Introduction Although the new classification of premature ejaculation (PE) has been proposed by Waldinger et al., there have been few studies investigating the four PE syndromes in China. Aims We investigated the prevalence and factors associated with the complaint of PE and the four PE syndromes in Anhui province, China. Methods Between September 2011 and September 2012, subjects were selected from five cities in Anhui province, China. They participated in this survey by completing a detailed verbal questionnaire regarding their demographic data and medical and sexual history. Men with PE complaint were diagnosed as lifelong PE (LPE), acquired PE (APE), natural variable PE (NVPE), or premature-like ejaculatory dysfunction (PLED). Main Outcome Measures PE complaint was divided into four PE syndromes. Anxiety, depression, and erectile dysfunction were independently assessed by the self-rating anxiety/depression scale and the international index of erectile function-5, respectively. Results Of the 3,016 men evaluated, 25.80% complained of PE. The distribution of the four PE syndromes in men with PE complaint was in the order of NVPE (44.09%), PLPE (24.81%), APE (18.77%), and LPE (12.34%). Patients with PE complaint were older and more likely to smoke, had more comorbidities, and a higher body mass index (BMI) than patients without the complaint (P < 0.001 for all). Similar findings were also observed in patients with APE compared with other PE patients (depression P = 0.012, cardiovascular P = 0.003, others P < 0.001). In addition, the rates of counseling by a doctor in men with LPE and APE were higher than those in men with NVPE and PLED (P < 0.001). Conclusion The prevalence of PE complaint in male population of Anhui province, China, was 25.80%, with the highest PE syndromes being NVPE and PLPE. Patients with PE complaint or APE were older and more likely to smoke, had more comorbidities, and a higher BMI.

Introduction Although infertility is known to be associated with psychological and sexual problems, the relationship between these two aspects in infertile men has not been well investigated. Aim To investigate the incidence of sexual dysfunction and psychological burden, and their possible associations in infertile men. Methods From June 2009 to June 2012, a total of 1,468 infertile men and 942 fertile men were evaluated. Premature ejaculation (PE) and erectile dysfunction (ED) were measured by the PE diagnostic tool (PEDT), the intravaginal ejaculatory latency time (IELT) and the international index of erectile function (IIEF)-5. Anxiety and depression, which reflect the degree of psychological burden, were measured by the self-rating anxiety scale (SAS) and self-rating depression scale (SDS), respectively. Main Outcome Measures PE and ED were measured by the PEDT, IELT, and IIEF-5. Anxiety and depression were measured by the SAS and SDS, respectively. Results The incidences of PE and ED in the infertile group were significantly higher than those in the fertile group (PE: 19.01% vs.10.93%, P < 0.001; ED: 18.05% vs. 8.28%, P < 0.001). In addition, anxiety and depression were more prevalent in infertile than fertile men (Anxiety: 38.01% vs. 26.65%, P < 0.001; Depression: 15.74% vs. 10.08%, P < 0.001). Furthermore, after adjusting for age in the infertile group, the PEDT score was positively associated with anxiety (adjusted r = 0.57; P < 0.001) and depression (adjusted r = 0.54; P < 0.001). Moreover, the IELT were negatively associated with anxiety (adjusted r = −0.40; P < 0.001) and depression (adjusted r = −0.52; P < 0.001). Similar negative relationships were also observed between the IIEF-5 score and anxiety (adjusted r = −0.49; P < 0.001) or depression (adjusted r = −0.50; P < 0.001). Conclusion This is the first study to systematically evaluate the incidence of sexual dysfunction and psychological burden, and their possible associations in infertile men in China. Further in-depth studies are needed to confirm and extend these results.

disease and treatment. The erectile capacity of the men was assessed using the five-question version of the International Index of Erectile Function. RESULTSOf the 2000 men with chronic prostatitis selected, 1786 completed the survey; the overall prevalence of sexual dysfunction in these patients was 49%. The prevalence of premature ejaculation and erectile dysfunction accounted for 26% and 15%, respectively; 7.7% had both premature ejaculation and erectile dysfunction. There was a negative correlation between prevalence and age, and with the duration of chronic prostatitis (both P < 0.001). CONCLUSIONSThe prevalence rate of sexual dysfunction in Chinese men with chronic prostatitis is high and related to age.

