Global research trends in the comorbidity of erectile dysfunction and premature ejaculation: a 20-year bibliometric analysis [2005-2025].

BACKGROUND: Erectile dysfunction (ED) and premature ejaculation (PE) frequently co-occur, presenting a significant clinical challenge in male health. However, existing research remains fragmented, lacking a systematic overview of the field's developmental trajectory, knowledge structure, and future trends. This study aims to systematically map the research landscape of ED/PE comorbidity over the past two decades [2005-2025] using bibliometric methods, revealing its evolutionary pathways, research hotspots, collaborative networks, and emerging frontiers. METHODS: Based on the Web of Science Core Collection (WoSCC) database, 1,089 ED/PE comorbidity-related publications were retrieved and analyzed. Tools including VOSviewer, CiteSpace, and Bibliometrix were employed for quantitative analysis and visualization of countries, institutions, authors, journals, keywords, and citation networks. RESULTS: Findings indicate: (I) annual publication volume exhibits exponential growth, with pivotal inflection points occurring in 2008 and 2021. (II) China leads in publication output, whereas Italy and the United States dominate academic influence and international collaboration. (III) Research themes evolved through three phases: epidemiology and disease definition [2005-2013], combination therapies and mechanism exploration [2014-2020], and diversified integrated interventions [2021-2025]. (IV) Cognitive behavioral therapy, pathophysiological mechanisms, and emerging physical therapies represent current frontiers, whereas patient psychological counseling and endocrine regulation remain relatively peripheral. CONCLUSIONS: This study presents the first knowledge map of ED/PE comorbidity research, revealing a clear trajectory from isolated disease perspectives toward integrated comorbidity models. Future research should deepen exploration of "neuro-vascular-psychological" integrated mechanisms, strengthen high-quality clinical trials, and address current research gaps to advance clinical practice to precision.