迟射精的独立特征之间的关系来确定诊断男性DE的最佳射精潜伏期（EL）阈值。
方法：在一项跨国调查中，1660人，有或没有伴随的勃起功能障碍（ED）并符合纳入标准，提供了关于他们估计的EL的信息，DE症状学的测量，和其他已知与DE相关的协变量。
结果：我们确定了男性DE的最佳诊断EL阈值。
结果：EL与性高潮困难之间的关系最强，当性高潮困难与性伴侣达到性高潮的成功发作百分比相关的项目组合来定义性高潮困难时。≥16分钟的EL在敏感性和特异性之间提供了最大的平衡；潜伏期≥11分钟是标记性高潮困难程度最高的男性人数/百分比最高的最佳阈值，但该阈值也显示出较低的特异性。即使将已知影响高潮功能/功能障碍的解释性协变量包括在多变量模型中，这些模式仍然存在。有和没有伴随ED的男性样本之间的差异可以忽略不计。
结论：除了评估男性在伴侣性交中达到性高潮/射精的困难以及达到性高潮的百分比之外，诊断DE的算法应考虑EL阈值以控制诊断错误。
■这项研究是第一个指定诊断DE的经验支持程序的研究。注意事项包括使用社交媒体进行参与者招募，依靠估计的而不是计时的EL，没有测试患有终身病因和获得性病因的DE男性之间的差异，以及与使用11分钟标准相关的较低特异性，这可能会增加包括假阳性的概率。
结论：在诊断患有DE的男性时，在确定男人在伴侣性交中难以达到性高潮/射精后，与其他诊断标准一起使用时,使用10~11分钟的EL有助于控制2型(假阴性)诊断错误.该男子是否患有ED似乎不会影响该程序的实用性。
