Sexual Functions in Men with Congenital Bilateral Absence of the Vas Deferens: A Comparative Study.

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Numan Baydilli, Emre Akınsal, Halil Tosun, Emrah Kızılay, Gokhan Sonmez This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-3881298/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract This study examines the sexual and psychological conditions of men with Bilateral Congenital Bilateral Absence of the Vas Deferens (CBAVD), a rare condition that contributes to male infertility, and compares it with healthy fertile men. A total of 52 patients with CBAVD and 66 healthy, fertile men who attended our infertility and andrology clinic were included in the study. Patients with cognitive impairments, language barriers, significant comorbidities, or a history of urogenital surgery were excluded. Reproductive hormone levels and semen volumes were evaluated. In addition, sexual status was investigated with validated questionnaires such as the International Index of erectile function, Male sexual health questionnaire, and Premature ejaculation profile. Semen volume was significantly lower in CBAVD men. The results showed that there was no significant difference between the CBAVD and control groups in terms of erectile function, orgasmic function, and sexual relationship satisfaction. However, sexual desire and overall satisfaction were found to be higher in the CBAVD group. The study suggests that CBAVD may not be a direct etiological factor for erectile dysfunction or premature ejaculation. Health sciences/Diseases/Reproductive disorders/Urogenital reproductive disorders Health sciences/Signs and symptoms/Reproductive signs and symptoms Congenital absence of vas deferens infertility sexual functions questionnaire Figures Figure 1 Introduction Congenital absence of the vas deferens (CAVD) is an uncommon abnormality that can contribute to male infertility [ 1 ]. This abnormality can be characterized as unilateral (CUAVD) or bilateral (CBAVD). CBAVD is found in 6% of azoospermic and 1% – 2% of infertile males [ 2 ]. The most characteristic findings of CBAVD are bilateral nonpalpable vas deferens and the absence of the distal part of the epididymis [ 3 ]. Azoospermia, low semen pH (< 7.2) and low semen volume (< 1.5 ml) are the most common findings in semen analysis. Testis volume and serum gonadotrophins are usually normal [ 2 ]. The rate of sexual dysfunction in men with infertility varies between 6.7% and 75% [ 4 , 5 ]. Infertility can have a negative impact on the sexual, psychological, and marital life of both partners [ 6 ]. The ability to reproduction is connected with self-respect and sexuality. Sexual intercourse may lose its erotic value when the main goal becomes conception. This situation may provoke certain sexual dysfunctions [ 7 , 8 ]. Besides that, although low ejaculate volume does not directly affect sexual function, it may affect sexual satisfaction. Many different studies have been conducted to date on men with CBAVD. These studies have generally focused on fertility status, the results of assisted reproductive techniques, the genetic basis of the anomaly, and other associated anomalies. There are also many studies evaluating the sexual function of infertile men. However, to the best of our knowledge, no study has been conducted to evaluate the sexual and physiologic function of men with CBAVD in detail. This study aims to investigate the sexual and physiologic conditions of men with CBAVD and compare them with the normal fertile healthy individuals using validated sexual function questionnaires. Materials and Methods Fifty-two men with CBAVD whose treatments and follow-ups were conducted in our infertility and andrology clinic enrolled in the study. As a control group, 66 healthy fertile men were included. CBAVD is diagnosed by decreased semen volume, clinical examination, and transrectal ultrasonography/magnetic resonance imaging. Cystic fibrosis transmembrane conductance regulator (CFTR) gene analyses were also performed, and cystic fibrosis (CF) related comorbidities were questioned. Heterosexual, over 18 years of age, and have had regular sexual intercourse within the last 3 months individuals were enrolled to study. Men with cognitive disabilities or lack of ability to understand and speak the Turkish language were excluded. Participants with any comorbidity such as diabetes mellitus, hypo/hyperthyroidism, etc., and undergone urogenital surgeries except testicular and epididymal sperm extraction procedures were also excluded from the study. Patients who have previously been diagnosed with any psychiatric disorder or have ever been treated were excluded. All participants filled up the sexual and psychological questionnaires voluntarily in the voiceless room at the clinic which were asked by the same urologist with a fellow of the European Board of Urology (FEBU) certificate. Semen analysis was performed obtained by masturbation at the clinic after 3 days of sexual abstinence. Blood samples were collected from patients for hormonal analysis (sex hormone binding globulin, total testosterone, luteinizing hormone, follicle-stimulating hormone, estradiol, prolactin) at around ten o’clock am. (Flowchart). Institutional review board approval was obtained for this study. Questionnaire forms Instruments 1. International index of erectile function, (IIEF)-15 [9] The IIEF-15 questionnaire which was validated for use in Turkey was filled up to all males. 2. Male sexual health questionnaire (MSHQ-Ejd short form) [10] Twenty-five item MSHQ was developed and validated (MSHQ-EjD Short Form) for assessing ejaculatory dysfunction (EjD). This form consists of 4 items and evaluates three ejaculatory functions at the first three items and one ejaculation bother at the last item. 3. Arabic index of premature ejaculation (AIPE) [11] This form consists of seven items based on an assessment of erectile function, sexual desire, ejaculation latency, ejaculation control, patient satisfaction, partner satisfaction, and psychological distress. Severity of premature ejaculation (PE) was classified as; severe (7-13 pts.), moderate (14-19 pts.), mild to moderate (20-25 pts.), mild (25-30 pts.), no-PE (31-35 pts.). 4. Premature ejaculation profile (PEP) [12] PEP is a self-reported outcome instrument for evaluating premature ejaculation (PE), notably control, distress, interpersonal difficulty, and sexual satisfaction. Each item was calculated for subjects with and without the complaint of ejaculating prematurely and their partners. 