The Relationship between Lifelong Premature Ejaculation and Monosymptomatic Enuresis

Introduction. Although both biological and psychological factors are important in the etiologies, the underlying physiopathologies of lifelong premature ejaculation (PE) and monosymptomatic enuresis (ME) are not completely understood. Aim. The aim of this study is to evaluate the prevalence of ME in men diagnosed with lifelong PE and relationships of these two conditions. Methods. Between December 2008 and November 2009, we designed a prospective randomized study in 51 patients who had presented with lifelong PE and in age-matched 106 healthy control cases without PE. If the patient declared that he ejaculated less than 1 minute more than half of his intercourse attempts, he was enrolled in the study. Main Outcome Measures. All subjects included in this study underwent general and urological physical examinations and were asked about their history of ME. The frequency of enuresis was graded using the following criteria: (i) 1-2 times/week as infrequent; (ii) 3-5 times/week as moderate; and (iii) 6-7 times/week as severe. Only patients with primary ME were evaluated. Results. Of the 51 premature ejaculator men, 19 (37.2%) had a history of ME. Among these 19 men, five (26.3%) had severe, six (31.6%) had moderate, and eight (42.1%) had infrequent enuresis. Of the 106 control cases, 16 (15.1%) had a history of ME and of these 16 patients, three (18.7%) had severe, five (31.2%) had moderate, and eight (50%) had infrequent enuresis. Compared with control population (15.1%), the prevalence of ME in the premature ejaculators (37.2%) was more than twofold higher (P < 0.005). Conclusion. We have found a significant increase in ME prevalence in lifelong premature ejaculators. A common deficiency of inhibitory signal processing in the central nervous system may underlie both inability to inhibit the ejaculation and micturition in these patients or genetic predisposition may play a significant role. Further prospective studies are needed to explain the relationship between lifelong PE and ME. Gokce A, and Ekmekcioglu O. The relationship between lifelong premature ejaculation and monosymptomatic enuresis. J Sex Med 2010;7:2868-2872.