Effect of Prostatic Urethra and Seminal Vesicle Morphometry on Ejaculation

May 30, 2026 updated by: SEZGIN, Başakşehir Çam & Sakura City Hospital

The Effect of Prostatic Urethral and Seminal Vesicle Morphometry on Multiparametric Prostate Magnetic Resonance Imaging on Ejaculation

The goal of this observational study is to learn whether the size and shape of the prostatic urethra and seminal vesicles - measured on multiparametric prostate MRI (mpMRI) - are related to premature ejaculation (PE) severity in men aged 18-55.

The main questions it aims to answer are:

  • Do men with premature ejaculation have different prostatic urethral length and angulation compared to men without PE?
  • Do men with premature ejaculation have different seminal vesicle dimensions compared to men without PE?
  • Do prostatic urethra and seminal vesicle measurements on mpMRI correlate with PE severity scores (PEDT) and ejaculation latency time (IELT)?

Researchers will compare men with premature ejaculation to healthy men without ejaculatory complaints to see if specific anatomical features are associated with PE severity.

Participants will:

  • Undergo a multiparametric prostate MRI that is already scheduled as part of their routine medical care
  • Complete validated questionnaires about ejaculation and sexual function (PEDT, PEP, IELT, IIEF-15)
  • Provide a blood sample for routine hormone level measurements

Study Overview

Status

Not yet recruiting

Conditions

Detailed Description

Premature ejaculation (PE) is the most common male sexual dysfunction, affecting approximately 20-30% of men worldwide. Despite its high prevalence, its pathophysiology remains incompletely understood. While neurobiological and psychological factors have been extensively studied, the potential role of anatomical variations in the lower urinary tract

- specifically the prostatic urethra and seminal vesicles - has received limited attention in the literature.

The seminal vesicles play a key role in ejaculation by contributing approximately 70% of seminal fluid volume. Previous ultrasound-based studies have suggested a possible relationship between seminal vesicle size and PE severity. However, no study to date has investigated prostatic urethral and seminal vesicle morphometry using the superior spatial resolution of multiparametric prostate MRI (mpMRI) in relation to PE.

STUDY DESIGN:

Single-center, prospective, observational cohort study conducted at Başakşehir Çam ve Sakura City Hospital Urology Clinic, Istanbul, Turkey.

PARTICIPANTS:

150 men aged 18-55 years scheduled for clinically indicated mpMRI (elevated PSA or hematospermia) will be enrolled and divided into two cohorts:

  • PE Group: Men meeting ISSM criteria for lifelong PE (ejaculation within ~1 minute of vaginal penetration) or acquired PE (ejaculation within ~3 minutes of vaginal penetration), with inability to delay ejaculation and negative personal consequences.
  • Control Group: Healthy men without PE or any other sexual dysfunction complaint, with good ejaculatory control.

All participants must be in a stable heterosexual monogamous relationship with the same partner for at least 6 months and have normal erectile function (IIEF-15 erectile function domain score ≥26). Men using medications that may affect sexual function (SSRIs, PDE5 inhibitors) or those with hormonal disorders, major psychiatric conditions, or erectile dysfunction will be excluded.

MRI MORPHOMETRIC PARAMETERS:

The following measurements will be obtained from existing mpMRI images by the study urologists, without need for additional radiology support:

  • Prostatic urethral length (mm)
  • Prostatic urethral angulation (degrees)
  • Prostate posterior-anterior and lateral dimensions (mm)
  • Seminal vesicle anterior-posterior length (mm)
  • Seminal vesicle superior-anterior length (mm)
  • Seminal vesicle size to prostatic urethra size ratio
  • Prostate size to prostatic urethra size ratio

OUTCOME ASSESSMENTS:

  • Premature Ejaculation Diagnostic Tool (PEDT): range 0-20, higher scores indicate greater PE severity
  • Premature Ejaculation Profile (PEP): assesses ejaculatory control, distress, satisfaction, and interpersonal difficulty
  • Intravaginal Ejaculation Latency Time (IELT): recorded in seconds, lower values indicate greater PE severity
  • International Index of Erectile Function (IIEF-15): used to confirm normal erectile function and exclude erectile dysfunction
  • Serum hormone levels: total testosterone, TSH, prolactin
  • Demographic data: age, sexual abstinence duration

STATISTICAL ANALYSIS:

Continuous variables will be tested for normality using Shapiro-Wilk and Kolmogorov-Smirnov tests and expressed as mean ± standard deviation or median (min-max) accordingly. Group comparisons will be performed using Student t-test or Mann-Whitney U test for continuous variables and Chi-square or Fisher exact test for categorical variables.