5. Premature ejaculation diagnostic tool (PEDT) [13,14] PEDT was developed to standardize the diagnosis of PE. It was designed to capture the main elements of the Diagnostic and Statistical Manual of Mental Disorders Fourth Edition, Text Revision (DSM-IV-TR); control, frequency, minimal sexual stimulation distress, and interpersonal difficulty. The original nine items of the PEDT are validated in the Turkish language with an items questionnaire. A score below 9 indicates a low likelihood of PE and above 11 indicate. high likelihood PE. 6. Beck depression inventory [15] This scale consists of a 21-item self-report instrument intended to assess the existence and severity of symptoms of depression. There is a four-point scale for each item ranging from 0 to 3. The severity of depression was classified as; minimal, mild, moderate, severe. Statistical Analyses To determine the appropriate sample size for our study, a power analysis was conducted using the G*Power software [16]. The power analysis aimed to estimate the minimum sample size required to achieve a statistical power of 80%, assuming an alpha level (significance level) of 0.05 and a medium effect size. The analysis revealed that a sample size of at least 47 participants for each group would be necessary to detect the expected effects with an 80% probability. Shapiro-Wilk test was used to evaluate data normality. Mann-Whitney U test was used to determine the differences between two independent groups with continuous variables that were not normally distributed. In cases where the median values were similar and statistically significant, the mean of the rank values was given in the Mann-Whitney U test. Chi-square analysis was performed for categorical variables. All analyses were performed using the IBM SPSS Statistics 29 software package (IBM, Armonk, NY, USA). Statistical significance was set at p < 0.05. Results There were 52 men in the CBAVD group and 66 normal healthy fertile men in the control group. Descriptive data of these two groups and p values of the differences between groups are given in Table 1 . There was no significant difference between the groups in terms of age, body mass index (BMI), and reproductive hormone levels. The Semen volume of the men with CBAVD was statistically significantly less than the control group (p = < 0.001) (Table 1 ). Table 1. Characteristics of groups CBAVD (n=52) Control (n=66) p* Age (year) 32.5 (29-36.7) 31 (29-36) 0.523 Body mass index (kg/m 2 ) 25.5 (23-28.3) 26 (23.2-28.7) 0.512 Total Testosterone (nmol/ml) 401 (335-558) 376 (236-492) 0.166 Prolactin (ng/ml) 7 (5.7-10.4) 7.5 (6.1-11.6) 0.678 Sex hormone binding globulin (nmol/L) 27.4 (19-37) 24 (21-41) 0.947 Follicle-stimulating hormone (mIU/ml) 3.9 (2.3-5.6) 4.8 (2.9-7.6) 0.113 Luteinizing hormone (mIU/ml) 3.9 (2.8-5.4) 5 (2.7-7.3) 0.137 Estradiol (pg/ml) 26.7 (19.1-38) 28.4 (16.5-42.8) 0.814 Semen volume (ml) 0.9 (0.6-1.3) 3 (2.5-3.9) <0.001 CBAVD: Congenital Bilateral absence of Vas Deferens Values are expressed as median (25th-75th percentiles). * = Mann-Whitney U test When the IIEF-15 questionnaire scores of the groups were compared; there were no significant differences between groups for erectile function, orgasmic function, and intercourse satisfaction scores. Sexual desire and overall satisfaction scores of the CBAVD group were significantly higher than the control group. There were no significant differences between groups when the groups were compared with AIPE, PEDT, PEP, and Beck depression inventory questionnaires. The men with CBAVD were more bothered when they had ejaculation difficulties according to MSHQ Ejd short form (Table 2 ). The prevalence of premature ejaculation among men with CBAVD was 38,5% according to PEDT questionnaires. There was no significant difference between the groups in the comparison of premature ejaculation rates. according to AIPE and PEDT. Results are given in Table 3 and Table 4 . Table 2 Comparison between groups CBAVD (n = 52) Control (n = 66) p* International index of erectile function (IIEF-15) • Erectile Function 27 (24–30) 28 (15–30) 0.908 • Orgasmic Function 10 (9–10) 10 (7.7–10) 0.388 • Sexual Desire 9 (8–10) 8 (6.7-9) 0.006 • Intercourse Satisfaction 13 (10–14) 12 (10–14) 0.283 • Overall Satisfaction 10 (8–10) 8 (8–10) 0.028 Arabic index of premature ejaculation 26 (21–31) 27 (24–31) 0.309 Premature ejaculation diagnostic tool 4 (2-11.7) 5 (2-9.2) 0.974 Male sexual health questionnaire (MSHQ-Ejd short form) • Ejaculatory function (3 items) 15 (13–15) 14 (12–15) 0.283 • Bother/satisfaction (1 item) # (mean of rank) 0.5 (0–2) (66.63) 0 (0–1) (53.89) 0.027 Premature ejaculation profile (PEP) (male) • Perceived control over ejaculation 3 (2–4) 3 (2–4) 0.243 • Satisfaction with sexual intercourse 3 (3–4) 3 (2.7-4) 0.384 • Personal distress related to ejaculation 0 (0–2) 1 (0–2) 0.358 • Interpersonal difficulty related to ejaculation 0 (0–1) 0 (0–1) 0.803 • Beck depression inventory 3 (0-14.2) 7 (1.7–17.2) 0.057 CBAVD: Congenital Bilateral absence of Vas Deferens Values are expressed as median (25th-75th percentiles). * = Mann-Whitney U test # = In the Mann-Whitney U test, mean of rank values were given for data with similar median values and statistically significant. Table 3 Comparison of Groups Based on the Arabic Index of Premature Ejaculation (AIPE) Arabic Index of Premature Ejaculation (AIPE) n, (%) CBAVD (n = 52) Control (n = 66) p • No PE 15 (28.8) 19 (28.8) 0.409 • Mild PE 14 (26.9) 21 (31.8) • Mild-Moderate PE 14 (26.9) 22 (33.3) • Moderate PE 7 (13.5) 3 (4.5) • Severe PE 2 (3.8) 1 (1.5) CBAVD: Congenital Bilateral Absence of the Vas Deferens Table 4 Comparison of Groups Based on the Premature Ejaculation Diagnostic Tool (PEDT) Premature Ejaculation Diagnostic Tool n, (%) CBAVD (n = 52) Control (n = 66) p • No PE 32 (61.5) 50 (75.8) 0.096 • PE 20 (38.5) 16 (24.2) CBAVD: Congenital Bilateral Absence of the Vas Deferens Discussion Common forms of male sexual dysfunction are erectile dysfunction and premature ejaculation. The studies that investigate erectile dysfunction and premature ejaculation in infertile men using validated tools are few in number. The most important limitations of the studies are the wide variety of causes of male infertility, small case populations, and non-standardized questionnaires. Evaluation of sexual functions in infertile men in subgroups according to etiology may overcome these limitations. Therefore, this study was designed to evaluate sexual dysfunction only in men with CBAVD. In studies evaluating erectile dysfunction among infertile men using the validated IIEF-15, the prevalence of erectile dysfunction has been reported between 11% and 30% [ 17 – 21 ]. Notably, some studies have been published on this issue, finding a higher prevalence (50,8%, 61,6%) of erectile dysfunction in infertile men [ 22 , 23 ]. It is very difficult to determine an independent relationship between erectile dysfunction and infertility. Because many factors such as age, infertility etiology, hormonal status, and comorbidities may affect this association. However, some studies have reported that infertility may be an independent factor for erectile dysfunction. Lotti et al. reported a significant association between erectile dysfunction and semen quality impairment after adjusting for age, comorbidities, serum testosterone levels, and prostatitis-like symptoms [ 17 ]. Besides this, another study reported a correlation between erectile dysfunction and depressive symptoms independent of age, BMI, and duration of marriage in men without comorbidities with primary or secondary infertility [ 24 ]. However, in these studies, cases were not evaluated separately according to the etiology of infertility. Although studies evaluating erectile function in isolated cases of CBAVD have not been performed in the past, there are studies on sexual function in cases of CF that are associated with CBAVD. Chambers et al. reported the prevalence of sexual dysfunction as 65% in their study evaluating sexual function in 32 male cases with CF [ 25 ]. Similar studies have also reported sexual dysfunction in men with CF. However, sexual function is not impaired until cystic fibrosis becomes severe enough to impact the patient’s general health, and sexual dysfunction is more often associated with disease-related problems than fertility status [ 25 – 27 ]. In our study, it was found that there was no significant difference between men with CBAVD and the control group in