Abstract
BACKGROUND: Premature ejaculation (PE) and erectile dysfunction (ED) are among the most prevalent sexual disorders in men, significantly impairing quality of life (QoL). This study aimed to assess and compare QoL among patients with PE and ED. METHODS: A cross-sectional, single-center study was conducted where participants aged ≥18 years with complaints of either PE or ED were included, while those with both conditions were excluded. PE, ED, and QoL, along with depression, were assessed using validated tools. All statistical analyses were conducted using IBM SPSS Statistics software, version 26 (IBM Corp., Armonk, NY). A two-tailed p-value of <0.05 was considered statistically significant. Continuous variables (e.g., QoL domain scores) were summarized using means and standard deviations (SD). Differences in QoL domain scores between patients with PE and ED were analyzed using one-way ANOVA. An independent samples t-test was used for the unadjusted analysis to compare mean differences in World Health Organization Quality-of-Life Scale Brief Version (WHOQOL-BREF) domain scores between the PE and ED groups. For the adjusted analysis, analysis of covariance (ANCOVA) was employed, controlling for potential confounders including depression severity (Patient Health Questionnaire-9 (PHQ-9)), physical illness, smoking status, physical activity, and education level. RESULTS: Among the 245 participants, 140 (57.1%) presented with PE and 105 (42.9%) with ED. Based on diagnostic tools, 87.1% of PE cases were confirmed using the Bengali-validated Premature Ejaculation Diagnostic Tool (PEDT), and 95.2% of ED cases were confirmed using the IIEF-6. Both groups scored highest in the physical domain and lowest in the social domain of WHOQOL-BREF, with PE generally showing better scores. Depression was prevalent in both groups, affecting 72.9% of PE and 65% of ED participants, with severe depression slightly more common in ED (7%). Physical illnesses like hypertension and diabetes were more frequent in ED patients. Education level, active lifestyle, smoking status, and living place (urban vs. rural) were significantly linked to the environmental and psychological domains (p = 0.028, p = 0.008, p = 0.013, p = 0.030). A history of physical illness significantly impacted the physical domain (p = 0.032). Statistical analyses revealed that PE participants had significantly better physical and psychological QoL scores than ED participants, both before and after adjusting for confounders such as depression severity (PHQ-9), physical illness, smoking status, physical activity, and education level. CONCLUSION: This study highlights that men with PE report significantly better physical and psychological QoL compared to those with ED, even after adjusting for key confounding factors. Depression and physical illnesses were more prevalent among ED patients, negatively influencing their QoL. Sociodemographic and lifestyle variables also played a notable role in shaping QoL outcomes. These findings underscore the need for targeted interventions addressing both sexual dysfunction and associated psychosocial factors.