Correlations between mpMRI morphometric parameters and PE severity (PEDT score, IELT) will be assessed using Pearson or Spearman correlation analyses. The primary analysis will use multiple linear regression to identify independent morphometric predictors of PE severity, with age, sexual abstinence duration, and hormone levels included as covariates. Multicollinearity will be assessed using variance inflation factor (VIF) and tolerance values.

Sample size was calculated using G*Power software (version 3.1.9.7) with medium effect size (f²=0.15), two-sided α=0.05, and 90% power, yielding a minimum of 123 participants. 150 participants will be enrolled to account for potential dropout.

All statistical analyses will be performed using IBM SPSS Statistics (version 30.0.0.0). Statistical significance will be set at p<0.05 (two-tailed).

No additional procedures beyond the clinically indicated mpMRI are required. The study poses no additional risk to participants.

Study Type

Observational

Enrollment (Estimated)

150

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Contact

Study Locations

  • Turkey (Türkiye)
    • Istanbul
      • Istanbul, Istanbul, Turkey (Türkiye), 34200
        • Başakşehir Çam and Sakura City Hospital, Department of Urology
        • Contact:

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

  • Adult

Accepts Healthy Volunteers

Yes

Sampling Method

Non-Probability Sample

Study Population

  • Any major psychiatric or somatic disorder
  • Hormonal disorders such as hypothyroidism or hyperthyroidism
  • Erectile dysfunction (IIEF-15 erectile function domain score <26)
  • Age below 18 or above 55 years

Description

Inclusion Criteria:

  • - Male aged 18 to 55 years
  • In a stable, heterosexual, monogamous relationship with the same female partner for at least 6 months
  • Normal erectile function defined as IIEF-15 erectile function domain score ≥26
  • Scheduled for clinically indicated multiparametric prostate MRI due to elevated PSA or hematospermia
  • Not using any medication that may affect sexual function or psychological status (e.g., SSRIs, PDE5 inhibitors)

Exclusion Criteria:

  • Any major psychiatric or somatic disorder
  • Hormonal disorders such as hypothyroidism or hyperthyroidism
  • Erectile dysfunction (IIEF-15 erectile function domain score <26)
  • Age below 18 or above 55 years

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

Cohorts and Interventions

Group / Cohort
Premature Ejaculation
Men aged 18-55 years meeting ISSM criteria for lifelong or acquired premature ejaculation. Lifelong PE is defined as ejaculation occurring within approximately 1 minute of vaginal penetration since first sexual experience. Acquired PE is defined as ejaculation within approximately 3 minutes of vaginal penetration. All participants must have an inability to delay ejaculation and report negative personal consequences. Participants must have normal erectile function (IIEF-15 ≥26), be in a stable heterosexual monogamous relationship for at least 6 months, and have a clinically indicated mpMRI scheduled.
Control Group
Healthy men aged 18-55 years without premature ejaculation or any other sexual dysfunction complaint. Participants must have good ejaculatory control, normal erectile function (IIEF-15 ≥26), and be in a stable heterosexual monogamous relationship for at least 6 months. Participants must have a clinically indicated mpMRI scheduled due to elevated PSA or hematospermia.

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Correlation Between Prostatic Urethral Length and Premature Ejaculation Severity
Time Frame: At enrollment (single time point)
Pearson or Spearman correlation between prostatic urethral length measured on mpMRI (mm) and PEDT score. Higher PEDT score indicates greater PE severity (range 0-20).
At enrollment (single time point)
Correlation Between Seminal Vesicle Dimensions and Premature Ejaculation Severity
Time Frame: At enrollment (single time point)
Pearson or Spearman correlation between seminal vesicle anterior-posterior length and superior-anterior length measured on mpMRI (mm) and PEDT score. Higher PEDT score indicates greater PE severity (range 0-20).
At enrollment (single time point)
Correlation Between Prostatic Urethral Angulation and Intravaginal Ejaculation Latency Time
Time Frame: At enrollment (single time point)
Pearson or Spearman correlation between prostatic urethral angulation measured on mpMRI (degrees) and IELT (seconds). Lower IELT indicates greater PE severity.
At enrollment (single time point)

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Başakşehir Çam & Sakura City Hospital

Publications and helpful links

The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.

General Publications

Helpful Links

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Estimated)

May 10, 2026

Primary Completion (Estimated)

August 10, 2026

Study Completion (Estimated)

August 10, 2026

Study Registration Dates

First Submitted

May 22, 2026

First Submitted That Met QC Criteria

May 22, 2026

First Posted (Actual)

May 29, 2026

Study Record Updates

Last Update Posted (Actual)

June 3, 2026

Last Update Submitted That Met QC Criteria

May 30, 2026

Last Verified

May 1, 2026

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID Numbers

  • KAEK-11/24.12.2025.472

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

NO

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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