Bulbocavernosus Reflex to Stimulation of Prostatic Urethra in Patients with Lifelong Premature Ejaculation

Introduction. Lifelong premature ejaculation (LPE) is a prevalent sexual dysfunction among men, while its precise pathologic mechanisms have remained poorly understood. Aim. In our study, the correlation between excitability of bulbocavernosus reflex (BCR) to stimulation of the prostatic urethra and LPE was studied. Methods. Twenty normal potent male volunteers and 42 patients with LPE were studied by inserting a specially designed Foley catheter with two electrodes mounted on its distal surface (intraurethral catheter electrode) into bladder to evoke the BCR to stimulation of prostatic urethra. Also, sensitivity of glans penis to electrical stimulation was detected by two surface electrodes. Main Outcome Measures. Sensory thresholds of BCR to stimulation of prostatic urethra, thresholds to evoke stable BCR, latencies of BCR, and sensory thresholds of glans penis to electrical stimulation. Results. The mean sensory thresholds of BCR to stimulation of prostatic urethra, thresholds to evoke stable BCR, latencies of BCR, and sensory thresholds of glans penis were 12.38 +/- 3.71 mA (0.2 ms in duration,1 Hz), 23.81 +/- 5.55 mA (0.2 ms, 1 Hz), 70.48 +/- 6.33 ms, and 11.89 +/- 2.26 mA (0.04 ms in duration,3 Hz) in the patients with LPE, respectively, and were 18.20 +/- 2.68 mA (0.2 ms, 1 Hz), 34.76 +/- 4.15 mA (0.2 ms, 1 Hz), 71.20 +/- 5.77 ms, and 14.16 +/- 1.94 mA (0.04 ms, 3 Hz) in the normal potent men, respectively (mean +/- SD). Statistically significant differences were seen regarding the sensory thresholds of BCR to stimulation of prostatic urethra, the thresholds to evoke stable BCR and the sensory thresholds of glans penis between the two groups (P < 0.001). No statistically significant differences were seen regarding the latencies of BCR between the two groups (P > 0.05). Conclusions. Patients with LPE might have hyperexcitable BCR to stimulation of prostatic urethra, which is probably one of the important factors for its etiology. Zhou C, Jiang X, Xu Z, Guo L, Chen J, Wang H, Zhang D, and Shi B. Bulbocavernosus reflex to stimulation of prostatic urethra in patients with lifelong premature ejaculation. J Sex Med 2010;7:3750-3757.