{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,9,25]],"date-time":"2025-09-25T15:40:54Z","timestamp":1758814854828},"reference-count":31,"publisher":"Oxford University Press (OUP)","issue":"9","license":[{"start":{"date-parts":[[2019,8,9]],"date-time":"2019-08-09T00:00:00Z","timestamp":1565308800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"},{"start":{"date-parts":[[2019,8,9]],"date-time":"2019-08-09T00:00:00Z","timestamp":1565308800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"}],"content-domain":{"domain":["jsm.jsexmed.org","elsevier.com","sciencedirect.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2019,9,1]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Introduction<\/jats:title><jats:p>Patients with premature ejaculation (PE) often complain of difficulty in having second erection, which is not yet investigated using scientific methodology.<\/jats:p><\/jats:sec><jats:sec><jats:title>Aim<\/jats:title><jats:p>Evaluation of the association between post-ejaculation refractory time (PERT) with PE by comparing PERT in premature ejaculators with their age-matched control subjects.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>After ethical committee approval and written informed consent from the participants were obtained, men in a monogamous stable sexual relationship and reporting PE were recruited into the study. Sexually active, matched control subjects were recruited for comparison. Exclusion criteria were erectile dysfunction, diabetes mellitus, cardiovascular diseases, hypogonadism, psychiatric conditions, instrumentation of the genitourinary tract, genitourinary anomalies, and genitourinary infections. Both the premature ejaculators and their control subjects were evaluated with the PE diagnostic tool before initiation of the study. They were asked to record their IELT and PERT over 4 weeks. The statistical analysis was done to obtain descriptive statistics, namely, mean and SD, paired t-tests, and logistic regression analysis. P &amp;lt; .001 was considered significant.<\/jats:p><\/jats:sec><jats:sec><jats:title>Main Outcome Measure<\/jats:title><jats:p>There was a statistically significant association between prolonged PERT and PE in patients with PE compared with their age-matched control subjects.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>102 premature ejaculators and an equal number of matched control subjects were evaluated from January 2016\u2013December 2017. The average PERT in premature ejaculators and control subjects was 330 \u00b1 296.63 minutes and 105.64 \u00b1 98.59 minutes, respectively (P &amp;lt; .0001). Increasing age was associated with increasing PERT. PE was more common in patients when PERT exceeded a threshold of 590 minutes.<\/jats:p><\/jats:sec><jats:sec><jats:title>Clinical Implications<\/jats:title><jats:p>Until now, the association between PE and PERT with matched-pair analysis was not reported. Our study addresses this association, which can add a new paradigm in the evaluation and management of PE.<\/jats:p><\/jats:sec><jats:sec><jats:title>Strength &amp; Limitations<\/jats:title><jats:p>The association between PE and prolonged PERT using a statistically appropriate, adequately powered methodology is the strength of the study. The inability to address the causal association between prolonged PERT and PE because of the paucity of evidence at present is the limitation of the study. We believe that the results of this study could trigger further research into such an association, so the mystery of such an association can be unraveled.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>The association between prolonged PERT and PE, as seen in our study, is a finding, that needs further research to establish a causal association. However, reporting such an association is necessary because it is contrary to the present understanding.