(PNM-30) Characterization of pelvic floor muscle in men with premature ejaculation: a cross-sectional study

Abstract Premature ejaculation is the most common male sexual dysfunction. The superficial pelvic floor muscles (PFM), ischiocavernosus and bulbospongiosus, are fundamental for erection and ejaculatory control. The bulbospongiosus muscle generates rhythmic contractions that propel seminal fluid. These coordinated actions maintain erectile function and regulate ejaculation. Studies suggest PFM therapy may improve ejaculatory control by enhancing voluntary muscle relaxation, though mechanisms remain unclear. Objective To evaluate and characterize the voluntary contractility and relaxation ability of the PFM in men with premature ejaculation. Methods A physical examination was conducted on men diagnosed with premature ejaculation, measuring age, weight, height, BMI, and pelvic floor function. Patients performed a voluntary PFM contraction. The physiotherapist placed the index finger on the perineum to effectively palpate the perineal response. The test was graded according to the modified Oxford scale (0-5). Subsequently, return of the perineum to its original resting position following the voluntary contraction was classified as present, partial or delayed and non-relaxing. A univariate statistical analysis was carried out using RStudio. Results A total of 14 men underwent a physical examination. Clinical data revealed a mean age of 52.2 (±12.8) years and a mean BMI of 29.3 (±4.7) kg/m2. Median performance score was 4.0 (Grade 4: a good PFM contraction producing elevation of the posterior wall against resistance and in-drawing of the perineum). The ability to relax was assessed, indicating that 50% of individuals exhibited normal relaxation, while 50% showed partial relaxation. Conclusions In this pilot study, our results suggest that men with premature ejaculation demonstrate good pelvic floor muscle contraction but a relaxation capacity ranging from normal to partial. Financing CAPES - Brasil 001.