Abstract：
BACKGROUND: Although premature ejaculation (PE) is the most common male sexual dysfunction, the underlying mechanisms are not fully understood.
OBJECTIVE: The study sought to evaluate the possible associations among glans penis volume and tissue stiffness measured using penile ultrasonography and penile shear wave elastography (SWE) with PE.
METHODS: Men 18 to 65 years of age with normal International Index of Erectile Function scores (>25) and who were diagnosed with PE between June 2021 and June 2022 were enrolled. The Premature Ejaculation Diagnostic Tool score and intravaginal ejaculation latency times were recorded. Healthy volunteers constituted the control group. The study group was divided into lifelong PE (LLPE) and acquired PE (AqPE) subgroups. In all groups, the glans penis volume was measured via penile ultrasonography and tissue stiffness of the glans penis, penile frenulum, postcircumcision mucosal cuff, and penile shaft were measured via SWE. The findings of the groups were compared using appropriate statistical methods.
RESULTS: The outcomes included ultrasonographic and elastographic measurements of the glans penis.
RESULTS: Data on 140 men, including 70 PE patients and 70 healthy volunteers, were evaluated. Of the patients, 20 had LLPE and 50 had AqPE. The median glans penis volume was significantly greater in the LLPE group (14.1 [range, 6.6-19] mm3) compared with the AqPE group (11.7 [range, 5.1-27] mm3) and control group (11.4 [range, 6.1-32] mm3) (P = .03). According to the Youden index, the best cutoff value for glans penis volume in LLPE compared with non-LLPE (AqPE + control) was 12.65 mm3 (area under the curve, 0.684; 95% confidence interval, 0.556-0.812; P = .009). The risk of having LLPE in those with a glans penis volume ≥12.65 mm3 was 3.326 (95% confidence interval, 1.234-8.965) times higher than the non-LLPE group (P = .014). There were no significant differences between the groups in the SWE evaluation of glans penis, penile frenulum, mucosal cuff, and penile shaft tissue stiffness.
CONCLUSIONS: The high incidence of PE in those with high glans penis volume may make glans penis volume a predictor for the development of LLPE.
UNASSIGNED: This was the first study to show that PE is more common in individuals with a high glans penis volume. It was also the first to perform a penile elastographic evaluation in patients with PE. The most important limitation was that we did not evaluate glans penile nerve function with a test, but rather we made an indirect inference about the density of free nerve endings based on increased glans penile volume.
CONCLUSIONS: Glans penis volume was a significant predictor for LLPE. However, there are no associations between PE and the glans penis, postcircumcision mucosal cuff, penile frenulum, or penile shaft tissue stiffness and development.
OBJECTIVE: The study sought to evaluate the possible associations among glans penis volume and tissue stiffness measured using penile ultrasonography and penile shear wave elastography (SWE) with PE.
METHODS: Men 18 to 65 years of age with normal International Index of Erectile Function scores (>25) and who were diagnosed with PE between June 2021 and June 2022 were enrolled. The Premature Ejaculation Diagnostic Tool score and intravaginal ejaculation latency times were recorded. Healthy volunteers constituted the control group. The study group was divided into lifelong PE (LLPE) and acquired PE (AqPE) subgroups. In all groups, the glans penis volume was measured via penile ultrasonography and tissue stiffness of the glans penis, penile frenulum, postcircumcision mucosal cuff, and penile shaft were measured via SWE. The findings of the groups were compared using appropriate statistical methods.
RESULTS: The outcomes included ultrasonographic and elastographic measurements of the glans penis.
RESULTS: Data on 140 men, including 70 PE patients and 70 healthy volunteers, were evaluated. Of the patients, 20 had LLPE and 50 had AqPE. The median glans penis volume was significantly greater in the LLPE group (14.1 [range, 6.6-19] mm3) compared with the AqPE group (11.7 [range, 5.1-27] mm3) and control group (11.4 [range, 6.1-32] mm3) (P = .03). According to the Youden index, the best cutoff value for glans penis volume in LLPE compared with non-LLPE (AqPE + control) was 12.65 mm3 (area under the curve, 0.684; 95% confidence interval, 0.556-0.812; P = .009). The risk of having LLPE in those with a glans penis volume ≥12.65 mm3 was 3.326 (95% confidence interval, 1.234-8.965) times higher than the non-LLPE group (P = .014). There were no significant differences between the groups in the SWE evaluation of glans penis, penile frenulum, mucosal cuff, and penile shaft tissue stiffness.
CONCLUSIONS: The high incidence of PE in those with high glans penis volume may make glans penis volume a predictor for the development of LLPE.
UNASSIGNED: This was the first study to show that PE is more common in individuals with a high glans penis volume. It was also the first to perform a penile elastographic evaluation in patients with PE. The most important limitation was that we did not evaluate glans penile nerve function with a test, but rather we made an indirect inference about the density of free nerve endings based on increased glans penile volume.
