Surgery for Premature Ejaculation: Exploring Options and Risks

Shilpi Jain
Medically reviewed by
Dr. Kaushal

Review medical content on WOW Rx Pharmacy, so that accurate drug use information is easily accessible to everybody.
Dr. Akansha is a licensed Clinical Pharmacologist. She possesses remarkable knowledge in Pharmacovigilance, prescription analysis, drug information, and drug safety services. Additionally, she is a keen learner and an educator.

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surgery for premature ejaculation

Premature Ejaculation, commonly called PE, affects a considerable portion of men.

According to the National Library of Science, its estimated prevalence ranges from 30 percent to 75 percent in the US. 

While the precise etiology of PE remains uncertain, available therapeutic interventions exist to extend one’s stamina during sexual activities. 

One such intervention is surgery for Premature Ejaculation. 

Continue reading to delve into the surgical approaches for addressing PE, explore the associated risks, and consider alternative treatment options.

Fact:
According to the National Library of Medicine, PE is primarily a psychological issue.
Premature Ejaculation persisting for a year or more can profoundly affect couples, often resulting in clinical depression, relationship strains, and various challenges.

Surgical approaches for Premature Ejaculation

In the realm of addressing Premature Ejaculation through surgical means, there exist several options varying in invasiveness. 

Presented below are the most prevalent surgical treatments for Premature Ejaculation.

Selective Dorsal Neurectomy (SDN)

Selective Dorsal Neurectomy (SDN) is a surgical intervention that entails severing nerves within the penis.

The penile dorsal nerve, a constituent of the penile anatomy, plays a pivotal role in transmitting sensory information from the penis and influencing ejaculatory reflexes. 

Studies have indicated that individuals afflicted with lifelong Premature Ejaculation possess more branches of the penile dorsal nerve than others.

An abundance of nerve branches can heighten penile sensitivity, thereby increasing the likelihood of Premature Ejaculation.

During the SDN procedure, a surgeon selectively severs some nerve branches. 

This surgical maneuver effectively diminishes hyper-sensitization and excitability, ultimately prolonging the duration before ejaculation. 

Clinical observations have demonstrated that SDN can enable men with lifelong Premature Ejaculation.

It extends their intercourse endurance from under a minute to more than a minute during penetrative sexual activity. 

It’s noteworthy that, contrary to misconceptions, the average time before Ejaculation typically falls within five to seven minutes.

It is important to emphasize that the effects of SDN are enduring, requiring neither medication nor specialized pre-coital measures.

Inner Condom Technique

The inner condom technique involves implanting a “condom” composed of an Acellular Dermal Matrix (ADM) beneath the penile skin.

Glossary:
ADM is constructed from materials akin to human skin and boasts compatibility with the human body. It finds application in various plastic surgeries, such as lip augmentation and breast reconstruction.

The ADM condom functions by mitigating sensitivity in the penile skin, thereby contributing to enhanced longevity during sexual intercourse.

A study involving 20 individuals who underwent the ICT procedure unveiled an elevation in the average time to Ejaculation from approximately 40 seconds to about two and a half minutes.

This study also reported the absence of severe complications or psychosexual repercussions, with patients typically resuming normal sexual activities six weeks post-surgery.

Cryoablation and radiofrequency

Radiofrequency surgerySource: Lais_Schulz_from_Lais_Schulz
Radiofrequency surgery

Cryoablation, utilizing extreme cold and radiofrequency, employing high-frequency current, is primarily employed in treating urinary tumors. 

When targeted at the dorsal nerve, these modalities can effectively address Premature Ejaculation by reducing hypersensitivity in the penis.

This dulls response to sexual stimuli.

Research examining Cryoablation has ascertained its capacity to prolong the time before ejaculation from approximately 55 seconds to over four minutes within one week.

However, there exists a diminishing return phenomenon, with the duration extending to about three minutes after 90 days and approximately one and a half minutes a year later.

Notably, following these treatments, some participants experienced diminished erectile rigidity.

Nevertheless, two spontaneously recovered, and two others regained their erectile function upon administration of PDE-5 inhibitors, a class of drugs used for treating Erectile Dysfunction.

Hyaluronic Acid (HA) Gel Glans Penis Augmentation

Hyaluronic acid (HA), often associated with skincare, also enhances sexual performance.

HA, a naturally occurring chemical within various human tissues, including skin, eyes, and connective tissue, is well-tolerated by the human body. 

When injected into the penis, HA can add up to its volume and circumference as a bulking agent. 

HA beneath the skin blocks signals to the dorsal nerve, prolonging sexual endurance. 

A 2019 study involving 20 men who received HA injections in the penile tip demonstrated improved longevity during sexual intercourse. 

A six-month follow-up revealed enhanced satisfaction in both the men and their partners, with no reported adverse effects.

Risks associated with surgical treatments for Premature Ejaculation

As with any surgical procedure, surgical treatments for Premature Ejaculation are not without risks. 

It’s important to note that there is not enough research to receive full endorsement from reputable organizations like the International Society of Sexual Medicine.

The long follow-up period after large-scale randomized trials contributes to the insufficiency for the lack of research and data. 

