From diagnosis to treatment: The office management of premature ejaculation

Abstract

Because diagnosis informs treatment decisions that have an impact on clinical outcomes, the ability to diagnose PE accurately is vital to the successful management of this condition. Diagnosis of PE is largely based on a decalogue. (i) Obtaining the patient's general medical and sexual history. (ii) Classifying the symptom on the basis of onset (e.g., lifelong or acquired PE),(iii) timing (e.g., prior to or during intercourse) and (iv) type (e.g., absolute/generalized or relative/situational). (v) Involving the partner to determine their view of the situation and the impact of PE on the couple as a whole. (vi) Identifying sexual comorbidities (e.g., erectile dysfunction) to define whether PE is simple (occurring in the absence of other sexual dysfunctions) or complicated (occurring in the presence of other sexual dysfunctions). (vii) Performing physical examination to check the man's sexual organs and reflexes. (viii) Identifying underlying aetiologies and risk factors (e.g., endocrine-, urological- or psychorelational/psychosexual-related) to determine the primary cause of PE and any associated comorbidities. (ix) Discussing treatment options to find the most suitable intervention, according to the needs of the man and his partner. (x) Prescribing a treatment.