CONCLUSIONS: Glans penis volume was a significant predictor for LLPE. However, there are no associations between PE and the glans penis, postcircumcision mucosal cuff, penile frenulum, or penile shaft tissue stiffness and development.
摘要：
背景：尽管早泄（PE）是最常见的男性性功能障碍，潜在的机制还没有完全理解。
目的：本研究旨在评估使用阴茎超声和阴茎剪切波弹性成像（SWE）与PE测量的龟头阴茎体积和组织硬度之间的可能关联。
方法：纳入具有正常国际勃起功能指数评分（>25）且在2021年6月至2022年6月之间诊断为PE的18至65岁男性。记录早泄诊断工具评分和阴道内射精潜伏期。健康志愿者组成对照组。将研究组分为终身PE（LLPE）和获得性PE（AqPE）亚组。在所有组中,通过阴茎超声和龟头组织硬度测量龟头体积，阴茎系带,包皮环切术后粘膜袖带，和阴茎轴通过SWE测量。使用适当的统计方法比较各组的发现。
结果：结果包括龟头的超声和弹性成像测量。
结果：140名男性的数据，包括70名PE患者和70名健康志愿者，进行了评估。在患者中，20人患有LLPE，50人患有AqPE。LLPE组的龟头阴茎体积中位数明显更大（14.1[范围，6.6-19]mm3）与AqPE组（11.7[范围，5.1-27]mm3)和对照组(11.4[范围，6.1-32]mm3)(P=.03)。根据Youden指数,与非LLPE（AqPE对照）相比，LLPE中龟头阴茎体积的最佳临界值为12.65mm3（曲线下面积，0.684；95%置信区间，0.556-0.812；P=.009）。龟头阴茎体积≥12.65mm3的患者患LLPE的风险为3.326(95%置信区间,非LLPE组高1.234-8.965）倍（P=0.014）。在龟头的SWE评估中，组间没有显着差异。阴茎系带,粘膜袖带，阴茎轴组织僵硬。
结论：龟头体积大的人群中PE的高发病率可能使龟头体积成为LLPE发展的预测因子。
■这是第一项研究表明，PE在龟头大体积的个体中更为常见。这也是第一次对PE患者进行阴茎弹性成像评估。最重要的限制是我们没有通过测试来评估阴沟的神经功能，而是我们根据阴沟体积的增加间接推断了游离神经末梢的密度。
结论：龟头体积是LLPE的重要预测因子。然而,PE和龟头之间没有关联,包皮环切术后粘膜袖带，阴茎系带,或阴茎轴组织僵硬和发育。
目的：本研究旨在评估使用阴茎超声和阴茎剪切波弹性成像（SWE）与PE测量的龟头阴茎体积和组织硬度之间的可能关联。
方法：纳入具有正常国际勃起功能指数评分（>25）且在2021年6月至2022年6月之间诊断为PE的18至65岁男性。记录早泄诊断工具评分和阴道内射精潜伏期。健康志愿者组成对照组。将研究组分为终身PE（LLPE）和获得性PE（AqPE）亚组。在所有组中,通过阴茎超声和龟头组织硬度测量龟头体积，阴茎系带,包皮环切术后粘膜袖带，和阴茎轴通过SWE测量。使用适当的统计方法比较各组的发现。
结果：结果包括龟头的超声和弹性成像测量。
结果：140名男性的数据，包括70名PE患者和70名健康志愿者，进行了评估。在患者中，20人患有LLPE，50人患有AqPE。LLPE组的龟头阴茎体积中位数明显更大（14.1[范围，6.6-19]mm3）与AqPE组（11.7[范围，5.1-27]mm3)和对照组(11.4[范围，6.1-32]mm3)(P=.03)。根据Youden指数,与非LLPE（AqPE对照）相比，LLPE中龟头阴茎体积的最佳临界值为12.65mm3（曲线下面积，0.684；95%置信区间，0.556-0.812；P=.009）。龟头阴茎体积≥12.65mm3的患者患LLPE的风险为3.326(95%置信区间,非LLPE组高1.234-8.965）倍（P=0.014）。在龟头的SWE评估中，组间没有显着差异。阴茎系带,粘膜袖带，阴茎轴组织僵硬。
结论：龟头体积大的人群中PE的高发病率可能使龟头体积成为LLPE发展的预测因子。
■这是第一项研究表明，PE在龟头大体积的个体中更为常见。这也是第一次对PE患者进行阴茎弹性成像评估。最重要的限制是我们没有通过测试来评估阴沟的神经功能，而是我们根据阴沟体积的增加间接推断了游离神经末梢的密度。
结论：龟头体积是LLPE的重要预测因子。然而,PE和龟头之间没有关联,包皮环切术后粘膜袖带，阴茎系带,或阴茎轴组织僵硬和发育。
