Namavar Mohammad Reza, Robati Boroomand
Department of Anatomical Sciences, School of Medicine, Histomorphometric and Stereology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.
Urol Ann. 2011 May;3(2):87-92. doi: 10.4103/0974-7796.82175.
Premature ejaculation (PE) is the most prevalent sexual dysfunction in every country. There are many types of treatment, but the main limitation of medical treatment for premature ejaculation is recurrence after withdrawal of medicine. The prepuce is a specific erogenous zone that contains a rich and complex network of nerves. Circumcision radically desensitizes the penis, but incomplete circumcision may cause premature ejaculation. We evaluate the effect of removal of foreskin remnants in adults on PE.
The sensitive area of penile skin and the remaining parts of foreskin in adult men were recognized in 47 selective patients. Under local anesthesia, the remnant parts of foreskin were incised and removed. They were asked to fill the investigating questionnaire about the changes of intravaginal latency ejaculatory time (IVELT), patients and their sexual partners' satisfaction with sexual life, control over ejaculation, and penile sensitivity, before and after treatment.
There were no signs of inflammation and no serious adverse reactions in all cases after operation. IVELT significantly increased from 64.25 before surgery to 731.49 sec after surgery (P<0.001). The percentage of postoperative satisfaction in both the patient and his partner significantly increased (P<0.001). After surgery, 95.7% of men had better control over their ejaculation. This surgery significantly decreased sensitivity of penis (P<0.001), but it did not change glans penis insensitivity.
These results indicate that removal of foreskin remnants in adults is an effective modality in selective patients of PE.
早泄(PE)是每个国家最普遍的性功能障碍。治疗方法有多种,但早泄药物治疗的主要局限性是停药后复发。包皮是一个特殊的性敏感区域,含有丰富而复杂的神经网络。包皮环切术可从根本上降低阴茎的敏感度,但不完全包皮环切术可能导致早泄。我们评估成人包皮残余切除对早泄的影响。
在47例选择性患者中识别成年男性阴茎皮肤的敏感区域和包皮的剩余部分。在局部麻醉下,切开并切除包皮的残余部分。要求他们在治疗前后填写关于阴道内射精潜伏期时间(IVELT)变化、患者及其性伴侣对性生活的满意度、射精控制和阴茎敏感度的调查问卷。
所有病例术后均无炎症迹象,也无严重不良反应。IVELT从术前的64.25秒显著增加至术后的731.49秒(P<0.001)。患者及其伴侣术后的满意度百分比均显著提高(P<0.001)。术后,95.7%的男性对射精的控制能力更好。该手术显著降低了阴茎的敏感度(P<0.001),但未改变阴茎头的感觉迟钝。
这些结果表明,成人包皮残余切除对选择性早泄患者是一种有效的治疗方式。