{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,21]],"date-time":"2026-09-21T18:08:48Z","timestamp":1790014128118,"version":"4.0.1"},"reference-count":29,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2023,8,22]],"date-time":"2023-08-22T00:00:00Z","timestamp":1692662400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Int J of Urology"],"published-print":{"date-parts":[[2023,12]]},"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>To identify atypical masturbatory behaviors (AMB) and to reveal their effects on both sexual and masturbational erection hardness in men with erectile dysfunction (ED).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Patients with ED and healthy controls were questioned about their masturbation habits. Accordingly, \u201crubbing in a prone position,\u201d \u201cpressure on penis,\u201d and \u201cmasturbation through clothes\u201d were included in the traumatic masturbation syndrome (TMS) group. Erection hardness score (EHS) is used to measure the erectile functions during masturbation (mast), foreplay (presex), and sexual intercourse (sex), separately.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The data of 448 participants, 266 (59%) from the patient group, and 182 (41%) from the control group were analyzed. The mean ages were 30\u2009years in both groups (<jats:italic>p<\/jats:italic>\u2009=\u20090.734). The rate of \u201crubbing in a prone position\u201d and \u201cpenile pressure\u201d while masturbating was higher in patients than the controls (10.2% vs. 6%, <jats:italic>p<\/jats:italic>\u2009=\u20090.024 and 8.6% vs. 3.3%, <jats:italic>p<\/jats:italic>\u2009=\u20090.0002, respectively). Patients had 2.2\u2010fold (odds ratio, 2.21; 95% confidence interval, 1.40\u20133.47; <jats:italic>p<\/jats:italic>\u2009=\u20090.001) increased risks of having at least one AMB, compared with controls. In the secondary analysis, the patient group was divided into 2 subgroups according to having TMS (ED\u2009+\u2009TMS) or not (ED). The percentage of patients with EHS\u22653 during masturbation was higher than those during sex and presex in the \u201cED\u2009+\u2009TMS\u201d group (60.2%, 38.8%, and 37.2%, respectively, <jats:italic>p<\/jats:italic>\u2009=\u20090.0001; <jats:italic>n<\/jats:italic>\u2009=\u200998). Comparing the percentage of patients with EHS\u22653 during mast, presex, and, sex was found to be similar in the \u201cED\u201d group (58.9%, 56.5%, and 56%, respectively, <jats:italic>p<\/jats:italic>\u2009=\u20090.753; <jats:italic>n<\/jats:italic>\u2009=\u2009168).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Atypical masturbatory behaviors are more common in young men presenting with erectile dysfunction. These patients have higher erection hardness scores during masturbation compared to partnered sex.<\/jats:p><\/jats:sec>","DOI":"10.1111\/iju.15279","type":"journal-article","created":{"date-parts":[[2023,8,22]],"date-time":"2023-08-22T08:19:06Z","timestamp":1692692346000},"page":"1134-1140","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Traumatic masturbation and erectile dysfunction: A matched case\u2013control study"],"prefix":"10.1111","volume":"30","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9805-3930","authenticated-orcid":false,"given":"Utku","family":"Can","sequence":"first","affiliation":[{"name":"Department of Urology Kartal Dr. Lutfi Kirdar Training and Research Hospital  Istanbul Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alper","family":"Kafkasli","sequence":"additional","affiliation":[{"name":"Department of Urology Istinye University, Gebze Medical Park Hospital  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