Patient's question:
I've felt weak urination for several years, and still feel like there's more after finishing. Just started dating a girlfriend and discovered I have premature ejaculation, it's less than a minute every time.Doctor's answer:
Erectile dysfunction (ED) is a self-diagnosed condition. Patients clearly articulate their sexual experiences, primarily focusing on the issue of ejaculation time. The perspective of a sexual partner plays a significant role in helping clinicians understand the condition. A comprehensive description is crucial for distinguishing ED from premature ejaculation (PE), as factors such as the ability to achieve or maintain an erection are often coexisting with PE. Additionally, some men are unaware that a softening of the penis after ejaculation is a normal phenomenon, leading them to mistakenly believe they have ED when, in fact, they have premature ejaculation.Recommendation: The diagnosis of premature ejaculation is based on the patient's sexual history. Patients with a primary complaint of ejaculation dysfunction should have their sexual history thoroughly examined. This includes the frequency and duration of premature ejaculation, the context of specific sexual relationships (e.g., always occurring or only sometimes), the level of stimulation that triggers it, sexual practices and frequency (foreplay, masturbation, intercourse, visual stimulation, etc.), the impact on sexual life, interpersonal relationships, and quality of life, as well as exacerbating and alleviating factors. Laboratory tests or physiological assessments are generally not employed unless the medical history and physical examination suggest a complex case of premature ejaculation.