Abstract
BACKGROUND: Men who have not engaged in vaginal intercourse in the past 6 months or have never engaged in it often seek help for sexual dysfunction, identifying factors influencing patients' self-assessment of sexual function and the value of masturbation-related parameters in diagnosing sexual dysfunction is of great importance. AIM: This study aims to understand the reason why patients self-report sexual dysfunction and evaluate the role of masturbation parameters in diagnosing sexual dysfunction in self-reported sexual dysfunction (SRSD) and self-reported no sexual dysfunction (SRNSD) groups. METHODS: Our study was conducted mainly by filling out a questionnaire, which collected demographic information, sexual history as well as sexual parameters. The questionnaire summarized the basis of patients' self-reported sexual dysfunction and also included the Erection Hardness Score (EHS), Masturbation Erection Index (MEI), Masturbatory Premature Ejaculation Diagnostic Tool (MPEDT), and masturbatory ejaculation latency time (MELT). OUTCOMES: The main outcomes were reasons for SRSD individuals to judge their sexual dysfunction, the EHS, MEI, MPEDT, and MELT scores. RESULTS: The most common complaints included insufficient erection hardness and short ejaculation latency time during masturbation, with 84.85% of self-reported erectile dysfunction and 91.80% of self-reported premature ejaculation patients reporting these issues. No significant difference was found between past vaginal sexual experiences (6 months ago) and current self-reported sexual dysfunction. Significant differences were found in EHS, MEI, MPEDT, and MELT scores between the SRSD and SRNSD groups. The MEI showed a sensitivity of 89.29% and a specificity of 81.82%. The MPEDT demonstrated a sensitivity of 98.04% and a specificity of 72.73%. CLINICAL IMPLICATIONS: We proposed that other than vaginal intercourse, sexual dysfunction should also be assessed from noncoital sex and verified the scientific validity of the masturbation parameters in people without recent vaginal intercourse. STRENGTHS & LIMITATIONS: We firstly explored the patients self-perceived basis for sexual dysfunction. However, the objective instruments were not employed in diagnosing sexual dysfunction. CONCLUSION: The findings emphasize the importance of a comprehensive clinical assessment that includes evaluating masturbation, noncoital sex (between men and women), morning erections, and past vaginal sexual experiences (6 months ago), moreover, masturbatory scales provide valuable insights in diagnosing sexual dysfunction.