Are urology residents ready to treat premature ejaculation after their training?

Introduction: The management of premature ejaculation (PE) among urology residents (URs) in the era of standard definition and new treatments is unknown.

Aim: To determine how future urologists currently address PE and to review their adherence to guidelines.

Methods: A specifically designed survey on the preferred approaches to the treatment of PE was given to residents during the Eighth European Urology Education Programme. The results were tabled, and descriptive statistics were used to analyze differences in practice patterns.

Main Outcomes Measures: The responses are compared with clinical guidelines and recommendations.

Results: A total of 360 URs attended the recommendation course, and 140 answered the survey (response rate: 38.8%). Seventeen (12.1%) of the respondents considered PE to be a very common sexual dysfunction, 62 (44.3%) considered PE to be frequent, 33 (23.6%) considered this condition uncommon, and 28 (20%) did not consider PE to be a dysfunction. Regarding incidents, 67 residents (47.9%) treated one patient per week. To assess PE, 132 (94.3%) used sexual history, 37 (26.4%) used physical examination, 38 (27.1%) used questionnaires, and 4 (2.9%) used laboratory testing. The preferred initial management strategy for PE was psychological/behavioral therapy for 65 (46.4%) residents. Topical anesthetic, andrological referral, and prescription of selective serotonin reuptake inhibitors (SSRIs) on demand were favored by 34 (24.3%), 19 (13.6%), and 8 (12.9%) of the respondents, respectively. Other options were psychiatric referral, which was preferred by two (1.4%) respondents, and prescription of daily SSRIs, which was preferred by two (1.4%) respondents. The preferred secondary treatment for patients who did not improve initially was prescription of SSRIs for on demand, which was 46 (32.9%) respondents. In cases where patients had concomitant erectile dysfunction (ED), 16 (11.4%) URs treated only the ED and 60 (42.9%) treated both conditions.

Conclusions: The majority of URs follow the established guidelines for diagnosis of PE, but not for treatment. The URs have an insufficient medical education in sexual medicine.