Purpose: Premature ejaculation (PE) is a commonly encountered male sexual dysfunction (MSD) with various definitions, diagnostic criteria, and treatment options, leading to significant heterogeneity and controversy in its management. This study aimed to explore the global practice patterns of the diagnosis and management of PE.

Materials and methods: A cross-sectional, global, online survey on PE was conducted using a questionnaire developed by an international cohort of experts. Results were analyzed using R version 4.1.2. Additionally, expert recommendations were formulated using a modified Delphi method.

Results: The survey was completed by 264 participants from 41 countries. The majority of respondents were below the age of 45 years and were urologists focusing on andrology and sexual health. PE diagnosis was primarily based (by 61.5%) on an intravaginal ejaculatory latency time of less than one minute. Lifelong PE was the most common category reported (47.7%), and most respondents (84.2%) observed ante-portas PE in less than 25% of cases. Distinguishing PE from erectile dysfunction was challenging for many respondents (60.7%). Diabetes mellitus was the most common comorbidity (17.1%). Pharmacological therapy was the most common treatment method (34.3%), with dapoxetine being the most preferred medication (37.9%). Surgical methods were infrequently used. Emerging treatments like hyaluronic acid gel glans augmentation were favored by only 11.7%. Patient satisfaction was the primary criterion for successful PE treatment (55.9%), and cost was a significant concern for many (35.5%).

Conclusions: This global survey highlights significant diversity in the diagnostic and treatment strategies for PE. Standard diagnostic criteria are generally accepted, off-label medication is widely used in therapy, and the role of surgery is still controversial. A multi-modal therapy approach, tailored to the patient's specific needs, is favored. Further research into the neurobiology of PE and the development of effective and safe options is crucial for improving the management of PE.

目的：早泄（PE）是一种常见的男性性功能障碍（MSD），其定义、诊断标准和治疗方案各不相同，导致其治疗存在显著的异质性和争议。本研究旨在探讨全球PE诊断与管理的实践模式。

材料和方法：一项横断面，全球，在线调查的PE进行了使用问卷开发的国际专家队列。使用R4.1.2版本对结果进行分析。此外，采用改进的德尔菲法制定专家建议。

结果：来自41个国家的264名参与者完成了这项调查。大多数受访者年龄在45岁以下，是专注于男科和性健康的泌尿科医生。PE诊断主要基于（61.5%）阴道内射精潜伏期小于1分钟。终身PE是最常见的类型（47.7%），大多数受访者（84.2%）在不到25%的病例中观察到门前PE。对于许多受访者（60.7%）来说，区分PE和勃起功能障碍是一项挑战。糖尿病是最常见的合并症（17.1%）。药物治疗是最常见的治疗方法（34.3%），首选达泊西汀（37.9%）。手术方法不常用。只有11.7%的人青睐透明质酸凝胶等新兴疗法。患者满意度是PE治疗成功的主要标准（55.9%），成本是许多人（35.5%）的主要关注点。

结论：这项全球调查突出了PE诊断和治疗策略的显著多样性。标准诊断标准被普遍接受，超说明书药物被广泛应用于治疗，手术的作用仍存在争议。多模式治疗方法，量身定制的病人的具体需要，是有利的。进一步研究PE的神经生物学和开发有效和安全的选择对于改善PE的管理至关重要。