The effect of pelvic rehabilitation on ejaculation time in patients with premature ejaculation

Aim: We aimed to evaluate the effect of neuromuscular transcutaneous electrical stimulation (TES) applied to the perineal region on ejaculation latency in patients with lifelong premature ejaculation (PE), and to compare the efficacy of regular use with on-demand use prior to intercourse. Material and Method: This prospective, single-blind, randomized study included 47 of 103 male patients with lifelong PE who met the eligibility criteria. In the pelvic rehabilitation (PR) group, patients performed pelvic floor muscle training (PFMT) combined with regular perineal TES for 3 months (n = 12). In the on-demand (OD) group, patients performed PFMT and applied perineal TES before intercourse whenever desired (n = 30). Intravaginal ejaculation latency time (IELT), Premature Ejaculation Diagnostic Tool (PEDT), and International Index of Erectile Function-5 (IIEF-5) scores were assessed before and after treatment. Results: Baseline demographic data and clinical scores were similar between the groups. In the PR group, IELT increased from 26.9 ± 19.0 to 82.1 ± 54.3 seconds, representing a 205% improvement (p = 0.001). PEDT decreased from 18.4 ± 1.6 to 12.8 ± 5.1 (p = 0.005), and a significant increase in IIEF-5 was observed (p = 0.015). In the OD group, IELT increased from 29.9 ± 17.0 to 47.3 ± 33.9 seconds, corresponding to a 58% improvement (p = 0.001). PEDT decreased from 18.4 ± 1.9 to 17.1 ± 3.4 (p = 0.008), while IIEF-5 showed no change. Between-group comparison showed no significant difference in post-treatment IELT (p = 0.057); however, the increase in IELT (p = 0.009), the IELT ratio (p = 0.001), and the reduction in PEDT (p = 0.005) were all significantly greater in the PR group. XIV Conclusion: Both TES application strategies improve IELT and reduce PEDT scores in lifelong PE; however, the PR protocol involving regular TES use demonstrated superior outcomes across all evaluated parameters.