Association between serum spermidine synthase levels and acquired premature ejaculation: a cross-sectional study

Kemal Ertas^1,*, Veysel Tahiroglu², Hasan Karagecili³, Emrah Yerlikaya⁴, Revsa Evin Canpolat Erkan⁵, Erkam Coskun⁶
1 Depertment of Urology, Memorial Dicle Hospital, Diyarbakır, Türkiye
2 Department of Nursing, Faculty of Health Sciences, Şirnak University, Şirnak, Türkiye
3 Department of Nursing, Faculty of Health Sciences, Siirt University, Siirt, Türkiye
4 Nutrition and Dietetics Department, Faculty of Health Sciences, Siirt University, Siirt, Türkiye
5 Department of Medical Biochemistry, Faculty of Medicine, Dicle University, Diyarbakir, Türkiye
6 Clinic of Medical Biochemistry, Şırnak State Hospital, Şırnak, Türkiye
* Corresponding Author: Kemal Ertas. Email: email
(This article belongs to the Special Issue: New Perspectives and Advances in Andrology and Andological Surgery)

Canadian Journal of Urology https://doi.org/10.32604/cju.2026.079146

Received 15 January 2026; Accepted 15 May 2026; Published online 10 July 2026

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Abstract

Background: Premature ejaculation (PE), the most common male sexual dysfunction worldwide, has a pathophysiology that is not fully understood and lacks reliable biomarkers. Recent studies suggest a potential role for polyamine metabolism in neuroregulation and sexual function. This study investigated the association between serum spermidine synthase (SRM) levels and acquired PE. Methods: In this prospective cross-sectional study conducted at Sirnak State Hospital between March and August 2024, 82 men (43 patients with acquired PE and 39 age-matched controls) were evaluated. Intravaginal ejaculation latency time (IELT) was measured by stopwatch (patient and/or partner-assisted), metabolic parameters were assessed, and serum SRM levels were quantified using a human-specific sandwich Enzyme-linked immunosorbent assay (ELISA) kit (research-use-only, detection range 75–5000 pg/mL). Statistical analyses included the Mann-Whitney U test, Student t-test, and Spearman correlation. Results: PE patients exhibited significantly lower SRM levels (141 vs. 189 pg/mL, p = 0.016), markedly shorter IELT (96 vs. 180 s, p < 0.001), higher triglycerides (156 vs. 78 mg/dL, p < 0.001), and lower High-Density Lipoprotein (HDL) cholesterol (42 vs. 47 mg/dL, p = 0.002). SRM showed a positive correlation with IELT (r = 0.284, p = 0.010). No significant correlations were found with BMI or other lipid parameters. Conclusions: Lower serum spermidine synthase levels are significantly associated with acquired PE and shorter IELT. These findings suggest SRM as a potential novel biomarker and support further exploration of polyamine pathways in PE pathophysiology.