AB038. Interplay between erectile dysfunction and premature ejaculation

Erectile dysfunction (ED) and premature ejaculation (PE) are common male sexual dysfunctions. They are considered different diseases because they have distinct clinical pictures, diagnostic criteria, pathophysiology, and therapy. How to make correct differential diagnosis between them becomes an important issue. It is recommended to screen for ED in men with PE and vice versa to achieve optimal treatment. A missing diagnosis of ED may result in PE treatment failure because the penis cannot maintain an erection sufficient till ejaculation. In addition, both may affect men’s and female partners’ sexual satisfaction and quality of life. A recent review and meta-analysis reported that ED and PE often coexist and an interplay relationship exists between them. They found that PE is associated with a fourfold increased risk of ED. The risk was significantly associated with depressive and anxiety symptoms and less dependent on vascular organic factors. The authors suggested that ED and PE are not distinctly separate entities and should be not categorized in rigid diagnostic figures, but should be seen in a dimensional prospective. These results highlighted the importance of recognizing the coexistence of ED and PE. It is also important to assess the efficacy and safety of combined use of phosphodiesterase type 5 (PDE5) inhibitors, the first-line treatment for ED, with dapoxetine, the only approved oral agent for PE.