The aim of the study was to evaluate the long-term results of pelvic floor muscle (PFM) rehabilitation in males suffering from lifelong and acquired premature ejaculation. To evaluate PE, patients were investigated with intravaginal ejaculatory latency time (IELT) and the self-report Premature Ejaculation Diagnostic Tool (PEDT). The primary outcomes endpoints were the IELT change, and the score reported at the PEDT.

This retrospective study evaluated 273 subjects with PE diagnosis (lifelong 198 and acquired 75), and a total of 241 pts out of 273 (88%) completed the rehabilitative protocol, whereas 207 pts (75%) attended the follow-up of 5 years. At baseline, all participants reported an IELT ≤60 s and PEDT score >11. All Participants completed a 12-week program of PFM rehabilitation, including physio-kinesiotherapy treatment, electrostimulation, and biofeedback, with three sessions per week, with 20 min for each component completed at each session. The effectiveness of intervention was evaluated by comparing the geometric means of IELT times and PEDT scores observed from baseline, to 6, and 12 months during the intervention, and at 24, 36, 48, 60 months postintervention, using a paired sample 2-tailed t-test, including the associated 95% confidence intervals.

241 out of 273 enrolled subjects completed the PFM rehabilitation protocol with 36 sessions of PFM. All patients reported a significant improvement of the ejaculatory time with a mean IELT of 185.4 s and PEDT score of 2.6 at the 12-week endpoint of the intervention (p < 0.0001). Of the 207 participants who completed the 60-month follow-up, 81%, 78%, 75%, and 66% maintained satisfactory and significant results (ejaculatory latency time and PEDT score) through the follow-up times at 24, 36, 48, and 60 months after the PFM training, respectively.

In the current study, the improvement in IELT and PEDT when compared to baseline were found to be significantly improved among those patients who completed the follow-up to 24 (63.9%) and 36 (56.8%) months postintervention. These results represent another important achievement obtained by way of an easily learned technique that can be mastered using pelvic floor biofeedback. Moreover, no adverse effects of the PFM rehabilitation protocol were identified, compared to other medical therapies such as gastrointestinal symptoms (nausea and diarrhea) and dizziness and headaches, which have been associated with the use of dapoxetine. In addition, the long-term effects of dapoxetine on reproductive functions should be cleared as some recent data demonstrated its negative impact on fertility.

Our study is the first on PE treatment with a representative number of patients and long-term evaluation (5 years). The results observed are significant and were maintained through the entire follow-up time. PFM rehabilitation in premature ejaculation is an effective therapy with lasting results.

Continence 12S (2024) 101539
DOI: 10.1016/j.cont.2024.101539