Anaissie James, Yafi Faysal A, Hellstrom Wayne J G
Department of Urology, Tulane University School of Medicine, New Orleans, LA, USA.
Transl Androl Urol. 2016 Aug;5(4):607-12. doi: 10.21037/tau.2016.03.10.
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.
早泄(PE)被认为是最常见的男性性功能障碍,在一生中的某些时候,高达75%的男性会受到影响。虽然药物治疗是主要的治疗方法,但诸如背神经切除术(DNN)、透明质酸(HA)凝胶阴茎头增大术和包皮环切术等手术选择已被作为替代治疗形式进行研究。初步研究表明,DNN和HA凝胶阴茎头增大术相对安全有效,但由于缺乏大型、多中心、长期随访的随机对照试验,国际性医学学会(ISSM)一直无法认可DNN或HA凝胶阴茎头增大术作为早泄治疗的选择。关于包皮环切术疗效和安全性的相互矛盾的数据同样导致其被排除在ISSM早泄治疗建议之外。伦理问题,尤其是不伤害的基本概念,也是早泄手术实施的障碍。