terms of erectile dysfunction. None of the patients in our study population had CF-related comorbidities. In addition, their serum testosterone levels were normal. Therefore, we can say that CBAVD may not be an etiological factor for erectile dysfunction. In the literature, there are some inconsistencies in studies investigating the frequency of premature ejaculation in infertile men. The prevalence of premature ejaculation has generally been reported quite high in studies using non-validated questionnaires in small cohort groups [ 5 , 28 – 31 ]. However, these rates were found lower in studies of infertile men with a larger number of patients and validated questionnaires [ 17 , 18 , 32 ]. In our study, the prevalence of premature ejaculation among men with CBAVD was 38,5% and 71,2% respectively according to PEDT and AIPE questionnaires. There was also no statistically significant difference in the premature ejaculation rate when compared with the control group. On the other hand, the prevalence of premature ejaculation in men with CBAVD in our study is higher than the prevalence reported for the Turkish population. In a previous study by Serefoğlu et al., the prevalence of premature ejaculation was reported as 20% among 2593 Turkish men [ 33 ]. According to these data, it is not reasonable to conclude that premature ejaculation is more common in CBAVD. The issue of sexual satisfaction in infertile men is still debated. Some studies showed no differences between sexual satisfaction in men in infertile couples and men in fertile couples [ 17 , 34 ] whereas others reported lower satisfaction in infertile men [ 4 , 35 ]. Many factors such as coitus frequency, duration of infertility, cause of infertility, timing of infertility diagnosis, age of the partner, and education levels have been addressed in these studies. We had the expectation that men with CBAVD would have low sexual satisfaction due to low ejaculate volume when we designed the study. In our clinical practice, we observed that sexual satisfaction was considerably reduced in patients with anejaculation or retrograde ejaculation after benign prostatic hyperplasia or prostate cancer treatments. But contrary to what we thought, sexual desire and overall satisfaction scores were higher in the CBAVD group than in the control group. A statistically significant difference was also found between the groups for the question "If you had any ejaculation difficulties or could not ejaculate, were you disturbed by this?" in the MSHQ-Ejd short-form questionnaire. Men with CBAVD felt more bothered when they experienced ejaculation difficulties than the control group. We attributed this to the fact that for the CBAVD group, the main goal of sexuality is the desire to have children rather than satisfaction. Our study has some limitations. While evaluating premature ejaculation, intravaginal ejaculatory latency time (IELT) and PEP-female questionnaire could have increased the value of our study. The results of these questionnaires are based on the respondents' own experiences and perceptions. Therefore, they can lead to misleading results as they are based on subjective assessments rather than objective measurements. In addition, a larger study population would have helped to make the results more reliable. In conclusion, CBAVD, one of the rare causes of male infertility, differs from other causes of infertility etiologically and genetically as well as in terms of erectile and sexual functions. This study can be a starting point for future studies. More comprehensive studies may reveal this situation clearly. Declarations Author Contributions ECA, NB designed the study and edited the paper. NB, EK created the database, collected data, performed data analysis, and assisted with paper writing and editing. HT, GS collected data and assisted with paper writing and editing. ECA, NB, HT collected data and assisted with paper writing and editing. GS assisted with paper editing. Competing Interests The authors declare no competing interests. Ethics Approval Institutional review board approval was obtained for this study. References Jequier AM, Ansell ID, Bullimore NJ. Congenital absence of the vasa deferentia presenting with infertility. J Androl 1985; 6(1): 15–19. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-3881298","acceptedTermsAndConditions":true,"allowDirectSubmit":true,"archivedVersions":[],"articleType":"Article","associatedPublications":[],"authors":[{"id":269422163,"identity":"050e334b-4d1a-47be-8ad2-a709e7f20cc9","order_by":0,"name":"Numan Baydilli","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAA4UlEQVRIiWNgGAWjYDCCA1Banr35GJjBxk6sFsOeY2kMDAlALczEamG4kWMG1sJASAvf7QNsj3lz7PIYe858e/DxxzZ5PmYGxg8fc3BrkTyXwG7Muy25mJ29d7vhjITbhm3MDMySM7fh1mJwhoFNmncbc2Jjz9lt0jwJtxmBWtiYeQlrqU9suJHzDKTFnlgth0Fa2EBaEglqkQRqkZy77Xjixp5jZpIz0m4ntzEzNuP1Cx9Qi8TbbdWJ89mbn0l8sLltO7+9+eCHj3i0MDDwf0AXYWzAp34UjIJRMApGAREAACztTTslAH6oAAAAAElFTkSuQmCC","orcid":"","institution":"Erciyes University Medical Faculty. Urology Department","correspondingAuthor":true,"prefix":"","firstName":"Numan","middleName":"","lastName":"Baydilli","suffix":""},{"id":269422164,"identity":"5b6d2e48-29a3-4f30-92dc-937d6807722c","order_by":1,"name":"Emre Akınsal","email":"","orcid":"","institution":"","correspondingAuthor":false,"prefix":"","firstName":"Emre","middleName":"","lastName":"Akınsal","suffix":""},{"id":269422165,"identity":"c36fe0ec-ff4b-4fc9-adc2-c9efedcbd662","order_by":2,"name":"Halil Tosun","email":"","orcid":"","institution":"","correspondingAuthor":false,"prefix":"","firstName":"Halil","middleName":"","lastName":"Tosun","suffix":""},{"id":269422166,"identity":"66a63a84-76d6-4c03-bc84-bfc79afaad42","order_by":3,"name":"Emrah Kızılay","email":"","orcid":"","institution":"","correspondingAuthor":false,"prefix":"","firstName":"Emrah","middleName":"","lastName":"Kızılay","suffix":""},{"id":269422167,"identity":"c16c1c1b-068c-4503-9736-70450f96043c","order_by":4,"name":"Gokhan Sonmez","email":"","orcid":"","institution":"","correspondingAuthor":false,"prefix":"","firstName":"Gokhan","middleName":"","lastName":"Sonmez","suffix":""}],"badges":[],"createdAt":"2024-01-20 10:40:11","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-3881298/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-3881298/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":50384217,"identity":"59830167-7db9-4991-add3-eba5ca9fd8c1","added_by":"auto","created_at":"2024-01-30 17:28:38","extension":"png","order_by":1,"title":"Figure 1","display":"","copyAsset":false,"role":"figure","size":192591,"visible":true,"origin":"","legend":"\u003cp\u003eFlowchart of the study design\u003c/p\u003e","description":"","filename":"flowchart.png","url":"https://assets-eu.researchsquare.com/files/rs-3881298/v1/b763ce61c63cec177de6c797.png"},{"id":56038315,"identity":"819b1caa-556f-4f66-91f5-f0a02b5e4d6c","added_by":"auto","created_at":"2024-05-07 19:00:16","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":760728,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-3881298/v1/cbf089f3-20e5-40e2-b8a5-4c4e7ee6d6a8.pdf"}],"financialInterests":"There is \u003cb\u003eNO\u003c/b\u003e conflict of interest to disclose.","formattedTitle":"Sexual Functions in Men with Congenital Bilateral Absence of the Vas Deferens: A Comparative Study.","fulltext":[{"header":"Introduction","content":"\u003cp\u003eCongenital absence of the vas deferens (CAVD) is an uncommon abnormality that can contribute to male infertility [\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e]. This