<\/jats:p><\/jats:sec>","DOI":"10.1016\/j.jsxm.2019.06.016","type":"journal-article","created":{"date-parts":[[2019,8,9]],"date-time":"2019-08-09T21:09:41Z","timestamp":1565384981000},"page":"1364-1370","update-policy":"http:\/\/dx.doi.org\/10.1016\/elsevier_cm_policy","source":"Crossref","is-referenced-by-count":3,"title":["Association Between Post-Ejaculatory Refractory Time (PERT) and Premature Ejaculation (PE)"],"prefix":"10.1093","volume":"16","author":[{"given":"Gajanan S.","family":"Bhat","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anuradha","family":"Shastry","sequence":"additional","affiliation":[{"name":"Department of Urology , Sirsi, Uttara Kannada District, Karnataka State , India"},{"name":"Andrology and Sexual Medicine , Sirsi, Uttara Kannada District, Karnataka State , India"},{"name":"TSS Shripad Hegde Kadave Institute of Medical Sciences , Sirsi, Uttara Kannada District, Karnataka State , India"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2019,8,9]]},"reference":[{"key":"2023010721201343600_bib1","doi-asserted-by":"crossref","first-page":"41","DOI":"10.1002\/sm2.27","article-title":"An evidence-based unified definition of Lifelong and Acquired premature ejaculation: Report of the second International Society for Sexual Medicine Ad Hoc Committee for the definition of premature ejaculation","volume":"2","author":"Serefoglu","year":"2014","journal-title":"Sex Med"},{"key":"2023010721201343600_bib2","doi-asserted-by":"crossref","first-page":"409","DOI":"10.21037\/tau.2016.05.11","article-title":"The epidemiology of premature ejaculation","volume":"5","author":"Saitz","year":"2016","journal-title":"Transl Androl Urol"},{"key":"2023010721201343600_bib3","doi-asserted-by":"crossref","first-page":"1079","DOI":"10.1111\/j.1743-6109.2008.00789.x","article-title":"The use of old and recent DSM definitions of premature ejaculation in observational studies: A contribution to the present debate for a new classification of PE in the DSM-V","volume":"5","author":"Waldinger","year":"2008","journal-title":"J Sex Med"},{"key":"2023010721201343600_bib4","doi-asserted-by":"crossref","first-page":"5","DOI":"10.1007\/978-88-470-2646-9_2","article-title":"History of premature ejaculation","volume-title":"Premature ejaculation\u2014From etiology to diagnosis and treatment","author":"Waldinger","year":"2013"},{"key":"2023010721201343600_bib5","doi-asserted-by":"crossref","first-page":"2376","DOI":"10.1111\/j.1743-6109.2009.01350.x","article-title":"Revisiting post-ejaculation refractory time\u2014What we know and what we do not know in males and in females","volume":"6","author":"Levin","year":"2009","journal-title":"J Sex Med"},{"key":"2023010721201343600_bib6","article-title":"Human sexual response","author":"Masters","year":"1966"},{"key":"2023010721201343600_bib7","doi-asserted-by":"crossref","first-page":"347","DOI":"10.1016\/j.urology.2004.09.012","article-title":"Effects of sildenafil citrate on ejaculation latency, detumescence time, and refractory period: Placebo-controlled, double-blind, crossover laboratory setting study","volume":"65","author":"Ekmekcioglu","year":"2005","journal-title":"Urology"},{"key":"2023010721201343600_bib8","doi-asserted-by":"crossref","first-page":"131","DOI":"10.1093\/humrep\/15.1.131","article-title":"Effects of sildenafil (Viagra) administration on seminal parameters and post-ejaculatory refractory time in normal males","volume":"15","author":"Aversa","year":"2000","journal-title":"Hum Reprod"},{"key":"2023010721201343600_bib9","doi-asserted-by":"crossref","first-page":"1037","DOI":"10.1111\/j.1743-6109.2008.00831.x","article-title":"Continuing medical education: Premature ejaculation: Current medical treatment and new directions (CME)","volume":"5","author":"Sadeghi-Nejad","year":"2008","journal-title":"J Sex Med"},{"key":"2023010721201343600_bib10","doi-asserted-by":"crossref","first-page":"565","DOI":"10.1016\/j.eururo.2007.01.028","article-title":"Development and validation of a premature ejaculation diagnostic tool","volume":"52","author":"Symonds","year":"2007","journal-title":"Eur Urol"},{"key":"2023010721201343600_bib11","article-title":"Statstical methods for the social sciences","author":"Agresti","year":"1997","edition":"3rd ed."},{"key":"2023010721201343600_bib12","doi-asserted-by":"crossref","first-page":"2084","DOI":"10.12688\/f1000research.12150.1","article-title":"Premature ejaculation: Challenging new and the old concepts","volume":"6","author":"Kalejaiye","year":"2017","journal-title":"F1000Res"},{"key":"2023010721201343600_bib13","doi-asserted-by":"crossref","first-page":"255","DOI":"10.1016\/0166-4328(84)90151-7","article-title":"Brain monoaminergic control of male reproductive behavour. 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