For instance, SDN is characterized by its invasiveness and does not guarantee a permanent resolution, as PE may reoccur in approximately 10 percent of patients post-procedure. 

Additionally, this surgical approach may result in complications such as pain, ED, penile curvature, and paresthesia in the penile tip, which is undesirable.

Warning:
Concerning hyaluronic acid injections, there is a risk of adverse reactions due to contamination and tissue necrosis attributable to inadequate blood flow following improperly administered injections.

Alternatives to Premature Ejaculation surgery

Surgery is not the sole recourse for individuals dealing with Premature Ejaculation. 

Alternative options include topical treatments, medications, and techniques that can effectively address this condition.

Topical PE treatments

Topical Premature Ejaculation treatments encompass substances such as Benzocaine, Prilocaine, and Lidocaine, which function by reducing penile sensitivity. 

These treatments are available in various forms, including creams, gels, wipes, and delay sprays, and can be obtained both over the counter and online. 

While less invasive than surgery, they typically require use before each sexual encounter. 

Cams and gels can be messy, necessitating a condom or removal before penetration to prevent affecting one’s partner.

Medications for PE

Although the FDA specifically approves no medications for treating PE, some medications are prescribed off-label to address this condition. 

These include Sildenafil, Paroxetine, Dapoxetine and Sertraline. 

For Premature Ejaculation and Erectile Dysfunction, healthcare providers may recommend PDE5 inhibitors such as Sildenafil, Vardenafil, Tadalafil, or Avanafil. 

Combination treatments along with Tadalafil, are more effective in treating Premature Ejaculation than Paroxetine and Dapoxetine alone. 

While medications can be effective, they may entail mild side effects, generally more manageable than the surgical alternative, depending on the individual’s condition.

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Techniques for PE

Interaction with latex condomsSource: rattanakun
Use of condoms

Several exercises can be performed at home to gain better control over Ejaculation.

While these techniques may not offer permanent solutions, they can be helpful at the moment and are worth considering before resorting to surgery. 

Here are some tips for managing Ejaculation during sexual activity:

  • The stop-start technique: Pause sexual activity before reaching climax, wait until the urge to ejaculate subsides, and then resume
  • The squeeze technique: As the name implies, this method involves squeezing the tip of the penis with the index finger and thumb just before orgasm
  • Use of condom: Employing a condom, if not already done, can reduce sensitivity and contribute to lasting longer during intercourse
  • Masturbation before sex: Masturbating a few hours before anticipated sexual activity can potentially help prolong the time before Ejaculation during subsequent sexual encounters
  • Distraction: While it may require a balance, thinking about something other than the sexual activity at hand can be effective in delaying Ejaculation
  • Pelvic floor exercises: Post-sex, engaging in pelvic floor exercises over 12 weeks has shown men gain control over their ejaculatory reflex

It’s important to acknowledge that PE can have psychological aspects.

Hence, addressing underlying issues such as anxiety, depression, or other mental health concerns may be necessary.

In such cases, seeking assistance from a healthcare provider is advisable, as treatment may entail addressing the root cause before tackling Premature Ejaculation directly.

Takeaway

Premature Ejaculation can be frustrating, but surgical options are just one avenue for treatment.

Surgical treatments like Selective Dorsal Neurectomy, Inner Condom Technique, Cryoablation, Radiofrequency, and Hyaluronic Acid Injections appear promising.

However, further research is needed to establish their safety conclusively. 

Surgery may be suitable when PE pills and topical treatments have proven ineffective.

Before considering surgery, explore alternative PE treatments, including wipes, sprays, and medications like Dapoxetine. 

To determine the most appropriate approach for your unique situation, consult a licensed healthcare provider .

They can guide you toward a solution that ensures you enjoy longer-lasting intimacy.

Frequently Asked Questions

Can Premature Ejaculation be treated permanently?

Premature Ejaculation is generally not considered a permanent condition. Depending on the underlying causes and the frequency of occurrences, it is often treatable, and many individuals can find effective solutions to address Premature Ejaculation.

How can I stop lifelong Premature Ejaculation?

To combat lifelong Premature Ejaculation, a combination of pharmacotherapy (medication) and behavioral therapy is often the most effective approach. Medication may be prescribed alongside therapy and other techniques, providing a comprehensive treatment plan to manage and reduce Premature Ejaculation effectively. Consult a healthcare professional for personalized guidance.

Which vitamin stops Premature Ejaculation?

Vitamin B12, found in foods like poultry, meat, fish, and dairy products, can support overall sexual health. While it may have some positive effects, it’s not a guaranteed remedy for Premature Ejaculation. A balanced diet with essential nutrients can improve sexual health, but consult a healthcare professional for comprehensive management.

What is the success rate of treating Premature Ejaculation?

Treating Premature Ejaculation often necessitates ongoing pharmacological therapy because discontinuation can result in a relapse of the condition. Success rates post-treatment range from 30% to 70%, but relapses are frequent, and some individuals may require lifelong therapy to manage the condition effectively.

Can surgery fix PE?

Surgical treatments to decrease the sensation of the glans have demonstrated efficacy for treating PE but are not recommended due to possible sensory loss and rare Erectile Dysfunction.

Citations:
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