abnormality can be characterized as unilateral (CUAVD) or bilateral (CBAVD). CBAVD is found in 6% of azoospermic and 1% \u0026ndash; 2% of infertile males [\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e]. The most characteristic findings of CBAVD are bilateral nonpalpable vas deferens and the absence of the distal part of the epididymis [\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e]. Azoospermia, low semen pH (\u0026lt;\u0026thinsp;7.2) and low semen volume (\u0026lt;\u0026thinsp;1.5 ml) are the most common findings in semen analysis. Testis volume and serum gonadotrophins are usually normal [\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eThe rate of sexual dysfunction in men with infertility varies between 6.7% and 75% [\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e, \u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e]. Infertility can have a negative impact on the sexual, psychological, and marital life of both partners [\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e]. The ability to reproduction is connected with self-respect and sexuality. Sexual intercourse may lose its erotic value when the main goal becomes conception. This situation may provoke certain sexual dysfunctions [\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e, \u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e]. Besides that, although low ejaculate volume does not directly affect sexual function, it may affect sexual satisfaction.\u003c/p\u003e \u003cp\u003eMany different studies have been conducted to date on men with CBAVD. These studies have generally focused on fertility status, the results of assisted reproductive techniques, the genetic basis of the anomaly, and other associated anomalies. There are also many studies evaluating the sexual function of infertile men. However, to the best of our knowledge, no study has been conducted to evaluate the sexual and physiologic function of men with CBAVD in detail.\u003c/p\u003e \u003cp\u003eThis study aims to investigate the sexual and physiologic conditions of men with CBAVD and compare them with the normal fertile healthy individuals using validated sexual function questionnaires.\u003c/p\u003e"},{"header":"Materials and Methods","content":"\u003cp\u003eFifty-two men with CBAVD whose treatments and follow-ups were conducted in our infertility and andrology clinic enrolled in the study. As a control group, 66 healthy fertile men were included. CBAVD is diagnosed by decreased semen volume, clinical examination, and transrectal ultrasonography/magnetic resonance imaging. Cystic fibrosis transmembrane conductance regulator (CFTR) gene analyses were also performed, and cystic fibrosis (CF) related comorbidities were questioned. Heterosexual, over 18 years of age, and have had regular sexual intercourse within the last 3 months individuals were enrolled to study. Men with cognitive disabilities or lack of ability to understand and speak the Turkish language were excluded. Participants with any comorbidity such as diabetes mellitus, hypo/hyperthyroidism, etc., and undergone urogenital surgeries except testicular and epididymal sperm extraction procedures were also excluded from the study. Patients who have previously been diagnosed with any psychiatric disorder or have ever been treated were excluded. All participants filled up the sexual and psychological questionnaires voluntarily in the voiceless room at the clinic which were asked by the same urologist with a fellow of the European Board of Urology (FEBU) certificate. Semen analysis was performed obtained by masturbation at the clinic after 3 days of sexual abstinence. Blood samples were collected from patients for hormonal analysis (sex hormone binding globulin, total testosterone, luteinizing hormone, follicle-stimulating hormone, estradiol, prolactin) at around ten o\u0026rsquo;clock am. (Flowchart).\u003c/p\u003e\n\u003cp\u003eInstitutional review board approval was obtained for this study.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eQuestionnaire forms\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eInstruments \u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e1. International index of erectile function, (IIEF)-15 [9]\u003c/p\u003e\n\u003cp\u003eThe IIEF-15 questionnaire which was validated for use in Turkey was filled up to all males.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e2. Male sexual health questionnaire (MSHQ-Ejd short form) [10]\u003c/p\u003e\n\u003cp\u003eTwenty-five item MSHQ was developed and validated (MSHQ-EjD Short Form) for assessing ejaculatory dysfunction (EjD). This form consists of 4 items and evaluates three ejaculatory functions at the first three items and one ejaculation bother at the last item.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e3. Arabic index of premature ejaculation (AIPE) [11]\u003c/p\u003e\n\u003cp\u003eThis form consists of seven items based on an assessment of erectile function, sexual desire, ejaculation latency, ejaculation control, patient satisfaction, partner satisfaction, and psychological distress. Severity of premature ejaculation (PE) was classified as; severe (7-13 pts.), moderate (14-19 pts.), mild to moderate (20-25 pts.), mild (25-30 pts.), no-PE (31-35 pts.).\u003c/p\u003e\n\u003cp\u003e4. Premature ejaculation profile (PEP) [12]\u003c/p\u003e\n\u003cp\u003ePEP is a self-reported outcome instrument for evaluating premature ejaculation (PE), notably control, distress, interpersonal difficulty, and sexual satisfaction. Each item was calculated for subjects with and without the complaint of ejaculating prematurely and their partners.\u003c/p\u003e\n\u003cp\u003e5. Premature ejaculation diagnostic tool (PEDT) [13,14]\u003c/p\u003e\n\u003cp\u003ePEDT was developed to standardize the diagnosis of PE. It was designed to capture the main elements of the Diagnostic and Statistical Manual of Mental Disorders Fourth Edition, Text Revision (DSM-IV-TR); control, frequency, minimal sexual stimulation distress, and interpersonal difficulty. The original nine items of the PEDT are validated in the Turkish language with an items questionnaire. A score below 9 indicates a low likelihood of PE and above 11 indicate.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003ehigh likelihood PE.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e6. Beck depression inventory [15]\u003c/p\u003e\n\u003cp\u003eThis scale consists of a 21-item self-report instrument intended to assess the existence and severity of symptoms of depression. There is a four-point scale for each item ranging from 0 to 3. The severity of depression was classified as; minimal, mild, moderate, severe.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eStatistical Analyses\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eTo determine the appropriate sample size for our study, a power analysis was conducted using the G*Power software [16]. The power analysis aimed to estimate the minimum sample size required to achieve a statistical power of 80%, assuming an alpha level (significance level) of 0.05 and a medium effect size. The analysis revealed that a sample size of at least 47 participants for each group would be necessary to detect the expected effects with an 80% probability.