Pelvic floor electromyographic dysfunction as a novel physiological indicator for subclassifying sexual dysfunction in patients with chronic prostatitis/chronic pelvic pain syndrome

Sexual dysfunction (SD) is a common complication in patients with chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS), and there remains a lack of objective diagnostic physiological indicators in clinical practice. This study aimed to explore the value of pelvic floor electromyography (PF-EMG) parameters as novel physiological indicators for SD in CP/CPPS patients. A total of 116 CP/CPPS patients were enrolled and stratified into PE and ED subgroups based on validated questionnaires (C-ISFPE and IIEF-5). All participants underwent standardized PF-EMG assessment to evaluate resting tone, fast-twitch, and slow-twitch functions. Statistical analyses included t-tests, logistic regression, and ROC curve analysis. In the PE subgroup (n = 66), resting tone was significantly elevated (anterior baseline: 6.49 ± 3.42 µV vs. 3.78 ± 2.79 µV in the non-PE group, P < 0.001) and served as an independent predictor of PE (OR = 1.428, P = 0.003). In the ED subgroup (n = 45), fast-twitch function was severely impaired (rapid contraction: 37.87 ± 18.36 µV vs. 69.92 ± 25.78 µV in the non-ED group, P < 0.001). With a cut-off value of < 45.41 µV for rapid contraction, the area under the curve (AUC) for ED diagnosis was 0.866, with a sensitivity of 92.6%. PF-EMG parameters serve as objective, non-invasive physiological indicators that can effectively distinguish between PE and ED subtypes in CP/CPPS patients, paving the way for targeted therapies.