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Introduction Because available definitions of premature ejaculation (PE) were unable to encompass the various forms of PE, Waldinger et al. proposed a new classification that distinguished four PE syndromes. However, few studies have examined the prevalence rates of these four PE syndromes. Aims The study aims to analyze the prevalence of and factors associated with four PE syndromes in outpatients who complained of ejaculating prematurely. Methods Between December 2009 and December 2011, outpatients who complained of PE completed a detailed verbal questionnaire regarding their demographic data and medical and sexual history. Each patient was classified as having one of four PE subtypes: lifelong PE (LPE), acquired PE (APE), natural variable PE (NVPE), or premature-like ejaculatory dysfunction (PLED). Main Outcome Measures Based on the new classification scheme, PE was classified into four subtypes. The anxiety/depression status of patients was assessed by the Zung self-rating anxiety/depression scales, and erectile function was assessed by the International Index of Erectile Function-5 instrument. Results This study included 1,988 male outpatients who complained of PE, with mean ages and body mass index (BMI) scores of 35.52 ± 10.38 years and 25.34 ± 4.51 kg/m2, respectively. Prevalence rates of PE syndromes were 35.66% for LPE, 28.07% for APE, 12.73% for NVPE, and 23.54% for PLED. Patients with APE had the highest mean ages and BMI scores, and they more frequently reported several comorbidities, including sexual desire disorder, hypertension, diabetes mellitus, chronic prostatitis, and erectile dysfunction. The PLED group had a lower mean frequency of sexual intercourse than other groups and higher rates of anxiety and depression. Conclusion The prevalence of LPE was higher than that of other PE subtypes in an outpatient setting. Several comorbidities were more common in patients with APE and PLED. In particular, a lower frequency of intercourse and higher frequencies of anxiety and depression were found in patients with PLED.

This study was performed to evaluate the prevalence of erectile dysfunction (ED) and to explore its correlation to chronic prostatitis in China. A cross-sectional investigation from a large cohort study of Chinese men was used in this survey. A questionnaire consisting of general information regarding socio-demographics, chronic disease history, sexual function, the National Institutes of Health-Chronic Prostatitis Symptom Index, and the International Index of Erectile Function-5 (IIEF-5) was administered to 15 000 Chinese men aged from 15 to 60. The prevalence of ED was determined from the patient's self-evaluation and IIEF-5 score. The eligible individual both was married and had intercourse experience. In total, there were 12 743 respondents, giving a response rate of 84.95%. Among 7372 eligible men, ED prevalence as assessed by self-report and IIEF-5 score was 12.0% and 17.1%, respectively. Among 771 men with prostatitis-like symptoms, ED prevalence as assessed by self-report and IIEF-5 score was 39.3% and 30.1%, respectively. Among 370 men suffering from chronic prostatitis, ED prevalence as assessed by self-report and IIEF-5 score was 40.5% and 35.1%, respectively. The prevalence of self-reported and IIEF-5 score-assessed ED had high correlation with increasing age among all eligible men, men with prostatitis-like symptoms, and men with chronic prostatitis (P t , .05, P s , .05, P cp , .05). ED prevalence as assessed by both self-report and IIEF-5 score was higher in men with prostatitis-like symptoms and with chronic prostatitis than in the general group (P s , .05, P cp , .05). The prevalence of ED was higher in the prostatitis population than in the general population with either self-reported or IIEF-5 score assessment. The prevalence was higher with self-reported than with IIEF-5 assessment in men with prostatitis. Estimates of ED prevalence among men with prostatitis should not rely on self-reporting alone in that this is likely to overestimate the true prevalence.

The heterogeneity of the immune microenvironment leads to different responses in immune checkpoint blockade therapy. We aimed to propose a robust molecular classification system to investigate the relevance of the immune microenvironment subtype and prognosis of prostate cancer patients, as well as the therapeutic response to immune checkpoint blockade therapy. A total of 1,557 prostate cancer patients were enrolled, including 69 real‐world samples from our institute (titled the AHMU‐PC cohort). The non‐negative matrix factorization algorithm was employed to virtually microdissect patients. The immune enrichment was characterized by a high enrichment of T cell‐, B cell‐, NK cell‐, and macrophage‐associated signatures, by which patients were subclassified into nonimmune and immune classes. Subsequently, the immune class was dichotomized into immune‐activated and immune‐suppressed subtypes based on the stromal signature, represented by the activation of WNT/TGF‐β, TGF‐β1, and C‐ECM signatures. Approximately 14.9% to 24.3% of patients belonged to the immune‐activated subtype, which was associated with favorable recurrence‐free survival outcomes. In addition, patients in the immune‐activated subtype were predicted to benefit more from anti‐PD‐1/PD‐L1 therapy. In conclusion, our study identifies a novel immune molecular classifier that is closely related to clinical prognosis and provides novel insights into immunotherapeutic strategies for prostate cancer patients.

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