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eShapiro-Wilk test was used to evaluate data normality. Mann-Whitney U test was used to determine the differences between two independent groups with continuous variables that were not normally distributed. In cases where the median values were similar and statistically significant, the mean of the rank values was given in the Mann-Whitney U test. Chi-square analysis was performed for categorical variables. All analyses were performed using the IBM SPSS Statistics 29 software package (IBM, Armonk, NY, USA). Statistical significance was set at p \u0026lt; 0.05.\u003cstrong\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e"},{"header":"Results","content":"\u003cp\u003eThere were 52 men in the CBAVD group and 66 normal healthy fertile men in the control group. Descriptive data of these two groups and p values of the differences between groups are given in Table\u0026nbsp;\u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e1\u003c/span\u003e. There was no significant difference between the groups in terms of age, body mass index (BMI), and reproductive hormone levels. The Semen volume of the men with CBAVD was statistically significantly less than the control group (p\u0026thinsp;=\u0026thinsp;\u0026lt;\u0026thinsp;0.001) (Table\u0026nbsp;\u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e1\u003c/span\u003e).\u003c/p\u003e \u003cp\u003e\u003cstrong\u003eTable 1. Characteristics of groups\u003c/strong\u003e\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\" width=\"637\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd width=\"45.21193092621664%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"21.978021978021978%\"\u003e\n \u003cp\u003e\u003cstrong\u003eCBAVD\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;(n=52)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"19.78021978021978%\"\u003e\n \u003cp\u003e\u003cstrong\u003eControl\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e(n=66)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.029827315541601%\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u003cem\u003ep*\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"45.21193092621664%\"\u003e\n \u003cp\u003eAge (year)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"21.978021978021978%\"\u003e\n \u003cp\u003e32.5 (29-36.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"19.78021978021978%\"\u003e\n \u003cp\u003e31 (29-36)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.029827315541601%\"\u003e\n \u003cp\u003e\u003cem\u003e0.523\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"45.21193092621664%\"\u003e\n \u003cp\u003eBody mass index (kg/m\u003csup\u003e2\u003c/sup\u003e)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"21.978021978021978%\"\u003e\n \u003cp\u003e25.5 (23-28.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"19.78021978021978%\"\u003e\n \u003cp\u003e26 (23.2-28.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.029827315541601%\"\u003e\n \u003cp\u003e\u003cem\u003e0.512\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"45.21193092621664%\"\u003e\n \u003cp\u003eTotal Testosterone (nmol/ml)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"21.978021978021978%\"\u003e\n \u003cp\u003e401 (335-558)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"19.78021978021978%\"\u003e\n \u003cp\u003e376 (236-492)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.029827315541601%\"\u003e\n \u003cp\u003e\u003cem\u003e0.166\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"45.21193092621664%\"\u003e\n \u003cp\u003eProlactin (ng/ml)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"21.978021978021978%\"\u003e\n \u003cp\u003e7 (5.7-10.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"19.78021978021978%\"\u003e\n \u003cp\u003e7.5 (6.1-11.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.029827315541601%\"\u003e\n \u003cp\u003e\u003cem\u003e0.678\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"45.21193092621664%\"\u003e\n \u003cp\u003eSex hormone binding globulin (nmol/L)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"21.978021978021978%\"\u003e\n \u003cp\u003e27.4 (19-37)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"19.78021978021978%\"\u003e\n \u003cp\u003e24 (21-41)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.029827315541601%\"\u003e\n \u003cp\u003e\u003cem\u003e0.947\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"45.21193092621664%\"\u003e\n \u003cp\u003eFollicle-stimulating hormone (mIU/ml)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"21.978021978021978%\"\u003e\n \u003cp\u003e3.9 (2.3-5.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"19.78021978021978%\"\u003e\n \u003cp\u003e4.8 (2.9-7.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.029827315541601%\"\u003e\n \u003cp\u003e\u003cem\u003e0.113\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"45.21193092621664%\"\u003e\n \u003cp\u003eLuteinizing hormone (mIU/ml)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"21.978021978021978%\"\u003e\n \u003cp\u003e3.9 (2.8-5.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"19.78021978021978%\"\u003e\n \u003cp\u003e5 (2.7-7.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.029827315541601%\"\u003e\n \u003cp\u003e\u003cem\u003e0.137\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"45.21193092621664%\"\u003e\n \u003cp\u003eEstradiol (pg/ml)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"21.978021978021978%\"\u003e\n \u003cp\u003e26.7 (19.1-38)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"19.78021978021978%\"\u003e\n \u003cp\u003e28.4 (16.5-42.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.029827315541601%\"\u003e\n \u003cp\u003e\u003cem\u003e0.814\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"45.21193092621664%\"\u003e\n \u003cp\u003eSemen volume (ml)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"21.978021978021978%\"\u003e\n \u003cp\u003e0.9 (0.6-1.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"19.78021978021978%\"\u003e\n \u003cp\u003e3 (2.5-3.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.029827315541601%\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u003cem\u003e\u0026lt;0.001\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003eCBAVD:\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003eCongenital Bilateral absence of Vas Deferens\u003c/p\u003e\n\u003cp\u003eValues are expressed as median (25th-75th percentiles).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u003cem\u003e* =\u0026nbsp;\u003c/em\u003e\u003c/strong\u003eMann-Whitney U test\u003c/p\u003e\u003cp\u003eWhen the IIEF-15 questionnaire scores of the groups were compared; there were no significant differences between groups for erectile function, orgasmic function, and intercourse satisfaction scores. Sexual desire and overall satisfaction scores of the CBAVD group were significantly higher than the control group. There were no significant differences between groups when the groups were compared with AIPE, PEDT, PEP, and Beck depression inventory questionnaires. The men with CBAVD were more bothered when they had ejaculation difficulties according to MSHQ Ejd short form (Table\u0026nbsp;\u003cspan refid=\"Tab2\" class=\"InternalRef\"\u003e2\u003c/span\u003e). The prevalence of premature ejaculation among men with CBAVD was 38,5% according to PEDT questionnaires. There was no significant difference between the groups in the comparison of premature ejaculation rates. according to AIPE and PEDT. Results are given in Table\u0026nbsp;\u003cspan refid=\"Tab3\" class=\"InternalRef\"\u003e3\u003c/span\u003e and Table\u0026nbsp;\u003cspan refid=\"Tab4\" class=\"InternalRef\"\u003e4\u003c/span\u003e.