Surgery is not indicated for the treatment of premature ejaculation

Abstract

Premature ejaculation (PE) is considered the most common male sexual disorder, affecting up to 75% of men at some point in their lives. While medical management is the mainstay of therapy, surgical options such as dorsal nerve neurectomy (DNN), hyaluronic acid (HA) gel glans penis augmentation, and circumcision have been studied as alternative forms of treatment. Preliminary studies have suggested that DNN and HA gel glans penis augmentation are relatively safe and effective, but due to a lack of large, multicenter, randomized-control trials with long-term follow-up, the International Society of Sexual Medicine (ISSM) has been unable to endorse DNN or HA gel glans penis augmentation as options in the treatment of PE. Conflicting data regarding the efficacy and safety of circumcision has similarly led to its exclusion from ISSM recommendations for the treatment of PE. Ethical concerns, particularly the fundamental concept of non-maleficence, are also barriers to the implementation of surgery for PE.

Hyaluronic acid injection to coronary sulcus of the penis for the treatment of premature ejaculation

“…With the gradual application of HA in the eld of andrology, it has shown a certain effect in the treatment of premature ejaculation (3,4,6,12). Generally, we can draw a conclusion from the current studies that patients received HA injection prolonged the latency of vaginal ejaculation (2,14). The effect of injecting HA gel into glans penis to increase IELT may be due to the reduced glans sensation of glans penis, the formation of obstacles between the stimulating factor and receptor and enhancing con dence explained by placebo effect (3,15).…”

“…As an andrology disease connected with sexual life, although PE does not damage the lifespan, the patients' psychological health is in potential impact zone, even their self-esteem and relationship with partners are marred. Although there is still not an established procedure for treating PE, three surgical procedures have been carried out to date, including dorsal nerve neurectomy (DNN), hyaluronic acid (HA) gel glans penis augmentation and circumcision (2). Compared to traditional surgical therapy DNN, HA gel therapy reaches similar extension in IELT but reduced complications.…”

Surgical treatment for primary premature ejaculation with an inner condom technique

“…Unlike dorsal nerve neurectomy, the process caused nearly no damages to blood vessel and nerve, eliminating the risk of developing paraesthesia of the glans, and preventing erectile dysfunction. [19] Our surgery also allowed fast recovery. Males could resume sexual activity in 6 weeks after the surgery.…”

Progresses in pharmaceutical and surgical management of premature ejaculation

“…Till now, no large, multi-center, double-blind randomized controlled trials or long-term follow-up data support the safety and efficacy of the surgical treatment of LPE. [99] More high-quality clinical trials and long-term follow-up data are needed to determine the efficacy and safety of surgery for the management of LPE.…”