早泄(PE)的诊断标准存在一些缺乏客观性的问题,清晰度和精度。它们妨碍了PE患病率估计值的准确确定,对功能障碍的病因进行调查,对合作伙伴的影响,开发经过验证的患者报告结果,监管机构的监督,以及哪些男性可能受益于特定的治疗干预措施。
我们试图审查,分析和评论体育定义的演变,并为体育定义的未来方向提供建议。我们的目标是提出策略,使标准集对研究人员有用,临床医生和政府监督机构都一样,在相互冲突和令人困惑的定义中带来和谐和科学的严谨性。
有几个早泄的定义发表在同行评审的医学文献。搜索了1970年至2021年的PUBMED电子数据库,以获取已发布的定义。搜索词包括早泄的医学主题词,定义和诊断。按时间顺序,表1列出了PE的各种诊断和标准集。我们讨论了构建的过程,构成诊断标准集,已操作和验证。
我们回顾了PE的定义,从Masters和Johnson对伴侣性高潮成就的关注开始,并通过早期诊断和统计手册以及国际疾病分类系列中发现的模糊和主观标准集。在国际性医学学会中发现的更有证据的定义,诊断和统计手册-5和美国泌尿外科协会(AUA)的定义。此外,我们讨论了如何采用构建体和标准集来最大限度地减少在定义疾病/功能障碍时纳入和排除的错误.
本手稿对已发布的PE定义进行了仔细的时间顺序分析。这个历史镜头使读者能够感知PE定义发展背后的科学变化。由于基于证据的研究不完整,因此手稿对我们对获得性PE的评论有限。
在过去的50年中,基于良好的科学研究,在定义PE方面取得了相当大的进展。我们支持美国泌尿外科协会将终身PE的阴道内射精潜伏期时间修改为2分钟,同意第11次修订的《国际疾病分类》关于将术语从早泄改为早泄的建议.我们还建议持续验证定义,摆脱目前基于阴茎-阴道性交的PE的异类定义,并敦促对获得性PE进行进一步的基于人群的研究,以开发针对该亚型的更强大的基于证据的标准集。AlthofSE,麦克马洪CG,罗兰DL.早泄诊断的进展和失误:分析和未来方向。JSexMed2022;19:64-73。
There are several problems with diagnostic criteria for premature ejaculation (PE) that lack objectivity, clarity and precision. They hamper accurate determination of PE prevalence estimates, investigations into the etiology of the dysfunction, impact on partners, development of validated Patient Reported Outcomes, regulatory authority oversight, and which men might benefit from specific treatment interventions.
We sought to review, analyze and comment on the evolution of the definitions of PE and offer suggestions for future directions for PE definitions. Our goal is to propose strategies whereby the criterion sets are useful to researchers, clinicians and governmental oversight agencies alike and bring harmony and scientific rigor among the conflicting and confusing definitions.
There are several premature ejaculation definitions published in the peer reviewed medical literature. The PUBMED electronic database from 1970 to 2021 was searched for published definitions. Search terms included the medical subject headings of premature ejaculation, definition and diagnosis. In chronological order, Table 1 lists the various diagnosis and criteria sets for PE. We discuss the process by which constructs, which make up diagnostic criteria sets, are operationalized and validated.
We review definitions of PE beginning with Masters and Johnson\'s focus on partner orgasmic attainment and move through the nebulous and subjective criterion sets found in the early Diagnostic and Statistical Manuals and International Classification of Disease series, to the more evidenced-based definitions found in International Society of Sexual Medicine, Diagnostic and Statistical Manuals-5 and the American Urological Association (AUA) definitions. Additionally, we discuss how constructs and criteria sets have been adopted to minimize errors of inclusion and exclusion in defining disease/dysfunction.
This manuscript offers a careful chronological analysis of the published definitions of PE. This historical lens allows the reader to perceive the shifting science underlying the development of PE definitions. The manuscript is limited regarding our comments on acquired PE as evidenced-based research is incomplete.
Over the past 50 years there has been considerable forward momentum in defining PE based on well conducted scientific studies. We support the American Urological Association\'s modification in Intravaginal ejaculatory latency time to 2-minutes for lifelong PE, concur with the 11th revision of the International Classification of Diseases recommendation for changing the terminology from premature ejaculation to early ejaculation. We also recommend ongoing validation of definitions, moving away from the current heterosexist definition of PE based on penile-vaginal sex and urge further population based research into acquired PE to develop stronger evidenced-based criterion sets for this subtype. Althof SE, McMahon CG, Rowland DL. Advances and Missteps in Diagnosing Premature Ejaculation: Analysis and Future Directions. J Sex Med 2022;19:64-73.