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab2\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 2\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eComparison between groups\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"4\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eCBAVD\u003c/p\u003e \u003cp\u003e(n\u0026thinsp;=\u0026thinsp;52)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eControl\u003c/p\u003e \u003cp\u003e(n\u0026thinsp;=\u0026thinsp;66)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u003cem\u003ep*\u003c/em\u003e\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eInternational index of erectile function (IIEF-15)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colspan=\"3\" nameend=\"c4\" namest=\"c2\"\u003e\u0026nbsp;\u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u0026bull; Erectile Function\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e27 (24\u0026ndash;30)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e28 (15\u0026ndash;30)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u003cem\u003e0.908\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u0026bull; Orgasmic Function\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e10 (9\u0026ndash;10)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e10 (7.7\u0026ndash;10)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u003cem\u003e0.388\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u0026bull; Sexual Desire\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e9 (8\u0026ndash;10)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e8 (6.7-9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u003cb\u003e0.006\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u0026bull; Intercourse Satisfaction\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e13 (10\u0026ndash;14)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e12 (10\u0026ndash;14)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u003cem\u003e0.283\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u0026bull; Overall Satisfaction\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e10 (8\u0026ndash;10)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e8 (8\u0026ndash;10)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u003cb\u003e0.028\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eArabic index of premature ejaculation\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e26 (21\u0026ndash;31)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e27 (24\u0026ndash;31)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u003cem\u003e0.309\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003ePremature ejaculation diagnostic tool\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e4 (2-11.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e5 (2-9.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u003cem\u003e0.974\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eMale sexual health questionnaire (MSHQ-Ejd short form)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"3\" nameend=\"c4\" namest=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u0026bull; Ejaculatory function (3 items)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e15 (13\u0026ndash;15)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e14 (12\u0026ndash;15)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u003cem\u003e0.283\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u0026bull; Bother/satisfaction (1 item) \u003csup\u003e\u003cb\u003e#\u003c/b\u003e\u003c/sup\u003e\u003c/p\u003e \u003cp\u003e(mean of rank)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.5 (0\u0026ndash;2)\u003c/p\u003e \u003cp\u003e(66.63)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0 (0\u0026ndash;1)\u003c/p\u003e \u003cp\u003e(53.89)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u003cb\u003e0.027\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003ePremature ejaculation profile (PEP) (male)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"3\" nameend=\"c4\" namest=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u0026bull; Perceived control over ejaculation\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e3 (2\u0026ndash;4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e3 (2\u0026ndash;4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u003cem\u003e0.243\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u0026bull; Satisfaction with sexual intercourse\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e3 (3\u0026ndash;4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e3 (2.7-4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u003cem\u003e0.384\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u0026bull; Personal distress related to ejaculation\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0 (0\u0026ndash;2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1 (0\u0026ndash;2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u003cem\u003e0.358\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u0026bull; Interpersonal difficulty related to ejaculation\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0 (0\u0026ndash;1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0 (0\u0026ndash;1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u003cem\u003e0.803\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u0026bull; Beck depression inventory\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e3 (0-14.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e7 (1.7\u0026ndash;17.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u003cem\u003e0.057\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003ctfoot\u003e \u003ctr\u003e\u003ctd colspan=\"4\"\u003eCBAVD: Congenital Bilateral absence of Vas Deferens\u003c/td\u003e\u003c/tr\u003e \u003ctr\u003e\u003ctd colspan=\"4\"\u003eValues are expressed as median (25th-75th percentiles).\u003c/td\u003e\u003c/tr\u003e \u003ctr\u003e\u003ctd colspan=\"4\"\u003e\u003cb\u003e* =\u003c/b\u003e Mann-Whitney U test\u003c/td\u003e\u003c/tr\u003e \u003ctr\u003e\u003ctd colspan=\"4\"\u003e\u003cb\u003e# =\u003c/b\u003e In the Mann-Whitney U test, mean of rank values were given for data with similar median values and statistically significant.\u003c/td\u003e\u003c/tr\u003e \u003c/tfoot\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab3\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 3\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eComparison of Groups Based on the Arabic Index of Premature Ejaculation (AIPE)\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"4\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eArabic Index of Premature Ejaculation (AIPE) n, (%)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eCBAVD\u003c/p\u003e \u003cp\u003e(n\u0026thinsp;=\u0026thinsp;52)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eControl\u003c/p\u003e \u003cp\u003e(n\u0026thinsp;=\u0026thinsp;66)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u003cem\u003ep\u003c/em\u003e\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u0026bull; No PE\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e15 (28.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e19 (28.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\" morerows=\"4\" rowspan=\"5\"\u003e \u003cp\u003e\u003cem\u003e0.409\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u0026bull; Mild PE\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e14 (26.