Sympathetic skin response and autonomic regulation in premature ejaculation: a comparative study in flaccid and erectile states

Abstract Aim This study aimed to compare patients with premature ejaculation (PE) to healthy men in terms of sympathetic skin responses (SSR) of the penis and foot and bodily autonomic nervous system responses in flaccid and erectile states. Patients and methods Penile and foot SSR and heart rates were recorded in 13 patients with PE and 17 healthy men. The latency times and amplitudes of the SSR were measured. The Premature Ejaculation Diagnostic Tool (PEDT) was used to evaluate PE scores. Patients with intravaginal ejaculatory latency time (IELT) of less than 1 min were included in the study. The International Index of Erectile Function Five-Question Form (IIEF-5) was used to evaluate erectile function status. Results There were no significant differences between the groups in terms of age, BMI, or IIEF-5 scores. In the flaccid state, the penile and foot SSRs were similar. In the erectile state, latency times in the foot and genitalia were similar, but amplitudes were significantly different between the groups. Amplitude levels in the genital area were suppressed considerably in normal men, whereas limited suppression was observed in patients with PE. Similarly, heart rate (HR) changes from the state of flaccid to erection were significantly different, −2.35 ± 3.3 for normal men vs 0.54 ± 3.13 in men with PE, p < 0.05. Considering the disturbed regulation of autonomic response in patients with PE in the erectile state. Conclusion These findings suggest that the etiology of premature ejaculation may extend beyond the genital region, and that impaired regulation of the sympathetic nervous system could contribute to the condition’s development.