{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,14]],"date-time":"2026-05-14T23:14:17Z","timestamp":1778800457837,"version":"3.51.4"},"reference-count":32,"publisher":"Oxford University Press (OUP)","issue":"8","license":[{"start":{"date-parts":[[2025,6,22]],"date-time":"2025-06-22T00:00:00Z","timestamp":1750550400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,8,4]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>There are no standardized, evidence-based rehabilitation protocols for premature ejaculation (PE) which hinders effective management, the development of validated patient-reported outcomes, regulatory oversight, and the potential benefits of targeted interventions.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Aim<\/jats:title>\n                  <jats:p>To investigate the effect of diaphragmatic breathing exercises (DBE) on PE.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>Sixty-two participants with PE were randomly assigned to Group I (n\u2009=\u200931) or Group II (n\u2009=\u200931). Both groups received behavioral therapy (BT) and pelvic floor muscle training (PFMT) twice daily, three\u00a0days a week, for eight\u00a0weeks. Additionally, Group I recieved DBE twice daily, every day, for eight\u00a0weeks. Intravaginal ejaculation latency time (IELT) was calculated with a stopwatch, at the end of the 8th week (post-treatment), and at 1-year follow-up. Pelvic floor muscle (PFM) strength and endurance were evaluated with ultrasound, and changes in the in the autonomic nerves system (ANS) parameters (including the root mean square of successive differences [RMSSD], proportion of NN50 [PNN50], low-frequency [LF] power, and high-frequency [HF] power) were evaluated with an Elite HRV device at pre-treatment and post-treatment by a blinded assessor.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Outcomes<\/jats:title>\n                  <jats:p>Primary outcome measurements were IELT, PFM strength and endurance, and changes in ANS paramaters.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>The study was completed by 29 participants (mean age\u2009=\u200931.4\u2009\u00b1\u20096.5\u00a0years) in Group I and 30 (mean age\u2009=\u200931.3\u2009\u00b1\u20097.6\u00a0years) in Group II. At post-treatment, all outcome measures showed significant improvements in both groups (P\u2009&amp;lt;.001 for all). Compared to Gropu II, Group I showed significantly greater improvements in IELT(P=0.12), RMSDD (P&amp;lt;.001), PNN50 (P=.003), LF Power (P&amp;lt;.001), HF Power (P=.003), strength(P&amp;lt;.001), and endurance (P&amp;lt;.001). The median IELT increase from baseline to post-treatment was 283 seconds (range: 84-870; 900%) in Group I and 204 seconds (range: 44- 581; 690%) in Group II. While IELT declined significantly from post-treatment to 1-year follow-up in Group II, no statistically significant change was found in Group I.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Clinical Implications<\/jats:title>\n                  <jats:p>The effect of DBE on the ANS may help regulate the ejaculatory reflex.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Strengths and Limitations<\/jats:title>\n                  <jats:p>This is the first study to apply breathing exercises with BT and PFMT in men with PE. Limitations include the lack of exercise adherence records beyond 8 weeks and the estimation-based IELT measurement at baseline.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>Adding DBE, to BT and PFMT, yields better results in IELT (at 8\u00a0weeks and 1\u00a0year) and inreases PFM strength and endurance of PFM (at 8\u00a0weeks) in men with PE.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/jsxmed\/qdaf107","type":"journal-article","created":{"date-parts":[[2025,6,28]],"date-time":"2025-06-28T18:17:31Z","timestamp":1751134651000},"page":"1422-1429","source":"Crossref","is-referenced-by-count":2,"title":["The effects of diaphragmatic breathing exercises on individuals with premature ejaculation: a randomized controlled trial"],"prefix":"10.1093","volume":"22","author":[{"given":"Umit","family":"Erkut","sequence":"first","affiliation":[{"name":"Health Sciences Faculty, 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