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e21 (31.8)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u0026bull; Mild-Moderate PE\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e14 (26.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e22 (33.3)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u0026bull; Moderate PE\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e7 (13.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e3 (4.5)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u0026bull; Severe PE\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e2 (3.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e1 (1.5)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003ctfoot\u003e \u003ctr\u003e\u003ctd colspan=\"4\"\u003eCBAVD: Congenital Bilateral Absence of the Vas Deferens\u003c/td\u003e\u003c/tr\u003e \u003c/tfoot\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab4\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 4\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eComparison of Groups Based on the Premature Ejaculation Diagnostic Tool (PEDT)\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"4\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePremature Ejaculation Diagnostic Tool\u003c/p\u003e \u003cp\u003en, (%)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eCBAVD (n\u0026thinsp;=\u0026thinsp;52)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eControl (n\u0026thinsp;=\u0026thinsp;66)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u003cem\u003ep\u003c/em\u003e\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u0026bull; No PE\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e32 (61.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e50 (75.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e\u003cem\u003e0.096\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u0026bull; PE\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e20 (38.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e16 (24.2)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003ctfoot\u003e \u003ctr\u003e\u003ctd colspan=\"4\"\u003eCBAVD: Congenital Bilateral Absence of the Vas Deferens\u003c/td\u003e\u003c/tr\u003e \u003c/tfoot\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e"},{"header":"Discussion","content":"\u003cp\u003eCommon forms of male sexual dysfunction are erectile dysfunction and premature ejaculation. The studies that investigate erectile dysfunction and premature ejaculation in infertile men using validated tools are few in number. The most important limitations of the studies are the wide variety of causes of male infertility, small case populations, and non-standardized questionnaires. Evaluation of sexual functions in infertile men in subgroups according to etiology may overcome these limitations. Therefore, this study was designed to evaluate sexual dysfunction only in men with CBAVD.\u003c/p\u003e \u003cp\u003eIn studies evaluating erectile dysfunction among infertile men using the validated IIEF-15, the prevalence of erectile dysfunction has been reported between 11% and 30% [\u003cspan additionalcitationids=\"CR18 CR19 CR20\" citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e]. Notably, some studies have been published on this issue, finding a higher prevalence (50,8%, 61,6%) of erectile dysfunction in infertile men [\u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e22\u003c/span\u003e, \u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e23\u003c/span\u003e]. It is very difficult to determine an independent relationship between erectile dysfunction and infertility. Because many factors such as age, infertility etiology, hormonal status, and comorbidities may affect this association. However, some studies have reported that infertility may be an independent factor for erectile dysfunction. Lotti et al. reported a significant association between erectile dysfunction and semen quality impairment after adjusting for age, comorbidities, serum testosterone levels, and prostatitis-like symptoms [\u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e]. Besides this, another study reported a correlation between erectile dysfunction and depressive symptoms independent of age, BMI, and duration of marriage in men without comorbidities with primary or secondary infertility [\u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e24\u003c/span\u003e]. However, in these studies, cases were not evaluated separately according to the etiology of infertility.\u003c/p\u003e \u003cp\u003eAlthough studies evaluating erectile function in isolated cases of CBAVD have not been performed in the past, there are studies on sexual function in cases of CF that are associated with CBAVD. Chambers et al. reported the prevalence of sexual dysfunction as 65% in their study evaluating sexual function in 32 male cases with CF [\u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e25\u003c/span\u003e]. Similar studies have also reported sexual dysfunction in men with CF. However, sexual function is not impaired until cystic fibrosis becomes severe enough to impact the patient\u0026rsquo;s general health, and sexual dysfunction is more often associated with disease-related problems than fertility status [\u003cspan additionalcitationids=\"CR26\" citationid=\"CR25\" class=\"CitationRef\"\u003e25\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR27\" class=\"CitationRef\"\u003e27\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eIn our study, it was found that there was no significant difference between men with CBAVD and the control group in terms of erectile dysfunction. None of the patients in our study population had CF-related comorbidities. In addition, their serum testosterone levels were normal. Therefore, we can say that CBAVD may not be an etiological factor for erectile dysfunction.\u003c/p\u003e \u003cp\u003eIn the literature, there are some inconsistencies in studies investigating the frequency of premature ejaculation in infertile men. The prevalence of premature ejaculation has generally been reported quite high in studies using non-validated questionnaires in small cohort groups [\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e, \u003cspan additionalcitationids=\"CR29 CR30\" citationid=\"CR28\" class=\"CitationRef\"\u003e28\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR31\" class=\"CitationRef\"\u003e31\u003c/span\u003e]. However, these rates were found lower in studies of infertile men with a larger number of patients and validated questionnaires [\u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e, \u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e, \u003cspan citationid=\"CR32\" class=\"CitationRef\"\u003e32\u003c/span\u003e]. In our study, the prevalence of premature ejaculation among men with CBAVD was 38,5% and 71,2% respectively according to PEDT and AIPE questionnaires. There was also no statistically significant difference in the premature ejaculation rate when compared with the control group. On the other hand, the prevalence of premature ejaculation in men with CBAVD in our study is higher than the prevalence reported for the Turkish population. In a previous study by Serefoğlu et al., the prevalence of premature ejaculation was reported as 20% among 2593 Turkish men [\u003cspan citationid=\"CR33\" class=\"CitationRef\"\u003e33\u003c/span\u003e]. According to these data, it is not reasonable to conclude that premature ejaculation is more common in CBAVD.\u003c/p\u003e \u003cp\u003eThe issue of sexual satisfaction in infertile men is still debated. Some studies showed no differences between sexual satisfaction in men in infertile couples and men in fertile couples [\u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e, \u003cspan citationid=\"CR34\" class=\"CitationRef\"\u003e34\u003c/span\u003e] whereas others reported lower satisfaction in infertile men [\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e, \u003cspan citationid=\"CR35\" class=\"CitationRef\"\u003e35\u003c/span\u003e]. Many factors such as coitus frequency, duration of infertility, cause of infertility, timing of infertility diagnosis, age of the partner, and education levels have been addressed in these studies. We had the expectation that men with CBAVD would have low sexual satisfaction due to low ejaculate volume when we designed the study. In our clinical practice, we observed that sexual satisfaction was considerably reduced in patients with anejaculation or retrograde ejaculation after benign prostatic hyperplasia or prostate cancer treatments. But contrary to what we thought, sexual desire and overall satisfaction scores were higher in the CBAVD group than in the control group. A statistically significant difference was also found between the groups for the question \"If you had any ejaculation difficulties or could not ejaculate, were you disturbed by this?\" in the MSHQ-Ejd short-form questionnaire. Men with CBAVD felt more bothered when they experienced ejaculation difficulties than the control group. We attributed this to the fact that for the CBAVD group, the main goal of sexuality is the desire to have children rather than satisfaction.\u003c/p\u003e \u003cp\u003eOur study has some limitations. While evaluating premature ejaculation, intravaginal ejaculatory latency time (IELT) and PEP-female questionnaire could have increased the value of our study. The results of these questionnaires are based on the respondents' own experiences and perceptions. Therefore, they can lead to misleading results as they are based on subjective assessments rather than objective measurements. In addition, a larger study population would have helped to make the results more reliable.\u003c/p\u003e \u003cp\u003eIn conclusion, CBAVD, one of the rare causes of male infertility, differs from other causes of infertility etiologically and genetically as well as in terms of erectile and sexual functions. This study can be a starting point for future studies. More comprehensive studies may reveal this situation clearly.\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eAuthor Contributions\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eECA, NB designed the study and edited the paper. NB, EK created the database, collected data, performed data analysis, and assisted with paper writing and editing. HT, GS collected data and \u0026nbsp;assisted with paper writing and editing. ECA, NB, HT collected data and assisted with paper writing and editing. GS assisted with paper editing.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eCompeting Interests\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors declare no competing interests.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eEthics Approval\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eInstitutional review board approval was obtained for this study.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\u003cli\u003e\u003cspan\u003eJequier AM, Ansell ID, Bullimore NJ. Congenital absence of the vasa deferentia presenting with infertility. J Androl 1985; 6(1): 15\u0026ndash;19.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eDohle GR, Veeze HJ, Overbeek SE, van den Ouweland AM, Halley DJ, Weber RF \u003cem\u003eet al\u003c/em\u003e. The complex relationships between cystic fibrosis and congenital bilateral absence of the vas deferens: clinical, electrophysiological and genetic data. 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Am J Public Health 2003; 93(6): 894\u0026ndash;898.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eLotti F, Corona G, Rastrelli G, Forti G, Jannini EA, Maggi M. Clinical correlates of erectile dysfunction and premature ejaculation in men with couple infertility. J Sex Med 2012; 9(10): 2698\u0026ndash;2707.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eSerefoglu EC, Yaman O, Cayan S, Asci R, Orhan I, Usta MF \u003cem\u003eet al\u003c/em\u003e. Prevalence of the complaint of ejaculating prematurely and the four premature ejaculation syndromes: results from the Turkish Society of Andrology Sexual Health Survey. J Sex Med 2011; 8(2): 540\u0026ndash;548.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eDrosdzol A, Skrzypulec V. Evaluation of marital and sexual interactions of Polish infertile couples. J Sex Med 2009; 6(12): 3335\u0026ndash;3346.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eM\u0026uuml;ller MJ, Schilling G, Haidl G. Sexual satisfaction in male infertility. Arch Androl 1999; 42(3): 137\u0026ndash;143.\u003c/span\u003e\u003c/li\u003e\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":true,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"Congenital absence of vas deferens, infertility, sexual functions, questionnaire","lastPublishedDoi":"10.21203/rs.3.rs-3881298/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-3881298/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003eThis study examines the sexual and psychological conditions of men with Bilateral Congenital Bilateral Absence of the Vas Deferens (CBAVD), a rare condition that contributes to male infertility, and compares it with healthy fertile men. A total of 52 patients with CBAVD and 66 healthy, fertile men who attended our infertility and andrology clinic were included in the study. Patients with cognitive impairments, language barriers, significant comorbidities, or a history of urogenital surgery were excluded. Reproductive hormone levels and semen volumes were evaluated. In addition, sexual status was investigated with validated questionnaires such as the International Index of erectile function, Male sexual health questionnaire, and Premature ejaculation profile. Semen volume was significantly lower in CBAVD men. The results showed that there was no significant difference between the CBAVD and control groups in terms of erectile function, orgasmic function, and sexual relationship satisfaction. However, sexual desire and overall satisfaction were found to be higher in the CBAVD group. The study suggests that CBAVD may not be a direct etiological factor for erectile dysfunction or premature ejaculation.\u003c/p\u003e","manuscriptTitle":"Sexual Functions in Men with Congenital Bilateral Absence of the Vas Deferens: A Comparative Study.","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2024-01-30 17:28:33","doi":"10.21203/rs.3.rs-3881298/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"47b108ef-0940-498a-b8e5-4ad697df6bfa","owner":[],"postedDate":"January 30th, 2024","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[{"id":28391155,"name":"Health sciences/Diseases/Reproductive disorders/Urogenital reproductive disorders"},{"id":28391156,"name":"Health sciences/Signs and symptoms/Reproductive signs and symptoms"}],"tags":[],"updatedAt":"2024-05-07T18:27:03+00:00","versionOfRecord":[],"versionCreatedAt":"2024-01-30 17:28:33","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-3881298","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-3881298","identity":"rs-3881298","version":["v1"]},"buildId":"qtupq5eGEP_6zYnWcrvyt","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}